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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  [3032 journals]
  • Computing quantitative indicators of structural renal damage in pediatric
           DMSA scans
    • Authors: F. Sampedro; A. Domenech; S. Escalera; I. Carrio
      Pages: 72 - 77
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      Author(s): F. Sampedro, A. Domenech, S. Escalera, I. Carrio
      Objectives The proposal and implementation of a computational framework for the quantification of structural renal damage from 99mTc-dimercaptosuccinic acid (DMSA) scans. The aim of this work is to propose, implement, and validate a computational framework for the quantification of structural renal damage from DMSA scans and in an observer-independent manner. Materials and methods From a set of 16 pediatric DMSA-positive scans and 16 matched controls and using both expert-guided and automatic approaches, a set of image-derived quantitative indicators was computed based on the relative size, intensity and histogram distribution of the lesion. A correlation analysis was conducted in order to investigate the association of these indicators with other clinical data of interest in this scenario, including C-reactive protein (CRP), white cell count, vesicoureteral reflux, fever, relative perfusion, and the presence of renal sequelae in a 6-month follow-up DMSA scan. Results A fully automatic lesion detection and segmentation system was able to successfully classify DMSA-positive from negative scans (AUC=0.92, sensitivity=81% and specificity=94%). The image-computed relative size of the lesion correlated with the presence of fever and CRP levels (p <0.05), and a measurement derived from the distribution histogram of the lesion obtained significant performance results in the detection of permanent renal damage (AUC=0.86, sensitivity=100% and specificity=75%). Conclusions The proposal and implementation of a computational framework for the quantification of structural renal damage from DMSA scans showed a promising potential to complement visual diagnosis and non-imaging indicators.

      PubDate: 2017-03-02T15:18:57Z
      DOI: 10.1016/j.remn.2016.06.010
  • Utilidad de la PET con 11C-metionina en la diferenciación precoz entre
           recurrencia tumoral y radionecrosis de pacientes tratados de glioma de
           alto grado con RM indeterminada
    • Authors: J.R. Garcia; M. Cozar; M. Baquero; J.M. Fernández Barrionuevo; A. Jaramillo; J. Rubio; G. Maida; M. Soler; E. Riera
      Pages: 85 - 90
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      Author(s): J.R. Garcia, M. Cozar, M. Baquero, J.M. Fernández Barrionuevo, A. Jaramillo, J. Rubio, G. Maida, M. Soler, E. Riera
      Objetivo Valorar la contribución de la PET con 11C-metionina en la diferenciación precoz entre recurrencia tumoral y radionecrosis en pacientes tratados de gliomas de alto grado. Método Treinta pacientes tratados de glioma (grado iii/iv) con cirugía/radioterapia/quimioterapia (5-18 meses) con RM indeterminada. A todos se les realizó estudio de PET con 11C-metionina (<15 días tras RM) con análisis visual (grado de intensidad y morfología de captación), cuantificación (relación SUV máximo lesión/SUV medio fondo) y corregistro PET/RM (3D-Flair). El manejo de los pacientes se decidió en el comité de neurooncología: seguimiento clínico-imagen, tratamiento de segunda línea o cirugía. Resultados Veintitrés estudios de PET con 11C-metionina fueron visualmente positivos. La morfología fue: 15 focales, 4 difusos y 4 anulares. Tres de los focales fueron resecados (AP+). En 16 se realizó terapia de segunda línea (11 respuesta, 5 progresión). En los 4 de morfología anular se decidió seguimiento, con progresión en 2 (verdaderos positivos) y libres de enfermedad en 2 (6 y 7 meses después) (falsos positivos). Siete estudios de PET con 11C-metionina fueron visualmente negativos, todos ellos libres de enfermedad (3-12 meses). La relación SUV lesión/fondo en la recurrencia tumoral fue de 2,79±1,35 mientras que en la radionecrosis fue de 1,53±0,39 (p<0,05). Con umbral de corte SUV lesión/fondo de 2,35 se obtuvo una sensibilidad y especificidad del 90,5 y 100%. Conclusión La valoración de la PET con 11C-metionina, con análisis visual, cuantitativo y corregistro PET/RM muestra un papel complementario en los pacientes con RM no concluyente, permitiendo una diferenciación precoz entre recurrencia tumoral y radionecrosis, que ayuda a la individualización de la terapia. Objective To evaluate the contribution of 11C-Methionine PET in the early differentiation between tumour recurrence and radionecrosis in patients treated for a high grade glioma. Method The study included 30 patients with glioma (III/IV grade) treated with surgery/radiotherapy/chemotherapy (5-8 months) and with an indeterminate MRI. All patients underwent a 11C-Methione PET (within 15 days of MRI) and studies were visually analysed (intensity and morphology of uptake), quantified (SUV max/SUV mean background), and coregistered to MRI (3D-Flair). Patient management was decided by the neuro-oncology committee to clinical and imaging follow-up, second-line treatment, or surgery. Results There were 23 11C-Methionine PET studies visually positive. Morphology of uptake was focal in 15, diffuse in 4, and ring-shaped in 4. Three out of the focal uptake cases und...
      PubDate: 2017-03-02T15:18:57Z
      DOI: 10.1016/j.remn.2016.06.002
  • Analysis of non-conformity in continuous quality improvement in a Hospital
           Radiopharmacy Unit
    • Authors: T. Martinez; J.F. Contreras
      Pages: 99 - 102
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      Author(s): T. Martinez, J.F. Contreras
      Aim To perform an analysis of non-conformities (NC) registered between 2012 and 2015, as a part of the review process of the Quality Management System of our Radiopharmacy Unit. Material and methods Non-conformities registered in the Radiopharmacy Unit in the period 2012–2015 are analyzed and sorted by their impact on the process (critical, major, and minor), cause/origin of the non-conformity, and nature of radiopharmaceutical (PET vs. SPECT). Results A decrease in the NC of 20% per year is observed, especially in PET radiopharmaceuticals. Non-conformities in SPECT make up about 62–84% of the total of the NC, mainly related to the high number of doses prepared and not administered, which is about 1.5–3% in the ratio of non-administered/administered per year. Conclusions Analysis of the NC can be considered as a useful indicator in assessment of quality assurance, and in our particular case, the decrease in the registration of NC indicates effectiveness in the corrective and preventive actions implemented.

