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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  [3039 journals]
  • El nomenclátor y unidades relativas de valor como herramientas de
           gestión
    • Authors: M. Mitjavila; D. Becerra
      Pages: 349 - 350
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): M. Mitjavila, D. Becerra


      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remn.2016.06.005
       
  • Contribution of early SPECT/CT to 99mTc-MIBI double phase scintigraphy in
           primary hyperparathyroidism: Diagnostic value and correlation between
           uptake and biological parameters
    • Authors: P. García-Talavera; G. Díaz-Soto; A.A. Montes; J.G. Villanueva; A. Cobo; C. Gamazo; M.Á. Ruiz; M.L. González-Selma
      Pages: 351 - 357
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): P. García-Talavera, G. Díaz-Soto, A.A. Montes, J.G. Villanueva, A. Cobo, C. Gamazo, M.Á. Ruiz, M.L. González-Selma
      Aim To evaluate the value of 99mTc-MIBI double-phase scintigraphy (DPS) and early SPECT/CT in the pre-surgical assessment of patients with primary hyperparathyroidism (PHPT). Also, to calculate the correlation between uptake and some biological parameters. Material and methods Forty patients with PHPT were included: 37 solitary adenomas, 1 hyperplasia, and 2 double adenomas. Fifteen patients had ectopic glands. DPS and early SPECT/CT were acquired in all patients. Ultrasound was performed in 31/40. All patients underwent surgery, intra-operative iPTH measurements, and histopathological examinations. Qualitative DPS uptake was assessed and correlated to pre-surgical calcium, iPTH levels, gland weight, and maximum diameter. Results In the planar study, there were 23 positive cases, 8 doubtful, and 9 negatives. With the SPECT/CT, 8/9 negatives cases were located. All doubtful cases were confirmed as positives. Gland location improved in 16 cases (12 ectopic). DPS+SPECT/CT failed to detect a solitary adenoma and at least one gland in three cases of multiglandular disease (MGD). The sensitivity by patient was: DPS 72.5%, DPS+SPECT/CT 90%, and ultrasound 42%. Ultrasound and scintigraphy (DPS+SPECT/CT) were concordant in 16/31 patients. For the rest of them, scintigraphy proved correct in 14/15, and both techniques failed in one case. There was a significant correlation between level of uptake and iPTH level, gland weight, and maximum diameter. Conclusion Early SPECT/CT improves sensitivity and the locating of parathyroid pathological glands and increases diagnostic confidence. iPTH level, glandular size, and weight are related to the qualitative assessment of 99mTc-MIBI uptake in early DPS.

      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remnie.2016.03.004
       
  • Detección selectiva del ganglio centinela tras administración
           intratumoral del radiotrazador, en pacientes con cáncer de mama tratadas
           con quimioterapia neoadyuvante en relación con el grado de respuesta
           tumoral
    • Authors: R. Díaz-Expósito; L. Martí-Bonmatí; O. Burgués; I. Casáns-Tormo; B. Bermejo-de las Heras; A. Julve-Parreño; A. Caballero-Garate
      Pages: 358 - 364
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): R. Díaz-Expósito, L. Martí-Bonmatí, O. Burgués, I. Casáns-Tormo, B. Bermejo-de las Heras, A. Julve-Parreño, A. Caballero-Garate
      Objetivo Nuestro objetivo fue analizar el rendimiento de la biopsia selectiva del ganglio centinela valorando la detección gammagráfica tras la administración intratumoral del radiofármaco en pacientes con cáncer de mama que recibieron quimioterapia neoadyuvante. Material y métodos Sesenta pacientes con diagnóstico de carcinoma infiltrante de mama, estadios T1-T3, que recibieron tratamiento con quimioterapia neoadyuvante fueron sometidas posteriormente a cirugía mamaria y biopsia del ganglio centinela mediante administración intratumoral del radiofármaco. Resultados Se consiguió la detección gammagráfica de algún ganglio centinela en 55/60 pacientes (91,6%). Cuando se excluyeron los casos con reinyección periareolar del radiofármaco por falta de migración, la detección fue del 70% (42/60). Cuando se comparó la detección o no del ganglio centinela en estas 42 pacientes, no se encontraron diferencias en función de la edad, lateralidad-localización de la lesión, tamaño pre y posquimioterapia, grado histológico del tumor o perfil inmunohistoquímico. Sí existieron diferencias significativas al comparar los grupos según el grado de respuesta patológica del tumor, valorado tanto con el sistema de Miller-Payne (no detección 44,4%-detección 16,7%, p = 0,003) como con el sistema residual cancer burden (72,2%-28,6%, p<0,01). Conclusiones La detección gammagráfica del ganglio centinela tras administración intratumoral del radiofármaco en pacientes con cáncer de mama que recibieron quimioterapia neoadyuvante estuvo por debajo del valor óptimo, siendo necesaria en ocasiones la reinyección periareolar, lo que podría estar en relación con una alteración de las vías de drenaje linfático. Existió una significativa relación inversa entre detección del ganglio centinela y el grado de respuesta patológica tumoral. Purpose Our objective was to analyse the accuracy of the sentinel node biopsy, taking into consideration the scintigraphy detection rate after the intratumoural administration of the radiopharmaceutical in patients with breast cancer who received neoadjuvant chemotherapy. Materials and methods The study included 60 patients with a diagnosis of invasive breast carcinoma, stage T1-T3, who received treatment with neoadjuvant chemotherapy, and were subsequently subjected to breast surgery and sentinel node biopsy after intra-tumour administration of the radiopharmaceutical. Results Scintigraphic detection of some sentinel node was achieved in 55/60 patients (91.6%). When those cases that received a second injection of the radiopharmaceutical, performed peri-areolarly due to a lack of tracer migration, were excluded, the detection rate dropped to 70% (42/60). When the detection of sentinel node, or its absence, was compared in those 42 patients, no differences were found with age, laterality-location of the lesion, size pre- and post-neoadjuvant chemotherapy, histological grade, or immunohistochemical profile. There were significant differences when comparing the groups according to the degree of pathological tumour response, both with the Miller-Payne system (non-detection 44.4%-detection 16.7%, p = 0.003) as well as the residual cancer burden (72.2%-28.6%, p<0.01).
      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remn.2016.04.005
       
