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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  [3089 journals]
  • 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
      Pages: 342 - 349
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      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: 2017-11-19T02:13:39Z
      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
    • Authors: A.F. Honguero Martínez; M.D. García Jiménez; A. García Vicente; M. Genovés Crespo; C.R. Rodríguez Ortega; M. Lázaro Sahuquillo; Á.M. Soriano Castrejón; P. León Atance
      Pages: 350 - 355
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      Author(s): A.F. Honguero Martínez, M.D. García Jiménez, A. García Vicente, M. Genovés Crespo, C.R. Rodríguez Ortega, M. Lázaro Sahuquillo, Á.M. Soriano Castrejón, P. León 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: 2017-11-19T02:13:39Z
      DOI: 10.1016/j.remn.2017.03.011
  • 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
      Pages: 356 - 361
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      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 ge...
      PubDate: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2017.03.010
  • 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
      Pages: 362 - 370
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      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: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2017.04.005
  • 131I-trazodone: preparation, quality control and in vivo biodistribution
           study by intranasal and intravenous routes as a hopeful brain imaging
    • Authors: M.A. Motaleb; I.T. Ibrahim; M.E. Sayyed; G.A.S. Awad
      Pages: 371 - 376
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      Author(s): M.A. Motaleb, I.T. Ibrahim, M.E. Sayyed, G.A.S. Awad
      Objectives The preparation of 131I-trazodone hydrochloride and its biological evaluation as a promising brain imaging radiopharmaceutical using two routes of administration. Material and methods Trazodone (TZ) was radiolabelled with 131I using direct electrophilic substitution, and different factors affecting labelling yield were studied. Quality control of 131I-TZ was carried out using ascending paper chromatography, paper electrophoresis, and high pressure liquid chromatography (HPLC). In vivo biodistribution of 131I-TZ was evaluated in Swiss albino mice using 3 methods: intravenous 131I-TZ solution (IVS), intranasal 131I-TZ solution (INS), and intranasal 131I-TZ microemulsion (INME). Results Optimum labelling yield of 91.23±2.12% was obtained with in vitro stability of 131I-TZ up to 6h at room temperature. The biodistribution results showed a notably higher and sustained brain uptake for INME compared to IVS and INS at all time intervals. In addition, heart and blood uptake levels for INME were lower than those for IV solution which, in turn, could decrease the systemic side effects of trazodone. Also, the 131I-trazodone INME brain uptake of 6.7±0.5%ID/g was higher than that of 99mTc-ECD and 99mTc-HMPAO (radiopharmaceuticals currently used for brain imaging). Conclusion 131/123I-trazodone formulated as INME could be used as a promising radiopharmaceutical for brain imaging.

      PubDate: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2017.03.001
  • 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
      Pages: 388 - 391
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      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: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2017.05.001
  • 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
      Pages: 392 - 395
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      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: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2017.02.011
  • Isolated hepatosplenic sarcoidosis: A pitfall for lymphoma evaluation by
           18F-FDG PET/CT
    • Authors: J. Dubreuil; J. Leenhardt; R. Noel; G. Salles; P.J. Valette; A. Skanjeti
      Pages: 399 - 400
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      Author(s): J. Dubreuil, J. Leenhardt, R. Noel, G. Salles, P.J. Valette, A. Skanjeti

      PubDate: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2017.04.003
  • Fatty thymic involution uptake mimicking a thymic epithelial tumour in a
           18F-FDG PET/CT study
    • Authors: M. Chiappetta; S. Rea; F. Facciolo
      Pages: 401 - 402
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      Author(s): M. Chiappetta, S. Rea, F. Facciolo

      PubDate: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2017.03.009
  • 18F-FDG PET/CT in aggressive angiomyxoma of the pelvis
    • Authors: L. Gilardi; M. Vadrucci; A. Pittaro; E. Pennacchioli; S. Rizzo
      Pages: 403 - 405
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      Author(s): L. Gilardi, M. Vadrucci, A. Pittaro, E. Pennacchioli, S. Rizzo

      PubDate: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remnie.2017.09.012
  • 18F-FDG PET/CT in the detection of a primary radiation-induced metastatic
    • Authors: M. Cortés-Romera; A. Sabaté-Llobera; J. Robles-Barba; J.L. Vercher-Conejero; R. Mast-Vilaseca; C. Gámez-Cenzano
      Pages: 406 - 407
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      Author(s): M. Cortés-Romera, A. Sabaté-Llobera, J. Robles-Barba, J.L. Vercher-Conejero, R. Mast-Vilaseca, C. Gámez-Cenzano

