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Journal Cover Revista Española de Medicina Nuclear e Imagen Molecular
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   ISSN (Print) 0212-6982
   Published by Elsevier Homepage  [3038 journals]
  • Safety of regadenoson in patients with severe chronic obstructive
           pulmonary disease
    • Authors: C. Salgado-Garcia; A. Jimenez-Heffernan; C. Ramos-Font; J. Lopez-Martin; E. Sanchez-de-Mora; T. Aroui; R. Lopez-Aguilar; F. Rivera-de-los-Santos; C. Ruiz-Frutos
      Pages: 283 - 286
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): C. Salgado-Garcia, A. Jimenez-Heffernan, C. Ramos-Font, J. Lopez-Martin, E. Sanchez-de-Mora, T. Aroui, R. Lopez-Aguilar, F. Rivera-de-los-Santos, C. Ruiz-Frutos
      Objective To assess the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise in subjects with severe chronic obstructive pulmonary disease (COPD), referred for myocardial perfusion imaging (MPI). Methods We studied prospectively 12 male patients with severe COPD. Stress was 4min of low-level exercise with bolus injection of regadenoson (0.4mg) at 1.5min, followed by 99mTc-MPI agent injection. Demographics, medical history, lung medications, adverse events, oxygen saturation (SatO2), MPI findings for coronary artery disease (CAD), and changes in systolic blood pressure (SBP), and heart rate (HR) were registered. Results The observed adverse event profile of regadenoson was similar to that of patients with mild–moderate COPD. There was no clinical exacerbation of COPD. Adverse events were self-limiting: dyspnea (33.3%), fatigue (25.0%), chest pain, headache (16.7%, respectively), and gastrointestinal discomfort, dry mouth, flushing, feeling hot and dizziness (8.3%, respectively). 25.0% of patients did not report any symptoms. We observed significant increases in SBP and HR from baseline (142.6mmHg±22.3 vs 152.5mmHg±18.5, and 80 b.p.m.±18 vs 105 b.p.m.±22, respectively; p <0.05). Conclusions Regadenoson combined with low-level exercise is safe and well tolerated in stable patients with severe COPD undergoing MPI.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.03.005
  • Initial experience in sentinel lymph node detection in pancreatic cancer
    • Authors: M. Beisani; I. Roca; R. Cardenas; L. Blanco; M. Abu-Suboh; J. Dot; J.R. Armengol; J.J. Olsina; J. Balsells; R. Charco; J. Castell
      Pages: 287 - 291
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): M. Beisani, I. Roca, R. Cardenas, L. Blanco, M. Abu-Suboh, J. Dot, J.R. Armengol, J.J. Olsina, J. Balsells, R. Charco, J. Castell
      Background The local recurrence of pancreatic cancer is around 30% when complete resection can be achieved. Extended lymphatic resections may improve survival, but increases severe morbidity. As accurate patient selection should be mandatory, a new method is presented for pancreatic sentinel lymph node (SLN) detection with lymphoscintigraphy and gamma probe. Materials and methods Seven patients with cT2N0M0 pancreatic head cancer were enrolled between 2009 and 2012 in this prospective study. One day prior to surgery, preoperative lymphoscintigraphy with echoendoscopic intratumoural administration of Tc99m-labelled nanocolloid was performed, with planar and SPECT-CT images obtained 2h later. Gamma probe detection of SLN was also carried out during surgery. Results Radiotracer administration was feasible in all patients. Scintigraphy images showed inter-aortocaval lymph nodes in 2 patients, hepatoduodenal ligament lymph nodes in 1, intravascular injection in 3, intestinal transit in 5, and main pancreatic duct visualisation in 1. Surgical resection could only be achieved in 4 patients owing to locally advanced disease. Intraoperative SLN detection was accomplished in 2 patients, both with negative results. Only in one patient could SLN be confirmed as truly negative by final histopathological analysis. Conclusions This new method of pancreatic SLN detection is technically feasible, but challenging. Our preliminary results with 7 patients are not sufficient for clinical validation.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.10.006
  • Hybrid radioguided occult lesion localization (hybrid ROLL) of
           18F-FDG-avid lesions using the hybrid tracer indocyanine
    • Authors: G.H. KleinJan; O.R. Brouwer; H.M. Mathéron; D.D.D. Rietbergen; R.A. Valdés Olmos; M.W. Wouters; N.S. van den Berg; F.W.B. van Leeuwen
      Pages: 292 - 297
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): G.H. KleinJan, O.R. Brouwer, H.M. Mathéron, D.D.D. Rietbergen, R.A. Valdés Olmos, M.W. Wouters, N.S. van den Berg, F.W.B. van Leeuwen
      Purpose To assess if combined fluorescence- and radio-guided occult lesion localization (hybrid ROLL) is feasible in patients scheduled for surgical resection of non-palpable 18F-FDG-avid lesions on PET/CT. Methods Four patients with 18F-FDG-avid lesions on follow-up PET/CT that were not palpable during physical examination but were suspected to harbor metastasis were enrolled. Guided by ultrasound, the hybrid tracer indocyanine green (ICG)-99mTc-nanocolloid was injected centrally in the target lesion. SPECT/CT imaging was used to confirm tracer deposition. Intraoperatively, lesions were localized using a hand-held gamma ray detection probe, a portable gamma camera, and a fluorescence camera. After excision, the gamma camera was used to check the wound bed for residual activity. Results A total of six 18F-FDG-avid lymph nodes were identified and scheduled for hybrid ROLL. Comparison of the PET/CT images with the acquired SPECT/CT after hybrid tracer injection confirmed accurate tracer deposition. No side effects were observed. Combined radio- and fluorescence-guidance enabled localization and excision of the target lesion in all patients. Five of the six excised lesions proved tumor-positive at histopathology. Conclusion The hybrid ROLL approach appears to be feasible and can facilitate the intraoperative localization and excision of non-palpable lesions suspected to harbor tumor metastases. In addition to the initial radioguided detection, the fluorescence component of the hybrid tracer enables high-resolution intraoperative visualization of the target lesion. The procedure needs further evaluation in a larger cohort and wider range of malignancies to substantiate these preliminary findings.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.04.001
  • Basal 18F-FDG PET/CT in follicular lymphoma: A comparison of metabolic and
           clinical variables in the prognostic assessment
    • Authors: G.A. Jiménez Londoño; A.M. García Vicente; V.M. Poblete García; M. Amo-Salas; C. Calle Primo; Á. Ibañez García; B. Martínez Sanchís; J.F. López-Fidalgo; F. Solano Ramos; A. Martínez Hellín; M. Díaz Morfa; Á. Soriano Castrejón
      Pages: 298 - 305
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): G.A. Jiménez Londoño, A.M. García Vicente, V.M. Poblete García, M. Amo-Salas, C. Calle Primo, Á. Ibañez García, B. Martínez Sanchís, J.F. López-Fidalgo, F. Solano Ramos, A. Martínez Hellín, M. Díaz Morfa, Á. Soriano Castrejón
      Aim To analyze the relationship of clinical variables related to prognosis and tumor burden, with metabolic variables obtained in the staging 18F-FDG PET/CT, and their value in the prognosis in follicular lymphoma (FL). Methods 82 patients with FL, a 18F-FDG PET/CT at diagnosis and a follow-up for a minimum of 12 months, were retrospectively enrolled in the present study. Clinical variables (Tumor grade, Follicular Lymphoma International Prognostic Index (FLIPI) and Tumor burden) were evaluated. Metabolic variables such as SUVmax in the highest hypermetabolic lesion, extralymphatic locations, number of involved lymph node locations, bone marrow (BM) involvement, PET stage and diameter of the biggest hypermetabolic lesion, were analyzed in order to establish a PET score and classify the studies in low, intermediate and high metabolic risk. Clinical and metabolic variables (included metabolic risk) were compared. The relation among all variables and disease-free survival (DFS) was studied. Results The 28% of patients had a high-grade tumor. The 30.5% had FLIPI risk low, 29.3% intermediate y 40.2% high. The 42.7% presented a high tumor burden. The PET/CT was positive in 94% of patients. The tumor grade did not show significant relation with metabolic variable. FLIPI risk and tumor burden showed statistical relations with the SUV max and the PET score (p <0.008 and p =0.003 respectively). With respect to DFS, significant differences were detected for the PET stage and FLIPI risk (p =0.015 and p =0.047 respectively). FLIPI risk was the only significant predictor in Cox regression analysis, with a Hazard Ratio of 5.13 between high risk and low risk. Conclusion The present research highlights the significant relation between metabolic variables obtained with FDG PET/CT and clinical variables although their goal as an independent factor of prognosis was not demonstrated in the present work.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.04.003
  • PET/RM simultánea vs. PET/TC en oncología. Una revisión
    • Authors: C. Riola-Parada; L. García-Cañamaque; V. Pérez-Dueñas; M. Garcerant-Tafur; J.L. Carreras-Delgado
      Pages: 306 - 312
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): C. Riola-Parada, L. García-Cañamaque, V. Pérez-Dueñas, M. Garcerant-Tafur, J.L. Carreras-Delgado
      Objetivo El objetivo de esta revisión fue evaluar la capacidad diagnóstica de la PET/RM simultánea en oncología, comparándola con la de la PET/TC, basándonos en la evidencia disponible. Material y métodos Se realizó una búsqueda sistemática en las bases de datos Medline y Embase hasta el 21 de enero de 2016, para identificar artículos clínicos originales que realizasen un análisis comparativo entre PET/RM simultánea y PET/TC en pacientes oncológicos. Resultados Se obtuvo un total de 57 artículos, distribuidos por enfermedades del siguiente modo: carcinoma de cabeza y cuello (5), pulmón y nódulos pulmonares (13), carcinoma colorrectal (1), lesiones hepáticas (2), incidentalomas abdominales (1), tumores neuroendocrinos (2), carcinoma de tiroides (2), carcinoma de mama (3), tumores ginecológicos (2), carcinoma de próstata (4), linfoma (2), mieloma múltiple (1), metástasis óseas (3), tumores intracraneales (2), oncología pediátrica (1) y neoplasias diversas (13). En la mayoría de las enfermedades oncológicas, el rendimiento diagnóstico de la PET/RM simultánea fue similar o incluso superior al de la PET/TC. Sin embargo, la PET/TC fue superior en la detección de pequeños nódulos pulmonares. Conclusión La PET/RM simultánea en oncología es factible, obteniendo resultados al menos equiparables a los de la PET/TC, con menor exposición a radiaciones ionizantes. No obstante, la evidencia disponible aún es limitada, y son necesarios estudios que incluyan a un mayor número de pacientes y neoplasias para establecer las indicaciones de la PET/RM e identificar los protocolos adecuados a cada enfermedad. Objective The aim of this review was to evaluate the diagnostic performance of simultaneous PET/MRI in oncology compared with that of PET/CT, based upon the available evidence. Material and methods A systematic search was performed in the Medline and Embase databases to identify original clinical articles published up to 21 January 2016, in order to compare simultaneous PET/MRI and PET/CT in oncology patients. Results A total of 57 articles were obtained that included various diseases: head and neck cancer (5), lung cancer and lung nodules (13), colorectal cancer (1), liver lesions (2), abdominal incidentalomas (1), neuroendocrine tumours (2), thyroid carcinoma (2), breast cancer (3), gynaecological cancer (2), prostate cancer (4), lymphoma (2), multiple myeloma (1), bone metastases (3), intracranial tumours (2), paediatric oncology (1) and various tumours (13). Diagnostic performance of simultaneous PET/MRI was similar or even better to that of PET/CT in most oncological diseases. However, PET/CT was superior for small lung nodule detection. Conclusion Simultaneous PET/MRI in oncology is feasible, performing at least equally as well as PET/CT, with lower radiation exposure. However, available evidence is still limited. Studies including more patients and tumours are needed to establish PET/MRI indications and to identify appropriate protocols for each disease.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.06.001
