Pub Date : 2011-07-01DOI: 10.1016/j.remngl.2010.08.001
M. Elola , A. Yoldi , J.I. Emparanza , T. Matteucci , I. Bilbao , M. Goena
Treatment with radioiodine (RDI) has been shown to be an effective option in patients with differentiated thyroid cancer with recurrent or metastatic disease. However, in spite of having elevated levels of thyroglobulin in blood, in some of these patients, the whole body scan does not detect radioiodine uptake due to loss of differentiation of the neoplastic cells, thus leading to loss of efficacy of the treatment. That is why drugs with potential differentiating properties, like rosiglitazone or retinoids, are being studied. The aim of these drugs is to improve RDI uptake by the tumor cells. In this work, we have described the case of a patient in whom uptake of RDI by the pulmonary metastases, with subsequent decrease of their size, was achieved after treatment with rosiglitazone (8 mg/day for 2 months) as redifferentation therapy.
{"title":"Redifferentiation therapy with rosiglitazone in a case of differentiated thyroid cancer with pulmonary metastases and absence of radioiodine uptake","authors":"M. Elola , A. Yoldi , J.I. Emparanza , T. Matteucci , I. Bilbao , M. Goena","doi":"10.1016/j.remngl.2010.08.001","DOIUrl":"10.1016/j.remngl.2010.08.001","url":null,"abstract":"<div><p>Treatment with radioiodine (RDI) has been shown to be an effective option in patients with differentiated thyroid cancer with recurrent or metastatic disease. However, in spite of having elevated levels of thyroglobulin in blood, in some of these patients, the whole body scan does not detect radioiodine uptake due to loss of differentiation of the neoplastic cells, thus leading to loss of efficacy of the treatment. That is why drugs with potential differentiating properties, like rosiglitazone or retinoids, are being studied. The aim of these drugs is to improve RDI uptake by the tumor cells. In this work, we have described the case of a patient in whom uptake of RDI by the pulmonary metastases, with subsequent decrease of their size, was achieved after treatment with rosiglitazone (8<!--> <!-->mg/day for 2 months) as redifferentation therapy.</p></div>","PeriodicalId":101111,"journal":{"name":"Revista Espa?ola de Medicina Nuclear (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.remngl.2010.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89316155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-07-01DOI: 10.1016/j.remngl.2011.03.001
I. Blanco , D. Díaz , C. Moriyón , L. Santamaría , M.A. Díez , M.T. López , H. Padín , F. Cantero , S. Artime , F. Domínguez , F.J. Aira , R. Álvarez-Obregón
Aim
The aim of this study was to establish the efficacy and safety of sentinel lymph node biopsy for lymph node staging in patients with breast cancer and prior breast surgery, considering its extension, localization and time since the previous surgical procedure.
Materials and methods
A sentinel lymph node biopsy was performed in 38 patients with early breast cancer and previous breast surgery: recent excisional biopsy in 22 patients (Group I), previous lumpectomy or mammoplasty in 16, including one case of cancer treated with breast-conserving surgery (tumor recurrence). Lymphoscintigraphy was performed after periareolar injection, also sometimes adding an injection near to the surgical scar. After removing the sentinel node, axillary lymph node dissection was performed when the lymph node was positive (and not localized).
Results
The efficacy of the scintigraphic localization of the sentinel node was 92.1% of the patients, with 15.8% of extra-axillary drainages. Axillary intraoperative detection was 81.6%. The identification rate after recent excisional biopsy or previous surgery was similar (81.8 vs 81.2%). However, extra-axillary sentinel nodes were more frequent in Group II (9.1 vs 25%). Having a localization of previous surgical procedures in upper outer quadrant caused drainages outside of the axilla more frequently (27.2 vs 11.1%). Axillary detection rate was similar to other quadrants (81.8 vs 81.5%). The rate of breast cancer-related events was 5.2% (2/38), without axillary recurrences (mean follow-up: 3 years).
Conclusion
Sentinel lymph node biopsy in patients with previous but not extensive breast surgery is safe. Extra-axillary drainages are more common when the previous surgical area was wide, especially in the upper-outer quadrant.