      PubDate: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2017.02.008
  • Metástasis en ciego de un cáncer lobulillar de mama
           diagnosticada con 18F-FDG PET/TC
    • Authors: D. Villasboas-Rosciolesi; C. Pérez; L. Capdevila; F. Ramos; V. Valenti; J.R. Garcia
      First page: 408
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      Author(s): D. Villasboas-Rosciolesi, C. Pérez, L. Capdevila, F. Ramos, V. Valenti, J.R. Garcia

      PubDate: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2016.11.002
  • 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
    • 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
  • 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
      Pages: 312 - 321
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      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: 2017-11-19T02:13:39Z
      DOI: 10.1016/j.remn.2017.03.004
  • 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
  • Seguimiento de pacientes pediátricos con histiocitosis de Langerhans
           mediante PET/TC con 18F-FDG
    • Authors: J.R. Garcia; E. Riera; P. Bassa; S. Mourelo; M. Soler
      Pages: 325 - 328
      Abstract: Publication date: September–October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 5
      Author(s): J.R. Garcia, E. Riera, P. Bassa, S. Mourelo, M. Soler
      Objetivo Evaluar el impacto de la 18F-FDG PET/TC en la identificación de focos de enfermedad activa y el seguimiento terapéutico en un grupo de pacientes pediátricos con histiocitosis de células de Langerhans (HCL). Método Entre 2007-2013 se efectuaron 13 estudios 18F-FDG PET/TC de seguimiento en 7 pacientes diagnosticados de HCL (4 niñas, 3 varones; 1-12 años). Se analizaron los hallazgos PET y se correlacionaron con los de la TC y la RM, así como el seguimiento evolutivo con estas técnicas. Resultados La PET fue negativa en 4 pacientes (todos diagnosticados de lesiones óseas y afectación hipofisaria en un caso). La TC mostró persistencia de lesiones, de carácter residual, en todos los pacientes, y la RM de hipófisis mostró su normalización. La PET permaneció negativa a los 10, 14, 25 y 28 meses, sin detectar nuevas lesiones mediante TC ni RM. La PET fue positiva en 3 pacientes (uno con adenopatías cervicales y 2 con lesiones óseas y afectación hipofisaria en uno de ellos, no identificada por la PET). Los hallazgos de la TC fueron adenopatía cervical patológica (n=1) y lesiones óseas (n=2), y de la RM, lesión hipofisaria (n=1). En el paciente con adenopatía cervical la anatomía patológica mostró afectación por HCL. En los otros 2 pacientes, la PET permaneció positiva, con aumento de la captación ósea de 18F-FDG a los 17 y 19 meses. Conclusión En este estudio preliminar, la 18F-FDG PET constituye una técnica de imagen útil, junto con otras pruebas diagnósticas, para identificar lesiones activas y monitorizar la respuesta terapéutica en pacientes pediátricos con HCL. Purpose We evaluated the impact of 18F-FDG PET/CT in identifying sites of active disease and to assess therapeutic follow up in a group of pediatric patients with Langerhans cell histiocytosis (LCH). Method During 2007-2013, 13 18F-FDG PET/CT studies were performed for follow-up in 7 patients with a diagnosis of LCH (4 female, 3 male; 1-12 years-old). PET findings were analyzed and correlated with the CT and MRI. Findings were also follow-up by these techniques. Results PET was negative in 4 patients (all diagnosed with bone lesions and one with pituitary involvement also). CT findings showed residual morphological bone lesions in all patients, and hypophysis MRI study showed no abnormal signal. PET remained negative at 10, 14, 25 and 28 months, and no new lesions on CT and MRI were detected. PET was positive in 3 patients (one with cervical lymphadenopathy and 2 with bone lesions, one also with pituitary involvement not identified by PET). CT findings showed pathological cervical lymphadenopathy (n=1), bone lesions (n=2) and also a pituitary MRI lesion (n=1). In a patient with cervical lymphadenopathy histology demonstrated LCH involvement. In the other 2 patients, PET remained positive with an increase of 18F-FDG bone uptake at 17 and 19 months. Conclusion In our preliminar study, 18F-F...
      PubDate: 2017-11-19T02:13:39Z
      DOI: 10.1016/j.remn.2017.01.007
  • 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
    • 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
    • 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
  • Valor de la 18F-FDG PET/TC en el diagnóstico de corea-acantocitosis
    • Authors: D.A. López-Mora; V. Camacho; A. Fernandez; F. Fuentes; J. Pérez-Pérez; I. Carrio
      Abstract: Publication date: Available online 6 December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): D.A. López-Mora, V. Camacho, A. Fernandez, F. Fuentes, J. Pérez-Pérez, I. Carrio