      PubDate: 2017-03-02T15:18:57Z
      DOI: 10.1016/j.remn.2016.05.010
  • 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
      Pages: 103 - 109
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      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: 2017-03-02T15:18:57Z
      DOI: 10.1016/j.remn.2016.09.003
  • 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
      Pages: 110 - 112
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      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: 2017-03-02T15:18:57Z
      DOI: 10.1016/j.remn.2016.07.005
  • Uterine leiomyosarcoma metastatic to thyroid shown by 18F-FDG PET/CT
    • Authors: M. Gauthé; N. Testart Dardel; C. Nascimento; M. Trassard; A. Banal; J.-L. Alberini
      Pages: 113 - 115
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      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: 2017-03-02T15:18:57Z
      DOI: 10.1016/j.remn.2016.09.002
  • Uso del 177Lu-DOTATATE como terapia en carcinomas de tiroides
    • Authors: P. Oliván-Sasot; M. Falgás-Lacueva; J. García-Sánchez; V. Vera-Pinto; C. Olivas-Arroyo; P. Bello-Arques
      Pages: 116 - 119
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      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: 2017-03-02T15:18:57Z
      DOI: 10.1016/j.remn.2016.08.001
  • A rare case of dorsal-cervical spine myeloid sarcoma detected on 18F-FDG
           PET/CT scan
    • Authors: S. Annunziata; C. Caldarella
      Pages: 127 - 128
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      Author(s): S. Annunziata, C. Caldarella

      PubDate: 2017-03-02T15:18:57Z
      DOI: 10.1016/j.remn.2016.06.006
  • Ischio-rectal mammary-type myofibroblastoma: MRI and 18F-FDG PET/CT
    • Authors: A.A. Pham; B.D. Nguyen
      Pages: 131 - 132
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      Author(s): A.A. Pham, B.D. Nguyen

      PubDate: 2017-03-02T15:18:57Z
      DOI: 10.1016/j.remn.2016.07.006
  • Laryngeal and cardiac amyloidosis diagnosed by 18F-Florbetapir PET/CT
    • Authors: P. García-González; R. Sánchez-Jurado; M.P. Cozar-Santiago; M. Ferrando-Beltrán; P.L. Pérez-Rodriguez; J. Ferrer-Rebolleda
      Pages: 135 - 136
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      Author(s): P. García-González, R. Sánchez-Jurado, M.P. Cozar-Santiago, M. Ferrando-Beltrán, P.L. Pérez-Rodriguez, J. Ferrer-Rebolleda

