Revista Espanola De Medicina Nuclear E Imagen Molecular最新文献

英文中文

Gestión de riesgo del tratamiento con radioyodo en el cáncer diferenciado de tiroides 分化型甲状腺癌放射性碘治疗的风险管理

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-07-01 DOI: 10.1016/j.remn.2024.500029

J. Villena-Salinas , M.A. Sempere Alcocer , M. Gallego Peinado

Introduction

Patient safety is paramount in providing quality healthcare and constitutes a global concern for healthcare systems. Radioiodine treatment to patients with well-differentiated thyroid cancer is not without risks. The aim of this study is to identify, evaluate and mitigate the risks associated with this procedure.

Materials and methods

A single-centre descriptive study was conducted in which risk management was carried out by establishing a risk map using FMEA methodology.

Results

Based on the process map 6 sub-processes and 23 failure modes in the three phases of the treatment process were analysed. According to risk priority number (RPN), the sub-process with the highest risk was administrative management (RPN 82), followed by treatment per se and post-treatment imaging (both with RPN 70). An overall process RPN of 300 (156 pre-treatment, 74 treatment and 70 post-treatment) was obtained. Failures directly related to the patient pose a high risk. The implementation of verification systems, performing tasks earlier and providing quality medical information are the most relevant preventive measures to be implemented.

Conclusions

The application of the FMEA methodology in the risk management for radioiodine treatment is a valuable tool for improving the quality and safety of this process. The risk map has been able to identify failures at different stages, assess their causes and effects, prioritise the risks identified and implement preventive and corrective measures that can be monitored, ensuring the effectiveness of the actions taken.

导言：患者安全是提供优质医疗服务的重中之重，也是全球医疗系统关注的问题。对分化良好的甲状腺癌患者进行放射性碘治疗并非没有风险。本研究的目的是识别、评估和降低与该治疗过程相关的风险。材料和方法开展了一项单中心描述性研究，通过使用 FMEA 方法绘制风险图进行风险管理。根据风险优先级编号（RPN），风险最高的子流程是行政管理（RPN 82），其次是治疗本身和治疗后成像（RPN 均为 70）。总体流程 RPN 为 300（治疗前 156，治疗中 74，治疗后 70）。与病人直接相关的故障风险很高。结论在放射性碘治疗风险管理中应用 FMEA 方法是提高该过程质量和安全的重要工具。风险图能够识别不同阶段的故障，评估其原因和影响，对识别出的风险进行优先排序，并实施可监测的预防和纠正措施，以确保所采取的行动的有效性。

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引用次数: 0

Meningioma nasosinusal recurrente: perspectivas de la imagen con receptores de somatostatina 复发性鼻咽部脑膜瘤：体生长抑素受体的成像视角

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-07-01 DOI: 10.1016/j.remn.2024.500014

A.S. Abdlkadir , R. Amarin , E. Estrada-Lobato , A. Al-Ibraheem

引用次数: 0

Ablación percutánea guiada por ecografía de nódulos tiroideos con [177Lu]Lu-MAA (LUTMA): estudio de viabilidad 经皮超声引导下用[177Lu]Lu-MAA（LUTMA）消融甲状腺结节：可行性研究

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-07-01 DOI: 10.1016/j.remn.2024.500023

S. Sager , E. Akgun , M. Abuqbeitah , A. Nazari , N. Yeyin , E. Karayel , H. Pehlivanoglu , A. Aygun , H. Burcak Sayman

Purpose

The main purpose is to evaluate the safety, and efficacy of ¹⁷⁷Lutetium labeled macroaggregated albumin (LUTMA) ablation of thyroid nodules.

Material and methods

Patients with confirmed benign nodules who were not candidate or did not accept surgery were enrolled. Under ultrasonography (USG) guidance, LUTMA which was produced in our department, was administered into the nodules. Nodule volumes were assessed via USG before the injection and at 1-week, 1-month, and 3-months post-treatment. We calculated the volume reduction rates (VRRs) for these intervals. To detect extranodular activity leakage, patients underwent SPECT/CT imaging at one hour, 24 hours, and one week post-injection.

