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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  [3042 journals]
  • Gammagrafía de tránsito gastrointestinal en el estudio del
           
    • Authors: J.R. Infante; J.I. Rayo; J. Serrano; L. García; M. Moreno; A. Martínez; J. Huertas
      Pages: 146 - 151
      Abstract: Publication date: May–June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 3
      Author(s): J.R. Infante, J.I. Rayo, J. Serrano, L. García, M. Moreno, A. Martínez, J. Huertas
      Objetivo El estreñimiento crónico es una enfermedad común en el niño. Nuestro objetivo fue poner de manifiesto la utilidad de la gammagrafía de tránsito gastrointestinal en el estudio de pacientes pediátricos con estreñimiento crónico y las ventajas que tiene respecto a otros estudios de imagen, a pesar de nuestra limitada experiencia. Material y métodos Se valoraron 5 pacientes remitidos a nuestro servicio con diagnóstico de estreñimiento crónico refractario al tratamiento. Se realizó un protocolo de estudio completo, incluyendo gammagrafía de vaciamiento gástrico para líquidos y tránsito de intestino delgado y grueso, utilizándose una única dosis de 111In-DTPA. Siguiendo guías internacionales se definieron áreas de interés en estómago, íleon terminal y en 6 regiones del intestino grueso. Resultados Todos los enfermos presentaron estudios gammagráficos alterados, mostrando 4 de ellos exploraciones radiológicas normales. El estudio radioisotópico cambió el diagnóstico del paciente en 2 casos y en otros 2 contribuyó a aclararlo, ante la discordancia entre pruebas radiológicas normales y biopsia rectal patológica. Uno de los pacientes mostró concordancia entre los 2 estudios de imagen. Tras la gammagrafía se produjo cambio en el manejo terapéutico en 2 casos. Conclusiones Nuestra limitada experiencia coincide con los datos publicados en los que el estudio gammagráfico resulta ser un método reproducible y preciso. Proporciona una información fisiológica, cuantitativa y útil en el estudio del estreñimiento, siendo la única exploración que permite la determinación tanto global como regional del tiempo de tránsito gastrointestinal. Aim Chronic constipation is a common pathology in children. The aim of this paper was to show the usefulness of gastrointestinal transit scintigraphy in pediatric patients with chronic constipation, and the advantages with respect to other imaging techniques, despite our limited experience. Material and methods We evaluated 5 patients sent to our service with a diagnosis of chronic constipation refractory to treatment. We performed a complete study protocol, including liquid gastric emptying scintigraphy and small and large bowel transit times, using a single dose of 111In-DTPA. Following international guidelines regions of interest were defined in stomach, terminal ileum and in 6 regions of the large intestine. Results All patients showed altered scintigraphy study, showing 4 of them normal radiological tests. Radioisotopic study changed diagnosis in 2 patients and in other 2 patients contributed to clarify it, since discordance between normal radiological tests and abnormal rectal biopsy. One of the patients showed concordance between each imaging modality. The results of the test changed the therapeutic management in 2 cases. Conclusions Our limited experience coincides with published data in which scintigraphy study turns out to be a reproducible and accurate method. It provides physiological, quantitative and useful information in the study of constipation, being the unique exploration that allows both global and regional gastrointestinal trans...
      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2016.10.011
       
  • Relationship between primary tumour 18F-FDG uptake and immunohistochemical
           and clinical prognostic parameters in breast carcinoma
    • Authors: G.K. Gedik; F. Yilmaz; O. Sari
      Pages: 152 - 157
      Abstract: Publication date: May–June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 3
      Author(s): G.K. Gedik, F. Yilmaz, O. Sari
      Objective The objective of this study was to investigate the relationship between level of 18F-fluorodeoxyglucose (18F-FDG) accumulation in primary breast tumour assessed by positron emission tomography/computed tomography (PET/CT) and histopathological and clinical prognostic factors. Material and methods A retrospective analysis was performed using the medical records of 58 female patients (age range: 31-86 years, mean age: 56) with biopsy of proven breast carcinoma, and who had undergone 18F-FDG PET/CT examination before chemotherapy/surgery. The 18F-FDG uptake of breast tumours was calculated as tumour to background ratio (TBR), which was compared with histopathological and clinical prognostic parameters. Results The histology of the breast tumour in the 58 patients was ductal type in 52 (90%), lobular in 4 (7%), and mucinous in 2 (3%). Tumour size was ≤ 2cm in 31 (53%) patients, and>2cm in 27 (47%). The levels of TBRs were not significantly different between the patients groups with tumours of 2cm or less and greater than 2cm (P =0.131). No significant difference between levels of TBR was observed neither with regards to axillary lymph node involvement (P =0.065) nor in terms of distant metastases (p=0.123). No statistically significant difference was found in levels of TBRs between patients with c-erbB-2 receptor positive and negative ones (P =0.107). Progesterone receptor (PR) expression was observed in 33 patients (57%), and 25 patients (43%) were PR negative. As regards progesterone receptor status, a statistically significant difference was observed in mean TBR levels between patients with and without progesterone receptor expression (P =0.020). Oestrogen receptor expression was positive in 41 (71%) patients, and negative in 17 (29%) patients. The difference in the levels of TBRs between patients with and without oestrogen receptor expression was at the level of significancy (P =0.050). Conclusions It is concluded that 18F-FDG uptake correlates with progesterone negativity of the tumour. However, a significant association with clinical prognostic parameters and level of 18F-FDG uptake levels could not be demonstrated.

      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2016.09.006
       
  • A novel semi-robotized device for high-precision 18F-FDG-guided breast
           cancer biopsy
    • Authors: D. Hellingman; S.C. Teixeira; M.L. Donswijk; E.J. Rijkhorst; L. Moliner; J. Alamo; C.E. Loo; R.A. Valdés Olmos; M.P.M. Stokkel
      Pages: 158 - 165
      Abstract: Publication date: May–June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 3
      Author(s): D. Hellingman, S.C. Teixeira, M.L. Donswijk, E.J. Rijkhorst, L. Moliner, J. Alamo, C.E. Loo, R.A. Valdés Olmos, M.P.M. Stokkel
      Purpose To assess the 3D geometric sampling accuracy of a new PET-guided system for breast cancer biopsy (BCB) from areas within the tumour with high 18F-FDG uptake. Materials and methods In the context of the European Union project MammoCare, a prototype semi-robotic stereotactic prototype BCB-device was incorporated into a dedicated high resolution PET-detector for breast imaging. The system consists of 2 stacked rings, each containing 12 plane detectors, forming a dodecagon with a 186mm aperture for 3D reconstruction (1mm3 voxel). A vacuum-assisted biopsy needle attached to a robot-controlled arm was used. To test the accuracy of needle placement, the needle tip was labelled with 18F-FDG and positioned at 78 target coordinates distributed over a 35mm×24mm×28mm volume within the PET-detector field-of-view. At each position images were acquired from which the needle positioning accuracy was calculated. Additionally, phantom-based biopsy proofs, as well as MammoCare images of 5 breast cancer patients, were evaluated for the 3D automated locating of 18F-FDG uptake areas within the tumour. Results Needle positioning tests revealed an average accuracy of 0.5mm (range 0–1mm), 0.6mm (range 0–2mm), and 0.4mm (range 0–2mm) for the x/y/z-axes, respectively. Furthermore, the MammoCare system was able to visualize and locate small (<10mm) regions with high 18F-FDG uptake within the tumour suitable for PET-guided biopsy after being located by the 3D automated application. Conclusions Accuracy testing demonstrated high-precision of this semi-automatic 3D PET-guided system for breast cancer core needle biopsy. Its clinical feasibility evaluation in breast cancer patients scheduled for neo-adjuvant chemotherapy will follow.

      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2016.11.003
       
  • Radioguided surgery and the GOSTT concept: From pre-operative image and
           intraoperative navigation to image-assisted excision
    • Authors: H. Bowles; N. Sánchez; A. Tapias; P. Paredes; F. Campos; C. Bluemel; R.A. Valdés Olmos; S. Vidal-Sicart
      Pages: 175 - 184
      Abstract: Publication date: May–June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 3
      Author(s): H. Bowles, N. Sánchez, A. Tapias, P. Paredes, F. Campos, C. Bluemel, R.A. Valdés Olmos, S. Vidal-Sicart
      Radio-guided surgery has been developed for application in those disease scheduled for surgical management, particularly in areas of complex anatomy. This is based on the use of pre-operative scintigraphic planar, tomographic and fused SPECT/CT images, and the possibility of 3D reconstruction for the subsequent intraoperative locating of active lesions using handheld devices (detection probes, gamma cameras, etc.). New tracers and technologies have also been incorporated into these surgical procedures. The combination of visual and acoustic signals during the intraoperative procedure has become possible with new portable imaging modalities. In daily practice, the images offered by these techniques and devices combine perioperative nuclear medicine imaging with the superior resolution of additional optical guidance in the operating room. In many ways they provide real-time images, allowing accurate guidance during surgery, a reduction in the time required for tissue location and an anatomical environment for surgical recognition. All these approaches have been included in the concept known as (radio) Guided intraOperative Scintigraphic Tumour Targeting (GOSTT). This article offers a general view of different nuclear medicine and allied technologies used for several GOSTT procedures, and illustrates the crossing of technological frontiers in radio-guided surgery.