      PubDate: 2017-12-12T06:47:09Z
      DOI: 10.1016/j.remn.2017.11.002
  • Imagen híbrida en la patología del pie y tobillo
    • Authors: R. García Jiménez; F.J. García-Gómez; E. Noriega Álvarez; C. Calvo Morón; J.J. Martín-Marcuartu
      Abstract: Publication date: Available online 6 December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): R. García Jiménez, F.J. García-Gómez, E. Noriega Álvarez, C. Calvo Morón, J.J. Martín-Marcuartu
      La patología del pie y tobillo es una de las más frecuentes del sistema musculoesquelético y de gran repercusión en la calidad de vida de los pacientes. El diagnóstico preciso supone un desafío clínico importante debido a que la compleja anatomía y la función del pie dificultan la localización del origen del dolor por un examen clínico de rutina. En el estudio de la patología del pie se han utilizado técnicas anatómicas (radiografía, resonancia magnética [RM], ultrasonido y tomografía computarizada [TC]) y funcionales (gammagrafía ósea [GO], tomografía de emisión de positrones [PET] y RM). La imagen híbrida combina las ventajas de los estudios morfológicos y funcionales de forma sinérgica, ayudando al clínico en la gestión de problemas complejos. En este artículo profundizamos en la anatomía y en la biomecánica del pie y tobillo y describimos las indicaciones potenciales de las técnicas hibridas actuales disponibles para el estudio de la patología del pie y tobillo. Disorders of the foot and ankle are some of the most frequent ones affecting the musculoskeletal system and have a great impact on patients’ quality of life. Accurate diagnosis is an important clinical challenge because of the complex anatomy and function of the foot, that make it difficult to locate the source of the pain by routine clinical examination. In the study of foot pathology, anatomical imaging (radiography, magnetic resonance imaging [MRI], ultrasound and computed tomography [CT]) and functional imaging (bone scan, positron emission tomography [PET] and MRI) techniques have been used. Hybrid imaging combines the advantages of morphological and functional studies in a synergistic way, helping the clinician manage complex problems. In this article we delve into the anatomy and biomechanics of the foot and ankle and describe the potential indications for the current hybrid techniques available for the study of foot and ankle disease.

      PubDate: 2017-12-12T06:47:09Z
      DOI: 10.1016/j.remn.2017.10.003
  • Aportación de la PET/TC con 18F-FDG en el diagnóstico de recidiva de la
           arteritis de Takayasu
    • Authors: A. Cabrera Villegas; A.F. Elena Ibañez; I.E. Sánchez Rodriguez; M.P. Garrastachu Zumaran; P. Santos Holgueras; M.C. Albornoz Almada
      Abstract: Publication date: Available online 26 November 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A. Cabrera Villegas, A.F. Elena Ibañez, I.E. Sánchez Rodriguez, M.P. Garrastachu Zumaran, P. Santos Holgueras, M.C. Albornoz Almada