  • PET/RM: ¿un lujo o una necesidad'
    • Authors: J.L. Carreras-Delgado; V. Pérez-Dueñas; C. Riola-Parada; L. García-Cañamaque
      Pages: 313 - 320
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): J.L. Carreras-Delgado, V. Pérez-Dueñas, C. Riola-Parada, L. García-Cañamaque
      La PET/RM es una nueva técnica multimodalidad con un futuro prometedor en el diagnóstico por imagen. Las limitaciones técnicas se están superando. La interferencia entre ambos sistemas (PET y RM) parece estar resuelta. La corrección de atenuación de PET mediante los datos de RM se puede realizar con garantía. El tiempo por estudio es aceptable y el estudio es tolerable con porcentajes de claustrofobia similares a los de RM. La cuantificación mediante los parámetros habituales como el Standardized Uptake Value (SUV) se correlaciona bastante bien entre ambos sistemas. Sin embargo, la PET/TC ofrece en estos momentos mejores datos de tiempo por estudio, costo por estudio y confortabilidad. Una gran ventaja de la PET/RM respecto a la PET/TC es la menor exposición del paciente a radiaciones, lo que la hace especialmente recomendable en pacientes pediátricos o adolescentes que requieran uno o varios estudios PET. Las indicaciones de la PET/RM en principio son las mismas que las de la PET/TC, teniendo en cuenta que en los casos en que la RM es superior a la TC, la PET/RM es superior a la PET/TC. Esta superioridad es clara en muchos de los tumores de tejidos blandos. Por otro lado, en patología neurológica y en algunos tumores como los de mama es habitual realizar, por un lado, un estudio PET/TC, y por otro, una RM. La realización de un único estudio PET/RM sustituye con evidente ventaja a los otros dos. La aplicación de la RM permite además aplicar otras correcciones a la PET, como la corrección del movimiento o del efecto de volumen parcial. La mejor resolución espacial de la RM hace posible transferir a las imágenes de PET áreas o volúmenes de interés de pequeño tamaño bien delimitados en la RM, para medir biomarcadores de la PET en esas áreas. La riqueza de información de ambas técnicas abre unas inmensas posibilidades de correlación entre ambas. PET/MRI is a new multimodality technique with a promising future in diagnostic imaging. Technical limitations are being overcome. Interference between the two systems (PET and MRI) seems to have been resolved. MRI-based PET attenuation correction can be performed safely. Scan time is acceptable and the study is tolerable, with claustrophobia prevalence similar to that of MRI. Quantification with common parameters, such as Standardized Uptake Value (SUV), shows a fairly good correlation between both systems. However, PET/CT currently provides better results in scan time, scan costs, and patient comfort. Less patient radiation exposure is a big advantage of PET/MRI over PET/CT, which makes it particularly recommended in paediatric and adolescent patients requiring one or more studies. PET/MRI indications are the same as those of PET/CT, given that in cases where MRI is superior to CT, PET/MRI is superior to PET/CT. This superiority is clear in many soft tissue tumours. Moreover, it is common to perform both PET/CT and MRI in neurological diseases, as well as in some tumours, such as breast cancer. A single PET/MRI study replaces both with obvious benefit. MRI also allows other MRI-based PET corrections, such as motion or partial volume effect corrections. The better spatial resolution of MRI allows the transfer of well-defined MRI areas or small volumes of interest to PET image, in order to measure PET biomarkers in these areas. The richness of information of both techniques opens up immense possibilities of synergistic correlation between them.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.05.007
  • An unusual presentation of primary hyperparathyroidism: multiple brown
           tumors and coexisting thyroid carcinoma
    • Authors: Y. Basaran; S. Ince; E. Alagoz; C. Meric; A. Taslipinar
      Pages: 321 - 324
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): Y. Basaran, S. Ince, E. Alagoz, C. Meric, A. Taslipinar
      We present a patient with a complex clinical picture of primary hyperparathyroidism with multiple destructive skeletal lesions suspicious of bone metastases and concomitant multifocal papillary thyroid carcinoma with a metastatic central lymph node. He presented with progressively worsening right hip pain and restricted motion. Magnetic resonance imaging revealed multiple lytic lesions involving predominantly the right trochanter minor and the left inferior and posterior pubic rami. Biochemical tests were consistent with primary hyperparathyroidism. Neck ultrasound and parathyroid scintigraphy revealed a single parathyroid adenoma and a thyroid nodule, preoperative cytology of which confirmed papillary thyroid carcinoma, as did the final surgical specimen. Biochemical results, regarding hyperparathyroidism, declined to normal levels and his complaints gradually decreased after surgery. Postoperative whole body bone scintigraphy showed increased tracer uptakes at multiple sites, but they were proved to be metabolically inactive by fluorodeoxyglucose positron emission tomography/computed tomography.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.02.005
  • Síndrome de web axilar secundario a la biopsia selectiva del ganglio
           centinela en cáncer de mama
    • Authors: S.M. Nieves Maldonado; V. Pubul Núñez; S. Argibay Vázquez; M. Macías Cortiñas; Á. Ruibal Morell
      Pages: 325 - 328
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): S.M. Nieves Maldonado, V. Pubul Núñez, S. Argibay Vázquez, M. Macías Cortiñas, Á. Ruibal Morell
      Paciente de 49 años diagnosticada de carcinoma lobulillar infiltrante de mama derecha, intervenida mediante mastectomía y biopsia selectiva de ganglio centinela (BSGC). Los ganglios linfáticos centinela resecados fueron negativos para malignidad, motivo por el cual no fue necesaria la realización de linfadenectomía axilar. En el periodo posquirúrgico temprano la paciente presentó una sensación de tensión cutánea en el hueco axilar asociada a un cordón palpable doloroso, manifestación típica del síndrome de web axilar (SWA), una complicación poco conocida de las intervenciones quirúrgicas axilares, tanto invasivas como conservadoras. Mediante la presentación de este caso queremos centrar la atención en una entidad patológica cuya incidencia podemos estar infravalorando al no incluirla en estudios prospectivos de BSGC. Es importante que los médicos nucleares seamos conscientes de la existencia del SWA como una posible consecuencia de la BSGC, más frecuente que la infección, el seroma o el linfedema y de que debemos informar a los pacientes que firman el consentimiento. A 49 year-old woman diagnosed with infiltrating lobular breast carcinoma, underwent a right mastectomy and sentinel node biopsy (SLNB). The resected sentinel lymph nodes were negative for malignancy, with an axillary lymphadenectomy not being performed. In the early post-operative period, the patient reported an axillary skin tension sensation, associated with a painful palpable cord. These are typical manifestations of axillary web syndrome (AWS), a poorly known axillary surgery complication, from both invasive and conservative interventions. By presenting this case we want to focus the attention on a pathological condition, for which its incidence may be underestimated by not including it in SLNB studies. It is important for nuclear medicine physicians to be aware of AWS as a more common complication than infection, seroma, or lymphoedema, and to discuss this possible event with the patient who is consenting to the procedure.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.04.008
  • Peritoneal Cancer Index mediante 18F-FDG PET/TC pre y poscirugía
           citorreductiva radical y quimioterapia intraperitoneal con hipertermia. A
           propósito de un caso
    • Authors: J.R. Garcia; D. Villasboas-Rosciolesi; M. Soler; P. Bassa; M. Cozar; E. Riera
      Pages: 329 - 331
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): J.R. Garcia, D. Villasboas-Rosciolesi, M. Soler, P. Bassa, M. Cozar, E. Riera
      La cirugía citorreductora radical seguida de quimioterapia intraperitoneal con hipertermia aumenta la supervivencia de los pacientes con carcinomatosis peritoneal. El Peritoneal Cancer Index cuantifica el tumor en el acto quirúrgico y permite planificar el tratamiento y establecer el pronóstico de la enfermedad. Se obtiene combinando la distribución del tumor en 13 regiones abdominopélvicas con el tamaño de la lesión más grande. La tomografía por emisión de positrones/tomografía computarizada con fluorodesoxiglucosa es la técnica de elección en la selección de los pacientes candidatos a cirugía citorreductora radical seguida de quimioterapia intraperitoneal con hipertermia debido a su mayor tasa de detección de la carcinomatosis y a que, además, permite el diagnóstico de enfermedad extraperitoneal. El Peritoneal Cancer Index simplificado (9 regiones definidas por 2 planos transversales y 2 sagitales) obtenido mediante tomografía por emisión de positrones/tomografía computarizada con fluorodesoxiglucosa permite su correlación con el acto quirúrgico, siendo su estandarización aconsejable. Radical cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy increases survival in patients with end-stage peritoneal carcinomatosis, and who are under palliative therapy. The Peritoneal Cancer Index enables the tumor burden to be quantified during surgery, as well as treatment planning and patient prognosis. It is obtained by combining the tumor spread in 13 abdominal and pelvic regions with the largest tumor size. Fluorodeoxyglucose positron emission tomography/computed tomography is the technique of choice for those patients selected to undergo radical cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy, due to its higher detection rate of carcinomatosis, and since it allows extra-peritoneal disease staging. The simplified Peritoneal Cancer Index (9 regions defined by 2 transverse and 2 sagittal planes) obtained by fluorodeoxyglucose positron emission tomography/computed tomography allows correlation with the surgical procedure, therefore its standardization is advisable.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.02.004
  • Radionecrosis versus progresión de la enfermedad en metástasis
           cerebrales: valor del 18F-DOPA PET/TC/RM
    • Authors: J. Hernández Pinzón; D. Mena; M. Aguilar; F. Biafore; G. Recondo; M. Bastianello
      Pages: 332 - 335
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): J. Hernández Pinzón, D. Mena, M. Aguilar, F. Biafore, G. Recondo, M. Bastianello
      La utilización del 18F-DOPA PET/TC junto a la superposición con imágenes de resonancia magnética y el empleo de métodos de análisis visual y semicuantitativo permitió diferenciar entre las alteraciones posradiocirugía vs. sospecha de progresión de la enfermedad en un paciente con metástasis cerebrales de melanoma, permitiendo tomar una conducta quirúrgica correcta precozmente. The use of 18F-DOPA PET/CT with magnetic resonance imaging fusion and the use of visual methods and quantitative analysis helps to differentiate between changes post-radiosurgery vs. suspicion of disease progression in a patient with brain metastases from melanoma, thus facilitating taking early surgical action.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.03.002
  • Thoracic 99mTc-MAA accumulations due to aberrant arteries originating from
           the phrenic artery
    • Authors: H. Ahmadzadehfar; M. Essler; C.C. Pieper; M. Muckle; C. Meyer
      Pages: 336 - 338
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): H. Ahmadzadehfar, M. Essler, C.C. Pieper, M. Muckle, C. Meyer