      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2016.09.004
       
  • 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
      Pages: 185 - 188
      Abstract: Publication date: May–June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 3
      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: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2016.06.008
       
  • Coexistencia de metástasis óseas por cáncer gástrico y osteopoiquilia
           diagnosticadas mediante gammagrafía ósea y 18F-FDG PET/TC
    • Authors: S. Prado Wohlwend; R. Sánchez Vaño; P. Sopena Novales; E. Uruburu García; F. Aparisi Rodríguez; C. Martínez Carsí
      Pages: 189 - 193
      Abstract: Publication date: May–June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 3
      Author(s): S. Prado Wohlwend, R. Sánchez Vaño, P. Sopena Novales, E. Uruburu García, F. Aparisi Rodríguez, C. Martínez Carsí
      La coexistencia de distintas alteraciones óseas en un mismo paciente es un hallazgo que plantea un diagnóstico diferencial complejo. Presentamos el caso de una paciente en estudio por una lesión renal, que en la radiografía convencional y en la TC presentó múltiples lesiones esclerosas en columna y extremidades, que se valoraron mediante gammagrafía ósea con 99mTc-HDP y 18F-FDG PET/TC, obteniéndose el diagnóstico definitivo mediante la anatomía patológica de coexistencia de metástasis óseas por cáncer gástrico y osteopoiquilia (OP). Entre las técnicas de imagen realizadas, la gammagrafía aportó el mayor rendimiento diagnóstico por su capacidad de discriminación entre enfermedad ósea benigna y metastásica. The coexistence of different bone diseases in the same patient involves a complex differential diagnosis. A patient is presented who was studied due to a renal mass that showed many sclerotic lesions in spine and limbs in conventional radiology and CT. These lesions were evaluated with 99mTC-HDP bone scintigraphy and 18F-FDG PET/CT, which helped to obtain the definitive pathological diagnosis of osteopoikilosis (OP) co-existing with gastric cancer bone metastases. Of the different imaging scans performed, bone scintigraphy was particularly relevant due to its ability to discriminate between benign and metastatic bone disease.

      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2016.04.010
       
  • 18F-FDG PET/CT follow-up of follicular dendritic cell sarcoma
    • Authors: D. Albano; G. Bosio; F. Bertagna
      Pages: 194 - 196
      Abstract: Publication date: May–June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 3
      Author(s): D. Albano, G. Bosio, F. Bertagna
      Follicular dendritic cell sarcoma (FDCS) is a rare lymphoid neoplasm which occurs mainly in lymph nodes, especially cervical and mediastinal; it can be difficult to diagnose and often is misdiagnosed. Its pathogenesis is still not clear, like its evolution. We report a case of 60-year-old woman with FDCS of left lateral cervical node followed for almost 10 years, after a left selective neck dissection, who underwent five 18F-FDG PET/CT. This technique has proven to be an useful method for the management of this patient, mainly for the follow up, detection of relapse and therapy response evaluation.

      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2016.09.001
       
  • Hemorrhagic pseudotumors of iliac bones in Noonan syndrome: PET/CT imaging
    • Authors: K.D. Nguyen; B.D. Nguyen
      Pages: 197 - 198
      Abstract: Publication date: May–June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 3
      Author(s): K.D. Nguyen, B.D. Nguyen


      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2016.08.006
       
  • A propósito de un caso de miopatía inflamatoria. Cuantificación de la
           inflamación muscular mediante PET/TC con 18F-FDG en la evaluación
           inicial y la respuesta terapéutica
    • Authors: J.R. García; A. Jaramillo; E. Iglesias; E. Inarejos; C. Jou; E. Riera
      Pages: 199 - 200
      Abstract: Publication date: May–June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 3
      Author(s): J.R. García, A. Jaramillo, E. Iglesias, E. Inarejos, C. Jou, E. Riera


      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2016.10.009
       
  • Oncocytoma as a growing FDG-avid adrenal mass on serial 18F-FDG PET/CT
           imaging: A potential pitfall in oncological evaluation
    • Authors: L. Gilardi; M. Vadrucci; S. Pirola; C.M. Grana
      Pages: 201 - 203
      Abstract: Publication date: May–June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 3
      Author(s): L. Gilardi, M. Vadrucci, S. Pirola, C.M. Grana


      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2016.10.007
       
  • The effect of tissue-segmented attenuation maps on PET quantification with
           a special focus on large arteries
    • Authors: A. Mota-Cobian; J.C. Alonso-Farto; L. Fernández-Friera; J. Sánchez-González; B. López-Melgar; L.J. Jiménez-Borreguero; V. Fuster; J. Ruiz-Cabello; S. España
      Abstract: Publication date: Available online 20 June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A. Mota-Cobian, J.C. Alonso-Farto, L. Fernández-Friera, J. Sánchez-González, B. López-Melgar, L.J. Jiménez-Borreguero, V. Fuster, J. Ruiz-Cabello, S. España
      Objectives Accuracy on quantitative PET image analysis relies on the correct application of attenuation correction which is one of the major challenges for PET/MRI that remains to be solved. The purpose of this study is to evaluate the effect of MRI-based attenuation maps and the use of flexible coils on the quantitative accuracy of PET images with a special focus on large arteries. Materials and methods PET/CT data from eight oncologic patients was used. PET data was reconstructed using attenuation maps with different level of detail emulating several approaches available on current PET/MRI scanners. PET images obtained with CT-based and MRI-based attenuation maps were compared to evaluate the quantitative biases obtained. The quantitative effect produced by flexible MRI receiver coils on the attenuation maps was also studied. Results The use of simpler attenuation maps produced increased biases between PET data reconstructed with CT-based and MRI-based attenuation maps for fat, non-fat soft-tissues and bone. Biases in lung were very high due to the large heterogeneity and inter-patient variability of the lung. The quantification on large arteries had small deviations except for the case when flexible coils were used. The TBR provided smaller biases in all cases as it cancelled out the similar deviations obtained for arteries and reference veins. Conclusions Simplified attenuation maps used on PET/MRI significantly increase the quantitative variability of PET images especially on lungs and bones. The quantification of PET images acquired with PET/MRI scanners applied to studies of atherosclerosis has small deviations, especially when the TBR is considered.

      PubDate: 2017-06-21T21:22:39Z
      DOI: 10.1016/j.remn.2017.03.008
       
  • Detección y cuantificación de la captación de 223Ra en metástasis
           óseas en pacientes con carcinoma de próstata resistente a la castración
           con vistas a la determinación de la dosis absorbida en dichas metástasis
           
    • Authors: P. Mínguez; A. Gómez de Iturriaga; I.L. Fernández; E. Rodeño
      Abstract: Publication date: Available online 20 June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): P. Mínguez, A. Gómez de Iturriaga, I.L. Fernández, E. Rodeño
      Objetivos Obtener los parámetros necesarios, tanto de calibración como de adquisición, para poder estudiar la posibilidad de detectar y cuantificar la actividad captada en metástasis óseas en pacientes con carcinoma de próstata resistente a la castración tratados con 223Ra. Además, en los casos en los que sea posible cuantificar la actividad, estimar la dosis absorbida. Material y métodos Se han realizado adquisiciones en la gammacámara de una placa Petri con 223Ra, que han sido complementadas con simulaciones Monte Carlo para estudiar el efecto de volumen parcial. Las fórmulas matemáticas para obtener los límites de detección y cuantificación de actividad de 223Ra fueron aplicadas a las imágenes planares de 2 pacientes 7días postadministración de 55kBq/kg de 223Ra. Para una localización previa de las lesiones se adquirieron barridos de cuerpo completo e imágenes SPECT/TC con 99 mTc-HDP. Resultados La ventana de adquisición óptima es de 82keV con un colimador de energías medias MEGP. De las lesiones presentes en los 2 pacientes, solo fueron cuantificables las lesiones que habían podido ser detectadas en las 2 proyecciones anterior y posterior. Estas lesiones eran las que captaban más actividad de 99 mTc-HDP. Los valores estimados de dosis absorbidas estuvieron en un rango de 0,7 a 7,8Gy. Conclusiones De entre las lesiones que se pueden detectar, en algunas no es posible cuantificar la actividad captada, ni por lo tanto determinar la dosis absorbida. Esto no implica que la dosis absorbida en esas lesiones pueda considerarse despreciable. Purposes To obtain the necessary acquisition and calibration parameters in order to evaluate the possibility of detecting and quantifying 223Ra uptake in bone metastases of patients treated for castration resistant prostate carcinoma. Furthermore, in the cases in which the activity can be quantified, to determine the absorbed dose. Material and methods Acquisitions from a Petri dish filled with 223Ra were performed in the gamma camera. Monte Carlo simulations were also performed to study the partial volume effect. Formulae to obtain the detection and quantification limits of 223Ra uptake were applied to planar images of two patients 7 days post-administration of 55kBq/kg of 223Ra. In order to locate the lesions in advance, whole-body scans and SPECT/CT images were acquired after injecting 99mTc-HDP. Results The optimal energy window was found to be at 82keV with a medium-energy collimator MEGP. Of the lesions found in the patients, only those that had been detected in both the AP and PA projections could be quantified. These lesions were those which had shown a higher 99mTc-HDP uptake. The estimated values of absorbed doses ranged between 0.7Gy and 7.8Gy. Conclusions Of the lesions that can be detected, it is not possible to quantify the activity uptake in some of them, which means that the absor...
      PubDate: 2017-06-21T21:22:39Z
      DOI: 10.1016/j.remn.2017.04.009
       
  • A single brain metastasis seen on 68Ga-PSMA PET/CT in recurrent of breast
           cancer
    • Authors: S.S. Medina-Ornelas; F.O. García-Pérez; C. Medel-Gamez; E. Paredes-Amoroto
      Abstract: Publication date: Available online 20 June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): S.S. Medina-Ornelas, F.O. García-Pérez, C. Medel-Gamez, E. Paredes-Amoroto


