{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T23:07:19Z","timestamp":1774566439272,"version":"3.50.1"},"reference-count":9,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100022298","name":"Hualien Tzu Chi Hospital","doi-asserted-by":"crossref","award":["113-2314-B-303-018-MY2"],"award-info":[{"award-number":["113-2314-B-303-018-MY2"]}],"id":[{"id":"10.13039\/501100022298","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) is widely used to evaluate patients with cancer and to detect various inflammatory processes. Here, we report a rare case of a 53-year-old woman with breast cancer who developed generalized pain, weakness, rash, and edema over the trunk after the first cycle of neoadjuvant pembrolizumab and cytotoxic chemotherapeutic agents. 18F-FDG PET revealed diffusely increased uptake in the muscles without skeletal or visceral metastasis, aiding in the diagnosis of paraneoplastic and pembrolizumab-associated myositis and subsequent monitoring. This case underscores the value of 18F-FDG PET in differentiating myositis from tumor progression and monitoring treatment response in such cases.<\/jats:p>","DOI":"10.3390\/diagnostics16040596","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T09:22:46Z","timestamp":1771320166000},"page":"596","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Value of 18F-FDG PET in Paraneoplastic and Pembrolizumab-Associated Myositis"],"prefix":"10.3390","volume":"16","author":[{"given":"Chang-Shen","family":"Tseng","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9227-0731","authenticated-orcid":false,"given":"Yu-Hung","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien 970374, Taiwan"},{"name":"Department of Medical Imaging and Radiological Sciences, Tzu Chi University, Hualien 970374, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching-Chun","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970374, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuei-Ying","family":"Su","sequence":"additional","affiliation":[{"name":"Division of Allergy, Immunology and Rheumatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970374, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2737-0787","authenticated-orcid":false,"given":"Sung-Chao","family":"Chu","sequence":"additional","affiliation":[{"name":"School of Medicine, Tzu Chi University, Hualien 970374, Taiwan"},{"name":"Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970374, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu-Hsin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"ref_1","first-page":"93","article-title":"The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1056\/NEJMoa1910549","article-title":"Pembrolizumab for Early Triple-Negative Breast Cancer","volume":"382","author":"Schmid","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e70240","DOI":"10.1111\/ene.70240","article-title":"What Are the Normal Serum Creatine Kinase Values for Skeletal Muscle? A Worldwide Systematic Review","volume":"32","author":"Aleksovska","year":"2025","journal-title":"Eur. J. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1093\/rheumatology\/kez572","article-title":"Anti-TIF1-gamma autoantibodies: Warning lights of a tumour autoantigen","volume":"59","author":"Vulsteke","year":"2020","journal-title":"Rheumatology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"vii68","DOI":"10.1093\/rheumatology\/kez295","article-title":"Clinical characteristics of rheumatic syndromes associated with checkpoint inhibitors therapy","volume":"58","author":"Kostine","year":"2019","journal-title":"Rheumatology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/S0140-6736(03)14368-1","article-title":"Polymyositis and dermatomyositis","volume":"362","author":"Dalakas","year":"2003","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"103710","DOI":"10.1016\/j.autrev.2024.103710","article-title":"Intravenous immunoglobulin as a therapy for autoimmune conditions","volume":"24","author":"Danieli","year":"2025","journal-title":"Autoimmun. 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