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remnie.2015.12.014
  • Acute cholangitis: An unexpected cause of fever of unknown origin
           diagnosed by 18F-FDG PET/CT
    • Authors: M. Vadrucci; M. Castellani; V. Longari
      Pages: 339 - 340
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): M. Vadrucci, M. Castellani, V. Longari

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remnie.2016.01.022
  • 18F-FDG PET/CT in staging and follow-up of adamantinoma
    • Authors: D. Albano; G. Bosio; F. Bertagna
      Pages: 341 - 343
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): D. Albano, G. Bosio, F. Bertagna

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.02.001
  • Es la hora de la medicina nuclear
    • Authors: J.C. Alonso Farto
      Pages: 213 - 214
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): J.C. Alonso Farto

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.04.004
  • Ventilation/Perfusion SPECT lung scintigraphy and computed tomography
           pulmonary angiography in patients with clinical suspicion of pulmonary
    • Authors: S. Ibáñez-Bravo; I. Banzo; R. Quirce; I. Martínez-Rodríguez; J. Jiménez-Bonilla; N. Martínez-Amador; J.A. Parra; J. González-Macías; J.M. Carril
      Pages: 215 - 220
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): S. Ibáñez-Bravo, I. Banzo, R. Quirce, I. Martínez-Rodríguez, J. Jiménez-Bonilla, N. Martínez-Amador, J.A. Parra, J. González-Macías, J.M. Carril
      The aim was to compare ventilation/perfusion SPECT lung scintigraphy (V/Q-SPECT) and computed tomography pulmonary angiography (CTPA) in patients with suspicion of pulmonary embolism (PE). Material and methods This prospectively designed study included 53 patients with intermediate or high clinical probability of PE. A V/Q-SPECT and CTPA was performed on all patients. The V/Q-SPECT was interpreted according to the European Association of Nuclear Medicine and Molecular Imaging (EANMMI) guidelines. CTPA was reported as positive, negative, or indeterminate. Results CTPA was positive in 22 cases, negative in 28, and indeterminate in 3. V/Q-SPECT was positive in 27 cases, negative in 24, and non-diagnostic in 2. In the 22 with positive CTPA, V/Q-SPECT was positive in 18, negative in 3, and non-diagnostic in 1. In the 28 with negative CTPA, V/Q-SPECT was positive in 8, negative in 19, and non-diagnostic in 1. In the 3 with indeterminate CTPA, V/Q-SPECT was positive in 1 and negative in 2. In the 2 non-diagnostic cases V/Q-SPECT, CTPA was positive in 1 and negative in one. In the 10 high clinical probabilities, CTPA and V/Q-SPECT were positive in 7, negative in 2, and in 1, CTPA was positive and V/Q-SPECT negative. In the 38 intermediate probability group, CTPA and V/Q-SPECT were positive in 11, negative in 17, with CTPA negative and V/Q-SPECT positive in 8, and in 2 CTPA was positive and V/Q-SPECT negative. The results show that V/Q-SPECT detected PE in 5 patients more than CTPA. Conclusion Our results show a 77% concordance of both techniques. Overall V/Q-SPECT detected PE in 18% more patients than CTPA in the intermediate group. Both techniques have a complementary role when a diagnosis cannot be made with one of them.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.12.008
  • Validación de la biopsia selectiva del ganglio centinela en mujeres con
           cáncer de mama N1-2 con respuesta axilar completa tras la neoadyuvancia.
           Estudio multicéntrico en la provincia de Tarragona
    • Authors: D. Carrera; M. de la Flor; J. Galera; K. Amillano; M. Gomez; V. Izquierdo; E. Aguilar; S. López; M. Martínez; S. Martínez; J.M. Serra; M. Pérez; L. Martin
      Pages: 221 - 225
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): D. Carrera, M. de la Flor, J. Galera, K. Amillano, M. Gomez, V. Izquierdo, E. Aguilar, S. López, M. Martínez, S. Martínez, J.M. Serra, M. Pérez, L. Martin
      Introducción El objetivo de nuestro estudio fue evaluar los resultados de los ganglios obtenidos mediante biopsia selectiva del ganglio centinela en mujeres T1-T3/N1-N2 que después de la neoadyuvancia presentaron una axila N0. Material y métodos Se realizó un estudio multicéntrico de validación diagnóstica en la provincia de Tarragona. Incluimos a mujeres afectadas por cáncer de mama en estadio T1-T3, N1-N2, que presentaron una respuesta axilar completa después de la quimioterapia neoadyuvante. El procedimiento consistió en la realización de la biopsia selectiva del ganglio centinela seguida de la linfadenectomía. El análisis estadístico consistió en la evaluación de la validez de la biopsia selectiva del ganglio centinela mediante la linfadenectomía como gold standard. Resultados Se incluyeron 53 mujeres. La tasa de detección quirúrgica fue del 90,5% (en 5 pacientes no se encontró el ganglio centinela). El análisis histopatológico de la linfadenectomía mostró remisión completa de los ganglios axilares en el 35,4% (17/48) de las pacientes y enfermedad residual en los ganglios axilares en el 64,6% (31/48) de ellas. En 28 pacientes existía afectación residual en el ganglio centinela, en el 20% (10/48) de las cuales esta se localizaba únicamente en el ganglio centinela, estando el resto de la linfadenectomía libre de enfermedad. En 3 pacientes el ganglio centinela era negativo pero existía enfermedad en la linfadenectomía, resultando falsos negativos. Así, obtenemos una sensibilidad del 93,5%, una tasa de falsos negativos del 9,7% y una eficiencia de prueba global del 93,7% Conclusiones La biopsia selectiva del ganglio centinela, después de la quimioterapia en las pacientes que han presentado una respuesta axilar completa, proporciona información válida y confiable sobre el estado axilar después del tratamiento neoadyuvante, y podría evitar la linfadenectomía en casos con ganglio centinela negativo. Introduction The aim of our study was to evaluate sentinel lymph node biopsy as a diagnostic test for assessing the presence of residual metastatic axillary lymph nodes after neoadjuvant chemotherapy, replacing the need for a lymphadenectomy in negative selective lymph node biopsy patients. Material and methods A multicentre, diagnostic validation study was conducted in the province of Tarragona, on women with T1-T3, N1-N2 breast cancer, who presented with a complete axillary response after neoadjuvant chemotherapy. Study procedures consisted of performing an selective lymph node biopsy followed by lymphadenectomy. Results A total of 53 women were included in the study. Surgical detection rate was 90.5% (no sentinel node found in 5 patients). Histopathological analysis of the lymphadenectomy showed complete disease regression of axillary nodes in 35.4% (17/48) of the patients, and residual axillary node involvement in 64.6% (31/48) of them. In lymphadenectomy positive patients, 28 had a positive selective lymph node biopsy (true positive), while 3 had a negative selective lymph node biopsy (false negative). Of the 28 true selective lymph node biopsy positives, the sentinel node was the only positive node in 10 cases. All lymphadenectomy negative cases were selective lymph node biopsy negative. These data yield a sensitivity of 93.5%, a false negative rate of 9.7%, and a global test efficiency of 93.7%.
      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.12.007
  • Dual time-point 18F-FDG PET/CT to assess response to radiofrequency
           ablation of lung metastases
    • Authors: S. Lafuente; D. Fuster; P. Arguis; U. Granados; P. Perlaza; P. Paredes; I. Vollmer; M. Sánchez; F. Lomeña
      Pages: 226 - 231
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): S. Lafuente, D. Fuster, P. Arguis, U. Granados, P. Perlaza, P. Paredes, I. Vollmer, M. Sánchez, F. Lomeña