      PubDate: 2017-06-21T21:22:39Z
      DOI: 10.1016/j.remn.2017.04.004
       
  • Concordancia entre la PET cerebral con 18F-FDG y los biomarcadores en
           líquido cefalorraquídeo en el diagnóstico de enfermedad de Alzheimer
    • Authors: S. Rubí; A. Noguera; S. Tarongí; M. Oporto; A. García; H. Vico; A. Espino; M.J. Picado; A. Mas; C. Peña; G. Amer
      Abstract: Publication date: Available online 20 June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): S. Rubí, A. Noguera, S. Tarongí, M. Oporto, A. García, H. Vico, A. Espino, M.J. Picado, A. Mas, C. Peña, G. Amer
      Objetivos El hipometabolismo cortical posterior por PET con 18F-FDG (PET-FDG) y la alteración de los niveles del péptido Aß1-42 y las proteínas Tau total (tTau) y Tau fosforilada (pTau) en líquido cefalorraquídeo (LCR) son biomarcadores establecidos para el diagnóstico de la enfermedad de Alzheimer (EA). Evaluamos la concordancia y la relación entre los resultados de la PET-FDG y los biomarcadores en LCR en pacientes sintomáticos con sospecha de EA. Material y métodos Revisión retrospectiva de 120 pacientes con deterioro cognitivo admitidos en la Unidad de Neurología Cognitiva a los que se les ha realizado punción lumbar para la determinación de biomarcadores en LCR y una PET-FDG cerebral. Para el análisis de concordancia (coeficiente Kappa), el resultado de la PET-FDG y del conjunto de los biomarcadores-LCR se clasificó en cada paciente como normal, no-concluyente, o compatible-EA. Se efectuó además una regresión logística incluyendo las variables cuantitativas Aß1-42, tTau y pTau como predictores y la PET-FDG como variable dependiente. Resultados El coeficiente Kappa ponderado entre PET-FDG y biomarcadores-LCR fue de 0,46 (IC 95%: 0,35-0,57). En el análisis por regresión logística, la Aß1-42 y la tTau fueron en conjunto capaces de discriminar un resultado PET metabólicamente sugestivo de EA de uno no sugestivo de EA, con una sensibilidad del 91% y una especificidad del 93% aplicando la recta de corte Aß1-42 =44+1,3×tTau. Conclusiones La concordancia entre la PET-FDG cerebral y los biomarcadores-LCR es moderada, lo cual indica su valor complementario en el diagnóstico de EA. Los niveles de Aß1-42 y tTau en LCR son buenos predictores del estatus metabólico característico de EA por PET-FDG cerebral. Objectives Cortical posterior hypometabolism on PET imaging with 18F-FDG (FDG-PET), and altered levels of Aß1-42 peptide, total Tau (tTau) and phosphorylated Tau (pTau) proteins in cerebrospinal fluid (CSF) are established diagnostic biomarkers in Alzheimer's disease (AD). An evaluation has been made of the concordance and relationship between the results of FDG-PET and CSF biomarkers in symptomatic patients with suspected AD. Material and methods A retrospective review was carried out on 120 patients with cognitive impairment referred to our Cognitive Neurology Unit, and who were evaluated by brain FDG-PET and a lumbar puncture for CSF biomarkers. In order to calculate their Kappa coefficient of concordance, the result of the FDG-PET and the set of the three CSF biomarkers in each patient was classified as normal, inconclusive, or AD-compatible. The relationship between the results of both methods was further assessed using logistic regression analysis, including the Aß1-42, tTau and pTau levels as quantitative predictors, and the FDG-PET result as the dependent variable. Results The weighted Kappa coefficient between FDG-PET and CSF biomarkers was 0.46 (95% CI: 0.35-0.57). Logistic regression analysis showed that the Aß1-42 and tTau values together were capable of discriminating an FDG-PET result metabolically suggestive o...
      PubDate: 2017-06-21T21:22:39Z
      DOI: 10.1016/j.remn.2017.05.003
       
  • Utilidad de la gammagrafía con leucocitos marcados y SPECT/TC en la
           infección de injertos vasculares
    • Authors: V. Marín-Oyaga; C. Gutierrez-Villamil; D. García-Concha; S. Arevalo-Leal
      Abstract: Publication date: Available online 12 June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): V. Marín-Oyaga, C. Gutierrez-Villamil, D. García-Concha, S. Arevalo-Leal
      La infección de injertos vasculares es una complicación poco frecuente en este tipo de procedimientos. Sin embargo, cuando se presentan suelen tener una alta morbilidad e incluso una alta mortalidad. Su adecuada identificación y localización es crucial para el pertinente y temprano manejo, ya sea médico o quirúrgico, por lo que el conocimiento de las herramientas adecuadas es primordial. Los estudios de medicina nuclear tienen un importante papel en este sentido, ya sea mediante gammagrafía con leucocitos marcados o con 18F-FDG. La elección dependerá de la experiencia con ambas técnicas de los diferentes grupos, del conocimiento de las mismas y de su disponibilidad, entre otros factores. Presentamos 2 casos en los que la gammagrafía con 99mTc-HMPAO-leucocitos autógenos marcados-SPECT/TC fue de gran utilidad en el diagnóstico y localización del compromiso infeccioso sospechado y, por lo tanto, en el adecuado y guiado manejo posterior. Ambos casos tuvieron confirmación clínica y microbiológica. Vascular graft infections are a rare complication in this type of procedure. However, when they do occur, they usually have high morbidity, and even a high mortality. Proper identification and location is crucial for the appropriate and early management, whether medical or surgical, thus knowledge of the right tools is paramount. Nuclear medicine studies play an important role in this regard, either by using labelled white blood cells scintigraphy or 18F-FDG. The choice, among other factors, will depend on the experience with both techniques by the different groups, their knowledge of them, as well as their availability. Two cases are presented in which 99mTc-HMPAO-white blood cells SPECT/CT scintigraphy was very useful in the diagnosis and location of the suspected infectious compromise, which led to the subsequent appropriate and guided management. Both cases were confirmed clinically and microbiologically.

      PubDate: 2017-06-16T21:15:28Z
      DOI: 10.1016/j.remn.2017.05.001
       
  • Estudio de los factores que influyen en el resultado del tratamiento con
           131I en el hipertiroidismo por bocio nodular
    • Authors: O. Tabuenca-Dopico; R. Boente-Varela; J.L. Lamas-Ferreiro
      Abstract: Publication date: Available online 12 June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): O. Tabuenca-Dopico, R. Boente-Varela, J.L. Lamas-Ferreiro
      Objetivo Determinar el resultado obtenido tras tratamiento con 131I en pacientes con bocio multinodular (BMN) y nódulo autónomo tóxico (NAT) en función de la dosis administrada (555 o 740MBq) y de otros factores relacionados con el paciente, la enfermedad o tratamientos previos. Material y métodos Es un estudio retrospectivo sobre 108 pacientes (67 BMN y 41 NAT) tratados un nuestra unidad y con un seguimiento mínimo de 2 años. Se valoró el desarrollo de hipotiroidismo y el fracaso del tratamiento así como su relación con la dosis administrada u otros factores dependientes del paciente (edad o sexo), de la enfermedad (autoinmunidad, grado de hipertiroidismo o tipo de bocio) o la toma previa de antitiroideos. Resultados El 36,9% de los pacientes con BMN desarrollaron hipotiroidismo no transitorio llegando al 51,2% en el caso de los NAT y sobre todo en aquellos que recibieron 740MBq (66,7%) sin encontrarse relación con ninguna otra variable así como tampoco en el desarrollo precoz del hipotiroidismo antes de un año. El fracaso del tratamiento no tuvo relación significativa con la dosis administrada pero sí con el sexo varón, la presencia de autoinmunidad o la toma previa de antitiroideos en el caso de los BMN. Conclusiones La elevada tasa de hipotiroidismo obtenida con dosis altas en el tratamiento de hipertiroidismo en el bocio nodular indica que dosis más bajas podrían ser suficientes para controlar la enfermedad sin producir un aumento de fracasos del tratamiento. Únicamente en los pacientes con BMN de sexo masculino, con autoinmunidad positiva o toma previa de antitiroideos se podría estudiar la posibilidad de administrar una dosis mayor pues tienen una tasa de fracasos más elevada. Objective To assess the outcome after 131I treatment in patients with multinodular (MNG) and nodular toxic goitre (NTG) according to the administered dose and other factors related to the patient, pathology, or previous treatments. Material and methods A retrospective study was conducted on 108 patients (67 MNG and 41 NTG) treated in our department, with a follow-up period of at least 2 years. Development of hypothyroidism and treatment failure were evaluated along with their relationship with the administered dose and other factors such as age, sex, grade of hyperthyroidism, type of goitre, presence of autoimmunity, or previous antithyroid medication. Results More than one-third (36.9%) of MNG patients, and even higher proportion of NTG patients (51.2%) developed non-transient hypothyroidism, particularly in those receiving 740MBq (66.7%). No relationship was found with any other variable. The development of early hypothyroidism (before one year) was also not related to any variable. Treatment failure was not related to the dose, but in MNG there was a relationship with male gender, presence of autoimmunity, or previous antithyroid drugs use. Conclusions The high rate of hypothyroidism obtained with high doses of 131I in hyperthyroidism secondary to nodular goitre treatment suggests that lower doses might be sufficient to control the disease without an increase in treatment failures. Only patients with positive autoimmunity, in previous anti-thyroid medication, and perhaps male gender in MNG might b...
      PubDate: 2017-06-16T21:15:28Z
      DOI: 10.1016/j.remn.2017.03.010
       
  • Spinal epidural involvement in Erdheim-Chester disease: 18F-FDG PET/CT
           findings
    • Authors: A. Biyi; H. Ennouali; S.N. Oueriagli; S.E. Moussaoui; M. Rabhi; A. Doudouh
      Abstract: Publication date: Available online 11 June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A. Biyi, H. Ennouali, S.N. Oueriagli, S.E. Moussaoui, M. Rabhi, A. Doudouh


