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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  [3043 journals]
  • Una etapa apasionante
    • Authors: J.A. Vallejo Casas
      Pages: 273 - 274
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      Author(s): J.A. Vallejo Casas


      PubDate: 2017-08-28T06:04:26Z
      DOI: 10.1016/j.remn.2017.07.007
       
  • A different scintigraphic approach to evaluate the glomerular filtration
           rate
    • Authors: T. Haciosmanoglu; A.O. Karacalioglu; T. Eyileten; S. Ince; N. Arslan
      Pages: 275 - 284
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      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: 2017-08-28T06:04:26Z
      DOI: 10.1016/j.remn.2017.01.015
       
  • 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
      Pages: 285 - 291
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      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: 2017-08-28T06:04:26Z
      DOI: 10.1016/j.remn.2017.02.004
       
  • 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
      Pages: 292 - 297
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      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: 2017-08-28T06:04:26Z
      DOI: 10.1016/j.remn.2017.02.007
       
  • 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
      Pages: 298 - 303
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      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 patien...
      PubDate: 2017-08-28T06:04:26Z
      DOI: 10.1016/j.remn.2017.03.006
       
  • 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
      Pages: 322 - 324
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      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: 2017-08-28T06:04:26Z
      DOI: 10.1016/j.remn.2017.02.005
       
  • Downstaging de carcinoma hepatocelular bilobar tras radioembolización con
           microesferas de 90Y como puente al trasplante hepático
    • Authors: L. Reguera-Berenguer; J. Orcajo-Rincón; A. Rotger-Regí; A.M. Matilla-Peña; M. Echenagusia-Boyra; R. Pérez-Pascual; A. Marí-Hualde; J.C. Alonso-Farto
      Pages: 329 - 332
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      Author(s): L. Reguera-Berenguer, J. Orcajo-Rincón, A. Rotger-Regí, A.M. Matilla-Peña, M. Echenagusia-Boyra, R. Pérez-Pascual, A. Marí-Hualde, J.C. Alonso-Farto
      La radioembolización hepática con 90Y es una terapia locorregional cada vez más ampliamente empleada en el tratamiento del carcinoma hepatocelular. Recientemente, se ha descrito su potencial beneficio como tratamiento de downstaging, logrando una disminución de la carga tumoral que permite rescatar a los pacientes para tratamientos más radicales como el trasplante hepático. Presentamos el caso de un paciente con el diagnóstico de carcinoma hepatocelular estadio intermedio de la Barcelona Clinic Liver Cancer (BCLC), multicéntrico y bilobar, en quien el tratamiento de radioembolización con 90Y consiguió una adecuada respuesta radiológica, reduciéndose de forma muy significativa la carga tumoral, permitiendo su rescate con trasplante hepático. Hepatic radioembolization with 90Y is an increasingly widely used locoregional therapy in the treatment of hepatocellular carcinoma. Its potential benefit has recently been described as a downstaging treatment, achieving a decreased tumour burden and allowing patients to be rescued for more radical treatments, such as liver transplantation. The case is presented of a patient diagnosed with multifocal bilobar hepatocellular carcinoma, Barcelona Clinic Liver Cancer (BCLC) intermediate stage, in whom treatment with 90Y achieved a satisfactory radiological response with a very significant reduction of tumour burden, allowing rescue with liver transplantation.

      PubDate: 2017-08-28T06:04:26Z
      DOI: 10.1016/j.remn.2016.12.006
       
  • Incidental meningioma detected by using 99mTc-MIBI SPECT/CT
    • Authors: D. Albano; L. Camoni; G. Bosio; F. Bertagna
      Pages: 333 - 334
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      Author(s): D. Albano, L. Camoni, G. Bosio, F. Bertagna


      PubDate: 2017-08-28T06:04:26Z
      DOI: 10.1016/j.remnie.2017.06.009
       
  • 64Cu-PSMA uptake in meningioma: A potential pitfall of a promising
           radiotracer
    • Authors: F. Calabria; V. Gangemi; D. Gullà; O. Schillaci; G.L. Cascini
      Pages: 335 - 336
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      Author(s): F. Calabria, V. Gangemi, D. Gullà, O. Schillaci, G.L. Cascini


      PubDate: 2017-08-28T06:04:26Z
      DOI: 10.1016/j.remnie.2017.01.001
       
  • 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
      Pages: 337 - 338
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      Author(s): C.M. Hernández Heredia, A. Seva Delgado, R.J. Ávila Martínez, P.C. Gálvez Diez, L.F. Villares