  • Papel pronóstico del volumen metabólico tumoral y de la glucólisis
           tumoral total en los estudios 18F-FDG PET/TC de estadificación del
           cáncer localmente avanzado de mama
    • Authors: A. Jiménez-Ballvé; M. García García-Esquinas; O. Salsidua-Arroyo; A. Serrano-Palacio; J.A. García-Sáenz; A. Ortega Candil; M.E. Fuentes Ferrer; C. Rodríguez Rey; J.M. Román-Santamaría; F. Moreno; J.L. Carreras-Delgado
      Pages: 365 - 372
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): A. Jiménez-Ballvé, M. García García-Esquinas, O. Salsidua-Arroyo, A. Serrano-Palacio, J.A. García-Sáenz, A. Ortega Candil, M.E. Fuentes Ferrer, C. Rodríguez Rey, J.M. Román-Santamaría, F. Moreno, J.L. Carreras-Delgado
      Objetivo Conocer si el volumen metabólico tumoral (VMT) y la glucólisis tumoral total (GTT) pueden predecir el riesgo de recurrencia en cáncer localmente avanzado de mama (CLAM). Material y métodos Estudio retrospectivo de pacientes con CLAM tratados con tratamiento neoadyuvante, local y adyuvante; en seguimiento. Se realizó una 18F-FDG PET/TC para estadificar la enfermedad, midiéndose diferentes parámetros metabólicos (VMT, GTT, SUVmáx y SUVmed), tanto en el tumor primario (T) como en los ganglios metastásicos (N) y en el cuerpo entero (CE). Resultados Se incluyeron 40 mujeres entre enero de 2010-2011; seguimiento hasta enero de 2015. Con una mediana de seguimiento de 46 meses el 20% tuvieron recidiva, local (n=2) o a distancia (n=6); fallecieron 3 (38% de aquellas con recidiva y 7,5% del total). EL SUVmáx, VMT y GTT, tanto en T, como N y CE, fue mayor en aquellas que presentaron recidiva. En el T tanto el VMT como la GTT se relacionaron con la recidiva de la enfermedad (p=0,020 y p=0,028, respectivamente), mientras que en la N fue el SUVmáx (p=0,008). Los puntos de corte óptimos para predecir recurrencia fueron: VMT T≥19,3cm3, GTT T≥74,4g y SUVmáx N≥13,8, existiendo 10-12 veces más probabilidad de experimentar progresión tumoral cuando superaban estos umbrales. El grado tumoral fue la única variable clínico-patológica asociada con la recidiva (p=0,035). Conclusiones En este estudio de CLAM los parámetros metabólicos que más se asocian con la tasa de recidiva son el VMT y la GTT en el tumor primario, el SUVmáx en la enfermedad ganglionar regional y los 3 índices PET en el cuerpo entero. Estos parámetros podrían utilizarse en la práctica asistencial para identificar a las pacientes con mayor riesgo. Objective To determine whether metabolic tumour volume (MTV) and total lesion glycolysis (TLG) are able to predict recurrence risk in locally advanced breast cancer (LABC) patients. Material and methods Retrospective study of LABC patients who undertook neoadjuvant, local and adjuvant treatment and follow up. A 18F-FDG PET/CT study for initial staging was performed analysing in this study different metabolic parameters (MTV, TLG, SUVmax and SUVmed) both in the primary tumour (T) as well as in axillary nodes (N) and whole-body (WB). Results Forty females were included between January 2010-2011; follow up until January 2015 was completed. The average follow-up was 46 months. Twenty percent presented recurrence: local disease (n=2) and distant metastasis (n=6); 3 patients died (38% of the patients which recurred and 7.5% from the total). SUVmax, MTV and TLG, in T, N and WB, were higher in those patients with recurrence. The MTV and TLG parameters in the tumour (T) were related to the recurrence rate (P =
      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remn.2016.01.007
       
  • Estudio comparativo en la definición del volumen de tratamiento en
           radioterapia con «Slow TC Scan» vs. 4D PET/TC Scan en estadios iniciales
           de cáncer de pulmón de célula no pequeña
    • Authors: M. Molla; N. Anducas; M. Simó; A. Seoane; M. Ramos; G. Cuberas-Borros; M. Beltran; J. Castell; J. Giralt
      Pages: 373 - 378
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): M. Molla, N. Anducas, M. Simó, A. Seoane, M. Ramos, G. Cuberas-Borros, M. Beltran, J. Castell, J. Giralt
      Objetivos Evaluar el uso de la 4D PET/TC para capturar el movimiento respiratorio en comparación con la «slow»-TC (TCs), en el procedimiento de planificación de radioterapia. Material y métodos Se ha incluido a 25 pacientes diagnosticados de estadio inicial de cáncer de pulmón de célula no pequeña (NSCLC) médicamente inoperable. A cada paciente se le realizó una TCs (4 s/corte) y una 4D PET/TC. La idoneidad de cada técnica en la captura del movimiento respiratorio fue evaluada comparando el volumen definido por cada una de ellas: internal target volumen (ITV) 4D y el ITVslow, con relación a la suma de los volúmenes de la 4D PET/TC y la TCs (ITVsuma). La máxima diferencia entre el volumen definido por cada técnica respecto al volumen suma fue evaluada en una proyección antero-posterior y otra lateral. Resultados Los volúmenes generados con 4D PET/TC consiguen una definición más precisa del ITV que los volúmenes obtenidos con TCs (ITV4D/ITVsuma 78% vs. ITVslow/ITVsuma 63%). En general, los volúmenes de la 4D PET/TC son de mayor tamaño (19,9 vs. 16,3 cc). El ITV4D muestra menor diferencia con el ITVsuma en los ejes cráneo-caudal y antero-posterior respecto al ITVslow y capta el movimiento de forma más exacta. La máxima diferencia observada es de 0,36mm en la 4D PET/TC y de 0,57mm en la TCs en el eje antero-posterior. Conclusiones La planificación con 4D PET/TC en comparación con TCs permite cuantificar el movimiento respiratorio del tumor y mejorar la planificación de radioterapia en estadios iniciales de NSCLC. Objectives To evaluate the use of 4D PET/CT to quantify tumor respiratory motion compared to the «Slow»-CT (CTs) in the radiotherapy planning process. Material and methods A total of 25 patients with inoperable early stage non small cell lung cancer (NSCLC) were included in the study. Each patient was imaged with a CTs (4s/slice) and 4D PET/CT. The adequacy of each technique for respiratory motion capture was evaluated using the volume definition for each of the following: Internal target volume (ITV) 4D and ITVslow in relation with the volume defined by the encompassing volume of 4D PET/CT and CTs (ITVtotal). The maximum distance between the edges of the volume defined by each technique to that of the total volume was measured in orthogonal beam's eye view. Results The ITV4D showed less differences in relation with the ITVtotal in both the cranio-caudal and the antero-posterior axis compared to the ITVslow. The maximum differences were 0.36mm in 4D PET/CTand 0.57mm in CTs in the antero-posterior axis. 4D PET/CT resulted in the definition of more accurate (ITV4D/ITVtotal 0.78 vs. ITVs/ITVtotal 0.63), and larger ITVs (19.9 cc vs. 16.3 cc) than those obtained with CTs. Conclusion Planning with 4D PET/CT in comparison with CTs, allows incorporating tumor respiratory...
      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remn.2016.02.003
       