      PubDate: 2017-03-02T15:18:57Z
      DOI: 10.1016/j.remn.2016.03.006
  • Enfermedad de Graves en un paciente de 3 años con agranulocitosis
           asociada a fármacos antitiroideos: terapia ablativa con radioyodo como
           una alternativa eficaz
    • Authors: E. Espinosa-Muñoz; D. Ramírez-Ocaña; A.M. Martín-García; F.J. Ruiz-García; C. Puentes-Zarzuela
      Abstract: Publication date: Available online 6 April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): E. Espinosa-Muñoz, D. Ramírez-Ocaña, A.M. Martín-García, F.J. Ruiz-García, C. Puentes-Zarzuela
      Se presenta el caso de una niña de 3 años pluripatológica, con una enfermedad genética mitocondrial (encefalomiopatía necrosante subaguda o síndrome de Leigh), insuficiencia renal crónica estadio v por una esclerosis mesangial difusa y alteraciones del desarrollo, que fue diagnosticada de hipertiroidismo autoinmune por enfermedad de Graves-Basedow. A las 6 semanas del inicio terapéutico con neocarbimazol, la paciente presentó un cuadro de agranulocitosis severa que obligó a suspender la medicación con fármacos antitiroideos, motivo por el cual fue tratada de manera eficaz con terapia metabólica con 131I. La relevancia del artículo radica en la infrecuencia de la enfermedad de Graves en niños prepuberales (especialmente menores de 6 años), las complicaciones en el desarrollo derivadas de un posible diagnóstico tardío, la aparición de agranulocitosis como efecto adverso potencialmente grave tras el uso de antitiroideos y los pocos casos reportados de terapia ablativa con 131I a esta edad, que otorgan singularidad al caso. The case is presented of a 3 year-old girl with mitochondrial disease (subacute necrotizing encephalomyelopathy of Leigh syndrome), v-stage chronic kidney disease of a diffuse mesangial sclerosis, as well as developmental disorders, and diagnosed with hyperthyroidism Graves-Basedow disease. Six weeks after starting the treatment with neo-carbimazole, the patient reported a serious case of agranulocytosis. This led to stopping the anti-thyroid drugs, and was treated successfully with 131I ablation therapy. The relevance of the article is that Graves’ disease is uncommon in the paediatric age range (especially in children younger than 6 years old), and developing complications due to a possible late diagnosis. Agranulocytosis as a potentially serious adverse effect following the use of anti-thyroid drugs, and the few reported cases of ablation therapy with 131I at this age, makes this case unique.

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

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

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

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

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

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

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

      PubDate: 2017-03-20T15:47:45Z
      DOI: 10.1016/j.remn.2017.01.012
  • Unusual case of tumor of unknown origin found by 18F-FDG PET/CT:
           Metastatic clear cell carcinoma of the thyroid gland
    • Authors: G. Treglia; P. Trimboli; V. Zilioli; F. Fulciniti; L. Giovanella
      Abstract: Publication date: Available online 18 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): G. Treglia, P. Trimboli, V. Zilioli, F. Fulciniti, L. Giovanella

      PubDate: 2017-03-20T15:47:45Z
      DOI: 10.1016/j.remn.2017.02.003
  • Uncommon distant metastasis of pleural mesothelioma detected by whole-body
           18F-FDG PET/CT
    • Authors: C. Rapicetta; S. Taddei; M. Casali; R. Valli; F. Lococo; G. Treglia; M. Paci
      Abstract: Publication date: Available online 18 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): C. Rapicetta, S. Taddei, M. Casali, R. Valli, F. Lococo, G. Treglia, M. Paci

      PubDate: 2017-03-20T15:47:45Z
      DOI: 10.1016/j.remn.2017.02.002
  • 18F-FDG PET/CT in initial staging and treatment response evaluation in a
           patient with thymoma
    • Authors: T.F.
      Abstract: Publication date: Available online 11 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): L. Uslu-Beşli, Y. Akın, T.F. Çermik