      PubDate: 2017-08-28T06:04:26Z
      DOI: 10.1016/j.remn.2017.02.001
       
  • Comparación de resultados cualitativos vs. cuantitativos de 99mTc-MDP
           SPECT en pacientes con sospecha clínica de hiperplasia condilar
    • Authors: D.F. López Buitrago; J. Ruiz Botero; C.M. Corral; A.R. Carmona; A. Sabogal
      Pages: 207 - 211
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): D.F. López Buitrago, J. Ruiz Botero, C.M. Corral, A.R. Carmona, A. Sabogal
      Objetivo Comparar el resultado de los informes cualitativos de la tomografía computarizada de emisión por fotón único (SPECT), con los resultados cuantitativos, calculados a partir del porcentaje de captación del radiofármaco 99mTc-MDP (metilendifosfonato), en cóndilos de pacientes con sospecha clínica de hiperplasia condilar. Materiales y método Estudio retrospectivo, descriptivo realizado en 51 pacientes con impresión clínica de asimetría facial y sospecha de hiperplasia condilar, remitidos a un centro de medicina nuclear para realizarles gammagrafía ósea-SPECT por el especialista en ortodoncia y/o cirugía maxilofacial. Se obtuvieron los datos cuantitativos del porcentaje de captación del radiofármaco 99mTc-MDP en ambos cóndilos, y se compararon con el informe cualitativo generado por el médico nuclear en cada uno de los sujetos. Resultados Se estableció la concordancia entre 51 informes cualitativos y sus resultados cuantitativos. Del total de la muestra, 32 eran mujeres (63%) y 19 hombres (37%). La edad de los pacientes estaba en un rango de 13-45 años (21±8 años). Según los informes cualitativos 19 pacientes fueron positivos para hiperplasia condilar derecha, 12 para izquierda, 8 bilaterales y 12 negativos. Según los resultados cuantitativos, 16 fueron positivos para hiperplasia condilar derecha, 10 izquierdos y 25 negativos. Conclusiones Las imágenes de medicina nuclear son una importante herramienta diagnóstica, pero la interpretación cualitativa de la imagen no es tan confiable como la determinación cuantitativa. Los informes cualitativos concuerdan con los resultados cuantitativos de la prueba SPECT 99mTc-MDP, en un bajo porcentaje (39,2%, kappa=0,13; p>0,2). La principal limitación del método cuantitativo es que no registra casos de hiperplasia condilar bilateral. Objective To compare qualitative vs quantitative results of Single Photon Emission Computerised Tomography (SPECT), calculated from percentage of 99mTc-MDP (methylene diphosphonate) uptake, in condyles of patients with a presumptive clinical diagnosis of condylar hyperplasia. Materials and method A retrospective, descriptive study was conducted on the 99mTc-MDP SPECT bone scintigraphy reports from 51 patients, with clinical impression of facial asymmetry related to condylar hyperplasia referred by their specialist in orthodontics or maxillofacial surgery, to a nuclear medicine department in order to take this type of test. Quantitative data from 99mTc-MDP condylar uptake of each were obtained and compared with qualitative image interpretation reported by a nuclear medicine expert. Results The concordances between the 51 qualitative and quantitative reports results was established. The total sample included 32 women (63%) and 19 men (37%). The patient age range was 13-45 years (21±8 years). According to qualitative reports, 19 patients were positive for right side condylar hyperplasia, 12 for left side condylar hyperplasia, with 8 bilateral, and 12 negative. The quantitative reports diagnosed 16 positives for right side condylar hyperplasia, 10 for left side condylar hyperplasia, and 25 negatives.
      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2017.01.003
       
  • Valor de la PET/TC cerebral con 18F-fluorocolina en la detección de
           recurrencias de neoplasias primarias del sistema nervioso central
    • Authors: A. Montes; A. Fernández; V. Camacho; C. de Quintana; O. Gallego; J. Craven-Bartle; D. López; J. Molet; B. Gómez-Ansón; I. Carrió
      Pages: 227 - 232
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): A. Montes, A. Fernández, V. Camacho, C. de Quintana, O. Gallego, J. Craven-Bartle, D. López, J. Molet, B. Gómez-Ansón, I. Carrió
      Objetivo Estudiar el impacto clínico en el manejo de los pacientes de la 18F-fluorocolina (18F-COL) en la recurrencia de neoplasias cerebrales primarias. Material y métodos Se estudió prospectivamente a 21 pacientes con sospecha de recidiva de neoplasia cerebral primaria mediante PET/TC cerebral con 18F-COL en uso compasivo. La distribución por patología de los pacientes estudiados fue: 3 astrocitomas grado ii, 3 astrocitomas grado iii, un oligodendroglioma grado ii, 3 oligodendrogliomas grado iii, un oligoastrocitoma grado iii, 4 glioblastomas multiformes, una gliomatosis cerebri y 5 meningiomas. Se consideraron positivos los estudios en los que había una captación visualmente significativa respecto al fondo del parénquima cerebral. Resultados Diecisiete de los pacientes fueron positivos, comprobándose dicho resultado por histología (10 de ellos) o seguimiento clínico y por neuroimagen, sin hallarse falsos positivos o negativos. El índice target to backgroud ratio medio para los positivos fue de 8,02 y para los negativos de 0,94, lo que representa una diferencia significativa (p=0,003). Conclusión La PET/TC con 18F-COL presenta resultados alentadores en la valoración de pacientes con sospecha de recidiva. Aim To study the usefulness of 18F-fluorocholine (FCH) in detecting the recurrence of primary brain tumours. Material and methods A prospective study was conducted on brain PET/CT with FCH for compassionate use in 21 patients with suspected recurrence of a primary brain tumour. The distribution by pathology was: three grade ii astrocytomas, three grade iii astrocytomas, one grade ii oligodendroglioma, three grade iii oligodendrogliomas, one grade iii oligoastrocytoma, four glioblastoma multiform, one gliomatosis cerebri, and five meningiomas. Studies in which there was a visually significant uptake in the brain parenchyma were classified as positive. Results A total of 17 patients were classified as positive, with the results being confirmed by histology (10 cases) or clinical follow-up and imaging, with no false positives or negatives. The mean SUVmax for positive patients was 8.02 and 0.94 for the negative ones, which was significantly different (P=.003) Conclusion PET/CT with FCH shows encouraging results in the evaluation of patients with suspected recurrence of primary brain neoplasms.