      Aim To establish the usefulness of dual time-point PET/CT imaging in determining the response to radiofrequency ablation (RFA) of solitary lung metastases from gastrointestinal cancer. Materials and methods This prospective study included 18 cases (3 female, 15 male, mean age 71±15 yrs) with solitary lung metastases from malignant digestive tract tumors candidates for RFA. PET/CT images 1h after injection of 4.07MBq/kg of 18F-FDG (standard images) were performed at baseline, 1 month, and 3 months after RFA. PET/CT images 2h after injection centered in the thorax at 1 month after RFA were also performed (delayed images). A retention index (RI) of dual time-point images was calculated as follows: RI=(SUVmax delayed image−SUVmax standard image/SUVmax standard image)*100. Pathological confirmation of residual tumor by histology of the treated lesion was considered as local recurrence. A negative imaging follow-up was considered as complete response. Results Local recurrence was found in 6/18 lesions, and complete response in the remaining 12. The mean percentage change in SUVmax at 1 month and at 3 months showed a sensitivity and specificity for PET/CT of 50% and 33%, and 67% and 92%, respectively. The RI at 1 month after RFA showed a sensitivity and specificity of 83% and 92%, respectively. Conclusions Dual time point PET/CT can predict the outcome at one month after RFA in lung metastases from digestive tract cancers. The RI can be used to indicate the need for further procedures to rule out persistent tumor due to incomplete RFA.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.12.002
  • 18F-FDG PET/CT, cytoreductive surgery and intraperitoneal
           chemohyperthermia for the therapeutic management in peritoneal
           carcinomatosis: A pilot study
    • Authors: A. Cistaro; M. Cucinotta; L. Cassalia; A. Priola; S. Priola; M. Pappalardo; P. Coppolino; M. De Simone; N. Quartuccio
      Pages: 232 - 237
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): A. Cistaro, M. Cucinotta, L. Cassalia, A. Priola, S. Priola, M. Pappalardo, P. Coppolino, M. De Simone, N. Quartuccio
      Aim Peritoneal carcinomatosis is a common evolution of neoplasms and the terminal stage of disease. A new therapeutic technique, based on the total surgical removal of peritoneal lesions (peritonectomy procedure – PP) combined with the intraperitoneal chemohyperthermia (IPCH), has been developed. Proper patient selection is mandatory for optimizing the results of treatment. The aim of this study was to investigate the role of [(18)F]fluoro-2-deoxy-d-glucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) in patients with peritoneal carcinosis selected to undergo PP and IPCH. Furthermore, we aimed to identify characteristic patterns of abdominal18F-FDG uptake and to correlate these patterns with available anatomic findings after surgery. Methods Patients with either histologically confirmed peritoneal carcinosis or suspected upon clinical follow-up and/or imaging findings were prospectively submitted to pre-surgery 18F-FDG PET/CT scan. Only those patients without evidence of extra-peritoneal metastases at PET/CT scan were treated with PP and IPCH. Results 11 patients with peritoneal carcinomatosis (5 colorectal, 4 ovarian, 1 pancreatic) and 1 unknown primitive cancer, were eligible for the study. In all cases PET/CT scan showed multiple peritoneal implants. In 6 out of 11 cases (54%) metastases were evidenced by 18F-FDG PET/CT: 2 cases with liver metastases; 1 case with bone metastases; 3 patients with lymph-node lesions. Two distinct imaging patterns, with focal or diffuse increased 18F-FDG uptake, were recognized. Conclusions PP+IPCH of patients selected by 18F-FDG PET/CT seems to be safe and feasible. PET/CT scan appears as a reliable tool for the detection, characterization of peritoneal implants with potential impact in the therapeutic management of these patients.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.01.001
  • Radioterapia de rescate en pacientes con cáncer de próstata.
           Planificación, respuesta al tratamiento y pronóstico mediante PET/TC con
    • Authors: J.R. García; M. Cozar; M. Soler; P. Bassa; E. Riera; J. Ferrer
      Pages: 238 - 245
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): J.R. García, M. Cozar, M. Soler, P. Bassa, E. Riera, J. Ferrer
      Objetivo Evaluar el valor pronóstico de la respuesta terapéutica mediante 11C-colina PET/TC en pacientes con recidiva bioquímica de cáncer de próstata en los que la exploración ha indicado el tratamiento con radioterapia radioguiada. Método Treinta y siete pacientes inicialmente tratados con prostatectomía, acudieron por recidiva bioquímica. La 11C-colina PET/TC permitió la detección de infiltración adenopática infradiafragmática. Todos ellos fueron seleccionados para radioterapia de intensidad modulada, escalando la dosis según los hallazgos de la PET/TC. Al año se les realizó PSA y 11C-colina PET/TC categorizando la respuesta (completa/parcial/progresión). Se efectuó seguimiento clínico/analítico/imagen hasta aparición de segunda recidiva o 36 meses en pacientes libres de enfermedad. Resultados La 11C-colina PET/TC permitió la detección adenopática en los 37 pacientes. En 18 (48,6%) fue supracentimétrica y en 19 (51,3%) no había criterios patológicos por TC: 9 (24,3%) ganglios positivos supra+infracentimétricos y 10 (27,0%) únicamente infracentimétricos. Categorizamos la respuesta mediante 11C-colina PET/TC un año tras la radioterapia: 16 pacientes (43,2%) respuesta completa; 15 (40,5%) respuesta parcial; 6 (16,2%) progresión. La respuesta fue concordante entre PSA y 11C-colina PET/TC en 32 pacientes (86,5%) y discordante en 5 (13,5%). Se detectó nueva recidiva en 12 pacientes (80%) con respuesta parcial y en 5 (31,2%) con respuesta completa. La media de tiempo libre de enfermedad ha sido 9 meses tras respuesta parcial y 18 meses tras respuesta completa (diferencia significativa, p<0,0001). Conclusión La 11C-colina PET/TC permite la selección de los pacientes con recidiva de cáncer de próstata candidatos a radioterapia, planificando la misma. La evaluación de la respuesta terapéutica mediante 11C-colina PET/TC presenta significación pronóstica. Objective To assess the prognostic value of the therapeutic response by 11C-choline PET/CT in prostate cancer patients with biochemical recurrence in which 11C-choline PET/CT indicated radio-guided radiotherapy. Methods The study included 37 patients initially treated with prostatectomy, who were treated due to biochemical recurrence. 11C-choline PE/CT detected infra-diaphragmatic lymph-node involvement. All were selected for intensity modulated radiation therapy, escalating the dose according to the PET findings. One year after treatment patients underwent PSA and 11C-choline PET/CT categorizing response (complete/partial/progression). Clinical/biochemical/image monitoring was performed until appearance of second relapse or 36 months in disease-free patients. Results 11C-choline PET/CT could detect lymph nodes in all 37 patients. They were 18 (48.6%) of more than a centimetre in size and 19 (51.3%) with no pathological CT morphology: 9 (24.3%) with positive lymph nodes of around one centimetre...
      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.11.007
  • Update on PET/CT colonography in the diagnosis of colorectal cancer
    • Authors: D. Fuster; M. Pagès; U. Granados; P. Perlaza; D. Rubello; F. Lomeña
      Pages: 246 - 252
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): D. Fuster, M. Pagès, U. Granados, P. Perlaza, D. Rubello, F. Lomeña