目的本研究的目的是建立前哨淋巴结活检对乳腺癌和既往乳房手术患者淋巴结分期的有效性和安全性,考虑其延伸、定位和时间。材料与方法对38例早期乳腺癌及既往乳房手术患者行前哨淋巴结活检:近期切除活检22例(I组),既往乳房肿瘤切除术或乳房成形术16例,其中保乳手术1例(肿瘤复发)。在乳晕周围注射后进行淋巴显影,有时也在手术疤痕附近进行注射。切除前哨淋巴结后,当淋巴结呈阳性(未定位)时进行腋窝淋巴结清扫。结果前哨淋巴结扫描定位有效率92.1%,腋外引流15.8%。术中腋窝检出率为81.6%。近期切除活检或既往手术后的检出率相似(81.8% vs 81.2%)。然而,第二组腋窝外前哨淋巴结发生率更高(9.1% vs 25%)。以前的手术定位在上外象限导致腋窝外引流更频繁(27.2% vs 11.1%)。腋窝检出率与其他象限相似(81.8 vs 81.5%)。乳腺癌相关事件发生率为5.2%(2/38),无腋窝复发(平均随访3年)。结论前哨淋巴结活检对既往未做过广泛乳房手术的患者是安全的。腋外引流在既往手术面积较宽时更为常见,尤其是在上外象限。
{"title":"Sentinel node biopsy in patients with breast cancer and previous breast surgery","authors":"I. Blanco , D. Díaz , C. Moriyón , L. Santamaría , M.A. Díez , M.T. López , H. Padín , F. Cantero , S. Artime , F. Domínguez , F.J. Aira , R. Álvarez-Obregón","doi":"10.1016/j.remngl.2011.03.001","DOIUrl":"10.1016/j.remngl.2011.03.001","url":null,"abstract":"<div><h3>Aim</h3><p>The aim of this study was to establish the efficacy and safety of sentinel lymph node biopsy for lymph node staging in patients with breast cancer and prior breast surgery, considering its extension, localization and time since the previous surgical procedure.</p></div><div><h3>Materials and methods</h3><p>A sentinel lymph node biopsy was performed in 38 patients with early breast cancer and previous breast surgery: recent excisional biopsy in 22 patients (Group I), previous lumpectomy or mammoplasty in 16, including one case of cancer treated with breast-conserving surgery (tumor recurrence). Lymphoscintigraphy was performed after periareolar injection, also sometimes adding an injection near to the surgical scar. After removing the sentinel node, axillary lymph node dissection was performed when the lymph node was positive (and not localized).</p></div><div><h3>Results</h3><p>The efficacy of the scintigraphic localization of the sentinel node was 92.1% of the patients, with 15.8% of extra-axillary drainages. Axillary intraoperative detection was 81.6%. The identification rate after recent excisional biopsy or previous surgery was similar (81.8 vs 81.2%). However, extra-axillary sentinel nodes were more frequent in Group II (9.1 vs 25%). Having a localization of previous surgical procedures in upper outer quadrant caused drainages outside of the axilla more frequently (27.2 vs 11.1%). Axillary detection rate was similar to other quadrants (81.8 vs 81.5%). The rate of breast cancer-related events was 5.2% (2/38), without axillary recurrences (mean follow-up: 3 years).</p></div><div><h3>Conclusion</h3><p>Sentinel lymph node biopsy in patients with previous but not extensive breast surgery is safe. Extra-axillary drainages are more common when the previous surgical area was wide, especially in the upper-outer quadrant.</p></div>","PeriodicalId":101111,"journal":{"name":"Revista Espa?ola de Medicina Nuclear (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.remngl.2011.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90687023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-07-01DOI: 10.1016/j.remngl.2011.02.001
M. Suárez-Piñera , M.L. Prat , A. Mestre-Fusco , J. Fuertes , S. Mojal , E. Balaguer
Aims
Using 123I-FP-CIT SPECT images makes it possible to identify presynaptic deterioration of the dopaminergic pathway by studying the dopamine transporter (DAT). A correct analysis of the SPECT images contributes to an adequate interpretation and diagnosis of movement disorders. Aims: 1. To compare visual and semiquantitative analysis of 123I-FP-CIT SPECT images in patients with movement disorders. 2. To evaluate interobserver agreement in visual and semiquantitative analysis. 3. To obtain a cut-off in the semiquantitative analysis to discriminate primary Parkinsonism Syndrome (PS) from non-primary PS.