      PubDate: 2017-12-01T06:31:08Z
      DOI: 10.1016/j.remn.2017.11.001
  • Aportación de la PET/TC con 11C-colina en la recidiva bioquímica del
           cáncer de próstata con antígeno específico prostático sérico
           inferior a 1 ng/ml
    • Authors: F.J. Gómez-de la Fuente; I. Martínez-Rodríguez; M. de Arcocha-Torres; R. Quirce; J. Jiménez-Bonilla; N. Martínez-Amador; I. Banzo
      Abstract: Publication date: Available online 12 November 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): F.J. Gómez-de la Fuente, I. Martínez-Rodríguez, M. de Arcocha-Torres, R. Quirce, J. Jiménez-Bonilla, N. Martínez-Amador, I. Banzo
      Objetivo La PET/TC con 11C-colina ha mostrado buenos resultados en la reestadificación del cáncer de próstata (CP) con antígeno específico prostático (PSA) elevado. Su uso con niveles bajos es controvertido. Nuestro objetivo fue evaluar la aportación de la 11C-colina PET/TC en pacientes con CP, recidiva bioquímica y PSA <1ng/ml. Material y método Se evaluaron retrospectivamente 50 pacientes consecutivos (edad: 65,9±5,6 años) con recidiva bioquímica de CP y PSA <1ng/ml (media: 0,4±0,2). La PET/TC fue adquirida a los 20 min de la administración intravenosa de 555-740 MBq de 11C-colina. El seguimiento mínimo fue de 30 meses. Resultados De los 50 pacientes, 21 (42%) mostraron una 11C-colina PET/TC anormal. En 7 (14%) se confirmó la afectación tumoral (4 en lecho prostático, 4 en ganglios pélvicos, 2 en ganglios mediastínicos y un tumor síncrono sigmoide) y se modificó en todos ellos el tratamiento inicialmente previsto. En 2 pacientes (4%) se confirmó enfermedad benigna (uno con sarcoidosis, otro con secuelas de TBC) y en 3 pacientes (6%) ausencia de enfermedad. En los otros 9 pacientes (18%) los hallazgos no fueron estudiados (7 en ganglios mediastínicos y 4 en pélvicos). La 11C-colina PET/TC fue normal en 29 pacientes (58%). Solo en 2 de ellos se confirmó recidiva a los 30 meses. Conclusión La 11C-colina PET/TC demostró su utilidad en la recidiva bioquímica de CP y PSA <1 ng/ml en el 14% de los pacientes al mostrar enfermedad tumoral, lo que tuvo implicaciones terapéuticas. En un 4% se detectó enfermedad benigna. Una 11C-colina PET/TC normal se asoció a una tasa de recurrencia muy baja a los 30 meses. Objective 11C-choline PET/CT has demonstrated good results in the restaging of prostate cancer (PCa) with high serum prostate specific antigen (PSA), but its use in patients with low serum PSA is controversial. Our aim was to evaluate the contribution of 11C-choline PET/CT in patients with PCa, biochemical relapse and PSA <1 ng/ml. Material and method Fifty consecutive patients (mean age: 65.9±5.6 years) with biochemical relapse of PCa and serum PSA <1ng/ml were evaluated retrospectively. PET/CT was performed 20min after intravenous administration of 555-740 MBq of 11C-choline. Minimum follow up time was 30 months. Results Twenty-one out of 50 patients (42%) had an abnormal 11C-choline PET/CT. In 7 out of 21 patients (14%) tumor was confirmed (4 in prostatic bed, 4 in pelvic lymph nodes, 2 in mediastinal lymph nodes and one synchronous sigmoid carcinoma), and in all cases the initial therapeutic planning was modified. In 2 patients (4%) subsequent tests diagnosed a benign disease (one sarcoidosis, one tuberculosis sequelae) and in 3 patients (6%) they ruled out pathology. The other 9 patients (18%) had no further assessment (7 mediastinal and 4 pelvic lymph nodes). Twenty-nine out of 50 patients (58%) had a normal PET/CT. At 30 months, follow up recurrence was confirmed only in 2 of these patients.
      PubDate: 2017-11-19T02:13:39Z
      DOI: 10.1016/j.remn.2017.10.001
  • Nuevas perspectivas para la cirugía radioguiada
    • Abstract: Publication date: Available online 11 November 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): E. Goñi Gironés

      PubDate: 2017-11-12T00:03:58Z
  • Predictive and prognostic potential of volume-based metabolic variables
           obtained by a baseline 18F-FDG PET/CT in breast cancer with neoadjuvant
           chemotherapy indication
    • Authors: A.M. Garcia-Vicente; J. Pérez-Beteta; M. Amo-Salas; D. Molina; G.A. Jimenez-Londoño; A.M. Soriano-Castrejón; F.J. Pena Pardo; A. Martínez-González
      Abstract: Publication date: Available online 2 November 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A.M. Garcia-Vicente, J. Pérez-Beteta, M. Amo-Salas, D. Molina, G.A. Jimenez-Londoño, A.M. Soriano-Castrejón, F.J. Pena Pardo, A. Martínez-González
      Aim To investigate the usefulness of metabolic variables using 18F-FDG PET/CT in the prediction of neoadjuvant chemotherapy (NC) response and the prognosis in locally advanced breast cancer (LABC). Materials and methods Prospective study including 67 patients with LABC, NC indication and a baseline 18F-FDG PET/CT. After breast tumor segmentation, SUV variables (SUVmax, SUVmean and SUVpeak) and volume-based variables, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG), were obtained. Tumors were grouped into molecular phenotypes, and classified as responders or non-responders after completion of NC. Disease-free status (DFs), disease-free survival (DFS), and overall survival (OS) were assessed. A univariate and multivariate analysis was performed to study the potential of all variables to predict DFs, DFS, and OS. Results Fourteen patients were classified as responders. Median±SD of DFS and OS was 43±15 and 46±13 months, respectively. SUV and TLG showed a significant correlation (p <0.005) with the histological response, with higher values in responders compared to non-responders. MTV and TLG showed a significant association with DFs (p =0.015 and p =0.038 respectively). Median, mean and SD of MTV and TLG for patients with DFs were: 8.90, 13.73, 15.10 and 33.78, and 90.54 and 144.64, respectively. Median, mean and SD of MTV and TLG for patients with non-DFs were: 16.72, 29.70 and 31.09 and 90.89, 210.98 and 382.80, respectively. No significant relationships were observed with SUV variables and DFs. Volume-based variables were significantly associated with OS and DFS, although in multivariate analysis only MTV was related to OS. No SUV variables showed an association with the prognosis. Conclusion Volume-based metabolic variables obtained with 18F-FDG PET/CT, unlike SUV based variables, were good predictors of both neoadjuvant chemotherapy response and prognosis.