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remnie.2016.05.001
  • Aportación diagnóstica de la SPECT de perfusión cerebral en un caso de
           malaria cerebral
    • Authors: M. Moreno-Caballero; L. García Bernardo; M.L. Domínguez Grande; J.R. Infante de la Torre; J. Serrano Vicente; L. Fernández Prudencio; J.I. Rayo Madrid
      Pages: 253 - 256
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): M. Moreno-Caballero, L. García Bernardo, M.L. Domínguez Grande, J.R. Infante de la Torre, J. Serrano Vicente, L. Fernández Prudencio, J.I. Rayo Madrid
      La malaria cerebral constituye una complicación severa de la infección por Plasmodium falciparum. Sus mecanismos fisiopatológicos y manifestaciones clínicas continúan siendo motivo de estudio en la actualidad. Durante el proceso diagnóstico, las técnicas de imagen estructural como la TC y la RM aportan una información poco específica. Sin embargo, apenas existen referencias bibliográficas que constaten la utilización y posibles beneficios de los procedimientos radioisotópicos para esta patología. En este artículo exponemos el caso de un paciente diagnosticado de malaria cerebral atendido en nuestro centro, sometido a control evolutivo mediante SPECT de perfusión. Cerebral malaria is a serious complication of infection with Plasmodium falciparum. Its pathophysiological mechanisms and clinical manifestations are still currently being studied. Structural imaging techniques such as CT and MRI provide non-specific information during the diagnostic process. However, there are hardly any references on the use and potential benefits of radioisotope procedures for this pathology. In this article we present the case of a patient diagnosed with cerebral malaria treated in our centre, subjected to progressive monitoring using SPECT perfusion.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.01.008
  • Adrenal tuberculosis masquerading as disseminated malignancy: A pitfall of
           18F-FDG PET/CT Imaging
    • Authors: A.K.R. Gorla; K. Gupta; A. Sood; C.K. Biswal; A. Bhansali; B.R. Mittal
      Pages: 257 - 259
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): A.K.R. Gorla, K. Gupta, A. Sood, C.K. Biswal, A. Bhansali, B.R. Mittal
      Non-invasive characterization of adrenal lesions is a commonly encountered diagnostic challenge. Characteristic clinical and correlative imaging findings may assist in only arriving at a probable diagnosis. Currently, 18F-FDG PET/CT is considered to provide the most comprehensive imaging information. We here present a case of bilateral adrenal tuberculosis that highlights the need for caution during the interpretation of 18F-FDG PET/CT and also the need to suggest histopathological correlation.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.11.008
  • Paraneoplastic pemphigus as a first sign of metastatic retroperitoneal
           inflammatory myofibroblastic tumor: 18F-FDG PET/CT findings
    • Authors: V.S. Dhull; A. Passah; N. Rana; S. Arora; S. Mallick; R. Kumar
      Pages: 260 - 262
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): V.S. Dhull, A. Passah, N. Rana, S. Arora, S. Mallick, R. Kumar
      A 30-year-old female presented with a 3-month history of erosive stomatitis and bullous lesions, along with recurrent episodes of abdominal pain. She was found to have a retroperitoneal lump in left lumbar region. Skin biopsy revealed bullous disorder. CT guided biopsy of the retroperitoneal mass was suggestive of inflammatory myofibroblastic tumor (IMT). She was started on oral steroids and supportive care, and surgery was being planned when she developed respiratory failure. CT chest revealed vertebral metastases. PET/CT for whole body work up revealed a left para-aortic mass along with multiple skeletal metastases. The patient was kept on conservative management. After 3 months, the patient has shown clinical improvement, and an exploratory laparotomy is now being planned for the excision of the tumor, followed by chemotherapy. This case of retroperitoneal IMT is rare in terms of skeletal metastases with paraneoplastic pemphigus.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.09.005
  • 99mTc-BrIDA cholescintigraphy in a spontaneous biliary perforation of an
    • Authors: J.A. Lojo-Ramírez; J.I. Cuenca Cuenca; J.A. García-Hernández; J.L. Tirado-Hospital
      Pages: 263 - 264
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): J.A. Lojo-Ramírez, J.I. Cuenca Cuenca, J.A. García-Hernández, J.L. Tirado-Hospital

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.10.009
  • Detección de megauréter en gammagrafía renal: síndrome
           de Prune-Belly
    • Authors: J. Sánchez Catalicio; M. Gallego Peinado; F. Pérez Angel; M.T. Martinez Martínez; J.D. González Rodríguez; J.F. Contreras Gutiérrez
      Pages: 265 - 266
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): J. Sánchez Catalicio, M. Gallego Peinado, F. Pérez Angel, M.T. Martinez Martínez, J.D. González Rodríguez, J.F. Contreras Gutiérrez

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.11.003
  • Multimodal imaging in an unusual case of radionecrosis of the pubic
    • Authors: B. Muoio; G. Treglia; T. Ruberto; A. Richetti; G.A. Pesce; L. Giovanella
      Pages: 267 - 269
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): B. Muoio, G. Treglia, T. Ruberto, A. Richetti, G.A. Pesce, L. Giovanella

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.01.004
  • Infected concha bullosa mimicking a malignant lesion on 18F-FDG PET/CT
    • Authors: S. Gungor; S. Asa; A. Özgür; M. Aras; F. Dede
      Pages: 270 - 271
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): S. Gungor, S. Asa, A. Özgür, M. Aras, F. Dede

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.12.001
  • Mediastinal schwannoma mimicking lymph node metastasis from locally
           advanced breast cancer in a 18F-FDG PET/CT study
    • Authors: A. Martínez-Esteve; R.M. Álvarez-Pérez; V.M. Pachón-Garrudo; R. González-Mancha; I. Borrego-Dorado
      Pages: 272 - 273
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): A. Martínez-Esteve, R.M. Álvarez-Pérez, V.M. Pachón-Garrudo, R. González-Mancha, I. Borrego-Dorado

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remnie.2015.11.005
  • Primary pulmonary giant cell tumor: 18F-FDG PET/CT imaging
    • Authors: R.S. Plowman; B.D. Nguyen
      Pages: 274 - 276
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): R.S. Plowman, B.D. Nguyen

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.11.004
  • Synchronous Kikuchi-Fujimoto disease and gastric adenocarcinoma mimicking
           malignant lymphoma on 18F-FDG PET/CT
    • Authors: B. Li; Y. Zhang; J. Hou; L. Cai; H. Shi
      Pages: 277 - 278
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): B. Li, Y. Zhang, J. Hou, L. Cai, H. Shi

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remnie.2016.04.005
  • Adenomatosis hepática múltiple con captación de 18F-FDG: una
           manifestación rara de una entidad poco frecuente
    • Authors: M. García García-Esquinas; A. Ortega Candil; R. Méndez; C. Díaz del Arco; J. Arrazola García; J.L. Carreras Delgado
      Pages: 279 - 280
      Abstract: Publication date: July–August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 4
      Author(s): M. García García-Esquinas, A. Ortega Candil, R. Méndez, C. Díaz del Arco, J. Arrazola García, J.L. Carreras Delgado

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2015.11.005
  • Ischio-rectal mammary-type myofibroblastoma: MRI and 18F-FDG PET/CT
    • Authors: A.A. Pham; B.D. Nguyen
      Abstract: Publication date: Available online 14 October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A.A. Pham, B.D. Nguyen