Methods
A 123I-FP-CIT SPECT was performed in 32 patients with movement disorders suggestive of primary PS. Visual and semiquantitative images analyses were performed independently by two nuclear medicine physicians. Visual analysis was based on the visual interpretation. Semiquantitative analysis was calculated as specific uptake (caudate, putamen and striatum) versus non-specific uptake (occipital). Sensitivity, specificity, PPV, and NPV were calculated. Data were compared using ANOVA test followed by Bonferroni post hoc test. Interobserver agreement of the visual and semiquantitative analysis was assessed by intraclass correlation coefficient and Kappa statistics, respectively. ROC curve was generated with semiquantitative data.
Results
Visual analysis showed 86% sensitivity and 100–88% specificity for the differential diagnosis of primary PS from non-primary PS. Semiquantitative analysis showed a gradual hypouptake proportional to the disease severity obtained in the visual analysis. Semiquantitative analysis did not provide any additional information to the visual analysis. Intraclass correlation coefficient and Kappa statistics showed 0.92 and 0.80 values, respectively. The cut-off value to differentiate primary PS from non-primary PS was 1.9 on the putamen index.
{"title":"Interobserver agreement in the visual and semi-quantitative analysis of the 123I-FP-CIT SPECT images in the diagnosis of Parkinsonian syndrome","authors":"M. Suárez-Piñera , M.L. Prat , A. Mestre-Fusco , J. Fuertes , S. Mojal , E. Balaguer","doi":"10.1016/j.remngl.2011.02.001","DOIUrl":"https://doi.org/10.1016/j.remngl.2011.02.001","url":null,"abstract":"<div><h3>Aims</h3><p>Using <sup>123</sup>I-FP-CIT SPECT images makes it possible to identify presynaptic deterioration of the dopaminergic pathway by studying the dopamine transporter (DAT). A correct analysis of the SPECT images contributes to an adequate interpretation and diagnosis of movement disorders. <em>Aims: 1.</em> To compare visual and semiquantitative analysis of <sup>123</sup>I-FP-CIT SPECT images in patients with movement disorders. <em>2.</em> To evaluate interobserver agreement in visual and semiquantitative analysis. <em>3.</em> To obtain a cut-off in the semiquantitative analysis to discriminate primary Parkinsonism Syndrome (PS) from non-primary PS.</p></div><div><h3>Methods</h3><p>A <sup>123</sup>I-FP-CIT SPECT was performed in 32 patients with movement disorders suggestive of primary PS. Visual and semiquantitative images analyses were performed independently by two nuclear medicine physicians. Visual analysis was based on the visual interpretation. Semiquantitative analysis was calculated as specific uptake (caudate, putamen and striatum) versus non-specific uptake (occipital). Sensitivity, specificity, PPV, and NPV were calculated. Data were compared using ANOVA test followed by Bonferroni post hoc test. Interobserver agreement of the visual and semiquantitative analysis was assessed by intraclass correlation coefficient and Kappa statistics, respectively. ROC curve was generated with semiquantitative data.</p></div><div><h3>Results</h3><p>Visual analysis showed 86% sensitivity and 100–88% specificity for the differential diagnosis of primary PS from non-primary PS. Semiquantitative analysis showed a gradual hypouptake proportional to the disease severity obtained in the visual analysis. Semiquantitative analysis did not provide any additional information to the visual analysis. Intraclass correlation coefficient and Kappa statistics showed 0.92 and 0.80 values, respectively. The cut-off value to differentiate primary PS from non-primary PS was 1.9 on the putamen index.</p></div>","PeriodicalId":101111,"journal":{"name":"Revista Espa?ola de Medicina Nuclear (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.remngl.2011.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136900348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1016/S1578-200X(11)70008-0
J. Serrano Vicente, L. García Bernardo, C. Durán Barquero, J.I. Rayo Madrid, J.R. Infante Torre, M.L. Domínguez Grande, J.R. Gutiérrez Casares