      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2016.11.005
       
  • PET/TC con 18F-FDG como predictor de la biología tumoral y del
           pronóstico en el cáncer epitelial ovárico
    • Authors: B. González García; A.M. García Vicente; G.A. Jiménez Londoño; F.J. Pena Pardo; M.E. Bellón Guardia; M.P. Talavera Rubio; A. Palomar Muñoz; P. Gómez Herrero; Á.M. Soriano Castrejón
      Pages: 233 - 240
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): B. González García, A.M. García Vicente, G.A. Jiménez Londoño, F.J. Pena Pardo, M.E. Bellón Guardia, M.P. Talavera Rubio, A. Palomar Muñoz, P. Gómez Herrero, Á.M. Soriano Castrejón
      Objetivo Investigar la relación del valor máximo estandarizado de captación (SUVmáx) de la lesión ovárica con el subtipo histopatológico (I/II) y su implicación en la respuesta al tratamiento y en el pronóstico de las pacientes con carcinoma epitelial de ovario (CEO). Material y métodos Análisis retrospectivo de 31 pacientes con CEO y 18F-FDG-PET/TC previo al tratamiento, determinándose el SUVmáx de la lesión ovárica y realizándose diagnóstico histopatológico del tumor y seguimiento clínico-radiológico. Se estudió la relación del SUVmáx con el tipo histológico (tipos I y II) y el estadio tumoral, así como la implicación de este y otros parámetros (histología, estadio) en la evolución de las pacientes (respuesta completa [RC], supervivencia global [SG], supervivencia libre de enfermedad [SLE], estado libre de enfermedad a los 12 meses [LE12m] y a los 24 meses [LE24m]). Resultados El SUVmáx medio en lesiones tipo I fue menor que en las tipo II (6,3 y 9,3, respectivamente; p=0,03). Se obtuvo un valor de corte de SUVmáx de 7,1 en la identificación del CEO tipo II (sensibilidad: 77,8%; especificidad: 69,2%; AUC=0,748; p=0,02). No se halló relación significativa entre SUVmáx y estadio tumoral. Alcanzar RC fue más frecuente en estadios precoces; riesgo relativo (RR) de 1,64; p=0,003, en tumores tipo I y en los de menor SUVmáx. El estadio tumoral fue determinante en la SLE (p=0,04), en el LE24m (p=0,07) y en la SG (p=0,08). Observamos SLE más prolongadas y mayor porcentaje de pacientes LE24m en tumores tipo I (RR: 1,32; p=0,26). Conclusiones El SUVmáx se relacionó con el tipo histológico del CEO. No se encontró relación entre la actividad glucolítica del tumor primario con la respuesta y el pronóstico. Objective To investigate the relationship between maximum standardised uptake value (SUVmax) of ovarian lesions and histopathology subtypes, and their involvement in the response and prognosis of patients with epithelial ovarian carcinoma (EOC). Material and methods A retrospective analysis of 31 patients with EOC and 18F-FDG-PET/CT before treatment, including an assessment of the SUVmax of ovarian lesion. Histopathological diagnosis and follow-up was performed. A study was made on the relationship between the SUVmax and histological type (type I and II) and tumour stage, as well as the role of various parameters (SUVmax, histology, stage) on the patient outcomes (complete response [CR], overall survival [OS], disease-free survival [DFS], and disease-free [DF] status, at 12 and 24 months). Results
      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2017.01.004
       
  • Assessment of cardiovascular impairment in obese patients: Limitations and
           troubleshooting of available imaging tools
    • Authors: V. Gaudieri; C. Nappi; W. Acampa; R. Assante; E. Zampella; M. Magliulo; M. Petretta; A. Cuocolo
      Pages: 247 - 253
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): V. Gaudieri, C. Nappi, W. Acampa, R. Assante, E. Zampella, M. Magliulo, M. Petretta, A. Cuocolo
      The prevalence and severity of obesity have increased over recent decades, reaching worldwide epidemics. Obesity is associated to coronary artery disease and other risk factors, including hypertension, heart failure and atrial fibrillation, which are all increased in the setting of obesity. Several noninvasive cardiac imaging modalities, such as echocardiography, cardiac computed tomography, magnetic resonance and cardiac gated single-photon emission computed tomography, are available in assessing coronary artery disease and myocardial dysfunction. Yet, in patients with excess adiposity the diagnostic accuracy of these techniques may be limited due to some issues. In this review, we analyze challenges and possibilities to find the optimal cardiac imaging approach to obese population.

      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2017.01.010
       
  • Carcinoma epidermoide primario de tiroides. Valoración inicial y control
           evolutivo mediante 18F-FDG PET/TC
    • Authors: L. Caballero Gullón; E. Carmona González; A. Martínez Estévez; M.P. Gómez Camarero; J.J. Corral; I. Borrego Dorado
      Pages: 257 - 259
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): L. Caballero Gullón, E. Carmona González, A. Martínez Estévez, M.P. Gómez Camarero, J.J. Corral, I. Borrego Dorado
      El carcinoma epidermoide primario de tiroides es una neoplasia muy poco frecuente, con comportamiento agresivo, de mal pronóstico, con pobre respuesta al tratamiento quimioterápico y radioterápico, y cuyo tratamiento de elección es la cirugía. Suele presentarse al diagnóstico como enfermedad extendida, como una tumefacción cervical que causa la mayoría de sus síntomas por invasión o metástasis locales. Su diagnóstico requiere excluir infiltración desde un tumor adyacente, afectación metastásica a distancia desde otro carcinoma epidermoide primario y realizar estudio inmunohistoquímico, el cual refleje el patrón característico de expresión de citoqueratinas. Presentamos el caso de un paciente de 53 años con antecedentes oncológicos de hepatocarcinoma, en el que durante el seguimiento se detecta una lesión cervical, caracterizada como hipermetabólica al realizar el estudio de extensión mediante tomografía por emisión de positrones con 18F-FDG (18F-FDG PET/TC). También presentamos el control evolutivo de dicha lesión mediante esta técnica y la utilidad de esta última. Squamous cell carcinoma of thyroid is an uncommon, very aggressive neoplasm, having a poor prognosis and poor response to chemotherapy and radiotherapy. Surgery is the initial treatment of choice, although it often presents as a widespread disease at the time of diagnosis, usually with cervical swelling that causes most of the symptoms due to local infiltration or metastasis. Local infiltration from adjacent tumour and metastatic disease needs to be excluded from other primary epidermoid carcinomas, in order to make a correct diagnosis. This also requires the typical cytokeratin pattern seen in histological studies. The case is presented of a 53 year-old man with a medical history of hepatocarcinoma, with a cervical hypermetabolic lesion detected in an 18F-FDG PET/CT performed to exclude widespread disease. The follow-up of this lesion with this technique and its usefulness is also described.

