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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]
  • 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
       
  • Nuevos tiempos para la neuroimagen de Medicina Nuclear en España: ¿de
           dónde partimos'
    • Authors: M.A. Balsa; V. Camacho; P. Garrastachu; D. García-Solís; M. Gómez-Río; S. Rubí; X. Setoain; J. Arbizu
      Pages: 219 - 226
      Abstract: Publication date: July–August 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 4
      Author(s): M.A. Balsa, V. Camacho, P. Garrastachu, D. García-Solís, M. Gómez-Río, S. Rubí, X. Setoain, J. Arbizu
      Objetivo conocer la situación de los estudios de neuroimagen de Medicina Nuclear que se realizaron en España en el año 2013 y primer trimestre del 2014, con el fin de definir las actividades del grupo de trabajo de Neuroimagen de la Sociedad Española de Medicina Nuclear e Imagen Molecular (SEMNIM). Material y métodos Se diseñó un cuestionario de 14 preguntas dividido en 3 partes: características de los servicios (equipamiento y profesionales involucrados), tipo de exploraciones e indicaciones clínicas y métodos de evaluación. El cuestionario se remitió a los 166 servicios de Medicina Nuclear que figuraban en la secretaría de la Sociedad Española de Medicina Nuclear e Imagen Molecular. Resultados Respondieron a la encuesta un total de 54 centros distribuidos entre todas las comunidades autónomas. La mayoría de los centros realizaron entre 300 y 800 exploraciones de neuroimagen al año, representando más de 25 exploraciones al mes. La media de equipos por servicio era de 3, teniendo la mitad de ellos equipos PET/TC y SPECT/TC. Las exploraciones realizadas con más frecuencia son la SPECT cerebral con 123I-FP-CIT, seguida de la SPECT cerebral de perfusión y de la PET con 18F-FDG, siendo las indicaciones clínicas más frecuentes los estudios de deterioro cognitivo seguidos por los de trastornos del movimiento. Para la evaluación de las pruebas la mayoría de los centros utilizaron únicamente la valoración visual, en la valoración cuantitativa la cuantificación por regiones de interés fue la más utilizada. Conclusiones Los resultados reflejan cuál fue la actividad clínica del año 2013 y primer trimestre del 2014, siendo las indicaciones principales los estudios de deterioro cognitivo y trastorno del movimiento. La variabilidad en la evaluación de los estudios PET y la colaboración con los especialistas clínicos que demandan las exploraciones de neuroimagen de Medicina Nuclear son algunos de los retos que debemos afrontar en los próximos años. Objective To determine the status of neuroimaging studies of Nuclear Medicine in Spain during 2013 and first quarter of 2014, in order to define the activities of the neuroimaging group of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). Material and methods A questionnaire of 14 questions was designed, divided into 3 parts: characteristics of the departments (equipment and professionals involved); type of scans and clinical indications; and evaluation methods. The questionnaire was sent to 166 Nuclear Medicine departments. Results A total of 54 departments distributed among all regions completed the questionnaire. Most departments performed between 300 and 800 neuroimaging examinations per year, representing more than 25 scans per month. The average pieces of equipment were three; half of the departments had a PET/CT scanner and SPECT/CT equipment. Scans performed more frequently were brain SPECT with 123I-FP-CIT, followed by brain perfusion SPECT and PET with 18F-FDG. The most frequent clinical indications were cognitive impairment followed by movement disorders. For evaluation of the images most sites used only visual assessment, and for the quantitative assessment the most used was quantification by region of interest.
      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2016.12.004
       