  • Identification of low variability textural features for heterogeneity
           quantification of 18F-FDG PET/CT imaging
    • Authors: J. Cortes-Rodicio; G. Sanchez-Merino; M.A. Garcia-Fidalgo; I. Tobalina-Larrea
      Pages: 379 - 384
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): J. Cortes-Rodicio, G. Sanchez-Merino, M.A. Garcia-Fidalgo, I. Tobalina-Larrea
      Objective To identify those textural features that are insensitive to both technical and biological factors in order to standardise heterogeneity studies on 18F-FDG PET imaging. Materials and methods Two different studies were performed. First, nineteen series from a cylindrical phantom filled with different 18F-FDG activity concentration were acquired and reconstructed using three different protocols. Seventy-two texture features were calculated inside a circular region of interest. The variability of each feature was obtained. Second, the data for 15 patients showing non-pathological liver were acquired. Anatomical and physiological features such as patient's weight, height, body mass index, metabolic active volume, blood glucose level, SUV and SUV standard deviation were also recorded. A liver covering region of interest was delineated and low variability textural features calculated in each patient. Finally, a multivariate Spearman's correlation analysis between biological factors and texture features was performed. Results Only eight texture features analysed show small variability (<5%) with activity concentration and reconstruction protocol making them suitable for heterogeneity quantification. On the other hand, there is a high statistically significant correlation between MAV and entropy (P <0.05). Entropy feature is, indeed, correlated (P <0.05) with all patient parameters, except body mass index. Conclusions The textural features that are correlated with neither technical nor biological factors are run percentage, short-zone emphasis and intensity, making them suitable for quantifying functional changes or classifying patients. Other textural features are correlated with technical and biological factors and are, therefore, a source of errors if used for this purpose.

      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remnie.2016.04.008
       
  • Osteomalacia hipofosfatémica sintomática secundaria a tratamiento con
           hierro carboximaltosa objetivada con gammagrafía ósea
    • Authors: M.J. Sangrós Sahún; E. Goñi Gironés; A. Camarero Salazar; C. Estébanez Estébanez; M.E. Lozano Martínez
      Pages: 391 - 393
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): M.J. Sangrós Sahún, E. Goñi Gironés, A. Camarero Salazar, C. Estébanez Estébanez, M.E. Lozano Martínez
      El desarrollo de osteomalacia hipofosfatémica se ha relacionado con diversos tratamientos, fundamentalmente antirretrovirales y administración de hierro por vía intravenosa. La frecuencia de la hipofosfatemia hace necesario vigilar el fosfato tras la administración de hierro carboximaltosa. Presentamos el caso de una mujer sin antecedentes de alteración del metabolismo fosfo-cálcico a la que se pautó este tratamiento por anemia debida a hipermenorrea e intolerancia al hierro por vía oral. Comenzó con dolor oligoarticular que se generalizó más tarde, con importante impotencia funcional y cuya relación con la administración por vía intravenosa de hierro fue descubierta cuando los hallazgos gammagráficos junto con la analítica orientaron hacia una osteomalacia hipofosfatémica. Respondió de forma satisfactoria al tratamiento con fosfato como se objetivó clínicamente y en la gammagrafía ósea de control. The development of hypophosphataemic osteomalacia has been linked with several treatments, mainly antiretroviral and intravenous iron administration. The frequency of the hypophosphataemia requires monitoring the phosphate after the administration of iron carboxymaltose. We describe a case of a woman with no calcium-phosphorous metabolism disorder, to whom this treatment was prescribed for anaemia due to menorrhagia and intolerance to oral iron. She started with oligoarticular pain, which was spreading with a significant functional loss. The relationship with the administration of intravenous iron was discovered when scintigraphic findings together with laboratory results led to a diagnosis of hypophosphataemic osteomalacia. The patient responded satisfactorily to treatment with phosphate both clinically and in the follow-up bone scintigraphy.

      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remn.2016.04.006
       
  • 18F-FDG PET/TC y RM funcional en un caso de afasia progresiva primaria
           logopénica cruzada
    • Authors: M.N. Cabrera-Martín; J.A. Matías-Guiu; M. Yus-Fuertes; M. Valles-Salgado; T. Moreno-Ramos; J. Matías-Guiu; J.L. Carreras Delgado
      Pages: 394 - 397
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): M.N. Cabrera-Martín, J.A. Matías-Guiu, M. Yus-Fuertes, M. Valles-Salgado, T. Moreno-Ramos, J. Matías-Guiu, J.L. Carreras Delgado
      La afasia progresiva primaria es un síndrome clínico secundario a la neurodegeneración de las áreas y redes neuronales involucradas en el lenguaje, habitualmente en el hemisferio izquierdo. El término «afasia cruzada» se refiere a una alteración del lenguaje como consecuencia de una lesión del hemisferio cerebral ipsilateral a la mano dominante. Presentamos el caso de una mujer diestra de 75 años con afasia progresiva primaria logopénica, con dificultad para encontrar palabras, de 2 años de evolución. La 18F-FDG PET/TC mostró un hipometabolismo temporoparietal derecho. Se realizó una RM funcional para caracterizar patrones de lateralización del lenguaje. Se observó un patrón de activación similar en ambos hemisferios y una menor activación de la esperada en el giro frontal inferior bilateral. Estos hallazgos apoyan que la afasia progresiva primaria logopénica no debería considerarse como una afectación de inicio en el hemisferio izquierdo, sino un síndrome caracterizado por una neurodegeneración asimétrica con preferencia por áreas y redes neuronales implicadas en el lenguaje. Primary progressive aphasia is a clinical syndrome caused by a neurodegeneration of areas and neural networks involved in language, usually in the left hemisphere. The term “crossed aphasia” denotes an acquired language dysfunction caused by a lesion in the hemisphere ipsilateral to the dominant hand. A case is presented on a 75-year-old right-handed woman with a logopenic variant of primary progressive aphasia with word-finding difficulties of 2 years onset. The 18F-FDG PET/CT showed right temporoparietal hypometabolism. A functional MRI scan was performed during a verb naming task in order to characterise language lateralisation patterns. A similar activation pattern was observed in both hemispheres, with less activation than expected in bilateral inferior frontal gyrus. These findings support that logopenic variant of primary progressive aphasia should not be considered as a neurodegeneration starting in the left brain hemisphere, but as a syndrome characterised by asymmetric neurodegeneration of brain regions and neural networks involved in language.

      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remn.2016.05.002
       
  • PET/CT in giant cell arteritis: High 18F-FDG uptake in the temporal,
           occipital and vertebral arteries
    • Authors: Z. Rehak; J. Vasina; J. Ptacek; T. Kazda; Z. Fojtik; P. Nemec
      Pages: 398 - 401
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): Z. Rehak, J. Vasina, J. Ptacek, T. Kazda, Z. Fojtik, P. Nemec
      18F-FDG PET/CT imaging is useful in patients with fever of unknown origin and can detect giant cell arteritis in extracranial large arteries. However, it is usually assumed that temporal arteries cannot be visualized with a PET/CT scanner due to their small diameter. Three patients with clinical symptoms of temporal arteritis were examined using a standard whole body PET/CT protocol (skull base – mid thighs) followed by a head PET/CT scan using the brain protocol. High 18F-FDG uptake in the aorta and some arterial branches were detected in all 3 patients with the whole body protocol. Using the brain protocol, head imaging led to detection of high 18F-FDG uptake in temporal arteries as well as in their branches (3 patients), in occipital arteries (2 patients) and also in vertebral arteries (3 patients).