      PubDate: 2017-06-11T20:12:50Z
      DOI: 10.1016/j.remn.2017.03.007
       
  • Primary myoepithelial carcinoma of the lung and 18F-FDG PET/CT
    • Authors: Y. Zhang; B. Li; J. Hou; H. Shi
      Abstract: Publication date: Available online 10 June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): Y. Zhang, B. Li, J. Hou, H. Shi


      PubDate: 2017-06-11T20:12:50Z
      DOI: 10.1016/j.remn.2017.04.006
       
  • High-grade glioma mimicking limbic encephalitis on 18F-FDG PET/CT scan
    • Authors: J.P. Suárez; M. Coronado; M.L. Domínguez; L. Domínguez
      Abstract: Publication date: Available online 10 June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J.P. Suárez, M. Coronado, M.L. Domínguez, L. Domínguez


      PubDate: 2017-06-11T20:12:50Z
      DOI: 10.1016/j.remn.2017.04.007
       
  • Isolated hepatosplenic sarcoidosis: A pitfall for lymphoma evaluation by
           18F-FDG PET/CT
    • Authors: Dubreuil Leenhardt; Noel Salles P.J. Valette Skanjeti
      Abstract: Publication date: Available online 26 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J. Dubreuil, J. Leenhardt, R. Noel, G. Salles, P.J. Valette, A. Skanjeti


      PubDate: 2017-05-27T18:43:06Z
       
  • Fatty thymic involution uptake mimicking a thymic epithelial tumour in a
           18F-FDG PET/CT study
    • Authors: Chiappetta Rea; Facciolo
      Abstract: Publication date: Available online 26 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. Chiappetta, S. Rea, F. Facciolo


      PubDate: 2017-05-27T18:43:06Z
       
  • Multimodal approach in radioguided surgery in a case of multiple
           paraganglioma
    • Authors: Tapias Bowles; Delgado Almenara Fuster Vidal-Sicart
      Abstract: Publication date: Available online 26 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): N. Sánchez, A. Tapias, H. Bowles, E. Delgado, R. Almenara, D. Fuster, S. Vidal-Sicart
      The case involves a 34-year-old who underwent surgical removal of a retroperitoneal paraganglioma adjacent to the left kidney lower pole, and visualized by CT and MRI. The 123I-MIBG scan was positive for this lesion and, in addition, another more caudal uptake, of smaller size and intensity, was observed at L5 level. It was not considered for removal, due to its lack of morphological definition. One week after the surgery, the patient presented with difficult-to-control high blood pressure. A second 123I-MIBG scan was performed. The previously described second image was more intense, and surgery was planned to remove it. A combination of techniques including Freehand-SPECT and a portable hybrid gamma camera (with optical camera) were used pre-operatively to identify the location of the lesion. The combination of intra-operative laparoscopic gamma probe and portable hybrid gamma camera enabled the tumor to be located, excised, and its complete removal to be assessed. The histopathology analysis confirmed a second paraganglioma.

      PubDate: 2017-05-27T18:43:06Z
       
  • Coste-efectividad de la utilización de la tirotropina recombinante humana
           previa a la ablación con radioyodo en el tratamiento del cáncer de
           tiroides en hospitales españoles
    • Authors: J.A. Vallejo; M.A. Muros
      Abstract: Publication date: Available online 20 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J.A. Vallejo, M.A. Muros
      Objetivos Previo a la ablación con radioyodo en el tratamiento del cáncer de tiroides, se necesita aumentar los niveles de tirotropina (TSH) mediante estimulación exógena (con tirotropina humana recombinante [rhTSH]) o endógena, retirando la terapia con hormona tiroidea (THW). La utilización de rhTSH evita el hipotiroidismo y favorece la eliminación posterior de radioyodo pero supone un coste del producto. Por tanto, era necesario realizar un análisis de coste-efectividad que tuviera en cuenta todos los costes y los beneficios de la utilización de esta terapia. Material y métodos Mediante un modelo de Markov con 2 brazos de análisis (rhTSH y THW), estratificado en dosis altas (100mCi/3.700 MBq) y bajas (30mCi/1.110 MBq) de radioyodo, y utilizando 17 ciclos semanales se determinó el coste incremental por años de vida ajustados por calidad (AVAC) asociados a la utilización de rhTSH. Los parámetros clínicos incluidos en el modelo se basan en estudios publicados y en una encuesta realizada en España. Resultados La preparación con rhTSH para la radioablación es superior a la THW, presentando beneficios adicionales (0,048AVAC) a la vez que un ahorro en costes (–614,16€), con un ratio de coste-efectividad incremental (ICER) de –12.795€/AVAC. Los análisis de sensibilidad univariantes y multivariantes demuestran que el resultado es consistente. Conclusiones La utilización de rhTSH previa a la radioablación en España supone un ahorro de costes a la vez que una serie de beneficios de salud para el paciente, por lo que es altamente coste-efectiva. Objectives In thyroid cancer treatment, the thyroid-stimulating hormone (TSH) must be elevated before radioiodine ablation, either by exogenous (with recombinant human thyrotropin [rhTSH]) or endogenous stimulation by thyroid hormone withdrawal (THW). The use of rhTSH avoids hypothyroidism and favours the subsequent elimination of radioiodine, but involves the cost of the product. For this reason, a cost-effectiveness analysis was performed, taking into account all costs involved and the benefits associated with the use of this therapy. Material and methods Using a Markov modelling with two analysis arms (rhTSH and THW), stratified into high (100mCi/3700 MBq) and low (30mCi/1110 MBq) radioiodine doses, and using 17 weekly cycles, the incremental cost per quality-adjusted life-year (QALY) related to the use of rhTSH was determined. The clinical inputs included in the model were based on published studies and in a treatment survey conducted in Spain. Results Radioablation preparation with rhTSH is superior to THW, showing additional benefits (0.048 AVAC), as well as cost savings (–€614.16), with an incremental cost-effectiveness rate (ICER) of –€12,795/QALY. The univariate and multivariate sensitivity analyses showed the result to be robust. Conclusions The use of rhTSH previous to radioablation in Spain has cost savings, as well as a series of health benefits for the patient, making it highly cost-effective.

      PubDate: 2017-05-22T18:36:06Z
      DOI: 10.1016/j.remn.2017.04.005
       
  • Fibroelastic pseudotumour elastofibroma dorsi detected by 18F-FDG PET/CT
           and by posttherapy radioiodine SPECT/CT
    • Authors: M. Oporto; F. Cepa; N. Orta; S. Rubí; H. Navalón; C. Peña
      Abstract: Publication date: Available online 16 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. Oporto, F. Cepa, N. Orta, S. Rubí, H. Navalón, C. Peña
      Radioiodine uptake in the thyroid tissue, metastasis of differentiated thyroid cancer (DTC), and in other tissues, depends on the expression of sodium-iodide symporter (NIS). Vascular permeability, effusions, inflammation, and other mechanisms may also play a role in the accumulation of radioactive iodine. A 63-year-old woman underwent radioiodine therapy, as well as a post-therapy whole-body scan,as she was suspected of having lung metastasis from thyroid carcinoma. The scan not only showed uptake at the lung metastasis but also a faint diffuse bilateral uptake in the posterior thorax. On SPECT/CT this uptake was located in a known ElastofibromaDorsi (ED) previously diagnosed by contrast CT and viewed in a FDG PET/CT. The radioiodine uptake in ED, especially if typical, is not a diagnostic problem in SPECT/CT study, but can be misleading in a study limited to a few planar images, particularly if the uptake occurs asymmetrically, or ED is located in a unsuspected area.

      PubDate: 2017-05-17T18:29:20Z
      DOI: 10.1016/j.remn.2017.02.012
       
  • 18F-FDG PET/CT helps in unmasking the great mimicker: A case of
           neurosarcoidosis with isolated involvement of the spinal cord
    • Authors: A. Gholamrezanezhad; L. Mehta
      Abstract: Publication date: Available online 16 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A. Gholamrezanezhad, L. Mehta
      A 36 year-old male with no significant past medical history presented with lower extremity numbness, gait instability, and urinary and bowel retention of 4 weeks onset. Spine MRI revealed diffuse oedema of cervicothoracic spinal cord with several solid enhancing intramedullary lesions, suggestive of metastases. The 18F-FDG PET/CT performed to identify the primary malignancy demonstrated mild hypermetabolic foci within the cervicothoracic cord, as well as a mildly hypermetabolic bilateral hilar lymphadenopathy and a mildly hypermetabolic pulmonary nodule, suggestive of sarcoidosis versus metastasis. The diagnosis of sarcoidosis was supported by identifying non-caseating granuloma in the biopsy of the pulmonary nodule. The patient responded well to steroid-therapy, with the symptoms being resolved within 3 weeks.

      PubDate: 2017-05-17T18:29:20Z
      DOI: 10.1016/j.remn.2017.02.013
       
  • Inflammatory pseudotumour of the infratemporal fossa visualized with
           18F-FDG PET/CT
    • Authors: A. Cabrera Villegas; B. González Juez; J.L. Llorente Pendás; M.C. Albornoz Almada; P. Santos Holgueras; I.E. Sanchez Rodriguez
      Abstract: Publication date: Available online 9 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A. Cabrera Villegas, B. González Juez, J.L. Llorente Pendás, M.C. Albornoz Almada, P. Santos Holgueras, I.E. Sanchez Rodriguez
      The inflammatory pseudotumour of the head and neck is a benign lesion, extremely rare outside the cranial orbits. A case is presented of an inflammatory pseudotumour not associated with the IgG4-related disease. The pseudotumour was found as a solitary mass in the infratemporal fossa of a young woman who complained of otalgia and hearing loss. A clear image of the lesion was obtained using an 18F-fluoro-deoxy-glucose (18F-FDG) PET. After the histopathological diagnosis, and treatment with corticosteroids, a second 18F-FDG PET was performed. The metabolic image had returned to normal, and the previously observed mass disappeared. A brief review is presented of the studies examining this type of lesion.