      PubDate: 2017-03-16T15:41:04Z
  • PET/TC con 18F-FDG como predictor de la biología tumoral y del
           pronóstico en el cáncer epitelial ovárico
    • Authors: B. González García; A.M. García Vicente; G.A. Jiménez Londoño; F.J. Pena Pardo; M.E. Bellón Guardia; M.P. Talavera Rubio; A. Palomar Muñoz; P. Gómez Herrero; Á.M. Soriano Castrejón
      Abstract: Publication date: Available online 9 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): B. González García, A.M. García Vicente, G.A. Jiménez Londoño, F.J. Pena Pardo, M.E. Bellón Guardia, M.P. Talavera Rubio, A. Palomar Muñoz, P. Gómez Herrero, Á.M. Soriano Castrejón
      Objetivo Investigar la relación del valor máximo estandarizado de captación (SUVmáx) de la lesión ovárica con el subtipo histopatológico (I/II) y su implicación en la respuesta al tratamiento y en el pronóstico de las pacientes con carcinoma epitelial de ovario (CEO). Material y métodos Análisis retrospectivo de 31 pacientes con CEO y 18F-FDG-PET/TC previo al tratamiento, determinándose el SUVmáx de la lesión ovárica y realizándose diagnóstico histopatológico del tumor y seguimiento clínico-radiológico. Se estudió la relación del SUVmáx con el tipo histológico (tipos I y II) y el estadio tumoral, así como la implicación de este y otros parámetros (histología, estadio) en la evolución de las pacientes (respuesta completa [RC], supervivencia global [SG], supervivencia libre de enfermedad [SLE], estado libre de enfermedad a los 12 meses [LE12m] y a los 24 meses [LE24m]). Resultados El SUVmáx medio en lesiones tipo I fue menor que en las tipo II (6,3 y 9,3, respectivamente; p=0,03). Se obtuvo un valor de corte de SUVmáx de 7,1 en la identificación del CEO tipo II (sensibilidad: 77,8%; especificidad: 69,2%; AUC=0,748; p=0,02). No se halló relación significativa entre SUVmáx y estadio tumoral. Alcanzar RC fue más frecuente en estadios precoces; riesgo relativo (RR) de 1,64; p=0,003, en tumores tipo I y en los de menor SUVmáx. El estadio tumoral fue determinante en la SLE (p=0,04), en el LE24m (p=0,07) y en la SG (p=0,08). Observamos SLE más prolongadas y mayor porcentaje de pacientes LE24m en tumores tipo I (RR: 1,32; p=0,26). Conclusiones El SUVmáx se relacionó con el tipo histológico del CEO. No se encontró relación entre la actividad glucolítica del tumor primario con la respuesta y el pronóstico. Objective To investigate the relationship between maximum standardised uptake value (SUVmax) of ovarian lesions and histopathology subtypes, and their involvement in the response and prognosis of patients with epithelial ovarian carcinoma (EOC). Material and methods A retrospective analysis of 31 patients with EOC and 18F-FDG-PET/CT before treatment, including an assessment of the SUVmax of ovarian lesion. Histopathological diagnosis and follow-up was performed. A study was made on the relationship between the SUVmax and histological type (type I and II) and tumour stage, as well as the role of various parameters (SUVmax, histology, stage) on the patient outcomes (complete response [CR], overall survival [OS], disease-free survival [DFS], and disease-free [DF] status, at 12 and 24 months). Results
      PubDate: 2017-03-16T15:41:04Z
      DOI: 10.1016/j.remn.2017.01.004
  • 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
      Abstract: Publication date: Available online 6 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      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: 2017-03-08T15:29:13Z
      DOI: 10.1016/j.remn.2016.12.006
  • Assessment of cardiovascular impairment in obese patients: Limitations and
           troubleshooting of available imaging tools
    • Authors: V. Gaudieri; C. Nappi; W. Acampa; R. Assante; E. Zampella; M. Magliulo; M. Petretta; A. Cuocolo
      Abstract: Publication date: Available online 3 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): V. Gaudieri, C. Nappi, W. Acampa, R. Assante, E. Zampella, M. Magliulo, M. Petretta, A. Cuocolo
      The prevalence and severity of obesity have increased over recent decades, reaching worldwide epidemics. Obesity is associated to coronary artery disease and other risk factors, including hypertension, heart failure and atrial fibrillation, which are all increased in the setting of obesity. Several noninvasive cardiac imaging modalities, such as echocardiography, cardiac computed tomography, magnetic resonance and cardiac gated single-photon emission computed tomography, are available in assessing coronary artery disease and myocardial dysfunction. Yet, in patients with excess adiposity the diagnostic accuracy of these techniques may be limited due to some issues. In this review, we analyze challenges and possibilities to find the optimal cardiac imaging approach to obese population.

      PubDate: 2017-03-08T15:29:13Z
      DOI: 10.1016/j.remn.2017.01.010
  • 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
      Abstract: Publication date: Available online 3 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      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-FDG PET is a useful ...
      PubDate: 2017-03-08T15:29:13Z
      DOI: 10.1016/j.remn.2017.01.007
  • Incidental meningioma detected by using 99mTc-MIBI SPECT/CT
    • Authors: D. Albano; L. Camoni; G. Bosio; F. Bertagna
      Abstract: Publication date: Available online 3 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): D. Albano, L. Camoni, G. Bosio, F. Bertagna

      PubDate: 2017-03-08T15:29:13Z
      DOI: 10.1016/j.remn.2017.01.011
  • Hydrothorax secondary to peritoneal dialysis detected by peritoneal
    • Authors: D. Balaguer; P. Abreu; T. Mut; M.D. Reyes; M.C. Plancha; E. Caballero
      Abstract: Publication date: Available online 3 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): D. Balaguer, P. Abreu, T. Mut, M.D. Reyes, M.C. Plancha, E. Caballero

      PubDate: 2017-03-08T15:29:13Z
      DOI: 10.1016/j.remn.2017.01.013
  • 18F-florbetapir uptake in a primary intraosseous haemangioma displayed in
           a cerebral PET/CT
    • Authors: Prado-Wohlwend Sopena-Novales; M.D. Monedero-Picazo
      Abstract: Publication date: Available online 2 March 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): R. Sánchez-Vañó, S. Prado-Wohlwend, P. Sopena-Novales, E. Uruburu-García, M.D. Monedero-Picazo, C. Martínez-Carsí

      PubDate: 2017-03-02T15:18:57Z
  • Tratamiento con 177Lu-DOTATATE: pasado, presente y futuro
    • Authors: Estorch
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      Author(s): M. Estorch