      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remnie.2016.03.008
       
  • Mejor rendimiento de la PET/TC con 18F-FDOPA para la detección de
           metástasis de un tumor neuroendocrino del íleon
    • Authors: N. Testart Dardel; F. Montravers; E. Triviño-Ibañez; M. Gauthé; S. Houry; J.N. Talbot
      Pages: 402 - 405
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): N. Testart Dardel, F. Montravers, E. Triviño-Ibañez, M. Gauthé, S. Houry, J.N. Talbot
      Los tumores neuroendocrinos (TNE) son un grupo de tumores muy heterogéneos y de distribución variable, lo que dificulta su localización anatómica. En medicina nuclear, durante décadas se han propuesto diferentes técnicas de imagen PET o SPECT con diversos radiotrazadores para el estudio de estos tumores, no existiendo consenso actualmente sobre la más adecuada, incluso al considerar solamente los TNE digestivos. Presentamos el caso de una mujer de 67 años con un TNE bien diferenciado del íleon en la que se sospechó una recidiva y ninguna técnica de imagen fue capaz de detectar la enfermedad, excepto la PET/TC con 18F-FDOPA. El seguimiento posterior mostró progresión de la enfermedad, confirmándose la positividad de este primer hallazgo. A raíz del caso se discuten y comparan los radiofármacos posibles para el diagnóstico de TNE digestivos, haciendo énfasis en los derivados embriológicamente del intestino medio. Neuroendocrine tumours (NET) are heterogeneous and frequently spread over the body, making their imaging difficult. With this aim, nuclear medicine imaging, using PET or SPECT with different tracers, has been proposed for decades, but there is currently no consensus on the most appropriate technique, even when only considering gastrointestinal NET. The case is presented of a 67year old woman with a well differentiated NET of the ileum with suspected recurrence, which was not detected by any imaging technique except 18F-FDOPA PET/CT. Subsequent follow up showed disease progression, which confirmed the true positivity of 18F-FDOPA. Using this case, we discuss and compare different radiotracers for the diagnosis of gastrointestinal NET, focusing on those embryologically originating from the mid-gut.

      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remn.2016.04.007
       
  • Evaluation of a crossed fused renal ectopia in a paediatric patient using
           99mTc-DMSA SPECT/CT
    • Authors: A. Dehesa; A. Zugazaga; M.B. De Miguel; L. Biassoni
      Pages: 406 - 408
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): A. Dehesa, A. Zugazaga, M.B. De Miguel, L. Biassoni


      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remnie.2016.01.023
       
  • Dual-time-point 18F-FDG-PET/CT imaging of a paravalvular pseudoaneurysm
           after infective endocarditis
    • Authors: B. Rodriguez-Alfonso; I. Zegri; J. Mucientes Rasilla; A. Forteza; D. Petite; A. Ramos Martinez
      Pages: 409 - 410
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): B. Rodriguez-Alfonso, I. Zegri, J. Mucientes Rasilla, A. Forteza, D. Petite, A. Ramos Martinez


      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remnie.2016.04.009
       
  • Co-existence of a giant cell tumour of the tendon sheath and schwannoma in
           a patient with bilateral breast cancer: A potential cause of false
           positive findings in 18F-FDG PET/CT studies
    • Authors: A. Ortega Candil; C. Rodríguez Rey; M. García García-Esquinas; M.N. Cabrera Martín; R. Couto Caro; J.L. Carreras Delgado
      Pages: 411 - 412
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): A. Ortega Candil, C. Rodríguez Rey, M. García García-Esquinas, M.N. Cabrera Martín, R. Couto Caro, J.L. Carreras Delgado


      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remnie.2016.05.002
       
  • A rare case of tonsillar metastatic small cell carcinoma originating from
           the lung assessed by 18F-FDG PET/CT
    • Authors: R. Zhang; Z. Hu; J. Tan; J. Shen
      Pages: 413 - 414
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): R. Zhang, Z. Hu, J. Tan, J. Shen


      PubDate: 2016-11-07T10:03:52Z
      DOI: 10.1016/j.remnie.2016.03.006
       
  • Safety of regadenoson in patients with severe chronic obstructive
           pulmonary disease
    • Authors: C. Salgado-Garcia; A. Jimenez-Heffernan; C. Ramos-Font; J. Lopez-Martin; E. Sanchez-de-Mora; T. Aroui; R. Lopez-Aguilar; F. Rivera-de-los-Santos; C. Ruiz-Frutos
      Pages: 283 - 286
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): C. Salgado-Garcia, A. Jimenez-Heffernan, C. Ramos-Font, J. Lopez-Martin, E. Sanchez-de-Mora, T. Aroui, R. Lopez-Aguilar, F. Rivera-de-los-Santos, C. Ruiz-Frutos
      Objective To assess the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise in subjects with severe chronic obstructive pulmonary disease (COPD), referred for myocardial perfusion imaging (MPI). Methods We studied prospectively 12 male patients with severe COPD. Stress was 4min of low-level exercise with bolus injection of regadenoson (0.4mg) at 1.5min, followed by 99mTc-MPI agent injection. Demographics, medical history, lung medications, adverse events, oxygen saturation (SatO2), MPI findings for coronary artery disease (CAD), and changes in systolic blood pressure (SBP), and heart rate (HR) were registered. Results The observed adverse event profile of regadenoson was similar to that of patients with mild–moderate COPD. There was no clinical exacerbation of COPD. Adverse events were self-limiting: dyspnea (33.3%), fatigue (25.0%), chest pain, headache (16.7%, respectively), and gastrointestinal discomfort, dry mouth, flushing, feeling hot and dizziness (8.3%, respectively). 25.0% of patients did not report any symptoms. We observed significant increases in SBP and HR from baseline (142.6mmHg±22.3 vs 152.5mmHg±18.5, and 80 b.p.m.±18 vs 105 b.p.m.±22, respectively; p <0.05). Conclusions Regadenoson combined with low-level exercise is safe and well tolerated in stable patients with severe COPD undergoing MPI.

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

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

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

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

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

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

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

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

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

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


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


      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remnie.2016.01.022
       
  • Nuevos tiempos para los grupos de trabajo de la SEMNIM
    • Authors: Arbizu
      Abstract: Publication date: Available online 2 December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J. Arbizu


      PubDate: 2016-12-05T10:51:54Z
       
  • 64Cu-PSMA uptake in meningioma: A potential pitfall of a promising
           radiotracer
    • Authors: F. Calabria; V. Gangemi; D. Gullà; O. Schillaci; G.L. Cascini
      Abstract: Publication date: Available online 22 November 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): F. Calabria, V. Gangemi, D. Gullà, O. Schillaci, G.L. Cascini