{"title":"Reversible brain perfusion changes in an acute depersonalization syndrome. Role of SPECT with 99mTc-ECD","authors":"J. Serrano Vicente, L. García Bernardo, C. Durán Barquero, J.I. Rayo Madrid, J.R. Infante Torre, M.L. Domínguez Grande, J.R. Gutiérrez Casares","doi":"10.1016/S1578-200X(11)70008-0","DOIUrl":"10.1016/S1578-200X(11)70008-0","url":null,"abstract":"","PeriodicalId":101111,"journal":{"name":"Revista Espa?ola de Medicina Nuclear (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1578-200X(11)70008-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86941920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1016/S1578-200X(11)70012-2
M. González-Forero, E. Prieto, I. Domínguez, C. Vigil, I. Peñuelas, J. Arbizu
18F-FDOPA is an amino acid analogue used to evaluate presynaptic dopaminergic activity, which has aroused great interest in neuro-oncology. We have evaluated five 18F-FDOPA PET studies of patients referred for study of parkinsonian syndrome. Two subjects had previously treated high- grade brain tumors, one nonspecific brain injury, and 2 subjects presented unexpected tumoral lesions. For all lesions SUVmax, time to SUVmax and tumor-to-normal grey matter SUVmax rate (T/N) were calculated, and 90 minutes 18F-FDOPA kinetics were analyzed. Tumor lesions corresponded to three malignant neurocytomas, one meningioma, one pineocytoma and one intrasinusal heman- gioma. Both malignant and benign tumors exhibited high uptake of 18F-FDOPA well above the normal cortex. However, the analysis of the curve uptake displayed characteristic patterns that facilitate the characterization of tumor lesions. A dual phase maximum uptake was observed, with an early 10 minutes uptake in malignant lesions, and a late 60 to 90 minutes uptake in benign or low grade lesions.
{"title":"Dual time point 18F-FDOPA PET as a tool for characterizing brain tumors","authors":"M. González-Forero, E. Prieto, I. Domínguez, C. Vigil, I. Peñuelas, J. Arbizu","doi":"10.1016/S1578-200X(11)70012-2","DOIUrl":"https://doi.org/10.1016/S1578-200X(11)70012-2","url":null,"abstract":"<div><p><sup>18</sup>F-FDOPA is an amino acid analogue used to evaluate presynaptic dopaminergic activity, which has aroused great interest in neuro-oncology. We have evaluated five <sup>18</sup>F-FDOPA PET studies of patients referred for study of parkinsonian syndrome. Two subjects had previously treated high- grade brain tumors, one nonspecific brain injury, and 2 subjects presented unexpected tumoral lesions. For all lesions SUVmax, time to SUVmax and tumor-to-normal grey matter SUVmax rate (T/N) were calculated, and 90 minutes <sup>18</sup>F-FDOPA kinetics were analyzed. Tumor lesions corresponded to three malignant neurocytomas, one meningioma, one pineocytoma and one intrasinusal heman- gioma. Both malignant and benign tumors exhibited high uptake of <sup>18</sup>F-FDOPA well above the normal cortex. However, the analysis of the curve uptake displayed characteristic patterns that facilitate the characterization of tumor lesions. A dual phase maximum uptake was observed, with an early 10 minutes uptake in malignant lesions, and a late 60 to 90 minutes uptake in benign or low grade lesions.</p></div>","PeriodicalId":101111,"journal":{"name":"Revista Espa?ola de Medicina Nuclear (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1578-200X(11)70012-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91598064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1016/S1578-200X(11)70015-8
L.M. Mena , F. Martín , A. Melero , A. Ramos , I.R. Jiménez
Takotsubo syndrome can mimic an acute myocardial infarction. It is characterized by anginal chest pain with ST elevation in precordial leads, no coronary obstruction on angiography, and typical and reversible deformation of the left ventricular due to antero-apical ballooning with basal hyperkinesis. The pathophysiology of this syndrome is uncertain. It is probably multifactorial, cardiac adrenergic nervous dysfunction standing out in the acute phase. We report two cases performed within the diagnostic context of Takotsubo syndrome. Cardiac SPECT was performed using 123I Metaiodobenzlguanidine (MIBG) and 99mTc-Tetrofosmin and the results of two cases were adrenergic denervation in the anterior wall without alterations in myocardial perfusion study. Identification of Takotsubo syndrome is of clinical importance because its management and prognosis differ significantly from that of acute myocardial infarction.