      PubDate: 2017-03-02T15:18:57Z
  • The value of quantitative analysis in 18F-NaF PET/CT
    • Authors: Lapa Marques; Costa J.P. Lima
      Abstract: Publication date: March–April 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular, Volume 36, Issue 2
      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: 2017-03-02T15:18:57Z
  • Comparación de resultados cualitativos vs. cuantitativos de 99mTc-MDP
           SPECT en pacientes con sospecha clínica de hiperplasia condilar
    • Authors: D.F. López Buitrago; J. Ruiz Botero; C.M. Corral; A.R. Carmona; A. Sabogal
      Abstract: Publication date: Available online 28 February 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): D.F. López Buitrago, J. Ruiz Botero, C.M. Corral, A.R. Carmona, A. Sabogal
      Objetivo Comparar el resultado de los informes cualitativos de la tomografía computarizada de emisión por fotón único (SPECT), con los resultados cuantitativos, calculados a partir del porcentaje de captación del radiofármaco 99mTc-MDP (metilendifosfonato), en cóndilos de pacientes con sospecha clínica de hiperplasia condilar. Materiales y método Estudio retrospectivo, descriptivo realizado en 51 pacientes con impresión clínica de asimetría facial y sospecha de hiperplasia condilar, remitidos a un centro de medicina nuclear para realizarles gammagrafía ósea-SPECT por el especialista en ortodoncia y/o cirugía maxilofacial. Se obtuvieron los datos cuantitativos del porcentaje de captación del radiofármaco 99mTc-MDP en ambos cóndilos, y se compararon con el informe cualitativo generado por el médico nuclear en cada uno de los sujetos. Resultados Se estableció la concordancia entre 51 informes cualitativos y sus resultados cuantitativos. Del total de la muestra, 32 eran mujeres (63%) y 19 hombres (37%). La edad de los pacientes estaba en un rango de 13-45 años (21±8 años). Según los informes cualitativos 19 pacientes fueron positivos para hiperplasia condilar derecha, 12 para izquierda, 8 bilaterales y 12 negativos. Según los resultados cuantitativos, 16 fueron positivos para hiperplasia condilar derecha, 10 izquierdos y 25 negativos. Conclusiones Las imágenes de medicina nuclear son una importante herramienta diagnóstica, pero la interpretación cualitativa de la imagen no es tan confiable como la determinación cuantitativa. Los informes cualitativos concuerdan con los resultados cuantitativos de la prueba SPECT 99mTc-MDP, en un bajo porcentaje (39,2%, kappa=0,13; p>0,2). La principal limitación del método cuantitativo es que no registra casos de hiperplasia condilar bilateral. Objective To compare qualitative vs quantitative results of Single Photon Emission Computerised Tomography (SPECT), calculated from percentage of 99mTc-MDP (methylene diphosphonate) uptake, in condyles of patients with a presumptive clinical diagnosis of condylar hyperplasia. Materials and method A retrospective, descriptive study was conducted on the 99mTc-MDP SPECT bone scintigraphy reports from 51 patients, with clinical impression of facial asymmetry related to condylar hyperplasia referred by their specialist in orthodontics or maxillofacial surgery, to a nuclear medicine department in order to take this type of test. Quantitative data from 99mTc-MDP condylar uptake of each were obtained and compared with qualitative image interpretation reported by a nuclear medicine expert. Results The concordances between the 51 qualitative and quantitative reports results was established. The total sample included 32 women (63%) and 19 men (37%). The patient age range was 13-45 years (21±8 years). According to qualitative reports, 19 patients were positive for right side condylar hyperplasia, 12 for left side condylar hyperplasia, with 8 bilateral, and 12 negative. The quantitative reports diagnosed 16 positives for right side condylar hyperplasia, 10 for left side condylar hyperplasia, and 25 negatives.
      PubDate: 2017-03-02T15:18:57Z
      DOI: 10.1016/j.remn.2017.01.003
  • Nuevos tiempos para la neuroimagen de Medicina Nuclear en España: ¿de
           dónde partimos?
    • Authors: M.A. Balsa; V. Camacho; P. Garrastachu; D. García-Solís; M. Gómez-Río; S. Rubí; X. Setoain; J. Arbizu
      Abstract: Publication date: Available online 22 February 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M.A. Balsa, V. Camacho, P. Garrastachu, D. García-Solís, M. Gómez-Río, S. Rubí, X. Setoain, J. Arbizu
      Objetivo conocer la situación de los estudios de neuroimagen de Medicina Nuclear que se realizaron en España en el año 2013 y primer trimestre del 2014, con el fin de definir las actividades del grupo de trabajo de Neuroimagen de la Sociedad Española de Medicina Nuclear e Imagen Molecular (SEMNIM). Material y métodos Se diseñó un cuestionario de 14 preguntas dividido en 3 partes: características de los servicios (equipamiento y profesionales involucrados), tipo de exploraciones e indicaciones clínicas y métodos de evaluación. El cuestionario se remitió a los 166 servicios de Medicina Nuclear que figuraban en la secretaría de la Sociedad Española de Medicina Nuclear e Imagen Molecular. Resultados Respondieron a la encuesta un total de 54 centros distribuidos entre todas las comunidades autónomas. La mayoría de los centros realizaron entre 300 y 800 exploraciones de neuroimagen al año, representando más de 25 exploraciones al mes. La media de equipos por servicio era de 3, teniendo la mitad de ellos equipos PET/TC y SPECT/TC. Las exploraciones realizadas con más frecuencia son la SPECT cerebral con 123I-FP-CIT, seguida de la SPECT cerebral de perfusión y de la PET con 18F-FDG, siendo las indicaciones clínicas más frecuentes los estudios de deterioro cognitivo seguidos por los de trastornos del movimiento. Para la evaluación de las pruebas la mayoría de los centros utilizaron únicamente la valoración visual, en la valoración cuantitativa la cuantificación por regiones de interés fue la más utilizada. Conclusiones Los resultados reflejan cuál fue la actividad clínica del año 2013 y primer trimestre del 2014, siendo las indicaciones principales los estudios de deterioro cognitivo y trastorno del movimiento. La variabilidad en la evaluación de los estudios PET y la colaboración con los especialistas clínicos que demandan las exploraciones de neuroimagen de Medicina Nuclear son algunos de los retos que debemos afrontar en los próximos años. Objective To determine the status of neuroimaging studies of Nuclear Medicine in Spain during 2013 and first quarter of 2014, in order to define the activities of the neuroimaging group of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). Material and methods A questionnaire of 14 questions was designed, divided into 3 parts: characteristics of the departments (equipment and professionals involved); type of scans and clinical indications; and evaluation methods. The questionnaire was sent to 166 Nuclear Medicine departments. Results A total of 54 departments distributed among all regions completed the questionnaire. Most departments performed between 300 and 800 neuroimaging examinations per year, representing more than 25 scans per month. The average pieces of equipment were three; half of the departments had a PET/CT scanner and SPECT/CT equipment. Scans performed more frequently were brain SPECT with 123I-FP-CIT, followed by brain perfusion SPECT and PET with 18F-FDG. The most frequent clinical indications were cognitive impairment followed by movement disorders. For evaluation of the images most sites used only visual assessment, and for the quantitative assessment the most used was quantification by region of interest.
      PubDate: 2017-02-23T15:04:37Z
      DOI: 10.1016/j.remn.2016.12.004
  • 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
      Abstract: Publication date: Available online 21 February 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): D. Villasboas-Rosciolesi, C. Pérez, L. Capdevila, F. Ramos, V. Valenti, J.R. Garcia