      PubDate: 2017-11-04T21:53:23Z
      DOI: 10.1016/j.remn.2017.09.002
  • Diagnosing neuroleukemiosis: Is there a role for 18F-FDG-PET/CT'
    • Authors: J.J.
      Abstract: Publication date: November–December 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 6
      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: 2017-10-28T21:43:19Z
  • 18F-FDG PET/contrast enhanced CT in the standard follow-up of patients
           with lymphoma
    • Authors: A.M. García Vicente; M.P. Talavera Rubio; E. Dominguez Ferreras; C. Calle Primo; M. Amo-Salas; M.J. Tello Galán; G.A. Jiménez Londoño; F. Jiménez Aragón; B. Hernández Ruiz; Á. Soriano Castrejón
      Abstract: Publication date: Available online 27 October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A.M. García Vicente, M.P. Talavera Rubio, E. Dominguez Ferreras, C. Calle Primo, M. Amo-Salas, M.J. Tello Galán, G.A. Jiménez Londoño, F. Jiménez Aragón, B. Hernández Ruiz, Á. Soriano Castrejón
      Aim To assess the diagnostic accuracy of 18F-FDG PET/contrast enhanced computed tomography (ceCT) in the detection of asymptomatic recurrences in patients with lymphoma. Material and methods Patients with lymphoma and clinical complete remission underwent 18F-FDG PET/ceCT for standard follow-up.18F-FDG PET and ceCT were evaluated blindly by two independent observers, and classified as positive or negative for recurrence. Additionally a combined evaluation of both techniques was performed. The final diagnosis was established by histopathological analysis or a clinical follow-up longer than 6 months. Statistical diagnostic parameters and concordance levels between both diagnostic techniques were calculated. Results A total of 114 explorations on 90 patients were analyzed. Only 4 patients were diagnosed as asymptomatic recurrence during the follow-up. 18F-FDG PET/ceCT, 18F-FDG PET and ceCT showed an association with the final diagnosis (p =.002 and χ 2 =11.96; p <.001 and χ 2 =15.60; p =.001 and χ 2 =11.96, respectively). The concordance between 18F-FDG PET and ceCT was moderate/high and significant (Kappa=0.672; p <.001). A sensitivity and specificity of 50% and 88% was obtained for the 18F-FDG PET/ceCT civ, 50% and 93% for the 18F-FDG PET, and 50% and 91% for the ceCT. Conclusion The combined use of 18F-FDG PET/ceCT did not offer any advantage compared to any isolated diagnostic technique in the detection of asymptomatic lymphoma recurrence.

      PubDate: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2017.09.003
  • Estadificación y seguimiento terapéutico en un paciente con sarcoma de
           Ewing mediante PET/TC con 18F-FDG
    • Authors: J.R. Garcia; A. Castañeda; A. Morales La Madrid; P. Bassa; M. Soler; E. Riera
      Abstract: Publication date: Available online 27 October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J.R. Garcia, A. Castañeda, A. Morales La Madrid, P. Bassa, M. Soler, E. Riera

      PubDate: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2017.09.001
  • Bladder wall paranganglioma located using 123I-mIBG SPECT and CT imaging
    • Authors: Viviana Frantellizzi; Mariano Pontico; Claudio Letizia; Giuseppe De Vincentis
      Abstract: Publication date: Available online 27 October 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): Viviana Frantellizzi, Mariano Pontico, Claudio Letizia, Giuseppe De Vincentis

      PubDate: 2017-10-28T21:43:19Z
      DOI: 10.1016/j.remn.2017.07.008
  • 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
    • 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
  • Hallazgo incidental de captación focal del colon en estudios 18F-FDG
    • 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
  • 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
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