{"title":"Takotsubo syndrome. Usefulness of Nuclear Medicine studies","authors":"L.M. Mena , F. Martín , A. Melero , A. Ramos , I.R. Jiménez","doi":"10.1016/S1578-200X(11)70015-8","DOIUrl":"https://doi.org/10.1016/S1578-200X(11)70015-8","url":null,"abstract":"<div><p>Takotsubo syndrome can mimic an acute myocardial infarction. It is characterized by anginal chest pain with ST elevation in precordial leads, no coronary obstruction on angiography, and typical and reversible deformation of the left ventricular due to antero-apical ballooning with basal hyperkinesis. The pathophysiology of this syndrome is uncertain. It is probably multifactorial, cardiac adrenergic nervous dysfunction standing out in the acute phase. We report two cases performed within the diagnostic context of Takotsubo syndrome. Cardiac SPECT was performed using <sup>123</sup>I Metaiodobenzlguanidine (MIBG) and <sup>99m</sup>Tc-Tetrofosmin and the results of two cases were adrenergic denervation in the anterior wall without alterations in myocardial perfusion study. Identification of Takotsubo syndrome is of clinical importance because its management and prognosis differ significantly from that of acute myocardial infarction.</p></div>","PeriodicalId":101111,"journal":{"name":"Revista Espa?ola de Medicina Nuclear (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1578-200X(11)70015-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91598067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1016/S1578-200X(11)70009-2
A.M. García Vicente, A. Núñez García, A. Palomar Muñoz, J.P. Pilkington Woll, M.E. Bellón Guardia, B. González García, A. Soriano Castrejón
Aim
To assess the role of PET/CT with retrograde filling of urinary bladder (RFUB) in the assessment of pelvic malignancy in patients with urothelial or gynecological tumors.
Material and methods
A retrospective longitudinal analysis based on 62 studies belonging to 52 patients was performed. All of them had a history of pelvic malignancy (29 urothelial and 23 gynecological) and 42 had undergone previous treatments. All patients underwent a standard PET/CT protocol. Inclusion criteria were radiological alterations in pelvic organs or increased urinary activity of 18F-FDG that hindered evaluation of the pelvic structures. Pathological pelvic locations were assessed as the additional value of PET/CT with RFUB. The pathologic lesions were histologically or clinically evaluated with a minimum follow-up of 12 months.
Results
Pelvic malignancy was confirmed in 33 cases, 16 of which were of urothelial origin. A total of 35/62 studies showed a pathologic PET/CT in pelvis, 4 of them were false positive and 2 false negative. In 19 cases, malignancy was detected in the bladder wall, 16 of which were true positive. No false negative was detected. Regarding standard imaging acquisition, RFUB helped to confirm or rule out bladder and/or gynecological disease in 54 cases.
Conclusion
Retrograde bladder filling is a highly recommended technique in the assessment of malignant pelvic disease, especially of bladder origin.