Results

Fifteen patients (male: 12, female: 3) with benign thyroid nodules were eligible to join this study. These nodules were categorized as cystic (n = 9), solid (n = 3), or mixed (n = 3). Median nodules volume was 6.59 ml (range: 0.56-55 ml). Predicted absorbed dosee to the nodules varied between 10 to 1036 Gy. The VRRs at 3. months was 85% for all nodule types with gradual increases over time: 0-92%, 20-97%, and 28-98% at 1. week, 1. month, and 3-months, respectively. The median VRR of cystic nodules was 89% (range: 81%-98%) at 3-months. It is significantly higher than solid ones (p = 0.009). None of the patients experienced adverse reactions or discomfort during the injection or follow-up.

Conclusion

LUTMA treatment significantly reduces the volume of benign thyroid nodules, offering relief from disease-associated symptoms and cosmetic concerns. It emerges as a promising alternative to surgical and other local treatments for benign thyroid nodule ablation.

Clinical signification

LUTMA is a novel theranostic radiopharmaceutical which is promising in local ablative treatment of benign thyroid nodules.

目的主要目的是评估 177Lutetium 标记的大聚合白蛋白（LUTMA）消融甲状腺结节的安全性和有效性。在超声波（USG）引导下，将本部门生产的 LUTMA 注入结节。在注射前、治疗后 1 周、1 个月和 3 个月，通过 USG 对结节体积进行评估。我们计算了这些时间段的体积缩小率（VRR）。为了检测结节外活动性渗漏，患者在注射后1小时、24小时和一周分别接受了SPECT/CT成像。这些结节分为囊性（9 个）、实性（3 个）和混合性（3 个）。结节体积中位数为 6.59 毫升（范围：0.56-55 毫升）。结节的预测吸收剂量介于 10 到 1036 Gy 之间。所有类型的结节在 3 个月时的 VRR 均为 85%，并随着时间的推移逐渐增加：1 周、1 个月和 3 个月时的 VRR 分别为 0-92%、20-97% 和 28-98%。囊性结节的中位 VRR 在 3 个月时为 89%（范围：81%-98%）。明显高于实性结节（P = 0.009）。结论LUTMA 治疗能明显缩小良性甲状腺结节的体积，缓解疾病相关症状，改善外观。临床意义LUTMA是一种新型治疗性放射性药物，在甲状腺良性结节的局部消融治疗中很有前景。

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引用次数: 0

Rabdomiosarcoma prostático en un paciente de seis años evaluado mediante [18F]FDG PET/TC 通过[18F]FDG PET/CT 评估一名六岁患者的前列腺横纹肌肉瘤

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-07-01 DOI: 10.1016/j.remn.2024.500016

引用次数: 0

Características de la imagen de un angiolipoma espinal atípico en PET/TC y resonancia magnética (RM) 非典型脊柱血管脂肪瘤在 PET/CT 和磁共振成像（MRI）上的成像特征

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-07-01 DOI: 10.1016/j.remn.2024.500015

Y. Li , R. Luo , W. Zhang, L. Li

引用次数: 0

Utilidad de la gammagrafía ósea como reflejo del estado nutritivo del paciente, un caso de escorbuto 骨闪烁成像在反映患者营养状况方面的作用，一个坏血病病例。

IF 1.2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-05-01 DOI: 10.1016/j.remn.2024.500012

J.A. Vázquez Gómez , M. Salvá Arteaga , I. Roncero Sánchez-Cano , A. Fernández Marín , M.P. Garrastachu Zumarán , M.Y. Ruiz del Prado

引用次数: 0

Evaluación de la heterogeneidad molecular en tumores neuroendocrinos mediante PET/TC con [68Ga]Ga-DOTA-TOC y [18F]FDG 用[68Ga]Ga-DOTA-TOC 和[18F]FDG PET/CT 评估神经内分泌肿瘤的分子异质性