      PubDate: 2016-11-28T10:38:50Z
      DOI: 10.1016/j.remn.2016.10.002
       
  • Tratamiento con 177LU-DOTATATE en tumores neuroendocrinos. Estudio
           preliminar
    • Authors: I. Hervás; P. Bello; M. Falgas; M.I. del Olmo; I. Torres; C. Olivas; V. Vera; P. Oliván; A.M. Yepes
      Abstract: Publication date: Available online 23 November 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): I. Hervás, P. Bello, M. Falgas, M.I. del Olmo, I. Torres, C. Olivas, V. Vera, P. Oliván, A.M. Yepes
      La terapia con péptidos análogos de la somatostatina marcados con radionúclidos es un nuevo tratamiento prometedor para tratar tumores neuroendocrinos. El objetivo del presente estudio preliminar es presentar nuestra experiencia en la terapia con 177Lu-DOTATATE y evaluar la tolerabilidad y la eficacia a corto plazo en pacientes con tumores que expresan receptores para la somatostatina. Se han tratado 7 pacientes con tumores neuroendocrinos metastásicos, cada uno con 4 dosis de 177Lu-DOTATATE y se ha evaluado su respuesta al tratamiento en forma de respuesta bioquímica (marcadores tumorales y analítica), según métodos de imagen (gammagrafía de receptores de somatostatina, tomografía computarizada y resonancia magnética) y respuesta funcional y de calidad de vida (mediante la Escala de actividad de Karnofsky). Se ha evaluado también la toxicidad del tratamiento. Los resultados obtenidos han sido los siguientes: respuesta bioquímica: el 60% de los pacientes mostraron una normalización de sus niveles de marcadores tumorales, mientras que en el 40% disminuyeron de manera significativa; respuesta en técnicas de imagen: el 85,7% presentaron una respuesta parcial, mientras que el 14,3% mostraron enfermedad estable; mejoría de la calidad de vida: el 100% de los pacientes mostraron una mejoría significativa en la calidad de vida con un incremento de la Escala de actividad de Karnofsky, y en cuanto a la toxicidad: ningún paciente presentó toxicidad aguda o crónica, y el 42,8% de los pacientes presentaron toxicidad subaguda hematológica transitoria. A pesar de tratarse de un estudio preliminar podemos afirmar que el tratamiento con 177Lu-DOTATATE es un tratamiento seguro, con pocos efectos adversos y que consigue una respuesta objetiva en la mayoría de los pacientes. Therapy with radiolabelled somatostatin analogue peptides is a promising new therapy to treat neuroendocrine tumours. The aim of this preliminary study is to present our experience with 177Lu-DOTATATE therapy, and evaluate tolerability and short-term efficacy in patients with tumours expressing somatostatin receptors. A total of 7 patients with metastatic neuroendocrine tumours were treated, each with 4 doses of 177Lu-DOTATATE. The treatment response was evaluated in the form of biochemical response (tumour markers), imaging methods (somatostatin receptor scintigraphy, computed tomography, and magnetic resonance), and functional and quality of life responses using the Karnofsky performance status scale. Treatment toxicity was also evaluated. The results obtained were as follows: Biochemical response: 60% of patients showed tumour marker levels returning to normal, while they decreased significantly in the remaining 40%. Imaging response: 85.7% had a partial response, while 14.3% showed stable disease. All (100%) patients showed a significant improvement in quality of life, with increased Karnofsky scale scores. No patient had acute or chronic toxicity, and subacute transient haematological toxicity was observed in 42.8% of patients. Despite being a preliminary study, it was found that treatment with 177Lu-DOTATATE is a safe treatment with few side effects, and an objective response was achieved in most patients.

      PubDate: 2016-11-28T10:38:50Z
      DOI: 10.1016/j.remn.2016.10.003
       
  • Eficacia de los análogos de somatostatina radiomarcados (90Y-DOTATOC y
           177Lu-DOTATATE) en pacientes con tumores neuroendocrinos metastásicos,
           experiencia de centro único en México
    • Authors: S.S. Medina-Ornelas; F.O. García-Pérez
      Abstract: Publication date: Available online 24 November 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): S.S. Medina-Ornelas, F.O. García-Pérez
      Objetivo Determinar la eficacia de la terapia con análogos de somatostatina radiomarcados 90Y-DOTATOC y 177Lu-DOTATATE en el tratamiento de tumores neuroendocrinos metastásicos con progresión después de la primera línea de tratamiento. Material y métodos Se estudiaron 30 pacientes con el diagnóstico con tumor neuroendocrino (gastroenteropancreático, broncopulmonar, MEN2A, MEN2B, feocromocitoma y paraganglioma) con enfermedad metastásica diagnosticados por el departamento de patología, con progresión después de la primera línea de tratamiento, reclutados de diciembre del 2014 a febrero del 2016. La eficacia fue analizada usando la TC siguiendo los criterios RECIST 1.1 y los cambios moleculares en el SUVmáx de la PET/TC con 68Ga-DOTATOC. La seguridad fue valorada mediante el renograma con 99mTc-MAG3. Resultados Los 30 pacientes recibieron un total de 49 ciclos de 90Y-DOTATOC (21 dosis) y 177Lu-DOTATATE (28 dosis), con una media de 1,5 ciclos por paciente; 17 (56,7%) mostraron respuesta morfológica parcial; 22 (73,3%) respuesta molecular y bioquímica, y 23 (76,6%) respuesta clínica. Durante la mediana de seguimiento (13 meses) un paciente falleció (3,4%). La mediana de supervivencia global desde el diagnóstico fue de 54 meses (IC 95%, 31,18-76,81), y la mediana de supervivencia libre de progresión fue de 32 meses (IC 95%, 15,00-48,99). Conclusión El tratamiento con 90Y-DOTATOC y 177Lu-DOTATATE es una terapia prometedora para los pacientes con tumores neuroendocrinos bien y moderadamente diferenciados. La eficacia es proporcional al número de ciclos administrados, inversamente proporcional al número de metástasis (<10) y en relación con el grado de captación conforme al SUVmáx por parte de las metástasis, independientemente del volumen tumoral metabólicamente activo. Objective To determine the effectiveness of therapy with the radiolabelled somatostatin analogues, 90Y-DOTATOC and 177Lu-DOTATATE, in the treatment of metastatic neuroendocrine tumours with progression to first-line treatment. Material and methods A study was conducted on 30 patients diagnosed with neuroendocrine tumours (gastroenteropancreatic, bronchopulmonary, MEN2A, MEN2B, phaeochromocytoma, and paraganglioma) with metastatic disease diagnosed by the pathology department, with progression to first-line treatment, and recruited from December 2014 to February 2016. Efficacy was analysed using computed tomography (CT) according RECIST 1.1 criteria, and the molecular changes using the SUVmax of PET/CT with 68Ga-DOTATOC. Safety was carried out with a renal scan with 99mTc-MAG3. Results The 30 patients received a total of 49 cycles 90Y-DOTATOC (21 doses) and 177 Lu-DOTATATE (28 doses), with a mean of 1.5 cycles per patient. Of these, 17 (56.7%) showed a partial morphological response, 22 (73.3%) molecular and biochemical response, and 23 (76.6%) clinical response. One patient died during the median follow-up of 13 months. The median overall survival from diagnosis was 54 months (95% CI; 31.18-76.81), and median progression-free survival was 32 months (95% CI; 15.00-48.99).
      PubDate: 2016-11-28T10:38:50Z
      DOI: 10.1016/j.remn.2016.09.005
       
  • Dr. Julio Barandela Salgado
    • Authors: L.M. Campos Villarino
      Abstract: Publication date: Available online 19 November 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): L.M. Campos Villarino