{"title":"18F-FDG PET/CT with retrograde filling of the urinary bladder in the assessment of malignant pelvic disease","authors":"A.M. García Vicente, A. Núñez García, A. Palomar Muñoz, J.P. Pilkington Woll, M.E. Bellón Guardia, B. González García, A. Soriano Castrejón","doi":"10.1016/S1578-200X(11)70009-2","DOIUrl":"10.1016/S1578-200X(11)70009-2","url":null,"abstract":"<div><h3>Aim</h3><p>To assess the role of PET/CT with retrograde filling of urinary bladder (RFUB) in the assessment of pelvic malignancy in patients with urothelial or gynecological tumors.</p></div><div><h3>Material and methods</h3><p>A retrospective longitudinal analysis based on 62 studies belonging to 52 patients was performed. All of them had a history of pelvic malignancy (29 urothelial and 23 gynecological) and 42 had undergone previous treatments. All patients underwent a standard PET/CT protocol. Inclusion criteria were radiological alterations in pelvic organs or increased urinary activity of <sup>18</sup>F-FDG that hindered evaluation of the pelvic structures. Pathological pelvic locations were assessed as the additional value of PET/CT with RFUB. The pathologic lesions were histologically or clinically evaluated with a minimum follow-up of 12 months.</p></div><div><h3>Results</h3><p>Pelvic malignancy was confirmed in 33 cases, 16 of which were of urothelial origin. A total of 35/62 studies showed a pathologic PET/CT in pelvis, 4 of them were false positive and 2 false negative. In 19 cases, malignancy was detected in the bladder wall, 16 of which were true positive. No false negative was detected. Regarding standard imaging acquisition, RFUB helped to confirm or rule out bladder and/or gynecological disease in 54 cases.</p></div><div><h3>Conclusion</h3><p>Retrograde bladder filling is a highly recommended technique in the assessment of malignant pelvic disease, especially of bladder origin.</p></div>","PeriodicalId":101111,"journal":{"name":"Revista Espa?ola de Medicina Nuclear (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1578-200X(11)70009-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91201115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1016/S1578-200X(11)70020-1
M.A. Muros , J. Arbizu , M.D. Abós , M. Mitjavilla , E. Caballero-Calabuig , J.A. Vallejo
Objective
To know the treatment and follow-up protocols of differentiated thyroid carcinoma patients in Spanish Metabolic Therapy Units, the clinical variability between them and the adaptation to the consensus guidelines.
Materials and methods
Analysis of the results obtained from the questionnaire submitted by E-mail to the Spanish Society of Nuclear Medicine (SEMNIM) members on the treatment and follow-up of differentiated thyroid carcinoma patients. A descriptive study was made of the qualitative variables (frequency, percentage) and quantitative variables (mean, standard deviation).
Results
Twenty Radiometabolic Therapy Units responded to the questionnaire. In spite of the varied origin of the patients, the Units receive sufficient clinical information and have specialized surgeons. There is variability in the surgical protocols and indication for ablation in patients with intermediate and low risk of recurrence. The Units agree on the use of 131I doses for ablation and therapy, but show great variability regarding the preparation protocols (previous 131I-whole body scan or other imaging techniques, 131I-whole body scan dose, diet and radioiodine contrast prohibition, total dose per patient). Nuclear Medicine physicians perceive radioiodine adverse effects and prevention methods are used. The post-ablation follow-up protocol differs between Units.
Conclusions
Treatment and follow-up protocols of differentiated thyroid carcinoma patients in the Spanish Radiometabolic Therapy Units show variability in aspects such as surgery and ablation indications, patient preparation for radioiodine therapy and follow-up. Our clinical practice differs in several aspects from the recent consensus guideline recommendations.