  • 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
       
  • 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
       
  • 18F-FDG PET/CT in lung cancer. The added value of quantification
    • Authors: P. Lapa; M. Marques; J. Isidoro; F. Barata; G. Costa; J.P. de Lima
      Abstract: Publication date: Available online 27 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): P. Lapa, M. Marques, J. Isidoro, F. Barata, G. Costa, J.P. de Lima
      Objective To test a software application for the quantification of metabolic heterogeneity and to evaluate its superiority in relation to visual interpretation. To investigate if a quantitative analysis adds information to the interpretation of 18F-FDG-PET/CT. Material and methods The study analyzed 215 patients with a 18F-FDG-PET/CT done for the initial staging of lung cancer between March 2011 and December 2015. The study included 57 (26.5%) women and 158 (73.5%) men, with ages ranging from 34 to 88 years (mean±SD: 67.23±10.04). There were 82 surgical stages (I, II, IIIA), and 133 non-surgical stages (IIIB, IV). The primary tumour was analyzed quantitatively by obtaining the following parameters: SUVmax, metabolic active tumour volume (MATV), total lesion glycolysis (TLG), and the entropy heterogeneity index (ET). Heterogeneity was assessed visually. Death dates and/or the follow-up time were registered, ranging from 0.70 to 67.60 months (mean±SD: 23.20±17.68). Results In multivariate analysis, ET emerged as a better predictor of survival than visual analysis of heterogeneity that was not statistically significant. The C-index determination demonstrated that all quantitative parameters were statistically-significant predictors of survival. Cut-offs were obtained in order to compare survival times. A multivariate analysis was performed. In the total population, the best predictor was the TNM stage, but MATV, ET, and male gender were statistically significant and independent predictors of survival. In stages without surgical indication, the best predictor was the TNM stage, but the MATV and male gender were statistically significant and independent predictors of survival. In the surgical stages, ET was the only statistically significant and independent predictor of survival. Conclusions Quantification adds prognostic information to the visual analysis of 18F-FDG-PET/CT.

      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2017.04.001
       
  • Is the prognosis of occult N2 disease similar to that of positive positron
           emission tomography-computed tomography (PET/CT) scan single-station N2
           disease in patients with non-small cell lung cancer treated by surgical
           resection'
    • Authors: A.F.H. Martínez; M.D.G. Jiménez; A.G. Vicente; M.G. Crespo; C.R.R. Ortega; M.L. Sahuquillo; Á.M.S. Castrejón; P.L. Atance
      Abstract: Publication date: Available online 26 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A.F.H. Martínez, M.D.G. Jiménez, A.G. Vicente, M.G. Crespo, C.R.R. Ortega, M.L. Sahuquillo, Á.M.S. Castrejón, P.L. Atance
      Objective A retrospective study, using a prospective database, was conducted on patients treated with surgery in order to analyze the prognosis between two groups: NSCLC (non-small cell lung cancer) patients with occult N2 disease and patients with single station N2 disease observed on pre-operative integrated PET/CT scan. Methods A total of 772 patients underwent surgical treatment for lung cancer from January 2007 to December 2014. All of them had an integrated PET/CT scan in the pre-operative work-up and a pulmonary resection plus mediastinal lymphadenectomy were performed in all cases. In the selected cases, no one received induction treatment. All patients from both groups had N2 disease after examination of the histopathology specimen. Clinical and pathological characteristics, disease free survival, and overall survival, were analyzed in both groups. Results A total of 34 cases presented occult N2 disease, whereas 11 cases showed single station N2 disease on pre-operative PET/CT scan. Mean disease free survival and mean overall survival for occult N2 disease compared to single-station N2 disease on PET/CT scan was 36.0 months (95% CI: 24.9–47.1) and 38.9 months (95% CI: 20.6–57.1), p =.586; and 52.3 months (95% CI: 38.9–65.7) and 38.2 months (95% CI: 21.9–54.5), p =.349, respectively. Conclusion The prognosis of patients with single-station N2 disease on PET/CT scan treated by surgical resection and mediastinal lymphadenectomy as first line treatment was similar to those with occult N2 disease. More studies are needed to support our findings.