IF 1.2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-05-01 DOI: 10.1016/j.remn.2024.500011

Z. Nogareda Seoane , M.C. Mallón Araújo , A. Calatayud Cubes , C. Barberán Corral , Y. Domínguez Novoa , A. Cousillas Castiñeira , N. Martínez Lago , J.M. de Matías Leralta , V. Pubul Nuñez

Objective

The aim of the study was evaluate the diagnostic performance of [⁶⁸Ga]Ga-DOTA-TOC and [¹⁸F]FDG PET/CT in patients with histologically proven neuroendocrine tumors (NETs), as well as the correlation of the visualized findings with the tumor grade.

Material and methods

We included 50 patients with NETs who underwent both [⁶⁸Ga]Ga-DOTA-TOC and [¹⁸F]FDG PET/TC. The pooled sensitivity of both scans was compared, as well as [⁶⁸Ga]Ga-DOTA-TOC and [¹⁸F]FDG for each tumor grade (grade 1 [G1], grade 2 [G2] and grade 3 [G3]). Also, the sensitivity of [⁶⁸Ga]Ga-DOTA-TOC and [¹⁸F]FDG as a function of the continuous variable Ki-67 was investigated. Finally, the number of lesions detected by both PET radiopharmaceuticals for each tumor grade was compared.

Results

The pooled sensitivity of both PET/CT (96%) was higher than [⁶⁸Ga]Ga-DOTA-TOC (84%) and [¹⁸F]FDG (44%) separately, with statistically significant differences. The sensitivity of [⁶⁸Ga]Ga-DOTA-TOC was higher than [¹⁸F]FDG in both G1 (P = .004) and G2 (P < .001). In G3 the performance of both scans detected disease in 100% of this subgroup. The sensitivity of [⁶⁸Ga]Ga-DOTA-TOC and [¹⁸F]FDG PET/CT correlated significantly with the Ki-67 proliferative index. In G2 patients the number of lesions detected with [⁶⁸Ga]Ga-DOTA-TOC was higher than [¹⁸F]FDG.

Conclusions

The performance of both PET/CT, particularly in G2 and G3, demonstrates the molecular heterogeneity of metastatic NETs and contributes to the selection of a more appropriate treatment, particularly in those high-grade patients who may benefit from radionuclide therapy (PRRT).

研究旨在评估[68Ga]Ga-DOTA-TOC和[18F]FDG PET/CT在组织学证实的神经内分泌肿瘤（NET）患者中的诊断性能，以及显像结果与肿瘤分级的相关性。比较了两种扫描的集合灵敏度，以及[68Ga]Ga-DOTA-TOC和[18F]FDG对各肿瘤分级（1级[G1]、2级[G2]和3级[G3]）的灵敏度。此外，还研究了[68Ga]Ga-DOTA-TOC和[18F]FDG的灵敏度与连续变量Ki-67的函数关系。结果两种 PET/CT 的综合灵敏度（96%）均高于[68Ga]Ga-DOTA-TOC（84%）和[18F]FDG（44%），且差异有统计学意义。在G1（P = .004）和G2（P < .001）中，[68Ga]Ga-DOTA-TOC的灵敏度均高于[18F]FDG。在 G3 组中，两种扫描方法都能在 100%的患者中检测到疾病。68Ga]Ga-DOTA-TOC和[18F]FDG PET/CT的灵敏度与Ki-67增殖指数显著相关。在G2患者中，[68Ga]Ga-DOTA-TOC检测到的病灶数量高于[18F]FDG。结论两种PET/CT的性能，尤其是在G2和G3中的性能，显示了转移性NET的分子异质性，有助于选择更合适的治疗方法，尤其是那些可能从放射性核素治疗（PRRT）中获益的高级别患者。

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引用次数: 0

Detección de salpingitis mediante PET con 18F-FDG en paciente que presenta síndrome febril de origen desconocido 通过 18F-FDG PET 检测一名不明原因发热综合征患者的输卵管炎。

IF 1.2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-05-01 DOI: 10.1016/j.remn.2024.500010