      PubDate: 2016-11-21T10:29:51Z
      DOI: 10.1016/j.remn.2016.10.001
       
  • Relationship between primary tumour 18F-FDG uptake and immunohistochemical
           and clinical prognostic parameters in breast carcinoma
    • Authors: G.K. Gedik; F. Yilmaz; O. Sari
      Abstract: Publication date: Available online 15 November 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): G.K. Gedik, F. Yilmaz, O. Sari
      Objective The objective of this study was to investigate the relationship between level of 18F-fluorodeoxyglucose (18F-FDG) accumulation in primary breast tumour assessed by positron emission tomography/computed tomography (PET/CT) and histopathological and clinical prognostic factors. Material and methods A retrospective analysis was performed using the medical records of 58 female patients (age range: 31-86 years, mean age: 56) with biopsy of proven breast carcinoma, and who had undergone 18F-FDG PET/CT examination before chemotherapy/surgery. The 18F-FDG uptake of breast tumours was calculated as tumour to background ratio (TBR), which was compared with histopathological and clinical prognostic parameters. Results The histology of the breast tumour in the 58 patients was ductal type in 52 (90%), lobular in 4 (7%), and mucinous in 2 (3%). Tumour size was ≤ 2cm in 31 (53%) patients, and>2cm in 27 (47%). The levels of TBRs were not significantly different between the patients groups with tumours of 2cm or less and greater than 2cm (P =0.131). No significant difference between levels of TBR was observed neither with regards to axillary lymph node involvement (P =0.065) nor in terms of distant metastases (p=0.123). No statistically significant difference was found in levels of TBRs between patients with c-erbB-2 receptor positive and negative ones (P =0.107). Progesterone receptor (PR) expression was observed in 33 patients (57%), and 25 patients (43%) were PR negative. As regards progesterone receptor status, a statistically significant difference was observed in mean TBR levels between patients with and without progesterone receptor expression (P =0.020). Oestrogen receptor expression was positive in 41 (71%) patients, and negative in 17 (29%) patients. The difference in the levels of TBRs between patients with and without oestrogen receptor expression was at the level of significancy (P =0.050). Conclusions It is concluded that 18F-FDG uptake correlates with progesterone negativity of the tumour. However, a significant association with clinical prognostic parameters and level of 18F-FDG uptake levels could not be demonstrated.

      PubDate: 2016-11-21T10:29:51Z
      DOI: 10.1016/j.remn.2016.09.006
       
  • Right atrial metastasis of GIST detected by 18F-FDG PET/CT
    • Authors: D. Albano; M. Bonacina; E. Cossalter; F. Bertagna
      Abstract: Publication date: Available online 12 November 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): D. Albano, M. Bonacina, E. Cossalter, F. Bertagna


      PubDate: 2016-11-14T10:18:34Z
      DOI: 10.1016/j.remn.2016.08.003
       
  • “Pine tree” appearance on 18F-FDG PET/CT MIP image in spinal
           tuberculosis
    • Authors: T. Kumar Jain; A. Sood; R. Kumar Basher; A. Bhattacharya; B. Rai Mittal; A.K. Aggarwal
      Abstract: Publication date: Available online 9 November 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): T. Kumar Jain, A. Sood, R. Kumar Basher, A. Bhattacharya, B. Rai Mittal, A.K. Aggarwal


      PubDate: 2016-11-14T10:18:34Z
      DOI: 10.1016/j.remn.2016.07.001
       
  • 18F-FDG PET/CT of common hepatic duct lymphoepithelioma-like carcinoma
    • Authors: B. Li; Y. Zhang; J. Hou; H. Shi
      Abstract: Publication date: Available online 9 November 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): B. Li, Y. Zhang, J. Hou, H. Shi


      PubDate: 2016-11-14T10:18:34Z
      DOI: 10.1016/j.remn.2016.06.009
       
  • Carney's triad with synchronous breast cancer: 18F-FDG PET/CT imaging
    • Authors: B.D. Nguyen
      Abstract: Publication date: November–December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 6
      Author(s): B.D. Nguyen


      PubDate: 2016-11-07T10:03:52Z
       
  • 18F-FDG PET/CT follow-up of follicular dendritic cell sarcoma
    • Authors: D. Albano; G. Bosio; F. Bertagna
      Abstract: Publication date: Available online 25 October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): D. Albano, G. Bosio, F. Bertagna
      Follicular dendritic cell sarcoma (FDCS) is a rare lymphoid neoplasm which occurs mainly in lymph nodes, especially cervical and mediastinal; it can be difficult to diagnose and often is misdiagnosed. Its pathogenesis is still not clear, like its evolution. We report a case of 60-year-old woman with FDCS of left lateral cervical node followed for almost 10 years, after a left selective neck dissection, who underwent five 18F-FDG PET/CT. This technique has proven to be an useful method for the management of this patient, mainly for the follow up, detection of relapse and therapy response evaluation.

      PubDate: 2016-10-31T07:50:15Z
      DOI: 10.1016/j.remn.2016.09.001
       
  • Uterine leiomyosarcoma metastatic to thyroid shown by 18F-FDG PET/CT
           imaging
    • Authors: M. Gauthé; N. Testart Dardel; C. Nascimento; M. Trassard; A. Banal; J.-L. Alberini
      Abstract: Publication date: Available online 21 October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. Gauthé, N. Testart Dardel, C. Nascimento, M. Trassard, A. Banal, J.-L. Alberini
      About one third of focal thyroid uptakes in a fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) study are malignant, the most frequent histological type being papillary carcinoma. Metastases to the thyroid account for approximately 7.5% of thyroid malignancies and come mainly from kidney, lung, head and neck, and breast cancers. We report the case of a 64-year-old woman presenting a fast growing thyroid nodule whose primitive or metastatic origin was not obvious, for which 18F-FDG PET/CT helped in the diagnostic process and in the later management of the patient. Histopathologic findings finally revealed a metastasis of uterine leiomyosarcoma.

      PubDate: 2016-10-31T07:50:15Z
      DOI: 10.1016/j.remn.2016.09.002
       
  • 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
      Abstract: Publication date: Available online 19 October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): J.R. Garcia, C. Corbella, M. Baquero, P. Bassa, M. Soler