      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2017.03.011
       
  • 18F-FDG PET/TC en el manejo clínico de los linfomas
    • Authors: P. Tamayo; A. Martín; L. Díaz; M. Cabrero; R. García; P. García-Talavera; D. Caballero
      Abstract: Publication date: Available online 5 May 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): P. Tamayo, A. Martín, L. Díaz, M. Cabrero, R. García, P. García-Talavera, D. Caballero
      El objetivo de la presente revisión es actualizar las recomendaciones sobre el papel de la tomografía por emisión de positrones (PET)/tomografía computarizada (TC) en la estadificación y valoración de la respuesta tras quimioterapia y/o trasplante de progenitores hematopoyéticos en pacientes con linfoma de Hodgkin (LH) y linfoma no-Hodgkin (LNH) en la práctica clínica habitual. En la primera reunión internacional sobre PET en linfoma, celebrada en 2009 en Deauville (Francia), se estableció una escala de 5 puntos para la valoración de la respuesta en pacientes con linfoma mediante la 18F-Fluordeoxiglucosa (FDG) PET/TC. Posteriormente, tras celebrarse la 11.a y 12.a Conferencia Internacional sobre Linfomas en Lugano (Suiza) en 2011 y 2013, respectivamente, se alcanzó un acuerdo en cuanto al uso de la PET/TC para la estadificación y se revisaron los criterios de respuesta en linfoma ávidos por la FDG en la práctica clínica y en ensayos clínicos; son los denominados criterios de valoración de respuesta de Lugano. Los principales consensos alcanzados fueron: i) la PET/TC con 18F-FDG fue formalmente incorporada en la estadificación de los linfomas con avidez por la FDG; ii) la biopsia de médula ósea ya no está indicada en la estadificación rutinaria de pacientes con LH y en la mayoría de los pacientes con linfoma B difuso de células grandes (LBDCG), y iii) la valoración de respuesta al tratamiento se hará mediante la PET/TC usando la escala de 5 puntos y la clasificación de Lugano. Actualmente, con la introducción de terapias basadas en agentes biológicos con mecanismos inmunes, los criterios de Lugano para valoración de la respuesta requieren una flexibilización y modificación, debido a que estos agentes pueden producir cambios en las técnicas de imagen que sugieren progresión de la enfermedad, a pesar de una respuesta clínica evidente (pseudoprogresión o tumor flare). Ello ha llevado a la adopción provisional de los criterios LYRIC (LYmphoma Response to Inmunomodulatory Therapy Criteria), con la introducción del término «respuesta indeterminada» para definir estos cambios hasta que sean confirmados o descartados como progresión de la enfermedad. El uso generalizado de todas estas recomendaciones mejorará la evaluación de pacientes con linfoma y hará posible la comparación de resultados procedentes de ensayos clínicos. The aim of this work was to review the current recommendations for staging and response assessment of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) in routine clinical practice after chemotherapy and/or stem cell transplantation. A five-point scale (5-PS) from the First International Workshop on PET in Lymphoma in Deauville, France, in 2009, was recommended as the standard tool to score imaging to assess treatment response in patients with lymphoma using 18F-Fluorodeoxyglucose (FDG) PET/CT. Following the recommendations of the 11th and 12th International Conferences on Malignant Lymphoma held in Lugano (Switzerland), in 2011 and 2013, respectively, a consensus (the so-called Lugano Classification) was reached regarding the use of PET/CT for staging and response assessment in FDG-avid lymphomas. As a result, 18F-FDG PET/CT was formally incorporated into standard staging for FDG-avid lymphomas. A bone marrow biopsy is no longer indicated for the routine staging of HL and most diffuse large B-cell lymphomas. PET/CT will be used to assess response in FDG-avid histologies using the 5-point scale. The recent introduction of biological agents with immune mechanisms requires flexibility in interpretations of the Lugano criteria due to tumour flare or a pseudo-progression effect produced by these agents. Provisional criteria have been proposed (Lymphoma Response to Immunomodulatory Therapy Criteria) with the introduction of the term ‘Indeterminate Response’ in order to identify this phenomenon until confirmed as flare/pseudoprogression or true progression. All these recommendations will improve evaluations of patients with lymphoma, and allow comparison of results from clinical practice and trials.

      PubDate: 2017-07-01T21:53:02Z
      DOI: 10.1016/j.remn.2017.03.004
       
  • 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
       
  • 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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