{"title":"Treatment protocols and follow-up of differentiated thyroid carcinoma: results of a questionnaire sent to the Spanish Metabolic Therapy Units","authors":"M.A. Muros , J. Arbizu , M.D. Abós , M. Mitjavilla , E. Caballero-Calabuig , J.A. Vallejo","doi":"10.1016/S1578-200X(11)70020-1","DOIUrl":"https://doi.org/10.1016/S1578-200X(11)70020-1","url":null,"abstract":"<div><h3>Objective</h3><p>To know the treatment and follow-up protocols of differentiated thyroid carcinoma patients in Spanish Metabolic Therapy Units, the clinical variability between them and the adaptation to the consensus guidelines.</p></div><div><h3>Materials and methods</h3><p>Analysis of the results obtained from the questionnaire submitted by E-mail to the Spanish Society of Nuclear Medicine (SEMNIM) members on the treatment and follow-up of differentiated thyroid carcinoma patients. A descriptive study was made of the qualitative variables (frequency, percentage) and quantitative variables (mean, standard deviation).</p></div><div><h3>Results</h3><p>Twenty Radiometabolic Therapy Units responded to the questionnaire. In spite of the varied origin of the patients, the Units receive sufficient clinical information and have specialized surgeons. There is variability in the surgical protocols and indication for ablation in patients with intermediate and low risk of recurrence. The Units agree on the use of <sup>131</sup>I doses for ablation and therapy, but show great variability regarding the preparation protocols (previous <sup>131</sup>I-whole body scan or other imaging techniques, <sup>131</sup>I-whole body scan dose, diet and radioiodine contrast prohibition, total dose per patient). Nuclear Medicine physicians perceive radioiodine adverse effects and prevention methods are used. The post-ablation follow-up protocol differs between Units.</p></div><div><h3>Conclusions</h3><p>Treatment and follow-up protocols of differentiated thyroid carcinoma patients in the Spanish Radiometabolic Therapy Units show variability in aspects such as surgery and ablation indications, patient preparation for radioiodine therapy and follow-up. Our clinical practice differs in several aspects from the recent consensus guideline recommendations.</p></div>","PeriodicalId":101111,"journal":{"name":"Revista Espa?ola de Medicina Nuclear (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1578-200X(11)70020-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137257120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1016/S1578-200X(11)70021-3
D. Boj Carceller , P. Liévano Segundo , P. Navarro Beltrán , A. Sanz París , P. de Castro Hernández , M. Monreal Villanueva , D. Abós Olivares
Objective
To assess the effectiveness of radioactive iodine (RAI) therapy and the incidence of hypothyroidism post RAI in patients with subclinical hyperthyroidism or clinical hyperthyroidism with Multinodular Goiter (MNG).
Methods
A retrospective study of 69 consecutive patients treated with 131I for MNG during the year 2008 observed for six months. All patients received a single fixed dose of 16 mCi (592 MBq) weighted by the gland size. They were categorized into two groups: subclinical hyperthyroidism or clinical hyperthyroidism. We compared the success rate and the incidence of hypothyroidism.
Results
The thyroid dysfunction was corrected in 82.09% of the patients. Success rate was 100% in the clinical hyperthyroidism group and 78.13% in the subclinical hyperthyroidism group (P = 0.105). The overall incidence of hypothyroidism was 16.42%; 25.00% of patients with clinical hyperthyroidism and 14.55% with subclinical hyperthyroidism developed this secondary effect (P = 0.400). No statistically significant differences were found in the success rate in the incidence of hypothyroidism when the results were analyzed according to the thyrotropin decrease in patients with subclinical hyperthyroidism. Seven patients had positive anti-thyroid peroxidase antibodies (anti-TPO) before therapy. The incidence of hypothyroidism was significantly higher in them (57.14% vs 11.67%; P = 0.011). Cardiac arrhythmias were four times more frequent in patients with clinical hyperthyroidism. Previous treatment with thiamazol positively affected the outcome.
Conclusions
A single fixed weighted dose of 131I is highly effective and safe for the control of clinical and subclinical hyperthyroidism due to MNG. Patients with anti-TPO antibodies may have a high risk of developing post-iodine hypothyroidism.