      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2017.01.001
       
  • Gammagrafía hepatobiliar con 99mTc-mebrofenina en una paciente con
           fístula bilio-pleuro-bronquial
    • Authors: V. Marín-Oyaga; K. Cohen-Castillo; C. Gutierrez-Villamil; S. Arevalo-Leal
      Pages: 263 - 264
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): V. Marín-Oyaga, K. Cohen-Castillo, C. Gutierrez-Villamil, S. Arevalo-Leal


      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2016.12.002
       
  • Pericardial metastases due to terminal ileum primary carcinoid tumour
           detected on 111In scintigraphy
    • Authors: D.R. Ocaña; E.E. Muñoz; J.R. García; C.P. Zarzuela
      Pages: 265 - 266
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): D.R. Ocaña, E.E. Muñoz, J.R. García, C.P. Zarzuela


      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2016.12.003
       
  • Incidental finding of 131I uptake in mesenteric cystic lymphangioma on
           post-therapy 131I SPECT/CT imaging
    • Authors: G. Shao; Y. Zhao; J. Song; S. Li
      Pages: 267 - 268
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): G. Shao, Y. Zhao, J. Song, S. Li


      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2017.01.002
       
  • 18F-FDG-PET/CT guiding to diagnosis of neurosarcoidosis
    • Authors: P. Guglielmo; C. Crivellaro; L. Marzorati; M. Patassini; S. Morzenti; C. Landoni
      Pages: 269 - 270
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): P. Guglielmo, C. Crivellaro, L. Marzorati, M. Patassini, S. Morzenti, C. Landoni


      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2016.12.001
       
  • Detección de metástasis extracraneal de glioblastoma multiforme mediante
           PET/TC cerebral con 11C-metionina
    • Authors: J.R. Garcia; C. Corbella; M. Baquero; P. Bassa; M. Soler
      Pages: 271 - 272
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): J.R. Garcia, C. Corbella, M. Baquero, P. Bassa, M. Soler


      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2016.08.004
       
  • Nueva etapa para la REMNIM
    • Authors: Pons
      Abstract: Publication date: Available online 6 October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): F. Pons


      PubDate: 2017-10-09T15:50:08Z
       
  • La PET/TC con 68Ga-PSMA en el cáncer de próstata
    • Authors: J.R. García Garzón; M. de Arcocha Torres; R. Delgado-Bolton; F. Ceci; S. Alvarez Ruiz; J. Orcajo Rincón; A.P. Caresia Aróztegui; M.J. García Velloso; A.M. García Vicente
      Abstract: Publication date: Available online 21 September 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J.R. García Garzón, M. de Arcocha Torres, R. Delgado-Bolton, F. Ceci, S. Alvarez Ruiz, J. Orcajo Rincón, A.P. Caresia Aróztegui, M.J. García Velloso, A.M. García Vicente
      La tomografía por emisión de positrones/tomografía computarizada (PET/TC) con 68Ga-PSMA es una técnica de imagen no invasiva para el estudio del cáncer de próstata con incremento de la expresión del antígeno prostático específico de membrana (prostate-specific membrane antigen, PSMA). El PSMA es una proteína transmembrana presente en todos los tejidos prostáticos. El incremento de la expresión de PSMA está presente en varios tumores, aunque su concentración es más elevada en el cáncer de próstata. Casi todos los adenocarcinomas de próstata muestran expresión de PSMA en la mayoría de las lesiones, tanto primarias como metastásicas. Estudios inmunohistoquímicos han demostrado que la expresión de PSMA está incrementada en pacientes con tumores desdiferenciados, metastásicos u hormonorrefractarios. Más aún, el nivel de expresión del PSMA tiene un valor pronóstico para la evolución de la enfermedad. La tomografía por emisión de positrones proporciona una medida de la distribución tridimensional del 68Ga-PSMA, obteniendo imágenes semicuantitativas que permiten valorar de forma no invasiva la expresión de PSMA. Positron emission tomography/computed tomography (PET/CT) with 68Ga-PSMA is a non-invasive diagnostic technique to image prostate cancer with increased prostate-specific membrane antigen (PSMA) expression. PSMA is a transmembrane protein present in all prostatic tissues. Increased PSMA expression is seen in several malignancies, although prostate cancer is the tumour where it presents higher concentrations. Almost all prostate adenocarcinomas show PSMA expression in most of lesions, primary and metastatic. Immunohistochemistry has demonstrated that the expression of PSMA increases in patients with de-differentiated, metastatic or hormone-refractory tumours. Moreover, the expression level of PSMA has a prognostic value for disease outcome. PET measures the three-dimensional distribution of 68Ga-PSMA, producing semi-quantitative images that allow for non-invasive assessment of PSMA expression.