      PubDate: 2017-05-12T18:21:25Z
      DOI: 10.1016/j.remn.2017.02.011
       
  • 18F-FDG PET/CT in the detection of a primary radiation-induced metastatic
           angiosarcoma
    • Authors: M. Cortés-Romera; A. Sabaté-Llobera; J. Robles-Barba; J.L. Vercher-Conejero; R. Mast-Vilaseca; C. Gámez-Cenzano
      Abstract: Publication date: Available online 9 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. Cortés-Romera, A. Sabaté-Llobera, J. Robles-Barba, J.L. Vercher-Conejero, R. Mast-Vilaseca, C. Gámez-Cenzano


      PubDate: 2017-05-12T18:21:25Z
      DOI: 10.1016/j.remn.2017.02.008
       
  • Optimización de los criterios metabólicos en la valoración pronóstica
           de los pacientes con linfoma. Estudio multicéntrico
    • Authors: M. del Puig Cózar-Santiago; J.R. García-Garzón; M. Moragas-Freixa; M. Soler-Peter; P. Bassa Massanas; M. Sánchez-Delgado; R. Sanchez-Jurado; J.E. Aguilar-Barrios; R. Sanz-Llorens; J. Ferrer-Rebolleda
      Abstract: Publication date: Available online 5 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. del Puig Cózar-Santiago, J.R. García-Garzón, M. Moragas-Freixa, M. Soler-Peter, P. Bassa Massanas, M. Sánchez-Delgado, R. Sanchez-Jurado, J.E. Aguilar-Barrios, R. Sanz-Llorens, J. Ferrer-Rebolleda
      Objetivo Comparar sensibilidad, especificidad y valor pronóstico de Deauville score (DS) versus ΔSUVmax, tanto en «interim» PET (iPET) como en «end» PET (ePET), en pacientes con linfoma difuso de células grandes B (LDCGB), linfoma de Hodgkin (LH), linfoma folicular (LF). Método Estudio multicéntrico retrospectivo longitudinal en 138 pacientes (46 LDCGB, 46 LH, 46 LF). Se realizaron 3 18F-FDG PET/TC: basal, iPET y ePET. En iPET y ePET se utilizaron 2 criterios de interpretación: visual (DS) y semicuantitativo (ΔSUVmax). Se estableció el valor pronóstico en relación con el intervalo libre de enfermedad. Resultados Análisis estadístico. Del iPET por subtipos histológicos (LDCGB, LH y LF): 1) DS obtuvo sensibilidad 76,92/83,33/61,53%; especificidad 78,78/85/81,81%, respectivamente; 2) ΔSUVmax obtuvo una sensibilidad del 53,84/83,33/61,53%; especificidad del 87,87/87,50/78,78%. Del ePET por subtipos histológicos: 1) DS obtuvo sensibilidad del 61,53/83,33/69,23%; especificidad del 90,90/85/87,87%; 2) ΔSUVmax obtuvo sensibilidad del 69,23/83,33/69,23%; especificidad del 90,90/87,5/84,84%. Evaluación pronóstica. Estudio iPET: en LDCGB el DS obtuvo que 10,3% con iPET negativo recidivó durante el intervalo libre de enfermedad y 17,1% con ΔSUVmax; en LH ambos métodos obtuvieron que 2,8% con iPET negativo recidivó; en LF el DS obtuvo que 15,6% con iPET negativo recidivó, con ΔSUVmax 16,1%, sin significación estadística para este método. Estudio ePET: en LDCGB el DS obtuvo que 14,3% con ePET negativo recidivó durante el intervalo libre de enfermedad, respecto al 11,8% con ΔSUVmax; en LH y LF ambos métodos obtuvieron que 2,8 y 12,5%, respectivamente, con ePET negativo recidivó. Conclusión DS y ΔSUVmax no muestran diferencias significativas en LDCGB, LH, LF. El valor pronóstico del DS y ΔSUVmax no muestra diferencias significativas en LH y LF; en LDCGB el DS es superior en iPET y el ΔSUVmax en ePET. Objective To compare sensitivity, specificity and predictive value of Deauville score (DS) vs. ΔSUVmax in interim-treatment PET (iPET) and end-treatment PET (ePET), in patients with diffuse large B cell lymphoma (DLBCL), Hodgkin lymphoma (HL), and follicular lymphoma (FL). Method Retrospective longitudinal multicentre study including 138 patients (46 DLBCL, 46 HL, 46 FL), on whom 3 18F-FDG PET/CT were performed: baseline, iPET, and ePET. Visual (DS) and semi-quantitative (ΔSUVmax) parameters were determined for iPET and ePET. Predictive value was determined in relation to disease-free interval. Results Statistical analysis. iPET for DLBCL, HL, and FL: 1) sensitivity of DS: 76.92/83.33/61.53%; specificity: 78.78/85/81.81%; 2) sensitivity of ΔSUVmax: 53.84/83.33/61.53%; specificity: 87.87/87.50/78.78%. ePET for DLBCL, HL and FL: 1) sensitivity of DS: 61.53/83.33/69.23%; specificity: 90.90/85/87.87%; 2) sensitivity of ΔSUVmax: 69.23/83.33/69.23%; specificity: 90.90/87.50/84.84%. Predictive assessment. iPET study: in DLBCL, DS resulted in 10.3% recurrence of negative iPET, and 17.1% in ΔSUVmax at disease-free interval; in HL, both parameters showed a 2.8% recurrence of negative iPET; in FL, DS resulted in 15.6% recurrence of negative iPET, and 16.1% in ΔSUVmax, with no statistical significance. ePET study: in DLBCL, DS resulted...
      PubDate: 2017-05-08T18:15:05Z
      DOI: 10.1016/j.remn.2017.03.003
       
  • Diagnosing neuroleukemiosis: Is there a role for 18F-FDG-PET/CT?
    • Authors: J.J.
      Abstract: Publication date: Available online 4 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A. Sabaté-Llobera, M. Cortés-Romera, E. Gamundí-Grimalt, J.J. Sánchez-Fernández, L. Rodríguez-Bel, C. Gámez-Cenzano
      An imaging case is presented on a patient referred to our department for an 18F-FDG-PET/CT, as a paraneoplastic syndrome was suspected due to his clinical situation. He had a history of acute myeloid leukemia (AML) treated two years earlier, with sustained complete remission to date. 18F-FDG-PET/CT findings revealed hypermetabolism in almost all nerve roots, suggesting meningeal spread, consistent with the subsequent MRI findings. Cerebrospinal fluid (CSF) findings confirmed a leptomeningeal reactivation of AML. Although not many studies have evaluated the role of 18F-FDG-PET/CT in leukemia, it is a noninvasive tool for detecting extramedullary sites of disease and a good imaging alternative for those patients on whom an MRI cannot be performed.

      PubDate: 2017-05-08T18:15:05Z
       
  • 131I-trazodone: preparation, quality control and in vivo biodistribution
           study by intranasal and intravenous routes as a hopeful brain imaging
           radiopharmaceutical
    • Authors: M.A. Motaleb; I.T. Ibrahim; M.E. Sayyed; G.A.S. Awad
      Abstract: Publication date: Available online 27 April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M.A. Motaleb, I.T. Ibrahim, M.E. Sayyed, G.A.S. Awad
      Objectives The preparation of 131I-trazodone hydrochloride and its biological evaluation as a promising brain imaging radiopharmaceutical using two routes of administration. Material and methods Trazodone (TZ) was radiolabelled with 131I using direct electrophilic substitution, and different factors affecting labelling yield were studied. Quality control of 131I-TZ was carried out using ascending paper chromatography, paper electrophoresis, and high pressure liquid chromatography (HPLC). In vivo biodistribution of 131I-TZ was evaluated in Swiss albino mice using 3 methods: intravenous 131I-TZ solution (IVS), intranasal 131I-TZ solution (INS), and intranasal 131I-TZ microemulsion (INME). Results Optimum labelling yield of 91.23±2.12% was obtained with in vitro stability of 131I-TZ up to 6h at room temperature. The biodistribution results showed a notably higher and sustained brain uptake for INME compared to IVS and INS at all time intervals. In addition, heart and blood uptake levels for INME were lower than those for IV solution which, in turn, could decrease the systemic side effects of trazodone. Also, the 131I-trazodone INME brain uptake of 6.7±0.5%ID/g was higher than that of 99mTc-ECD and 99mTc-HMPAO (radiopharmaceuticals currently used for brain imaging). Conclusion 131/123I-trazodone formulated as INME could be used as a promising radiopharmaceutical for brain imaging.