      PubDate: 2016-10-31T07:50:15Z
      DOI: 10.1016/j.remn.2016.08.004
       
  • Gammagrafía con 75SeHCAT en la diarrea crónica por malabsorción de
           ácidos biliares
    • Authors: L.M. Mena Bares; E. Carmona Asenjo; M.V. García Sánchez; E. Moreno Ortega; F.R. Maza Muret; M.V. Guiote Moreno; A.M. Santos Bueno; E. Iglesias Flores; J.M. Benítez Cantero; J.A. Vallejo Casas
      Abstract: Publication date: Available online 17 October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): L.M. Mena Bares, E. Carmona Asenjo, M.V. García Sánchez, E. Moreno Ortega, F.R. Maza Muret, M.V. Guiote Moreno, A.M. Santos Bueno, E. Iglesias Flores, J.M. Benítez Cantero, J.A. Vallejo Casas
      La diarrea crónica es una entidad común en la práctica clínica diaria y supone un deterioro en la calidad de vida de los pacientes. Puede ser el síntoma principal de múltiples etiologías, entre las que se encuentra la malabsorción de ácidos biliares (MAB), que en la población general presenta una prevalencia comparable a la enfermedad celíaca. La MAB ocurre por una alteración en la homeostasis de los ácidos biliares en la circulación enterohepática. Puede aparecer como consecuencia de una disfunción o enfermedad ileal (MAB tipo i), por causas idiopáticas (MAB tipo ii) o asociada con otras entidades gastrointestinales (MAB tipo iii). Entre los diferentes métodos diagnósticos disponibles destacamos la gammagrafía con 75SeHCAT como gold standard debido a sus valores de sensibilidad, especificidad, seguridad y bajo coste. La principal desventaja es que no se encuentra disponible en todos los países, por lo que se han desarrollado otros métodos como la medición sérica de FGF19 y C4 que, sin embargo, presentan una mayor complejidad y coste. El tratamiento de primera línea ante un diagnóstico de MAB es con quelantes de ácidos biliares como la colestiramina, pero presenta baja tolerabilidad y efectos secundarios, que son menores con los nuevos fármacos como el colesevelam. En resumen, la MAB es una entidad común que se encuentra infradiagnosticada e infratratada, por lo que es fundamental establecer un adecuado algoritmo diagnóstico de la diarrea crónica en el que el estudio con 75SeHCAT ocuparía la primera o segunda línea en el diagnóstico diferencial de estos pacientes. Chronic diarrhoea is a common entity in daily clinical practice and it leads to a loss in these patients quality of life. It may be the main symptom of multiple ethiologies including bile acid malabsorption (BAM) which has a comparable prevalence to celiac disease. The BAM results from imbalances in the homeostasis of bile acids in the enterohepatic circulation. It can be a consequence of ileal disease or ileal dysfunction (BAM type i), it can be considered idiopathic or primary (BAM type ii) or associated with other gastrointestinal entities (BAM type iii). Among the different diagnostic methods available, 75SeHCAT study is the primary current method due to its sensitivity, specificity, safety and low cost. The main disadvantage is that it's not available in all countries, so other diagnostic methods have appeared, such as serum measurement of FGF19 and C4, however they are significantly more complex and costly. The first-line treatment of bile acid diarrhoea is bile acid sequestrant, such as cholestyramine, which can be difficult to administer due to its poor tolerability and gastrointestinal side effects. These are less prominent with newer agents such as colesevelam. In summary, the BAM is a common entity underdiagnosed and undertreated, so it is essential to establish a diagnosis algorithm of chronic diarrhoea in which the 75SeHCAT study would be first or second line in the differential diagnosis of these patients.

      PubDate: 2016-10-31T07:50:15Z
      DOI: 10.1016/j.remn.2016.08.005
       
  • The value of quantitative analysis in 18F-NaF PET/CT
    • Authors: P. Lapa; M. Marques; G. Costa; J.P. Lima
      Abstract: Publication date: Available online 25 October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): P. Lapa, M. Marques, G. Costa, J.P. Lima
      Aim To evaluate the ability of SUVmax to differentiate bone metastases from degenerative lesions, blastic from lytic metastases, as well as to determine the correlation between SUVmax with 18F-NaF and with 18F-FDG. Material and methods A review was performed on 115 18F-NaF PET/CT studies. Of the 64 patients with bone metastases, 49 (39 women, 10 men, 61±12 years (16–81)), in whom the PET/CT supported the diagnosis of bone metastases, were selected for analysis. A record was made of the SUVmax of a maximum of ten metastases in each patient (total 172: 141 blastic, 31 lytic), as well as four degenerative lesions (total 188) with the greatest 18F-NaF uptake intensity. Of the 49 patients analyzed, 43 also had a 18F-FDG PET/CT performed in which a record was made of the SUVmax values for 18F-FDG calculated in the locations corresponding to the bone metastases observed in the 18F-NaF PET/CT: 128 metastases (106 blastic, 22 lytic). Results The mean of the SUVmax values was significantly higher in metastases than in degenerative lesions, 26.8±17.3 vs. 15.3±6.3 (P <0.001) and in blastic than in lytic metastases, 27.9±18.3 vs. 22.1±11.3 (P =0.03). A SUVmax value above 42 always represented metastases, with all values above 49 representing blastic metastases. Using the SUVmax values, it was possible to predict the occurrence of metastases (AUC=0.723; P <0.001; 95% CI=0.671–0.776). The mean of the SUVmax with 18F-NaF was significantly higher in blastic metastases (27.9±18.3 vs. 22.1±11.3, P =0.03), whereas with 18F-FDG it was significantly higher in lytic ones (3.9±3.4 vs. 9.6±3.3; P <0.01). Conclusions SUVmax can contribute to the differentiation of metastases from degenerative lesions, and blastic from lytic metastases.

      PubDate: 2016-10-31T07:50:15Z
      DOI: 10.1016/j.remn.2016.08.002
       
  • Hemorrhagic pseudotumors of iliac bones in Noonan syndrome: PET/CT imaging
    • Authors: K.D. Nguyen; B.D. Nguyen
      Abstract: Publication date: Available online 28 October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): K.D. Nguyen, B.D. Nguyen


      PubDate: 2016-10-31T07:50:15Z
      DOI: 10.1016/j.remn.2016.08.006
       
  • Additional value of hybrid SPECT/CT systems in neuroendocrine tumors,
           adrenal tumors, pheochromocytomas and paragangliomas
    • Authors: K.K. Wong; S. Chondrogiannis; D. Fuster; C. Ruiz; M.C. Marzola; F. Giammarile; P.M. Colletti; D. Rubello
      Abstract: Publication date: Available online 25 October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): K.K. Wong, S. Chondrogiannis, D. Fuster, C. Ruiz, M.C. Marzola, F. Giammarile, P.M. Colletti, D. Rubello
      The aim of this review was to evaluate the potential advantages of SPECT/CT hybrid imaging in the management of neuroendocrine tumors, adrenal tumors, pheochromocytomas and paragangliomas. From the collected data, the superiority of fused images was observed as providing both functional/molecular and morphological imaging compared to planar imaging. This provided an improvement in diagnostic imaging, with significant advantages as regards: (1) precise locating of the lesions; (2) an improvement in characterization of the findings, resulting higher specificity, improved sensitivity, and overall greater accuracy, (3) additional anatomical information derived from the CT component; (4) CT-based attenuation correction and potential for volumetric dosimetry calculations, and (5) improvement on the impact on patient management (e.g. in better defining treatment plans, in shortening surgical operating times). It can be concluded that SPECT/CT hybrid imaging provides the nuclear medicine physician with a powerful imaging modality in comparison to planar imaging, providing essential information about the location of lesions, and high quality homogeneous images.