      PubDate: 2017-09-24T06:41:38Z
      DOI: 10.1016/j.remn.2017.07.004
       
  • Isolated osteomyelitis of the humerus diagnosed with 18F-FDG PET/CT
    • Authors: T.K. Jain; A.G.A. Jois; R.K. Basher; S.S. Dhatt; A. Bhattacharya; B.R. Mittal
      Abstract: Publication date: Available online 18 September 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): T.K. Jain, A.G.A. Jois, R.K. Basher, S.S. Dhatt, A. Bhattacharya, B.R. Mittal


      PubDate: 2017-09-24T06:41:38Z
      DOI: 10.1016/j.remn.2017.02.009
       
  • Actualización de la biopsia del ganglio centinela tras quimioterapia
           neoadyuvante en el cáncer de mama sin y con afectación ganglionar al
           diagnóstico
    • Authors: R. Ruano Pérez; A.C. Rebollo Aguirre; P. García-Talavera San Miguel; R. Díaz Expósito; S. Vidal-Sicart; J.M. Cordero García; D. Carrera Salazar; M.E. Rioja Martín
      Abstract: Publication date: Available online 30 August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): R. Ruano Pérez, A.C. Rebollo Aguirre, P. García-Talavera San Miguel, R. Díaz Expósito, S. Vidal-Sicart, J.M. Cordero García, D. Carrera Salazar, M.E. Rioja Martín
      Esta actualización pretende contextualizar la relevancia de la biopsia selectiva del ganglio centinela (BSGC) en mujeres con cáncer de mama e indicación de quimioterapia neoadyuvante (QTN). El Grupo de Trabajo de Cirugía Radioguiada de la SEMNIM es consciente de la variabilidad existente en nuestro país sobre todo en cuanto al momento de realizar la técnica (previa o tras la QTN) y en cuanto al manejo de pacientes con axila negativa o positiva al diagnóstico. Existe suficiente experiencia contrastada para aseverar que mediante técnicas radioisotópicas la BSGC es factible, eficaz y segura en estos escenarios. Una adecuada valoración mediante técnicas de imagen de la situación tumoral a nivel de la axila previa a la cirugía y la posibilidad del marcaje previo a la QTN de cualquier ganglio infiltrado deben ser los pilares fundamentales para garantizar el éxito de la BSGC. Es un hecho que incorporar la BSGC en el cáncer de mama con indicación de QTN favorece un tratamiento conservador de la axila, lo cual redunda en claro beneficio de las pacientes. The role of the selective sentinel node biopsy (SNB) is increasing in relevance in breast cancer women with indication of neoadjuvant chemotherapy (NAC). The Radiosurgery Working Group of the SEMNIM is aware of the necessity of establishing the need for SNB before or after NAC, and also how to manage patients with axillary node-negative or node-positive. There is sufficient data to assess that the SNB with radioisotope techniques are feasible and safe in all these scenarios. An adequate axilla evaluation prior to surgery and the possibility of marking prior to NAC the nodes infiltrated must be the two main pillars to guarantee the success of the SNB. It has been shown that to incorporate the SNB in breast cancer women with indication of NAC increases the rate of a conservative treatment of the axilla that will be a clear benefit for these patients.

      PubDate: 2017-09-06T06:17:09Z
      DOI: 10.1016/j.remn.2017.06.007
       
  • Correlation of 18F-FDG uptake on PET/CT with Ki67 immunohistochemistry in
           pre-treatment epithelial ovarian cancer
    • Authors: M. Mayoral; P. Paredes; A. Saco; P. Fusté; P. Perlaza; A. Tapias; A. Fernandez-Martinez; L. Vidal; J. Ordi; J. Pavia; S. Martinez-Roman; F. Lomeña
      Abstract: Publication date: Available online 30 August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. Mayoral, P. Paredes, A. Saco, P. Fusté, P. Perlaza, A. Tapias, A. Fernandez-Martinez, L. Vidal, J. Ordi, J. Pavia, S. Martinez-Roman, F. Lomeña
      Objective Standardized uptake value (SUV) and volumetric parameters such as metabolic tumour volume (MTV) and total lesion glycolysis (TLG) from 18F-FDG PET/CT are useful criteria for disease prognosis in pre-operative and post-treatment epithelial ovarian cancer (EOC). Ki67 is another prognostic biomarker in EOC, associated with tumour aggressiveness. The aim of this study is to evaluate the association between 18F-FDG PET/CT measurements and Ki67 in pre-treatment EOC to determine if PET/CT parameters could non-invasively predict tumour aggressiveness. Material and methods A pre-treatment PET/CT was performed on 18 patients with suspected or newly diagnosed EOC. Maximum SUV (SUVmax), mean SUV (SUVmean), whole-body MTV (wbMTV), and whole-body TLG (wbTLG) with a threshold of 30% and 40% of the SUVmax were obtained. Furthermore, Ki67 index (mean and hotspot) was estimated in tumour tissue specimens. Immunohistochemical findings were correlated with PET parameters. Results The mean age was 57.0 years old (standard deviation 13.6 years). A moderate correlation was observed between mean Ki67 index and SUVmax (r =0.392), SUVmean 30% (r =0.437), and SUVmean 40% (r =0.443), and also between hotspot Ki67 index and SUVmax (r =0.360), SUVmean 30% (r =0.362) and SUVmean 40% (r =0.319). There was a weaker correlation, which was inversely negative, between mean and hotspot Ki67 and volumetric PET parameters. However, no statistical significant differences were found for any correlations. Conclusions SUVmax and SUVmean were moderately correlated with Ki67 index, whereas volumetric PET parameters overall showed a weaker correlation. Thus, SUVmax and SUVmean could be used to assess tumour aggressiveness in pre-treatment EOC.