J.R. Garcia, A. Compte, L. Mont, S. Mourelo, P. Bassa, E. Riera

引用次数: 0

Análisis radiómico PET intra y peritumoral para predecir la respuesta patológica en pacientes con cáncer de mama que reciben quimioterapia neoadyuvante 用于预测接受新辅助化疗的乳腺癌患者病理反应的瘤内和瘤周 PET 放射线组学分析

IF 1.2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-05-01 DOI: 10.1016/j.remn.2024.500002

A. Aksu , Z.G. Güç , K.A. Küçüker , A. Alacacıoğlu , B. Turgut

Objective

The aim of our study was to evaluate the contribution of ¹⁸Fluorine-fluorodeoxyglucose positron emission tomography (18F-FDG PET) radiomic data obtained from both the tumoral and peritumoral area in predicting pathological complete response (pCR) in patients with locally advanced breast cancer receiving neoadjuvant chemotherapy (NAC).

Methods

Female patients with a diagnosis of invasive ductal carcinoma who received NAC were evaluated retrospectively. The volume of interest (VOI) of the primary tumor (VOI-_T) was manually segmented, then a voxel-thick VOI was added around VOI-_T to define the peritumoral area (VOI-_PT). Morphological, intensity-based, histogram and texture parameters were obtained from VOIs. The patients were divided into two groups as pCR and non-complete pathological response (npCR). A «radiomic model» was created with only radiomic features, and a «patho-radiomic model» was created using radiomic features and immunohistochemical data.

Results

Of the 66 patients included in the study, 21 were in the pCR group. The only statistically significant feature from the primary tumor among patients with pCR and npCR was Morphological_Compacity-_T (AUC: 0.666). Between response groups, a significant difference was detected in 2 morphological, 1 intensity, 4 texture features from VOI-_PT; no correlation was found between Morphological_Compacity-_PT and NGLDM_contrast-_PT. The obtained radiomic model's sensitivity and accuracy values were calculated as 61.9% and 75.8%, respectively (AUC: 0.786). When HER2 status was added, sensitivity and accuracy values of the patho-radiomic model increased to 85.7% and 81.8%, respectively (AUC: 0.903).

Conclusions

Evaluation of PET peritumoral radiomic features together with the primary tumor, rather than just the primary tumor, provides a better prediction of the pCR to NAC in patients with breast cancer.

方法对接受新辅助化疗（NAC）的浸润性导管癌女性患者进行回顾性评估。人工分割原发肿瘤的感兴趣体积（VOI）（VOI-T），然后在VOI-T周围添加一个体素厚的VOI来定义瘤周区域（VOI-PT）。根据 VOI 获取形态、基于强度、直方图和纹理参数。患者被分为两组，即 pCR 和非完全病理反应（npCR）。仅利用放射学特征创建 "放射学模型"，利用放射学特征和免疫组化数据创建 "病理放射学模型"。在pCR和npCR患者中，唯一具有统计学意义的原发肿瘤特征是Morphological_Compacity-T（AUC：0.666）。在反应组之间，VOI-PT 的 2 个形态特征、1 个强度特征和 4 个纹理特征存在显著差异；Morphological_Compacity-PT 与 NGLDM_contrast-PT 之间没有相关性。计算得出的放射学模型的灵敏度和准确度值分别为 61.9% 和 75.8%（AUC：0.786）。结论与原发肿瘤一起评估 PET 周围肿瘤放射学特征，而不仅仅是原发肿瘤，能更好地预测乳腺癌患者对 NAC 的 pCR。

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Valor diagnóstico de la imagen PET/TC con [68Ga]Ga-FAPI en el tumor de células redondas pequeñas desmoplásticas 68Ga]Ga-FAPI PET/CT 成像在脱鳞小圆形细胞瘤中的诊断价值

IF 1.2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-05-01 DOI: 10.1016/j.remn.2024.500013

Y. Liu , H. Liu , Z. Wan , Y. Chen , J. Zhang

引用次数: 0

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