      PubDate: 2016-10-16T13:28:41Z
      DOI: 10.1016/j.remn.2016.07.006
  • 18F-FDG PET/CT and sentinel lymph node biopsy in the staging of patients
           with cervical and endometrial cancer. Role of dual-time-point imaging
    • Authors: M. Mayoral; P. Paredes; B. Domènech; P. Fusté; S. Vidal-Sicart; A. Tapias; A. Torné; J. Pahisa; J. Ordi; F. Pons; F. Lomeña
      Abstract: Publication date: Available online 22 September 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. Mayoral, P. Paredes, B. Domènech, P. Fusté, S. Vidal-Sicart, A. Tapias, A. Torné, J. Pahisa, J. Ordi, F. Pons, F. Lomeña
      Objective Definitive staging for cervical (CC) and endometrial cancer (EC) takes place once surgery is performed. The aim of this study was to evaluate the role of PET/CT in detecting lymphatic metastasis in patients with CC and EC using dual-time-point imaging (DPI), taking the histopathological results of sentinel lymph node (SLN) and lymphadenectomy as the reference. Material and methods A prospective study was conducted on 17 patients with early CC, and 13 patients with high-risk EC. The patients had a pre-operative PET/CT, MRI, SLN detection, and lymphadenectomy, when indicated. PET/CT findings were compared with histopathological results. Results In the pathology study, 4 patients with CC and 4 patients with EC had lymphatic metastasis. PET/CT showed hypermetabolic nodes in 1 patient with CC, and 5 with EC. Four of these had metastasis, one detected in the SLN biopsy. Four patients who had negative PET/CT had micrometastasis in the SLN biopsy, 1 patient with additional lymph nodes involvement. The overall patient-based sensitivity, specificity, positive and negative predictive values, and accuracy of PET/CT to detect lymphatic metastasis was 20.0%, 100.0%, 100.0%, 87.9%, and 88.2%, respectively, in CC, and 57.1%, 88.9%, 66.7%, 84.2% and 80.0%, respectively, in EC. DPI showed higher retention index in malignant than in inflammatory nodes, although no statistically significant differences were found. Conclusions PET/CT has low sensitivity in lymph node staging of CC and EC, owing to the lack of detection of micrometastasis. Thus, PET/CT cannot replace SLN biopsy. Although no statistically significant differences were found, DPI may help to differentiate between inflammatory and malignant nodes.

      PubDate: 2016-09-27T11:00:40Z
      DOI: 10.1016/j.remn.2016.07.003
  • Radioinmunoterapia en el linfoma no Hodgkin, posicionamiento, seguridad y
           eficacia de 90Y-ibritumomab. Experiencia y seguimiento a los 10 años
    • Authors: A. Martínez; M. Martínez-Ramirez; D. Martínez-Caballero; P. Beneit; J. Clavel; G. Figueroa; J. Verdú
      Abstract: Publication date: Available online 13 July 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A. Martínez, M. Martínez-Ramirez, D. Martínez-Caballero, P. Beneit, J. Clavel, G. Figueroa, J. Verdú
      Introducción La radioinmunoterapia (RIT) es uno de los tratamientos dirigidos contra dianas moleculares del linfoma no Hodgkin (LNH). Objetivo Evaluar el posicionamiento de la RIT con 90Y-ibritumomab en pacientes con LNH, así como su seguridad y efectividad. Método Estudio retrospectivo de pacientes con LNH que recibieron RIT con 90Y-ibritumomab. Se evaluaron la concordancia con las guías clínicas, la toxicidad según la clasificación Common Terminology Criteria for Adverse Events (CTCAE) y la efectividad en función de la respuesta al tratamiento y de la supervivencia global (SG) y la supervivencia libre de progresión (SLP). Resultados Se solicitó RIT en 26 pacientes, de los que 21 (11 mujeres, edad media ± desviación estándar 56±10 años) fueron incluidos en el estudio, con la siguiente distribución: LNH folicular 67%, LNH del manto 14%, LNH difuso de células B grandes 9,5% y LNH transformado 9,5%. Se trató a 12 pacientes con LNH refractario, 7 para consolidación de respuesta y 2 para acondicionamiento a trasplante. El 71% de los pacientes presentó efectos adversos, generalmente manejables y transitorios, siendo la trombocitopenia el más frecuente. A los 3-4 meses, se obtuvo una tasa de respuesta global del 76,2% (completa en 71,4% y parcial en 4,8%) y el 19% mostró progresión de su enfermedad. Con una mediana de seguimiento de 70 meses, la SG fue 96±8 y la SLP de 54±11 meses. Conclusiones La RIT presentó una moderada correlación con las guías clínicas y probablemente esté infrautilizada. Los efectos adversos fueron frecuentes, leves y manejables. Los datos muestran una alta tasa de respuesta completa y una prolongación de la SG y la SLP. Introduction Radioimmunotherapy (RIT) is one of the therapies directed against molecular targets in non-Hodgkin's lymphoma (NHL). Objective To evaluate the positioning, safety, and effectiveness of RIT with 90Y-Ibritumomab in NHL patients. Method A retrospective study was conducted on patients with NHL who received RIT with 90Y-Ibritumomab. An evaluation was made of the concordance with clinical guidelines, toxicity as rated by the Common Terminology Criteria for Adverse Events (CTCAE), and effectiveness was assessed based on response to treatment, overall survival (OS), and progression-free survival (PFS). Results RIT was requested in 26 patients, of whom 21 (11 women, mean age 56±10 years) were included in the study, with the following distribution: Follicular NHL, 67%, Mantle NHL, 14%, Diffuse large B-cell NHL, 9.5%, and Transformed NHL 9.5%. Twelve patients with refractory NHL, 7 for consolidation response, and 2 transplant conditioning, were treated. Adverse effects were observed in 71% of patients, which were usually manageable and transient, and with the most common being thrombocytopenia. At 3-4 mon...
      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.05.004
  • Utilidad de la 18F-FDG PET/cardio-TC en el diagnóstico de endocarditis
           protésica aórtica tardía con absceso periprotésico
    • Authors: S. Aguadé-Bruix; M.N. Pizzi; A. Roque; H. Cuellar Calabria; N. Fernández-Hidalgo; M.T. González Alujas
      Abstract: Publication date: Available online 1 August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): S. Aguadé-Bruix, M.N. Pizzi, A. Roque, H. Cuellar Calabria, N. Fernández-Hidalgo, M.T. González Alujas

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.06.007
  • The HURRA filter: An easy method to eliminate collimator artifacts in
           high-energy gamma camera images
    • Authors: H. Perez-Garcia; R. Barquero
      Abstract: Publication date: Available online 16 July 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): H. Perez-Garcia, R. Barquero
      Purpose The correct determination and delineation of tumor/organ size is crucial in 2-D imaging in 131I therapy. These images are usually obtained using a system composed of a Gamma camera and high-energy collimator, although the system can produce artifacts in the image. This article analyses these artifacts and describes a correction filter that can eliminate those collimator artifacts. Methods Using free software, ImageJ, a central profile in the image is obtained and analyzed. Two components can be seen in the fluctuation of the profile: one associated with the stochastic nature of the radiation, plus electronic noise and the other periodically across the position in space due to the collimator. These frequencies are analytically obtained and compared with the frequencies in the Fourier transform of the profile. A specially developed filter removes the artifacts in the 2D Fourier transform of the DICOM image. This filter is tested using a 15-cm-diameter Petri dish with 131I radioactive water (big object size) image, a 131I clinical pill (small object size) image, and an image of the remainder of the lesion of two patients treated with 3.7GBq (100mCi), and 4.44GBq (120mCi) of 131I, respectively, after thyroidectomy. Results The artifact is due to the hexagonal periodic structure of the collimator. The use of the filter on large-sized images reduces the fluctuation by 5.8–3.5%. In small-sized images, the FWHM can be determined in the filtered image, while this is impossible in the unfiltered image. The definition of tumor boundary and the visualization of the activity distribution inside patient lesions improve drastically when the filter is applied to the corresponding images obtained with HE gamma camera. Conclusion The HURRA filter removes the artifact of high-energy collimator artifacts in planar images obtained with a Gamma camera without reducing the image resolution. It can be applied in any study of patient quantification because the number of counts remains invariant. The filter makes possible the definition and delimitation of small uptakes, such as those presented in treatments with 131I.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.06.003
  • A rare case of dorsal-cervical spine myeloid sarcoma detected on 18F-FDG
           PET/CT scan
    • Authors: S. Annunziata; C. Caldarella
      Abstract: Publication date: Available online 3 August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): S. Annunziata, C. Caldarella