      PubDate: 2017-09-06T06:17:09Z
      DOI: 10.1016/j.remn.2017.07.005
       
  • Infección de bypass axilo-bifemoral diagnosticada con 18F-FDG PET/TC
    • Authors: N. Carrión Fernández; A. Moreno Bonillo
      Abstract: Publication date: Available online 30 August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): N. Carrión Fernández, A. Moreno Bonillo


      PubDate: 2017-09-06T06:17:09Z
      DOI: 10.1016/j.remn.2017.07.001
       
  • 11C-PIB retention patterns in white and grey cerebral matter in idiopathic
           normal pressure hydrocephalus patients. A visual analysis
    • Authors: J.F. Jiménez-Bonilla; R. Quirce; M. De Arcocha-Torres; I. Martínez-Rodríguez; N. Martínez-Amador; P. Sánchez-Juan; A. Pozueta; R. Martín-Láez; I. Banzo; E. Rodríguez-Rodríguez
      Abstract: Publication date: Available online 30 August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J.F. Jiménez-Bonilla, R. Quirce, M. De Arcocha-Torres, I. Martínez-Rodríguez, N. Martínez-Amador, P. Sánchez-Juan, A. Pozueta, R. Martín-Láez, I. Banzo, E. Rodríguez-Rodríguez
      Objective Cortical cerebral amyloid disease, a hallmark of Alzheimer's disease, has also been observed in idiopathic normal pressure hydrocephalus (iNPH). The aim of this study was to compare the 11C-PIB PET/CT retention pattern in iNPH patients and healthy subjects. Material and methods A comparison was made of the 11C-PIB PET/CT retention pattern in 13 iNPH patients selected for surgical deviation, compared to a normal control population. Images were visually analyzed and scored for gray matter and white matter (WM) from 1 to 4 (slight to very high PIB retention). The scoring was analyzed in both groups separately for infra- and supra-tentorial regions. A comprehensive clinical report was presented in terms of positive, negative, or equivocal. Results 11C-PIB PET/CT scan were reported as negative in 8, positive in 3, and equivocal in 2. Five of 13 patients showed at least one cortical area with PIB retention with an intensity higher than that observed in the control group. Overall, white matter (WM) PIB retention of iNPH scored lower than in the control group, showing a statistically significant difference in the infratentorial WM (92/104 vs 54/56; P <0.05) and a tendency to be lower in the supratentorial regions (70/84 vs 122/156, P =0.327), in particular in the upper periventricular region (25/28 vs 40/52; P =0.134). Conclusions The PIB retention pattern seems to be different in NPH, compared to normal subjects. PIB retention in WM of NPH appears less intense than in healthy subjects, and they show a higher degree of PIB retention in cortical regions. This deserves to be taken it into account.

      PubDate: 2017-09-06T06:17:09Z
      DOI: 10.1016/j.remn.2017.07.006
       
  • 18F-FDG PET/CT in initial staging and treatment response evaluation in a
           patient with thymoma
    • Authors: T.F.
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      Author(s): L. Uslu-Beşli, Y. Akın, T.F. Çermik


      PubDate: 2017-08-28T06:04:26Z
       
  • Optic nerve glioblastoma detected by 11C-Methionine brain PET/CT
    • Authors: V. Rizzo; M.V. Mattoli; G. Trevisi; A. Coli; M.L. Calcagni; N. Montano
      Abstract: Publication date: Available online 10 August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): V. Rizzo, M.V. Mattoli, G. Trevisi, A. Coli, M.L. Calcagni, N. Montano


      PubDate: 2017-08-17T05:49:47Z
      DOI: 10.1016/j.remn.2017.06.006
       
  • Hybrid whole body 18F-FDG PET/MR in evaluation of plexiform
           neurofibromatosis type 1
    • Authors: M. Yang; Y. Zhou; J.M. Hoxworth; A.B. Porter; M.C. Roarke
      Abstract: Publication date: Available online 10 August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. Yang, Y. Zhou, J.M. Hoxworth, A.B. Porter, M.C. Roarke


      PubDate: 2017-08-17T05:49:47Z
      DOI: 10.1016/j.remn.2017.07.003
       
  • Incidental pituitary adenoma detected by 18F-FDG PET/CT and 18F-choline
           PET/CT in the same patient
    • Authors: D. Albano; G. Bosio; F. Bertagna
      Abstract: Publication date: Available online 8 August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): D. Albano, G. Bosio, F. Bertagna


      PubDate: 2017-08-17T05:49:47Z
      DOI: 10.1016/j.remn.2017.07.002
       
  • Captación de yoduro sódico 131I en un teratoma ovárico
    • Authors: M. Oporto; N. Orta; F. Cepa; M. Pons; M. Cabrer; C. Peña
      Abstract: Publication date: Available online 8 August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. Oporto, N. Orta, F. Cepa, M. Pons, M. Cabrer, C. Peña


      PubDate: 2017-08-17T05:49:47Z
      DOI: 10.1016/j.remn.2017.06.005
       
  • From interventionist imaging to intraoperative guidance: New perspectives
           by combining advanced tools and navigation with radio-guided surgery
    • Authors: S. Vidal-Sicart; R. Valdés Olmos; O.E. Nieweg; R. Faccini; M.R. Grootendorst; H.J. Wester; N. Navab; B. Vojnovic; H. van der Poel; S. Martínez-Román; J. Klode; F. Wawroschek; F.W.B. van Leeuwen
      Abstract: Publication date: Available online 3 August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): S. Vidal-Sicart, R. Valdés Olmos, O.E. Nieweg, R. Faccini, M.R. Grootendorst, H.J. Wester, N. Navab, B. Vojnovic, H. van der Poel, S. Martínez-Román, J. Klode, F. Wawroschek, F.W.B. van Leeuwen
      The integration of medical imaging technologies into diagnostic and therapeutic approaches can provide a preoperative insight into both anatomical (e.g. using computed tomography (CT), magnetic resonance (MR) imaging, or ultrasound (US)), as well as functional aspects (e.g. using single photon emission computed tomography (SPECT), positron emission tomography (PET), lymphoscintigraphy, or optical imaging). Moreover, some imaging modalities are also used in an interventional setting (e.g. CT, US, gamma or optical imaging) where they provide the surgeon with real-time information during the procedure. Various tools and approaches for image-guided navigation in cancer surgery are becoming feasible today. With the development of new tracers and portable imaging devices, these advances will reinforce the role of interventional molecular imaging.