      PubDate: 2017-02-23T15:04:37Z
      DOI: 10.1016/j.remn.2016.11.002
  • Pericardial metastases due to terminal ileum primary carcinoid tumour
           detected on 111In scintigraphy
    • Authors: D.R. Ocaña; E.E. Muñoz; J.R. García; C.P. Zarzuela
      Abstract: Publication date: Available online 20 February 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): D.R. Ocaña, E.E. Muñoz, J.R. García, C.P. Zarzuela

      PubDate: 2017-02-23T15:04:37Z
      DOI: 10.1016/j.remn.2016.12.003
  • Valor de la PET/TC cerebral con 18F-fluorocolina en la detección de
           recurrencias de neoplasias primarias del sistema nervioso central
    • Authors: A. Montes; A. Fernández; V. Camacho; C. de Quintana; O. Gallego; J. Craven-Bartle; D. López; J. Molet; B. Gómez-Ansón; I. Carrió
      Abstract: Publication date: Available online 17 February 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A. Montes, A. Fernández, V. Camacho, C. de Quintana, O. Gallego, J. Craven-Bartle, D. López, J. Molet, B. Gómez-Ansón, I. Carrió
      Objetivo Estudiar el impacto clínico en el manejo de los pacientes de la 18F-fluorocolina (18F-COL) en la recurrencia de neoplasias cerebrales primarias. Material y métodos Se estudió prospectivamente a 21 pacientes con sospecha de recidiva de neoplasia cerebral primaria mediante PET/TC cerebral con 18F-COL en uso compasivo. La distribución por patología de los pacientes estudiados fue: 3 astrocitomas grado ii, 3 astrocitomas grado iii, un oligodendroglioma grado ii, 3 oligodendrogliomas grado iii, un oligoastrocitoma grado iii, 4 glioblastomas multiformes, una gliomatosis cerebri y 5 meningiomas. Se consideraron positivos los estudios en los que había una captación visualmente significativa respecto al fondo del parénquima cerebral. Resultados Diecisiete de los pacientes fueron positivos, comprobándose dicho resultado por histología (10 de ellos) o seguimiento clínico y por neuroimagen, sin hallarse falsos positivos o negativos. El índice target to backgroud ratio medio para los positivos fue de 8,02 y para los negativos de 0,94, lo que representa una diferencia significativa (p=0,003). Conclusión La PET/TC con 18F-COL presenta resultados alentadores en la valoración de pacientes con sospecha de recidiva. Aim To study the usefulness of 18F-fluorocholine (FCH) in detecting the recurrence of primary brain tumours. Material and methods A prospective study was conducted on brain PET/CT with FCH for compassionate use in 21 patients with suspected recurrence of a primary brain tumour. The distribution by pathology was: three grade ii astrocytomas, three grade iii astrocytomas, one grade ii oligodendroglioma, three grade iii oligodendrogliomas, one grade iii oligoastrocytoma, four glioblastoma multiform, one gliomatosis cerebri, and five meningiomas. Studies in which there was a visually significant uptake in the brain parenchyma were classified as positive. Results A total of 17 patients were classified as positive, with the results being confirmed by histology (10 cases) or clinical follow-up and imaging, with no false positives or negatives. The mean SUVmax for positive patients was 8.02 and 0.94 for the negative ones, which was significantly different (P=.003) Conclusion PET/CT with FCH shows encouraging results in the evaluation of patients with suspected recurrence of primary brain neoplasms.