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.06.006
  • Utilidad de la 18F-FDG PET/TC en un caso de sospecha de infección de
           injerto vascular
    • Authors: R. Fernández-López; A. de-Bonilla-Damiá; I. Acevedo-Báñez; R. Luque-Márquez; I. Borrego-Dorado
      Abstract: Publication date: Available online 1 August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): R. Fernández-López, A. de-Bonilla-Damiá, I. Acevedo-Báñez, R. Luque-Márquez, I. Borrego-Dorado
      La infección del injerto vascular protésico (VPGI) se asocia a una gran morbimortalidad. Es esencial un diagnóstico precoz y preciso para llevar a cabo el tratamiento más adecuado. Presentamos el caso de un varón de 74 años intervenido de by-pass aorto-bifemoral con sospecha clínica de infección de la prótesis vascular y pruebas complementarias no concluyentes, en el que se realiza un estudio PET/TC con 18F-FDG que muestra una captación patológica a nivel periprotésico sugestiva de infección, así como lesión incidental pulmonar sugestiva de neoplasia primaria. Una 18F-FDG PET/TC de control tras tratamiento antibiótico prolongado demostró una mejoría significativa en la captación en el injerto vascular. La 18F-FDG es un trazador prometedor para detectar VPGI, ya que los leucocitos activados tienen una gran demanda de la 18F-FDG y se acumulan en el lugar de la infección, y podría ayudar a definir la respuesta al tratamiento antibiótico. Vascular prosthetic graft infection (VPGI) is associated with high mortality and morbidity. An early and accurate diagnosis is essential in order to give the most appropriate treatment. The case is presented of a 74 year old male subjected to an aortobifemoral bypass graft, with clinical suspicion of VPGI with inconclusive tests. Later on an 18F-FDG PET/CT study showed a pathological uptake, suggestive of periprosthetic infection, as well as an incidental pulmonary lesion, suggestive of a primary neoplasm. A new 18F-FDG PET/CT showed a significant improvement in the uptake by the vascular graft after prolonged antibiotic treatment. 18F-FDG is a promising tracer for detecting VPGI as the accumulated activated white cells at the infection site have a high demand for 18F-FDG, and could help define the response to antibiotic treatment.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.06.008
  • SEMNIM 2.0: una estrategia sólidamente líquida
    • Authors: Becerra
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): D. Becerra García

      PubDate: 2016-09-22T10:53:27Z
  • Utilidad de la PET con 11C-metionina en la diferenciación precoz entre
           recurrencia tumoral y radionecrosis de pacientes tratados de glioma de
           alto grado con RM indeterminada
    • Authors: J.R. Garcia; M. Cozar; M. Baquero; J.M. Fernández Barrionuevo; A. Jaramillo; J. Rubio; G. Maida; M. Soler; E. Riera
      Abstract: Publication date: Available online 6 August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J.R. Garcia, M. Cozar, M. Baquero, J.M. Fernández Barrionuevo, A. Jaramillo, J. Rubio, G. Maida, M. Soler, E. Riera
      Objetivo Valorar la contribución de la PET con 11C-metionina en la diferenciación precoz entre recurrencia tumoral y radionecrosis en pacientes tratados de gliomas de alto grado. Método Treinta pacientes tratados de glioma (grado iii/iv) con cirugía/radioterapia/quimioterapia (5-18 meses) con RM indeterminada. A todos se les realizó estudio de PET con 11C-metionina (<15 días tras RM) con análisis visual (grado de intensidad y morfología de captación), cuantificación (relación SUV máximo lesión/SUV medio fondo) y corregistro PET/RM (3D-Flair). El manejo de los pacientes se decidió en el comité de neurooncología: seguimiento clínico-imagen, tratamiento de segunda línea o cirugía. Resultados Veintitrés estudios de PET con 11C-metionina fueron visualmente positivos. La morfología fue: 15 focales, 4 difusos y 4 anulares. Tres de los focales fueron resecados (AP+). En 16 se realizó terapia de segunda línea (11 respuesta, 5 progresión). En los 4 de morfología anular se decidió seguimiento, con progresión en 2 (verdaderos positivos) y libres de enfermedad en 2 (6 y 7 meses después) (falsos positivos). Siete estudios de PET con 11C-metionina fueron visualmente negativos, todos ellos libres de enfermedad (3-12 meses). La relación SUV lesión/fondo en la recurrencia tumoral fue de 2,79±1,35 mientras que en la radionecrosis fue de 1,53±0,39 (p<0,05). Con umbral de corte SUV lesión/fondo de 2,35 se obtuvo una sensibilidad y especificidad del 90,5 y 100%. Conclusión La valoración de la PET con 11C-metionina, con análisis visual, cuantitativo y corregistro PET/RM muestra un papel complementario en los pacientes con RM no concluyente, permitiendo una diferenciación precoz entre recurrencia tumoral y radionecrosis, que ayuda a la individualización de la terapia. Objective To evaluate the contribution of 11C-Methionine PET in the early differentiation between tumour recurrence and radionecrosis in patients treated for a high grade glioma. Method The study included 30 patients with glioma (III/IV grade) treated with surgery/radiotherapy/chemotherapy (5-8 months) and with an indeterminate MRI. All patients underwent a 11C-Methione PET (within 15 days of MRI) and studies were visually analysed (intensity and morphology of uptake), quantified (SUV max/SUV mean background), and coregistered to MRI (3D-Flair). Patient management was decided by the neuro-oncology committee to clinical and imaging follow-up, second-line treatment, or surgery. Results There were 23 11C-Methionine PET studies visually positive. Morphology of uptake was focal in 15, diffuse in 4, and ring-shaped in 4. Three out of the focal uptake cases underwent resec...
      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.06.002
  • Hybrid-fusion SPECT/CT systems in parathyroid adenoma: Technological
           improvements and added clinical diagnostic value
    • Authors: K.K. Wong; S. Chondrogiannis; H. Bowles; D. Fuster; N. Sánchez; L. Rampin; D. Rubello
      Abstract: Publication date: Available online 21 August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): K.K. Wong, S. Chondrogiannis, H. Bowles, D. Fuster, N. Sánchez, L. Rampin, D. Rubello
      Nuclear medicine traditionally employs planar and single photon emission computed tomography (SPECT) imaging techniques to depict the biodistribution of radiotracers for the diagnostic investigation of a range of disorders of endocrine gland function. The usefulness of combining functional information with anatomy derived from computed tomography (CT), magnetic resonance imaging (MRI), and high resolution ultrasound (US), has long been appreciated, either using visual side-by-side correlation, or software-based co-registration. The emergence of hybrid SPECT/CT camera technology now allows the simultaneous acquisition of combined multi-modality imaging, with seamless fusion of 3D volume datasets. Thus, it is not surprising that there is growing literature describing the many advantages that contemporary SPECT/CT technology brings to radionuclide investigation of endocrine disorders, showing potential advantages for the pre-operative locating of the parathyroid adenoma using a minimally invasive surgical approach, especially in the presence of ectopic glands and in multiglandular disease. In conclusion, hybrid SPECT/CT imaging has become an essential tool to ensure the most accurate diagnostic in the management of patients with hyperparathyroidism.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.07.004
  • Computing quantitative indicators of structural renal damage in pediatric
           DMSA scans
    • Authors: F. Sampedro; A. Domenech; S. Escalera; I. Carrio
      Abstract: Publication date: Available online 16 August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): F. Sampedro, A. Domenech, S. Escalera, I. Carrio
      Objectives The proposal and implementation of a computational framework for the quantification of structural renal damage from 99mTc-dimercaptosuccinic acid (DMSA) scans. The aim of this work is to propose, implement, and validate a computational framework for the quantification of structural renal damage from DMSA scans and in an observer-independent manner. Materials and methods From a set of 16 pediatric DMSA-positive scans and 16 matched controls and using both expert-guided and automatic approaches, a set of image-derived quantitative indicators was computed based on the relative size, intensity and histogram distribution of the lesion. A correlation analysis was conducted in order to investigate the association of these indicators with other clinical data of interest in this scenario, including C-reactive protein (CRP), white cell count, vesicoureteral reflux, fever, relative perfusion, and the presence of renal sequelae in a 6-month follow-up DMSA scan. Results A fully automatic lesion detection and segmentation system was able to successfully classify DMSA-positive from negative scans (AUC=0.92, sensitivity=81% and specificity=94%). The image-computed relative size of the lesion correlated with the presence of fever and CRP levels (p <0.05), and a measurement derived from the distribution histogram of the lesion obtained significant performance results in the detection of permanent renal damage (AUC=0.86, sensitivity=100% and specificity=75%). Conclusions The proposal and implementation of a computational framework for the quantification of structural renal damage from DMSA scans showed a promising potential to complement visual diagnosis and non-imaging indicators.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.06.010
  • 18F-FDG PET/CT in a case of primary hepatic adenosquamous carcinoma
    • Authors: Zhang Chen; Hou Shi
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): B. Li, Y. Zhang, S. Chen, J. Hou, H. Shi

      PubDate: 2016-09-22T10:53:27Z
  • FDG PET/CT imaging of metastatic renal squamous cell carcinoma
    • Authors: S.Y. Aksoy; Kandemir
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): S.Y. Aksoy, E. Özdemir, Z. Kandemir, N. Yıldırım, Ş. Türkölmez