{"title":"Short-term results of treatment with 131I in patients with multinodular goiter: effect of the associated degree of hyperthyroidism and other variables","authors":"D. Boj Carceller , P. Liévano Segundo , P. Navarro Beltrán , A. Sanz París , P. de Castro Hernández , M. Monreal Villanueva , D. Abós Olivares","doi":"10.1016/S1578-200X(11)70021-3","DOIUrl":"10.1016/S1578-200X(11)70021-3","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the effectiveness of radioactive iodine (RAI) therapy and the incidence of hypothyroidism post RAI in patients with subclinical hyperthyroidism or clinical hyperthyroidism with Multinodular Goiter (MNG).</p></div><div><h3>Methods</h3><p>A retrospective study of 69 consecutive patients treated with <sup>131</sup>I for MNG during the year 2008 observed for six months. All patients received a single fixed dose of 16 mCi (592<!--> <!-->MBq) weighted by the gland size. They were categorized into two groups: subclinical hyperthyroidism or clinical hyperthyroidism. We compared the success rate and the incidence of hypothyroidism.</p></div><div><h3>Results</h3><p>The thyroid dysfunction was corrected in 82.09% of the patients. Success rate was 100% in the clinical hyperthyroidism group and 78.13% in the subclinical hyperthyroidism group (P<!--> <!-->=<!--> <!-->0.105). The overall incidence of hypothyroidism was 16.42%; 25.00% of patients with clinical hyperthyroidism and 14.55% with subclinical hyperthyroidism developed this secondary effect (P<!--> <!-->=<!--> <!-->0.400). No statistically significant differences were found in the success rate in the incidence of hypothyroidism when the results were analyzed according to the thyrotropin decrease in patients with subclinical hyperthyroidism. Seven patients had positive anti-thyroid peroxidase antibodies (anti-TPO) before therapy. The incidence of hypothyroidism was significantly higher in them (57.14% vs 11.67%; P<!--> <!-->=<!--> <!-->0.011). Cardiac arrhythmias were four times more frequent in patients with clinical hyperthyroidism. Previous treatment with thiamazol positively affected the outcome.</p></div><div><h3>Conclusions</h3><p>A single fixed weighted dose of <sup>131</sup>I is highly effective and safe for the control of clinical and subclinical hyperthyroidism due to MNG. Patients with anti-TPO antibodies may have a high risk of developing post-iodine hypothyroidism.</p></div>","PeriodicalId":101111,"journal":{"name":"Revista Espa?ola de Medicina Nuclear (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1578-200X(11)70021-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84431419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1016/S1578-200X(11)70024-9
A. Santiago Chinchilla, C. Ramos Font, M.A. Muros de Fuentes, M. Navarro-Pelayo Láinez, H. Palacios Gerona, M. Moreno Caballero, J.M. Llamas Elvira
Parathyroid carcinoma (PTC) is a rare malignant disease that is usually hyperfunctioning, which produces an excess of parathyroid hormone. Hyperparathyroidism causes bone metabolism disorders, as osteopenia and sometimes brown tumors. Brown tumors are benign but locally aggressive bone lesions, whose differential diagnosis with metastases or other primary malignancies may be complicated. 99mTc- Sestamibi scan is the usual procedure for the detection of parathyroid pathology, with a sensitivity of 85–100% and specificity close to 100% in parathyroid adenomas, it having similar percentages in the detection of PTC. We present the case of a patient diagnosed of a malignant hyperparathyroidism associated with bone lesions in which the 99mTc-Sestamibi scan showed a false negative result in the detection of parathyroid condition. However, 18F-FDG-PET/CT detected the PTC and helped in the differential diagnosis of associated bone lesions, which were finally confirmed as brown tumors
{"title":"False negative scintigraphy with 99mTc-sestamibi in parathyroid carcinoma with associated brown tumors. Contributions of 18F-FDG-PET/CT","authors":"A. Santiago Chinchilla, C. Ramos Font, M.A. Muros de Fuentes, M. Navarro-Pelayo Láinez, H. Palacios Gerona, M. Moreno Caballero, J.M. Llamas Elvira","doi":"10.1016/S1578-200X(11)70024-9","DOIUrl":"10.1016/S1578-200X(11)70024-9","url":null,"abstract":"<div><p>Parathyroid carcinoma (PTC) is a rare malignant disease that is usually hyperfunctioning, which produces an excess of parathyroid hormone. Hyperparathyroidism causes bone metabolism disorders, as osteopenia and sometimes brown tumors. Brown tumors are benign but locally aggressive bone lesions, whose differential diagnosis with metastases or other primary malignancies may be complicated. 99mTc- Sestamibi scan is the usual procedure for the detection of parathyroid pathology, with a sensitivity of 85–100% and specificity close to 100% in parathyroid adenomas, it having similar percentages in the detection of PTC. We present the case of a patient diagnosed of a malignant hyperparathyroidism associated with bone lesions in which the 99mTc-Sestamibi scan showed a false negative result in the detection of parathyroid condition. However, 18F-FDG-PET/CT detected the PTC and helped in the differential diagnosis of associated bone lesions, which were finally confirmed as brown tumors</p></div>","PeriodicalId":101111,"journal":{"name":"Revista Espa?ola de Medicina Nuclear (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1578-200X(11)70024-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83923362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}