      PubDate: 2017-02-23T15:04:37Z
      DOI: 10.1016/j.remn.2016.11.005
  • Gammagrafía hepatobiliar con 99mTc-mebrofenina en una paciente con
           fístula bilio-pleuro-bronquial
    • Authors: V. Marín-Oyaga; K. Cohen-Castillo; C. Gutierrez-Villamil; S. Arevalo-Leal
      Abstract: Publication date: Available online 17 February 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): V. Marín-Oyaga, K. Cohen-Castillo, C. Gutierrez-Villamil, S. Arevalo-Leal

      PubDate: 2017-02-23T15:04:37Z
      DOI: 10.1016/j.remn.2016.12.002
  • 18F-FDG-PET/CT guiding to diagnosis of neurosarcoidosis
    • Authors: P. Guglielmo; C. Crivellaro; L. Marzorati; M. Patassini; S. Morzenti; C. Landoni
      Abstract: Publication date: Available online 16 February 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): P. Guglielmo, C. Crivellaro, L. Marzorati, M. Patassini, S. Morzenti, C. Landoni

      PubDate: 2017-02-23T15:04:37Z
      DOI: 10.1016/j.remn.2016.12.001
  • Carcinoma epidermoide primario de tiroides. Valoración inicial y control
           evolutivo mediante 18F-FDG PET/TC
    • Authors: L. Caballero Gullón; E. Carmona González; A. Martínez Estévez; M.P. Gómez Camarero; J.J. Corral; I. Borrego Dorado
      Abstract: Publication date: Available online 16 February 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): L. Caballero Gullón, E. Carmona González, A. Martínez Estévez, M.P. Gómez Camarero, J.J. Corral, I. Borrego Dorado
      El carcinoma epidermoide primario de tiroides es una neoplasia muy poco frecuente, con comportamiento agresivo, de mal pronóstico, con pobre respuesta al tratamiento quimioterápico y radioterápico, y cuyo tratamiento de elección es la cirugía. Suele presentarse al diagnóstico como enfermedad extendida, como una tumefacción cervical que causa la mayoría de sus síntomas por invasión o metástasis locales. Su diagnóstico requiere excluir infiltración desde un tumor adyacente, afectación metastásica a distancia desde otro carcinoma epidermoide primario y realizar estudio inmunohistoquímico, el cual refleje el patrón característico de expresión de citoqueratinas. Presentamos el caso de un paciente de 53 años con antecedentes oncológicos de hepatocarcinoma, en el que durante el seguimiento se detecta una lesión cervical, caracterizada como hipermetabólica al realizar el estudio de extensión mediante tomografía por emisión de positrones con 18F-FDG (18F-FDG PET/TC). También presentamos el control evolutivo de dicha lesión mediante esta técnica y la utilidad de esta última. Squamous cell carcinoma of thyroid is an uncommon, very aggressive neoplasm, having a poor prognosis and poor response to chemotherapy and radiotherapy. Surgery is the initial treatment of choice, although it often presents as a widespread disease at the time of diagnosis, usually with cervical swelling that causes most of the symptoms due to local infiltration or metastasis. Local infiltration from adjacent tumour and metastatic disease needs to be excluded from other primary epidermoid carcinomas, in order to make a correct diagnosis. This also requires the typical cytokeratin pattern seen in histological studies. The case is presented of a 53 year-old man with a medical history of hepatocarcinoma, with a cervical hypermetabolic lesion detected in an 18F-FDG PET/CT performed to exclude widespread disease. The follow-up of this lesion with this technique and its usefulness is also described.