      PubDate: 2017-08-06T05:35:20Z
      DOI: 10.1016/j.remn.2017.06.004
       
  • Estratificación de riesgo de enfermedad coronaria con métodos
           isotópicos. Estado actual de la práctica clínica
    • Authors: T. Massardo; L. Alarcón; J. Spuler
      Abstract: Publication date: Available online 25 July 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): T. Massardo, L. Alarcón, J. Spuler
      Se discute el uso actual de los radioisótopos para la evaluación de la enfermedad coronaria con relación a otras técnicas disponibles. La revisión se centra en la estratificación de riesgo de enfermedad coronaria mediante tomografía de fotón único y de doble fotón, y su la aplicación en viabilidad miocárdica y miocardiopatía isquémica. Se presentan conceptos sobre flujo absoluto y reserva de flujo coronario, valor diagnóstico y pronóstico, así como criterios de uso apropiados de las pruebas y también los métodos actuales para disminuir la radiación innecesaria de los pacientes, optimizando la práctica de la cardiología nuclear. A discussion is presented on the current use of radioisotopes for evaluation of coronary artery disease in relation to other available techniques. The review is focused on coronary artery disease risk stratification employing single photon emission computed tomography and positron emission tomography, as well as on ischaemic cardiomyopathy and myocardial viability applications. Concepts are presented regarding coronary blood flow reserve, diagnostic and prognostic values, criteria for its appropriate use, as well as current methods to reduce unnecessary patient irradiation, in order to optimise nuclear cardiology practice.

      PubDate: 2017-07-28T04:50:06Z
      DOI: 10.1016/j.remn.2017.06.001
       
  • Value of post-therapy 177Lu PSMA images for accurate interpretation of
           therapy response with 68Ga-PSMA PET/CT
    • Authors: M. Tuncel; T. Telli
      Abstract: Publication date: Available online 24 July 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. Tuncel, T. Telli
      A 54-year-old man with progressive prostate cancer underwent a 68Ga-PSMA-PET/CT, which showed lymph node and bone metastases. After 2-cycles of 177Lu-PSMA therapy, the repeated 68Ga-PSMA PET/CT showed decreased radiotracer uptake in lymph node and bones metastases, but there were new lesions which may be compatible with progression or tumour sink-effect. A review of 177Lu-PSMA-therapy images revealed that new lesions in the second PET/CT were the metastatic lesions that progressed after the first PET/CT, and subsequently showed a good response. The patient received additional cycles of 177Lu-PSMA therapy, and the disease regressed further, with a PSA of 0.06ng/mL. Response evaluation of new therapeutic diagnostics (theranostic) agents needs a review of not only diagnostic PET/CT images, but also post-therapy images and laboratory results.

      PubDate: 2017-07-28T04:50:06Z
      DOI: 10.1016/j.remn.2017.05.004
       
  • Hallazgo incidental de captación focal del colon en estudios 18F-FDG
           PET/TC
    • Authors: L. Servente; V. Gigirey; M. García Fontes; O. Alonso
      Abstract: Publication date: Available online 24 July 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): L. Servente, V. Gigirey, M. García Fontes, O. Alonso
      Objetivos Evaluar la frecuencia de la captación focal de colon como observación incidental en estudios 18F-FDG PET/TC. Correlacionar dicho hallazgo con resultados histopatológicos. Material y métodos Se analizaron de forma sistemática 30 estudios en los que se constató captación focal del colon de un total de 3.176 PET/TC con 18F-FDG. Se excluyeron pacientes con neoplasia colorrectal conocida. Se consignó el valor del SUV máximo (SUVm) y el hallazgo morfológico de la TC. Los estudios fueron informados por un médico radiólogo y un médico nuclear. Los hallazgos fueron correlacionados con la endoscopia y la anatomía patológica. Resultados De los 30 pacientes con lesiones focales hipermetabólicas del colon (0,94%), 15 eran hombres y 15 mujeres con edades comprendidas entre los 27 y 73 años (media 55 años). Los motivos de realización de la PET/TC fueron: cáncer broncopulmonar (4), cáncer de mama (4), tumor de origen desconocido (4), melanoma (3), carcinoma renal (3), neoplasia de cuello uterino (2), adenocarcinoma de ovario (2) y otros (8). Se realizaron 23 fibrocolonoscopias (FCC): 10 pacientes (43,4%) presentaron lesiones malignas, 6 pacientes (26,1%) lesiones premalignas y en 7 pacientes (30,4%) no se identificó ninguna lesión o esta fue benigna. En 7 pacientes no se hizo endoscopia por diversos motivos (rechazo del paciente para realizar el estudio, enfermedad oncológica avanzada). Se correlacionó con valores de SUVm y no se encontraron diferencias estadísticamente significativas entre lesiones malignas-premalignas y las lesiones benignas. Conclusiones La captación focal en colon de 18F-FDG tiene relevancia clínica sobre todo asociada a lesión morfológica en TC, puede tratarse de un segundo tumor o una lesión premaligna. Se recomienda que todas las captaciones focales del colon sean valoradas con endoscopia, tengan o no alteraciones en TC. Objectives To assess the frequency of focal colonic uptake as an incidental observation in 18F-FDG PET/CT studies, and to correlate this finding with histopathological results. Material and methods Out of a total of 3,176 PET/CT studies with 18F-FDG systematic analysis was carried out on 30 studies in which colonic focal uptake was observed. Patients with known colorectal neoplasia were excluded. The maximum standardised uptake values (SUVm) and the morphological findings provided by the CT were recorded. The studies were reported by a radiologist and a nuclear medicine doctor. The findings were compared with endoscopy and pathology findings. Results Of the 30 patients with focal hypermetabolic lesions of the colon (0.94%), 15 were men and 15 were women with ages between 27 and 73 (mean 55 years). The reasons for PET/CT were bronchopulmonary cancer (4), breast cancer (4), tumour of unknown origin (4), melanoma (3), renal carcinoma (3), cervical neoplasia (2), adenocarcinoma of ovary (2), and others (8). Of the 23 colonoscopies performed, 10 patients (43.4%) had malignant lesions, 6 (26.1%) had pre-malignant lesions, and in 7 patients (30.4%) no lesion was identified or was benign. No endoscopy was performed on 7 patients for various reasons (patient refusal to perform the study, advanced oncological disease). An analysis was performed with the SUVm, with no statistically significant differences being found between malignant-premalignant lesions and benign lesions.
      PubDate: 2017-07-28T04:50:06Z
      DOI: 10.1016/j.remn.2017.03.012
       