      PubDate: 2016-09-22T10:53:27Z
  • Homeopathic mistletoe adverse reaction mimics nodal involvement in 18F-FDG
           PET/CT performed for evaluation of response to chemotherapy in lymphoma
    • Authors: P. Abreu; R. Sánchez; T. Mut; D. Balaguer; I. Latorre; H. Rodríguez
      Abstract: Publication date: Available online 13 September 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): P. Abreu, R. Sánchez, T. Mut, D. Balaguer, I. Latorre, H. Rodríguez
      Some patients use complementary medicine. We present a patient with Hodgkin's lymphoma, scanned with 18F-FDG PET/CT for evaluation of response after chemotherapy, who was self-administering mistletoe as a homeopathic medicine product. The careful review of the images of the entire scan and patient collaboration in anamnesis were crucial to avoid a false positive result. A review of the published scientific data on the effects of mistletoe is also presented.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.07.005
  • La estimulación previa con rhTSH mejora la respuesta al tratamiento con
           radioyodo en pacientes con bocio multinodular tóxico de baja captación
    • Authors: M.J. Azorín Belda; A. Martínez Caballero; G.C. Figueroa Ardila; M. Martínez Ramírez; C.A. Gómez Jaramillo; J.I. Dolado Ardit; J. Verdú Rico
      Abstract: Publication date: Available online 12 July 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M.J. Azorín Belda, A. Martínez Caballero, G.C. Figueroa Ardila, M. Martínez Ramírez, C.A. Gómez Jaramillo, J.I. Dolado Ardit, J. Verdú Rico
      Introducción La estimulación con TSH recombinante humana (rhTSH) aumenta la captación tiroidea de yodo, ayudando al tratamiento con radioyodo en el bocio multinodular (BMN) no tóxico. Sin embargo, son escasos los estudios que utilicen rhTSH previo a terapia con radioyodo en el BMN tóxico para controlar la hiperfunción y clínica compresiva. Material y método Se llevó a cabo un estudio prospectivo en pacientes con BMN e hipertiroidismo. Los pacientes se reclutaron de forma consecutiva y se dividieron en un grupo I, estimulados con 0,3mg de rhTSH antes de recibir radioyodo, y un grupo control o grupo II, sin estimulación previa. Se midió función tiroidea, captación tiroidea de radioyodo, peso tiroideo y síntomas compresivos, y se siguió a los pacientes durante 9 meses. Resultados Un total de 16 pacientes (14 mujeres) de edad media 69,7años constituyeron el grupo I y 16 pacientes (12 mujeres) de edad media 70,7años, el grupo II. Tras el estímulo con 0,3mg rhTSH en el grupo I, la captación de 131I a las 24h aumentó un 78,4% y la dosis estimada absorbida, un 89,3%. En el grupo II, la dosis estimada absorbida fue inferior a la del grupo I tras la estimulación con rhTSH (29,8Gy vs. 56,4Gy; p=0,001). A los 9 meses, se había controlado el hipertiroidismo en un 87,5% de pacientes en el grupo I, y en un 56,2% en el grupo II (p=0,049). La reducción media de peso tiroideo fue mayor en el grupo I que en el II (39,3% vs. 26,9%; p=0,017), con una tendencia a la mejoría subjetiva de la clínica compresiva en el grupo I, aunque no significativa. Solo 2 pacientes describieron taquicardias tras la administración de rhTSH, que se resolvieron con beta-bloqueantes. Conclusiones La estimulación con rhTSH a dosis de 0,3mg previa al tratamiento con radioyodo consigue una reducción del tamaño tiroideo y mejoría funcional en pacientes con hipertiroidismo y BMN de baja captación, sin necesidad de ingreso hospitalario. Aim Stimulation with recombinant human thyrotropin (rhTSH) increases thyroid radioiodine uptake, and is an aid to 131I therapy in non-toxic multinodular goitre (MNG). However, there are not many studies using rhTSH prior to 131I in toxic multinodular goitre to improve hyperthyroidism and compressive symptoms. Material and method A prospective study was conducted on patients with MNG and hyperthyroidism. Patients were recruited consecutively and divided into group I, stimulated with 0.3mg of rhTSH before radioiodine therapy, and a control group or group II, without stimulation. Thyroid function, radioiodine thyroid uptake, thyroid weight, and compressive symptoms were measured, and patients were followed-up for 9 months. Results Group I consisted of 16 patients (14 women), with a mean age 69.7 years, and group II with 16 patients (12 women),...
      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.05.009
  • Analysis of non-conformity in continuous quality improvement in a Hospital
           Radiopharmacy Unit
    • Authors: T. Martinez; J.F. Contreras
      Abstract: Publication date: Available online 25 June 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): T. Martinez, J.F. Contreras
      Aim To perform an analysis of non-conformities (NC) registered between 2012 and 2015, as a part of the review process of the Quality Management System of our Radiopharmacy Unit. Material and methods Non-conformities registered in the Radiopharmacy Unit in the period 2012–2015 are analyzed and sorted by their impact on the process (critical, major, and minor), cause/origin of the non-conformity, and nature of radiopharmaceutical (PET vs. SPECT). Results A decrease in the NC of 20% per year is observed, especially in PET radiopharmaceuticals. Non-conformities in SPECT make up about 62–84% of the total of the NC, mainly related to the high number of doses prepared and not administered, which is about 1.5–3% in the ratio of non-administered/administered per year. Conclusions Analysis of the NC can be considered as a useful indicator in assessment of quality assurance, and in our particular case, the decrease in the registration of NC indicates effectiveness in the corrective and preventive actions implemented.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.05.010
  • Síndrome de hipotensión intracraneal espontánea: aportación de la
           cisternografía radioisotópica
    • Authors: J.P. M.L.; M.A. J.L.
      Abstract: Publication date: Available online 20 June 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J.P. Suárez, M.L. Domínguez, M.A. Gómez, J.L. Muñoz
      La hipotensión intracraneal espontánea es un síndrome clínico debido a la pérdida de volumen de líquido cefalorraquídeo, generalmente secundario a su fuga por defectos estructurales de la duramadre espinal. La cisternografía radioisotópica (CR) es una técnica que puede aportar un diagnóstico confirmatorio en este síndrome, principalmente en casos dudosos o de presentación atípica. Estudiamos retrospectivamente 8 pacientes con CR realizada por sospecha de hipotensión intracraneal espontánea con clínica atípica y/o hallazgos no concluyentes en las técnicas de imagen. La CR detectó extravasación paraespinal de líquido cefalorraquídeo en 7 de ellos. Además, se apreciaron signos indirectos de fuga de líquido cefalorraquídeo en los 8 pacientes, consistentes en la presencia precoz del radiotrazador en orina, presencia de actividad de fondo corporal y/o reducción de la cantidad de radiotrazador en cráneo a las 24 h. La CR tuvo un impacto significativo en el diagnóstico de 6 pacientes y en el manejo terapéutico de 4 pacientes. Spontaneous intracranial hypotension is a clinical syndrome caused by a loss of cerebrospinal fluid volume, usually secondary to leaking through structural defects of the spinal dura mater. Radioisotope cisternography (RC) can confirm the diagnosis of spontaneous intracranial hypotension, especially in doubtful or atypical case presentations. A retrospective study was conducted on 8 patients who underwent RC because spontaneous intracranial hypotension was suspected, and they presented with atypical clinical manifestations and/or inconclusive findings in other imaging techniques. RC detected paradural extravasation of cerebrospinal fluid in 7 patients. Moreover, there was indirect evidence of cerebrospinal fluid leaks in all 8 patients (early appearance of radioactivity in the bladder, soft tissue uptake of radioisotope and/or reduction in the amount of radiotracer in the brain at 24hours). RC had a significant impact on the diagnosis of 6 patients, and on the therapeutic management of 4 patients.

      PubDate: 2016-09-22T10:53:27Z
  • Pancreatic accessory spleen. False positive with 99mTc-Octreotide
    • Authors: J. Serrano-Vicente; J.R. Infante-Torre; L. García-Bernardo; M. Moreno-Caballero; A. Martínez-Esteve; J.I. Rayo-Madrid
      Abstract: Publication date: Available online 18 June 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J. Serrano-Vicente, J.R. Infante-Torre, L. García-Bernardo, M. Moreno-Caballero, A. Martínez-Esteve, J.I. Rayo-Madrid
      The case is presented on a patient with abdominal pain and suspicion of neuroendocrine tumor in the tail of the pancreas shown in the abdominal CT and MRI. Whole-body scintigraphy and abdominal SPECT/CT with 99mTc-octreotide were performed that showed a nodular lesion partially on the posterior side of the pancreas tail. This nodule showed faint tracer uptake, and was reported as probable neuroendocrine tumor. Partial pancreatectomy and splenectomy were performed, and the histological study identified the lesion as an ectopic spleen. There are similar cases in the literature that match these findings, but this lesion is still frequently diagnosed after performing unnecessary surgery. When an asymptomatic intrapancreatic mass is detected, an accessory spleen should be considered and specific diagnostic techniques should be performed, such as labeled and denatured red blood cell SPECT/CT.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.05.003
  • Co-existence of a giant cell tumour of the tendon sheath and schwannoma in
           a patient with bilateral breast cancer: A potential cause of false
           positive findings in 18F-FDG PET/CT studies
    • Authors: A. Ortega Candil; C. Rodríguez Rey; M. García García-Esquinas; M.N. Cabrera Martín; R. Couto Caro; J.L. Carreras Delgado
      Abstract: Publication date: Available online 18 June 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A. Ortega Candil, C. Rodríguez Rey, M. García García-Esquinas, M.N. Cabrera Martín, R. Couto Caro, J.L. Carreras Delgado

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.05.008
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