      PubDate: 2017-02-23T15:04:37Z
      DOI: 10.1016/j.remn.2017.01.001
  • Incidental finding of 131I uptake in mesenteric cystic lymphangioma on
           post-therapy 131I SPECT/CT imaging
    • Authors: G. Shao; Y. Zhao; J. Song; S. Li
      Abstract: Publication date: Available online 10 February 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): G. Shao, Y. Zhao, J. Song, S. Li

      PubDate: 2017-02-16T14:46:17Z
      DOI: 10.1016/j.remn.2017.01.002
  • Acute pulmonary embolism detection with ventilation/perfusion SPECT
           combined with full dose CT: What is the best option?
    • Authors: M. Milà; J. Bechini; A. Vázquez; V. Vallejos; M. Tenesa; A. Espinal; M. Fraile; M. Monreal
      Abstract: Publication date: Available online 6 February 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): M. Milà, J. Bechini, A. Vázquez, V. Vallejos, M. Tenesa, A. Espinal, M. Fraile, M. Monreal
      Aim To compare diagnostic accuracy of Ventilation/Perfusion (V/P) single-photon emission computed tomography (SPECT) combined with simultaneous full-dose CT with a hybrid SPECT/CT scanner versus planar ventilation/perfusion (V/P) SPECT and CT angiography (CTA) in patients suspected with acute pulmonary embolism (PE). Methods Between 2009 and 2011, consecutive patients suspected of acute PE were referred for V/P SPECT/CT (reviewed board approved study). A contrast agent was administered to patients who had no contraindications. Non-contrast V/P SPECT/CT was performed on the remaining patients. All patients were followed-up for at least 3 months. Results A total of 314 patients were available during the study period, with the diagnosis of PE confirmed in 70 (22.29%) of them. The overall population sensitivity and specificity was 90.91% and 92.44%, respectively for V/P SPECT, 80% and 99.15%, respectively, for CTA, and 95.52% and 97.08% for V/P SPECT/CT. SPECT/CT performed better than V/P SPECT (AUC differences=0.0419, P =0.0043, 95% CI; 0.0131–0.0706) and CTA (AUC differences=0.0681, P =0.0208, 95% CI; 0.0103–0.1259)). Comparing imaging modalities when contrast agent could be administered, sensitivity and specificity increased and V/P SPECT/CT was significantly better than CTA (AUC differences=0.0681, P =0.0208, 95% CI; 0.0103–0.1259) and V/P SPECT (AUC differences=0.0659, P =0.0052, 95% CI; 0.0197–0.1121). In case of non-contrast enhancement, there was non-significant increase of specificity. Secondary findings on CT impacted patient management in 14.65% of cases. Conclusion Our study shows that combined V/P SPECT/CT scanning has a higher diagnostic accuracy for detecting acute PE than V/P SPECT and CTA alone. When feasible, V/P SPECT/CT with contrast enhancement is the best option.

      PubDate: 2017-02-10T14:37:16Z
      DOI: 10.1016/j.remn.2016.11.001
  • Response assessment in relapsing polychondritis with 18F-FDG PET/CT
    • Authors: T.K. Jain; A. Sood; A. Sharma; R.K. Basher; A. Bhattacharya; B.R. Mittal
      Abstract: Publication date: Available online 26 January 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): T.K. Jain, A. Sood, A. Sharma, R.K. Basher, A. Bhattacharya, B.R. Mittal

      PubDate: 2017-01-28T14:19:26Z
      DOI: 10.1016/j.remn.2016.10.004
  • Incidental detection of tracer avidity in meningioma in 68Ga-PSMA PET/CT
           during initial staging for prostate cancer
    • Authors: T.K. Jain; A.G.S. Jois; S. Kumar V; S.K. Singh; R. Kumar; B.R. Mittal
      Abstract: Publication date: Available online 26 January 2017
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): T.K. Jain, A.G.S. Jois, S. Kumar V, S.K. Singh, R. Kumar, B.R. Mittal

      PubDate: 2017-01-28T14:19:26Z
      DOI: 10.1016/j.remn.2016.10.005
  • Primary hyperparathyroidism regression associated to cinacalcet therapy
           proved by 99mTc-MIBI scintigraphy
    • Authors: A. Coloma; S. Hernández-Estrada; H. Bowles; N. Sánchez; D. Fuster; J. Torregrosa
      Abstract: Publication date: Available online 20 December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): A. Coloma, S. Hernández-Estrada, H. Bowles, N. Sánchez, D. Fuster, J. Torregrosa

      PubDate: 2016-12-27T13:24:04Z
      DOI: 10.1016/j.remn.2016.10.010
  • Unexpected primary bone lymphoma
    • Authors: S. Rodríguez Martínez de Llano; M.L. Poncet Souto; R. Álvarez Rodríguez; C. Lancha Hernández; I. Candal Casado; P. Pais Silva
      Abstract: Publication date: Available online 6 December 2016
      Source:Revista Española de Medicina Nuclear e Imagen Molecular
      Author(s): S. Rodríguez Martínez de Llano, M.L. Poncet Souto, R. Álvarez Rodríguez, C. Lancha Hernández, I. Candal Casado, P. Pais Silva

      PubDate: 2016-12-12T11:02:32Z
      DOI: 10.1016/j.remn.2016.10.006
  • Tratamiento con 177LU-DOTATATE en tumores neuroendocrinos. Estudio
    • 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
  • 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
    • 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
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