      PubDate: 2017-05-02T18:07:06Z
      DOI: 10.1016/j.remn.2017.03.001
       
  • Hyperparathyroidism-induced osterosclerosis mimicking diffuse
           osteo-medullary metastases on 18F-FDG-PET/CT: The role of the “rugger
           jersey” spine sign
    • Authors: A. Besson; N. Testart Dardel; G. Collet; H. Gauthier-Kolesnikov; M. Gauthé
      Abstract: Publication date: Available online 26 April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A. Besson, N. Testart Dardel, G. Collet, H. Gauthier-Kolesnikov, M. Gauthé


      PubDate: 2017-05-02T18:07:06Z
      DOI: 10.1016/j.remn.2017.03.002
       
  • 18F-FDG PET/CT in aggressive angiomyxoma of the pelvis
    • Authors: L. Gilardi; M. Vadrucci; A. Pittaro; E. Pennacchioli; S. Rizzo
      Abstract: Publication date: Available online 22 April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): L. Gilardi, M. Vadrucci, A. Pittaro, E. Pennacchioli, S. Rizzo


      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2017.03.005
       
  • Utilidad de la 18F-FDG PET/TC en el linfoma cerebral primario
    • Authors: Á. de-Bonilla-Damiá; R. Fernández-López; F.J. Capote-Huelva; F. de la Cruz-Vicente; J.J. Egea-Guerrero; I. Borrego-Dorado
      Abstract: Publication date: Available online 21 April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): Á. de-Bonilla-Damiá, R. Fernández-López, F.J. Capote-Huelva, F. de la Cruz-Vicente, J.J. Egea-Guerrero, I. Borrego-Dorado
      Objetivo Estudiar la utilidad de la 18F-FDG PET/TC en la evaluación inicial y valoración de la respuesta al tratamiento en el linfoma cerebral primario. Material y métodos Se analizaron retrospectivamente 18 pacientes diagnosticados de linfoma cerebral primario, subtipo histológico linfoma difuso de células grandes B, habiéndose realizado en todos ellos un estudio con 18F-FDG PET/TC y RM inicial y, en 7 casos, también tras la realización de tratamiento con el fin de valorar la respuesta. Resultados La 18F-FDG PET/TC inicial detectó un total de 26 depósitos hipermetabólicos frente a un total de 46 lesiones de la RM. La media del SUV máximo de las lesiones fue de 17,56 y del T/N, de 3,55. La concordancia de ambas pruebas para identificar el mismo número de lesiones fue moderada, obteniendo un índice kappa de 0,395 (p<0,001). En la valoración de la respuesta al tratamiento la RM identificó 16 lesiones frente a los 7 acúmulos patológicos de la 18F-FDG PET/TC. La concordancia de ambas pruebas para valorar el tipo de respuesta al tratamiento fue moderada (índice kappa 0,41) (p=0,04). Tanto en la evaluación inicial como en la valoración de la respuesta al tratamiento la PET/TC facilitó un cambio de estrategia en un 22% de los pacientes que presentaron lesiones fuera del parénquima cerebral. Conclusiones La RM parece ser la técnica de elección en la valoración de la enfermedad cerebral en pacientes con linfoma cerebral primario, mientras que la PET/TC ha demostrado tener un papel importante en la valoración de la enfermedad extracerebral. Objective To study the usefulness of 18F-FDG PET/CT in the initial evaluation and in the response assessment in primary brain lymphoma. Material and methods A retrospective analysis was carried out on 18 patients diagnosed with primary brain lymphoma, a histological subtype of diffuse large B-cell lymphoma, on whom an initial 18F-FDG PET/CT and MRI was performed, with 7 of the cases being analysed after the completion of treatment in order to assess response and clinical follow up. Results Initial 18F-FDG PET/CT showed 26 hypermetabolic foci, whereas 46 lesions were detected by MRI. The average SUV maximum of the lesions was 17.56 with T/N 3.55. The concordance of both tests for identifying the same number of lesions was moderate, obtaining a kappa index of 0.395 (P <.001). In the evaluation of treatment, MRI identified 16 lesions compared to 7 pathological accumulations observed by 18F-FDG PET/CT. The concordance of both tests to assess type of response to treatment was moderate (kappa index 0.41) (P =.04). In both the initial evaluation and the assessment of the response to treatment, PET/CT led to a change strategy in 22% of patients who had lesions outside the cerebral parenchyma. Conclusions MRI appears to be the method of choice for detecting brain disease in patients with primary br...
      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2017.03.006
       
  • Unusual isolated pelvic metastasis from a clear cell hepatocellular
           carcinoma demonstrated on 18F-FDG PET/CT after liver transplantation
    • Authors: R. Zhang; J. Tan; G. Zhang; R. Wang; Q. Jia
      Abstract: Publication date: Available online 20 April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): R. Zhang, J. Tan, G. Zhang, R. Wang, Q. Jia


      PubDate: 2017-04-26T17:57:03Z
      DOI: 10.1016/j.remn.2017.02.014
       
  • Enfermedad de Graves en un paciente de 3 años con agranulocitosis
           asociada a fármacos antitiroideos: terapia ablativa con radioyodo como
           una alternativa eficaz
    • Authors: E. Espinosa-Muñoz; D. Ramírez-Ocaña; A.M. Martín-García; F.J. Ruiz-García; C. Puentes-Zarzuela
      Abstract: Publication date: Available online 6 April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): E. Espinosa-Muñoz, D. Ramírez-Ocaña, A.M. Martín-García, F.J. Ruiz-García, C. Puentes-Zarzuela
      Se presenta el caso de una niña de 3 años pluripatológica, con una enfermedad genética mitocondrial (encefalomiopatía necrosante subaguda o síndrome de Leigh), insuficiencia renal crónica estadio v por una esclerosis mesangial difusa y alteraciones del desarrollo, que fue diagnosticada de hipertiroidismo autoinmune por enfermedad de Graves-Basedow. A las 6 semanas del inicio terapéutico con neocarbimazol, la paciente presentó un cuadro de agranulocitosis severa que obligó a suspender la medicación con fármacos antitiroideos, motivo por el cual fue tratada de manera eficaz con terapia metabólica con 131I. La relevancia del artículo radica en la infrecuencia de la enfermedad de Graves en niños prepuberales (especialmente menores de 6 años), las complicaciones en el desarrollo derivadas de un posible diagnóstico tardío, la aparición de agranulocitosis como efecto adverso potencialmente grave tras el uso de antitiroideos y los pocos casos reportados de terapia ablativa con 131I a esta edad, que otorgan singularidad al caso. The case is presented of a 3 year-old girl with mitochondrial disease (subacute necrotizing encephalomyelopathy of Leigh syndrome), v-stage chronic kidney disease of a diffuse mesangial sclerosis, as well as developmental disorders, and diagnosed with hyperthyroidism Graves-Basedow disease. Six weeks after starting the treatment with neo-carbimazole, the patient reported a serious case of agranulocytosis. This led to stopping the anti-thyroid drugs, and was treated successfully with 131I ablation therapy. The relevance of the article is that Graves’ disease is uncommon in the paediatric age range (especially in children younger than 6 years old), and developing complications due to a possible late diagnosis. Agranulocytosis as a potentially serious adverse effect following the use of anti-thyroid drugs, and the few reported cases of ablation therapy with 131I at this age, makes this case unique.

      PubDate: 2017-04-11T16:18:54Z
      DOI: 10.1016/j.remn.2016.12.005
       
  • Adenoma quístico paratiroideo: hiperparatiroidismo primario sin
           captación de 99mTc-MIBI
    • Authors: J.R. Oliver Guillén; L. de la Cueva Barrao; J.M. Miguelena Bobadilla; T. Giménez Maurel; E. Hernando Almudí; M.C. Casamayor Franco
      Abstract: Publication date: Available online 6 April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J.R. Oliver Guillén, L. de la Cueva Barrao, J.M. Miguelena Bobadilla, T. Giménez Maurel, E. Hernando Almudí, M.C. Casamayor Franco
      El adenoma quístico paratiroideo es una entidad poco frecuente (<0,01% de las masas cervicales) que cursa con hiperparatiroidismo primario en un 9% de los casos. La gammagrafía de paratiroides es fundamental para su diagnóstico y no es frecuente un resultado falso negativo. El uso de equipos híbridos SPECT/TC permite establecer un diagnóstico de localización más preciso. El tratamiento en casos funcionales es finalmente quirúrgico. Se presenta el caso de una mujer de 64 años diagnosticada de hiperparatiroidismo con adenoma quístico paratiroideo y gammagrafía negativa. Cystic parathyroid adenoma is a rare disease (<0.01% of all cervical masses) that associates primary hyperparathyroidism in 9% of cases. Parathyroid scintigraphy is essential for its diagnosis with uncommon false negative results. Hybrid SPECT/CT equipments allow a more accurate diagnosis. Functional cystic parathyroid adenomas are surgically treated. A case of a 64-year-old woman with diagnoses of hyperparathyroidism and a cystic parathyroid adenoma without uptake in scintigraphy is described.