      PubDate: 2016-10-31T07:50:15Z
      DOI: 10.1016/j.remn.2016.09.003
       
  • Radioguided surgery and the GOSTT concept: From pre-operative image and
           intraoperative navigation to image-assisted excision
    • Authors: H. Bowles; N. Sánchez; A. Tapias; P. Paredes; F. Campos; C. Bluemel; R.A. Valdés Olmos; S. Vidal-Sicart
      Abstract: Publication date: Available online 25 October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): H. Bowles, N. Sánchez, A. Tapias, P. Paredes, F. Campos, C. Bluemel, R.A. Valdés Olmos, S. Vidal-Sicart
      Radio-guided surgery has been developed for application in those disease scheduled for surgical management, particularly in areas of complex anatomy. This is based on the use of pre-operative scintigraphic planar, tomographic and fused SPECT/CT images, and the possibility of 3D reconstruction for the subsequent intraoperative locating of active lesions using handheld devices (detection probes, gamma cameras, etc.). New tracers and technologies have also been incorporated into these surgical procedures. The combination of visual and acoustic signals during the intraoperative procedure has become possible with new portable imaging modalities. In daily practice, the images offered by these techniques and devices combine perioperative nuclear medicine imaging with the superior resolution of additional optical guidance in the operating room. In many ways they provide real-time images, allowing accurate guidance during surgery, a reduction in the time required for tissue location and an anatomical environment for surgical recognition. All these approaches have been included in the concept known as (radio) Guided intraOperative Scintigraphic Tumour Targeting (GOSTT). This article offers a general view of different nuclear medicine and allied technologies used for several GOSTT procedures, and illustrates the crossing of technological frontiers in radio-guided surgery.

      PubDate: 2016-10-31T07:50:15Z
      DOI: 10.1016/j.remn.2016.09.004
       
  • Uso del 177Lu-DOTATATE como terapia en carcinomas de tiroides
           yodorrefractarios
    • Authors: P. Oliván-Sasot; M. Falgás-Lacueva; J. García-Sánchez; V. Vera-Pinto; C. Olivas-Arroyo; P. Bello-Arques
      Abstract: Publication date: Available online 25 October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): P. Oliván-Sasot, M. Falgás-Lacueva, J. García-Sánchez, V. Vera-Pinto, C. Olivas-Arroyo, P. Bello-Arques
      Ante un paciente con cáncer diferenciado de tiroides, el protocolo de tratamiento estándar a seguir es cirugía, ablación con 131Iodo (131I) de restos tiroideos y supresión de TSH. Pero en algunos casos, el tratamiento con 131I no es efectivo y deja de ser una opción terapéutica debido a la desdiferenciación celular con pérdida de la captación de 131I. Como otras opciones, se puede recurrir a tratamiento sistémico, si bien los pacientes no siempre son respondedores, pudiendo progresar la enfermedad y quedando sin opciones terapéuticas. Los tumores endocrinos pueden expresar receptores de la somatostatina, lo que se ha utilizado tanto para el diagnóstico como para su tratamiento mediante el marcaje de los análogos de la somatostatina con isótopos radiactivos. Presentamos el caso de una paciente con carcinoma folicular de tiroides yodorrefractario, con expresión de receptores de la somatostatina, tratada con 177Lu-DOTATATE, con excelente respuesta clínica y analítica. In a patient with a differentiated thyroid cancer the standard treatment protocol to be followed is surgery, ablation of thyroid remnants with 131Iodine (131I), and TSH suppression. However, the treatment with 131I is not effective in some cases, and it no longer becomes a therapeutic option due to cell de-differentiation with loss of 131I uptake. Systemic treatment can be used as other options, although patients are not always responsive; thus, the disease may progress and therapeutic options may run out. Endocrine tumours may express somatostatin receptors,and this characteristic has been used, not only for diagnosis, but also for their treatment through somatostatin analogue labelling with radioactive isotopes. This was the case of a patient suffering from iodine-refractory follicular thyroid carcinoma, with somatostatin receptors expression, treated with 177Lu-DOTATATE, showing an excellent clinical and analytical response.

      PubDate: 2016-10-31T07:50:15Z
      DOI: 10.1016/j.remn.2016.08.001
       
  • Ischio-rectal mammary-type myofibroblastoma: MRI and 18F-FDG PET/CT
           imaging
    • Authors: A.A. Pham; B.D. Nguyen
      Abstract: Publication date: Available online 14 October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A.A. Pham, B.D. Nguyen


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

      PubDate: 2016-09-27T11:00:40Z
      DOI: 10.1016/j.remn.2016.07.003
       
  • SEMNIM 2.0: una estrategia sólidamente líquida
    • Authors: Becerra
      Abstract: Publication date: September–October 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 35, Issue 5
      Author(s): D. Becerra García


      PubDate: 2016-09-22T10:53:27Z
       
  • Hybrid-fusion SPECT/CT systems in parathyroid adenoma: Technological
           improvements and added clinical diagnostic value
    • Authors: K.K. Wong; S. Chondrogiannis; H. Bowles; D. Fuster; N. Sánchez; L. Rampin; D. Rubello
      Abstract: Publication date: Available online 21 August 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): K.K. Wong, S. Chondrogiannis, H. Bowles, D. Fuster, N. Sánchez, L. Rampin, D. Rubello
      Nuclear medicine traditionally employs planar and single photon emission computed tomography (SPECT) imaging techniques to depict the biodistribution of radiotracers for the diagnostic investigation of a range of disorders of endocrine gland function. The usefulness of combining functional information with anatomy derived from computed tomography (CT), magnetic resonance imaging (MRI), and high resolution ultrasound (US), has long been appreciated, either using visual side-by-side correlation, or software-based co-registration. The emergence of hybrid SPECT/CT camera technology now allows the simultaneous acquisition of combined multi-modality imaging, with seamless fusion of 3D volume datasets. Thus, it is not surprising that there is growing literature describing the many advantages that contemporary SPECT/CT technology brings to radionuclide investigation of endocrine disorders, showing potential advantages for the pre-operative locating of the parathyroid adenoma using a minimally invasive surgical approach, especially in the presence of ectopic glands and in multiglandular disease. In conclusion, hybrid SPECT/CT imaging has become an essential tool to ensure the most accurate diagnostic in the management of patients with hyperparathyroidism.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.07.004
       
  • Homeopathic mistletoe adverse reaction mimics nodal involvement in 18F-FDG
           PET/CT performed for evaluation of response to chemotherapy in lymphoma
    • Authors: P. Abreu; R. Sánchez; T. Mut; D. Balaguer; I. Latorre; H. Rodríguez
      Abstract: Publication date: Available online 13 September 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): P. Abreu, R. Sánchez, T. Mut, D. Balaguer, I. Latorre, H. Rodríguez
      Some patients use complementary medicine. We present a patient with Hodgkin's lymphoma, scanned with 18F-FDG PET/CT for evaluation of response after chemotherapy, who was self-administering mistletoe as a homeopathic medicine product. The careful review of the images of the entire scan and patient collaboration in anamnesis were crucial to avoid a false positive result. A review of the published scientific data on the effects of mistletoe is also presented.

      PubDate: 2016-09-22T10:53:27Z
      DOI: 10.1016/j.remn.2016.07.005
       
 
 
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