  • Can metabolic tumour parameters on primary staging 18F-FDG-PET/CT
           contribute to risk stratification of primary central nervous system
           lymphomas for patient management as a prognostic model'
    • Authors: K. Okuyucu; E. Alagoz; S. Ince; S. Ozaydin; N. Arslan
      Abstract: Publication date: Available online 18 July 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): K. Okuyucu, E. Alagoz, S. Ince, S. Ozaydin, N. Arslan
      Objective Primary central nervous system (CNS) lymphoma is an aggressive and fatal extranodal non-Hodgkin lymphoma (NHL) jailed in CNS at initial diagnosis. Its prognosis is poor and the disease has a fatal outcome when compared with systemic NHL. A few baseline risk stratification scoring systems have been suggested to estimate the prognosis mainly based on serum lactate dehydrogenase (LDH) level, age, Karnofsky performance score (KPS), involvement of deep brain structures (DBS) and cerebrospinal fluid protein concentration. 18F-FDG-PET/CT has a high prognostic value with respect to overall survival (OS) and disease-free survival (DFS) in many cancers and lymphomas. We aimed to investigate metabolic tumour indexes on primary staging 18F-FDG-PET/CT as prognostic markers in primary CNS lymphoma. Material and methods 14 patients with primary CNS diffuse large B-cell lymphoma (stage I) were enrolled in this retrospective cohort study. Primary staging 18F-FDG-PET/CT was performed and quantitative parameters like maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) were calculated for all patients before the treatment. Cox regression models were performed to determine their relation with survival time. Results In the evaluation of all potential risk factors impacting recurrence/metastases (age, sex, serum LDH, involvement of DBS, SUVmax, SUVmean, MTV, TLG) with univariate analysis, TLG remained statistically significant (p =0.02). Conclusion Metabolic tumour parameters are useful in prognosis estimation of primary CNS lymphomas, especially TLG, which is the most important one and may play a role in patient management.

      PubDate: 2017-07-22T04:38:58Z
      DOI: 10.1016/j.remn.2017.06.003
       
  • A unusual pediatric case of focal nodular hyperplasia studied with
           99mTc-mebrofenin
    • Authors: Mª.V. Guiote Moreno; L.Mª. Mena Bares; A.M. Santos Bueno; E. Rodríguez Cáceres; J.A. Vallejo Casas
      Abstract: Publication date: Available online 18 July 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): Mª.V. Guiote Moreno, L.Mª. Mena Bares, A.M. Santos Bueno, E. Rodríguez Cáceres, J.A. Vallejo Casas


      PubDate: 2017-07-22T04:38:58Z
      DOI: 10.1016/j.remn.2017.05.005
       
  • “Miner's cap-like” solitary frontal bone metastasis from rectal
           adenocarcinoma on 18F-FDG PET/CT
    • Authors: I. Banzo; I. Martínez-Rodríguez; N. Martínez-Amador; M. Jiménez-Alonso; R. Quirce; J. Jiménez-Bonilla
      Abstract: Publication date: Available online 17 July 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): I. Banzo, I. Martínez-Rodríguez, N. Martínez-Amador, M. Jiménez-Alonso, R. Quirce, J. Jiménez-Bonilla


      PubDate: 2017-07-22T04:38:58Z
      DOI: 10.1016/j.remn.2017.06.002
       
  • Balance
    • Authors: J.C. Alonso; Farto
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): J.C. Alonso Farto


      PubDate: 2017-07-01T21:53:02Z
       
  • 18F-FDG PET/CT in a cardiac metastasis in a patient with history of
           malignant neuroectodermal tumour of the chest wall: Case report and review
           of the literature
    • Authors: J.A. Marroquín; A.C. Hernández; J.P. Pilkington; A. Saviatto; M.J. Tabuenca; J.M. Estenoz
      Abstract: Publication date: Available online 23 June 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J.A. Marroquín, A.C. Hernández, J.P. Pilkington, A. Saviatto, M.J. Tabuenca, J.M. Estenoz
      The case presented is a 25-year-old male with a malignant neuroectodermal tumour on the left chest wall (Askin tumour), treated with surgery after neoadyuvant chemotherapy and followed by consolidation chemotherapy. After 9 years of disease free survival, the patient developed an acute pulmonary embolism. The echocardiogram, thoracic CT, and cardiac MRI scans revealed a mass in the right atrium. Recurrence of an Askin tumour versus an atrium myxoma was suspected. 18F-FDG PET/CT showed an intense hypermetabolic right atrium mass with extension to the right ventricle highly suggestive of malignancy. The result of the histopathology examination after biopsy and subsequently exeresis of the right atrium mass was consistent with a metastasis of the primary tumour.

      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2017.04.008
       
  • 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
       
  • 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
       
  • 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
       
  • 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
       
  • 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
       
 
 
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