      PubDate: 2017-04-11T16:18:54Z
      DOI: 10.1016/j.remn.2017.01.006
       
  • La PET/TC con 18F-Colina en la estadificación y recidiva bioquímica de
           pacientes con cáncer de próstata: cambios en la clasificación y
           planificación de radioterapia
    • Authors: J. Cardona Arboniés; B. Rodríguez Alfonso; J. Mucientes Rasilla; C. Martínez Ballesteros; I. Zapata Paz; A. Prieto Soriano; J. Carballido Rodriguez; M. Mitjavila Casanovas
      Abstract: Publication date: Available online 31 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J. Cardona Arboniés, B. Rodríguez Alfonso, J. Mucientes Rasilla, C. Martínez Ballesteros, I. Zapata Paz, A. Prieto Soriano, J. Carballido Rodriguez, M. Mitjavila Casanovas
      Objetivo Valorar la utilidad de la 18F-Colina PET/TC en la detección de enfermedad a distancia en la estadificación inicial de pacientes con cáncer de próstata de alto riesgo y en pacientes con recidiva bioquímica, con intención de planificación con radioterapia, así como valorar los cambios en el manejo terapéutico influenciados por los resultados de la misma. Material y métodos Se evaluaron de manera retrospectiva los estudios 18F-Colina PET/TC de pacientes con diagnóstico de adenocarcinoma de próstata, con indicación de estadificación inicial en pacientes de alto riesgo (o con sospecha de afectación a distancia) y/o planificación de radioterapia y en pacientes con recidiva bioquímica con intención de rescate con radioterapia con un seguimiento adecuado durante al menos 9 meses. Se seleccionaron un total de 56 estudios, 33 (58,93%) de estadificación y 23 (41,07%) de planificación de radioterapia. Para el estudio PET/TC se empleó un equipo multimodal PET/TC, la dosis empleada fue de 296-370MBq de 18F-Colina, con un protocolo de adquisición en 2 fases. Resultados Del total de los 56 estudios, 43 (76,8%) fueron considerados positivos (para enfermedad local, a distancia o ambas) y 13 (23,2%) negativos. En 13 estudios (23,2%) los hallazgos de la 18F-Colina PET/TC modificaron la clasificación NM. En 4 de los 13 estudios (30,7%) bajó la clasificación (descartando afectación a distancia sospechada por otras técnicas) y en 9 (69,3%) detectó enfermedad a distancia no conocida. Conclusiones La 18F-Colina PET/TC es una técnica útil en la estadificación, recurrencia bioquímica y planificación de radioterapia en el cáncer de próstata para localizar enfermedad a distancia no detectada con pruebas de imagen convencionales, por lo que deberían ampliarse sus indicaciones en las guías de manejo del mismo. Objective To evaluate the role of the 18F-Choline PET/CT in prostate cancer management when detecting distant disease in planning radiotherapy and staging and to evaluate the therapy changes guided by PET/TC results. Material and methods A retrospective evaluation was performed on 18F-Choline PET/CT scans of patients with prostate cancer. Staging and planning radiotherapy scans were selected in patients with at least 9 months follow up. There was a total of 56 studies, 33 (58.93%) for staging, and 23 (41.07%) for planning radiotherapy. All scans were obtained using a hybrid PET/CT scanner. The PET/CT acquisition protocol consisted of a dual-phase procedure after the administration of an intravenous injection of 296-370MBq of 18F-Choline. Results There were 43 out of 56 (76.8%) scans considered as positive, and 13 (23.2%) were negative. The TNM staging was changed in 13 (23.2%) scans. The PET/CT findings ruled out distant disease in 4 out of 13 scans, and unknown distant disease was detected in 9 (69.3%) scans. Conclusions
      PubDate: 2017-04-04T16:09:10Z
      DOI: 10.1016/j.remn.2017.02.007
       
  • A different scintigraphic approach to evaluate the glomerular filtration
           rate
    • Authors: T. Haciosmanoglu; A.O. Karacalioglu; T. Eyileten; S. Ince; N. Arslan
      Abstract: Publication date: Available online 29 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): T. Haciosmanoglu, A.O. Karacalioglu, T. Eyileten, S. Ince, N. Arslan
      Objective Multiple nuclear medicine techniques for measuring renal glomerular filtration rate (GFR) are available but some of them are not practical in daily routine use and others have some accuracy issues. Hence the aim of the study was to design a new camera-based approach to measure the GFR and to compare our results with other measured GFR (mGFR) and estimated GFRs (eGFRs) derived from available measurements and equations used in daily clinical practice. Material and methods 34 patients were included in the study. ∼74MBq (2mCi) Technetium 99m diethylene-triamine-pentaacetic acid (99mTc-DTPA) was administered to the patients during 5min. A simple formula based on a dilution principle was used to measure GFR (ScinGFR). Results Our formula provided similar mGFR results in narrower range as creatinine clearance did and our results correlated well with results derived from other equations. When ScinGFR values were compared to others, there was a significant difference among them (p =0.031) due to difference between the ScinGFR and Cockroft–Gault. When the results of the ScinGFR compared to others without Cockroft-Gault, the difference among them was not significant (p =0.164). Conclusion A simple formula considering the extracellular fluid volume was used to predict the split and global kidney functions and despite some discrepancies, good correlation among our results and those derived from available formulas was detected.

      PubDate: 2017-04-04T16:09:10Z
      DOI: 10.1016/j.remn.2017.01.015
       
  • Influencia de la cirugía mamaria previa en la biopsia selectiva del
           ganglio centinela en pacientes con cáncer de mama
    • Authors: Tormo
      Abstract: Publication date: Available online 27 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): V. López-Prior, R. Díaz-Expósito, I. Casáns Tormo
      Objetivo Revisar la aplicabilidad de la biopsia selectiva del ganglio centinela en pacientes con cáncer de mama y antecedente de cirugía mamaria previa, y examinar los factores que podrían influir en la detección del ganglio centinela. Material y métodos Revisamos retrospectivamente la biopsia selectiva del ganglio centinela en 91 pacientes con cáncer de mama dividiéndolas en 2 grupos según el antecedente quirúrgico de la mama: cirugía estética en 30 (grupo I) y conservadora en 61 (grupo II). Se realizó linfogammagrafía prequirúrgica tras inyección intratumoral en 21 casos y periareolar en 70. Se analizaron los patrones de drenaje linfático y la detección global del ganglio centinela según características clínicas, patológicas y quirúrgicas. Resultados La detección global del ganglio centinela en la linfogammagrafía fue del 92,3%, con un 7,7% de drenajes extraaxilares. La detección fue similar en el grupo I (93,3%) y grupo II (91,8%). En 2 pacientes (2,2%) detectamos ganglios centinelas en la axila contralateral, estando afectados en el estudio anatomopatológico. El porcentaje de no detección del ganglio centinela en la gammagrafía fue del 7,7%. Se encontró una proporción de no detección significativamente mayor en tumores con mayor grado histológico (28,6% grado III, 4,5% grado I y 3,6% grado II). Conclusión Se puede realizar la biopsia selectiva del ganglio centinela en pacientes con antecedente de cirugía mamaria previa, pero serían necesarios más estudios para valorar la influencia en la detección del ganglio centinela de diferentes aspectos en este escenario clínico. Un elevado grado histológico se relaciona significativamente con una menor detección. Aim The aim of this study was to review the feasibility of selective sentinel lymph node biopsy in patients with previous surgery for breast cancer, as well as to examine the factors that may interfere with sentinel node detection. Material and methods A retrospective review was performed on 91 patients with breast cancer and previous breast surgery, and who underwent sentinel lymph node biopsy. Patients were divided into two groups according to their previous treatment: aesthetic breast surgery in 30 patients (group I) and breast-conserving surgery in 61 (group II). Lymphoscintigraphy was performed after an intra-tumour injection in 21 cases and a peri-areolar injection in 70 cases. An analysis was made of lymphatic drainage patterns and overall sentinel node detection according to clinical, pathological and surgical variables. Results The overall detection of the sentinel lymph node in the lymphoscintigraphy was 92.3%, with 7.7% of extra-axillary drainages. The identification rate was similar after aesthetic breast surgery (93.3%) and breast-conserving surgery (91.8%). Sentinel lymph nodes were found in the contralateral axilla in two patients (2.2%), and they were included in the histopathology study. The non-identification rate in the lymphoscintigraphy was 7.7%. There was a significantly higher non-detection rate in the highest histological grade tumours (28.6% grade III, 4.5% grade I and 3.6% grade II).
      PubDate: 2017-04-04T16:09:10Z
       
  • Valoración de la extensión en partes blandas de las úlceras por
           presión y diagnóstico de osteomielitis mediante PET/TC con 18F-FDG
    • Authors: J.R. Garcia; M. Soler; P. Bassa; M. Minoves; E. Riera
      Abstract: Publication date: Available online 22 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J.R. Garcia, M. Soler, P. Bassa, M. Minoves, E. Riera
      La correcta valoración de la extensión de las úlceras de presión en los pacientes con enfermedad neurológica presenta implicaciones terapéuticas, en especial en la detección precoz de la fistulización hacia estructuras profundas y la osteomielitis. Presentamos aquí a dos pacientes con una úlcera isquiática similar y en los que la PET/TC con 18F-FDG permitió delimitar adecuadamente las complicaciones infecciosas profundas, por lo que se sugiere la necesidad de incluir esta técnica como primera línea diagnóstica. The precise assessment of pressure ulcer extension in patients with neurological diseases has crucial therapeutic implications, especially in the early detection of fistula to interior structures and osteomyelitis. Two case reports are presented on patients with a similar ischial ulcer, in whom an 18F-FDG PET/CT study enabled a precise assessment of infectious complications in underlying tissues. These cases support the implementation of 18F-FDG PET/CT as a first-line technique in their management.

      PubDate: 2017-03-27T15:56:58Z
      DOI: 10.1016/j.remn.2017.02.005
       
  • Utilidad de la técnica ROLL en la exéresis de lesiones no
           palpables de mama
    • Authors: D. Carrera; L. Martín; M. de la Flor; F. Guspí; J. Picas; V. Izquierdo; S. Martínez; C. Jordà; R. Siurana; M. Martínez-Casals; J.M. Jaén; A. Pujol; A. Benítez
      Abstract: Publication date: Available online 22 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): D. Carrera, L. Martín, M. de la Flor, F. Guspí, J. Picas, V. Izquierdo, S. Martínez, C. Jordà, R. Siurana, M. Martínez-Casals, J.M. Jaén, A. Pujol, A. Benítez
      Objetivo Evaluar la eficacia de la localización radioguiada de lesiones no palpables de mama (LNPM) respecto al arpón quirúrgico. Método Se han estudiado prospectivamente 161 mujeres con LNPM, 80 marcadas con arpón (grupo 1) y 81 con inyección intratumoral de 99mTc nanocoloide (grupo 2). Las lesiones se localizaron por ecografía o estereotaxia. Las tumorectomías se realizaron, en el grupo 1 siguiendo la dirección del arpón y en el grupo 2 con la ayuda de una sonda gammadetectora. Posteriormente se comprobaron los márgenes quirúrgicos, determinando la necesidad de ampliación si el margen era menor a 5mm en el estudio intraoperatorio y menor a 2mm en el estudio diferido. Se recogieron datos de porcentaje de detección quirúrgica, afectación de márgenes quirúrgicos, número de ampliaciones, presencia de lesión residual en la ampliación, número de reintervenciones, volumen de la tumorectomía y volumen total extraído, ratio volumen/tumor y complicaciones. Resultados No hubo diferencias significativas entre ambos grupos en porcentaje de detección, afectación de márgenes, número de ampliaciones, presencia de lesión residual en la ampliación, reintervenciones, volumen de la tumorectomía, volumen total extraído, ratio volumen/tumor y complicaciones. El análisis multivariante mostró que los factores condicionantes del volumen extraído son la técnica de marcaje radiológico y el cirujano. Conclusiones La técnica de localización radioguiada de lesiones ocultas permite la detección y exeresis de las LNPM con la misma eficacia que el arpón y añade la posibilidad de detección simultánea del ganglio centinela. Los condicionantes del volumen extraído son la técnica de marcaje radiológico y el cirujano. Objective To evaluate the efficiency of radioguided occult lesion localising in non-palpable breast lesions (NPBL) compared to the surgical wire technique. Method A prospective study was conducted on 161 women with NPBL, of whom 80 marked with the wire (group 1), whereas 81 women were marked with an intratumour injection of 99mTc-nanocoloid (group 2). The NPBL were located by ultrasound or stereotactic guidance. The lumpectomies were performed following the wire direction in group 1, and with the aid of a gamma-probe in group 2. Surgical margins were then checked, determining the need of extension if the margin was less than 5mm in the intra-surgical study, and less than 2mm in the deferred study. Data were collected on the mean number detected by surgery, surgical margins, number of extensions, presence of residual tumour in the extension, second surgeries, lumpectomy volume, as well as total resected volume, volume/tumour ratio, and complications. Results No significant differences were observed between the two groups in the mean number detected, surgical margins, number of extensions, presence of residual tumour in the extension, second surgeries, lumpectomy volume, total resected volume, volume/tumour ratio or complications. The multivariate analysis showed the determining factors of the resected volume were the radiological guidance technique, as well as the surgeon.
      PubDate: 2017-03-27T15:56:58Z
      DOI: 10.1016/j.remn.2017.02.004
       
  • Unexpected detection of non-palpable breast ductal invasive carcinoma with
           99mTc-HYNIC-TOC (Tektrotyd®)
    • Authors: S. Prado-Wohlwend; R. Sánchez-Vañó; P. Sopena-Novales; E. Uruburu-García; C. Martínez-Carsí
      Abstract: Publication date: Available online 18 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): S. Prado-Wohlwend, R. Sánchez-Vañó, P. Sopena-Novales, E. Uruburu-García, C. Martínez-Carsí


      PubDate: 2017-03-20T15:47:45Z
      DOI: 10.1016/j.remn.2017.02.006
       
  • Role of 18F-Choline PET/CT in guiding biopsy in patients with risen PSA
           levels and previous negative biopsy for prostate cancer
    • Authors: G.A. Jiménez Londoño; A.M. García Vicente; M. Amo-Salas; F. Fúnez Mayorga; M.A. López Guerrero; M.P. Talavera Rubio; P. Gutierrez Martin; B. González García; J.A. de la Torre Pérez; Á.M. Soriano Castrejón
      Abstract: Publication date: Available online 18 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): G.A. Jiménez Londoño, A.M. García Vicente, M. Amo-Salas, F. Fúnez Mayorga, M.A. López Guerrero, M.P. Talavera Rubio, P. Gutierrez Martin, B. González García, J.A. de la Torre Pérez, Á.M. Soriano Castrejón
      Objectives To study 18F-Choline PET/CT in the diagnosis and biopsy guide of prostate cancer (pCa) in patients with persistently high prostate-specific antigen (PSA) and previous negative prostate biopsy. To compare the clinical risk factors and metabolic variables as predictors of malignancy. Methods Patients with persistently elevated PSA in serum (total PSA >4ng/mL) and at least a previous negative or inconclusive biopsy were consecutively referred for a whole body 18F-Choline PET/CT. Patient age, PSA level, PSA doubling time (PSAdt) and PSA velocity (PSAvel) were obtained. PET images were visually (positive or negative) and semiquantitatively (SUVmax) reviewed. 18F-Choline uptake prostate patterns were defined as focal, multifocal, homogeneous or heterogeneous. Histology on biopsy using transrectal ultrasound-guided approach was the gold standard. Sensitivity (Se), specificity (Sp) and accuracy (Ac) of PET/CT for diagnosis of pCa were evaluated using per-patient and per-prostate lobe analysis. Receiver-operating-characteristic (ROC) curve analysis was used to assess the value of SUVmax to diagnose pCa. Correlation between PET/CT and biopsy results per-prostate lobe was assessed using the Chi-square test. Univariate and multivariate logistic regression analysis were applied to compare clinical risk factors and metabolic variables as predictors of malignancy. Results Thirty-six out of 43 patients with histologic confirmation were included. In 11 (30.5%) patients, pCa was diagnosed (Gleason score from 4 to 9). The mean values of patient age, PSA level, PSAdt and PSAvel were: 65.5 years, 15.6ng/ml, 28.1 months and 8.5ng/mL per year, respectively. Thirty-three patients had a positive PET/CT; 18 had a focal pattern, 7 multifocal, 4 homogeneous and 4 heterogeneous. Se, Sp and Ac of PET/CT were of 100%, 12% and 38% in the patient based analysis, and 87%, 29% and 14% in the prostate lobe based analysis, respectively. The ROC curve analysis of SUVmax showed an AUC of 0.568 (p =0.52). On a lobe analysis, poor agreement was observed between PET/CT findings and biopsy results (p =0.097). In the univariate/multivariate analysis, none of clinical and metabolic variables were statistically significant as predictor of pCa. Conclusion Choline PET/CT is a suitable procedure for the detection of pCa in highly selected patients, however, a high rate of false positive should be expected.

      PubDate: 2017-03-20T15:47:45Z
      DOI: 10.1016/j.remn.2017.01.014
       
  • Hibernoma intramuscular, falso positivo de recidiva tumoral en PET/TC con
           18F-FDG
    • Authors: C.M. Hernández Heredia; A. Seva Delgado; R.J. Ávila Martínez; P.C. Gálvez Diez; L.F. Villares
      Abstract: Publication date: Available online 18 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): C.M. Hernández Heredia, A. Seva Delgado, R.J. Ávila Martínez, P.C. Gálvez Diez, L.F. Villares


      PubDate: 2017-03-20T15:47:45Z
      DOI: 10.1016/j.remn.2017.02.001
       
  • La directiva ya está aquí. ¿Estamos preparados?
    • Authors: F.J. de Haro del Moral; R. Barquero
      Abstract: Publication date: Available online 18 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): F.J. de Haro del Moral, R. Barquero


      PubDate: 2017-03-20T15:47:45Z
      DOI: 10.1016/j.remn.2017.01.012
       
  • Acute pulmonary embolism detection with ventilation/perfusion SPECT
           combined with full dose CT: What is the best option?
    • Authors: M. Milà; J. Bechini; A. Vázquez; V. Vallejos; M. Tenesa; A. Espinal; M. Fraile; M. Monreal
      Abstract: Publication date: Available online 6 February 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. Milà, J. Bechini, A. Vázquez, V. Vallejos, M. Tenesa, A. Espinal, M. Fraile, M. Monreal
      Aim To compare diagnostic accuracy of Ventilation/Perfusion (V/P) single-photon emission computed tomography (SPECT) combined with simultaneous full-dose CT with a hybrid SPECT/CT scanner versus planar ventilation/perfusion (V/P) SPECT and CT angiography (CTA) in patients suspected with acute pulmonary embolism (PE). Methods Between 2009 and 2011, consecutive patients suspected of acute PE were referred for V/P SPECT/CT (reviewed board approved study). A contrast agent was administered to patients who had no contraindications. Non-contrast V/P SPECT/CT was performed on the remaining patients. All patients were followed-up for at least 3 months. Results A total of 314 patients were available during the study period, with the diagnosis of PE confirmed in 70 (22.29%) of them. The overall population sensitivity and specificity was 90.91% and 92.44%, respectively for V/P SPECT, 80% and 99.15%, respectively, for CTA, and 95.52% and 97.08% for V/P SPECT/CT. SPECT/CT performed better than V/P SPECT (AUC differences=0.0419, P =0.0043, 95% CI; 0.0131–0.0706) and CTA (AUC differences=0.0681, P =0.0208, 95% CI; 0.0103–0.1259)). Comparing imaging modalities when contrast agent could be administered, sensitivity and specificity increased and V/P SPECT/CT was significantly better than CTA (AUC differences=0.0681, P =0.0208, 95% CI; 0.0103–0.1259) and V/P SPECT (AUC differences=0.0659, P =0.0052, 95% CI; 0.0197–0.1121). In case of non-contrast enhancement, there was non-significant increase of specificity. Secondary findings on CT impacted patient management in 14.65% of cases. Conclusion Our study shows that combined V/P SPECT/CT scanning has a higher diagnostic accuracy for detecting acute PE than V/P SPECT and CTA alone. When feasible, V/P SPECT/CT with contrast enhancement is the best option.

      PubDate: 2017-02-10T14:37:16Z
      DOI: 10.1016/j.remn.2016.11.001
       
 
 
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