Pub Date : 2024-11-01DOI: 10.1016/j.remn.2024.500032
S. Gülbahar Ateş , B.B. Demirel , E. Kekilli , E. Öztürk , G. Uçmak
Purpose
The aim of this study is to research the value of the texture analysis of primary tumors in pre-treatment [68Ga]Ga-PSMA PET in the prediction of the development of biochemical recurrence (BCR) in prostate cancer patients who underwent definitive therapies.
Methods
Fifty-one patients with prostate adenocarcinoma who had a pre-treatment [68Ga]Ga-PSMA-11 PET/CT and underwent definitive radiotherapy (RT) or radical prostatectomy (RP) were included in the study. Demographics, clinicopathologic features, the presence of BCR, and the last follow-up date of patients were recorded. Textural and conventional PET parameters (maximum standardized uptake value (SUVmax), total lesion-PSMA (TL-PSMA), and PSMA-tumor volume (PSMA-TV)) were obtained from PET/CT images using LifeX program. Parameters were grouped using the Youden index in ROC analysis. Factors predicting the BCR were determined using Cox regression analyses.
Results
Twenty-nine (56.9%) patients have received primary curative RT, while the remaining 22 (43.1%) patients have undergone RP. 5 (22.7%) patients with RP and 3 (10.3%) patients with curative RT have developed BCR during the follow-up. INTENSITY-BASED-minimum grey level (P=.050), GLCM-sum variance (P=.019), and GLCM-cluster prominence (P=.050) were associated with BCR in univariate analysis. INTENSITY-BASED-minimum grey level (P=.009) and GLCM-sum variance (P=.004) were found as independent predictors of BCR in the multivariate analysis.
Conclusion
Tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET is associated with a high risk of BCR in PCa patients who underwent definitive therapies.
{"title":"Heterogeneidad del tumor primario en la PET/TC con [68Ga]Ga-PSMA previa al tratamiento para la predicción de la recurrencia bioquímica en el cáncer de próstata","authors":"S. Gülbahar Ateş , B.B. Demirel , E. Kekilli , E. Öztürk , G. Uçmak","doi":"10.1016/j.remn.2024.500032","DOIUrl":"10.1016/j.remn.2024.500032","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study is to research the value of the texture analysis of primary tumors in pre-treatment [68Ga]Ga-PSMA PET in the prediction of the development of biochemical recurrence (BCR) in prostate cancer patients who underwent definitive therapies.</div></div><div><h3>Methods</h3><div>Fifty-one patients with prostate adenocarcinoma who had a pre-treatment [68Ga]Ga-PSMA-11 PET/CT and underwent definitive radiotherapy (RT) or radical prostatectomy (RP) were included in the study. Demographics, clinicopathologic features, the presence of BCR, and the last follow-up date of patients were recorded. Textural and conventional PET parameters (maximum standardized uptake value (SUVmax), total lesion-PSMA (TL-PSMA), and PSMA-tumor volume (PSMA-TV)) were obtained from PET/CT images using LifeX program. Parameters were grouped using the Youden index in ROC analysis. Factors predicting the BCR were determined using Cox regression analyses.</div></div><div><h3>Results</h3><div>Twenty-nine (56.9%) patients have received primary curative RT, while the remaining 22 (43.1%) patients have undergone RP. 5 (22.7%) patients with RP and 3 (10.3%) patients with curative RT have developed BCR during the follow-up. INTENSITY-BASED-minimum grey level (<em>P</em>=.050), GLCM-sum variance (<em>P</em>=.019), and GLCM-cluster prominence (<em>P</em>=.050) were associated with BCR in univariate analysis. INTENSITY-BASED-minimum grey level (<em>P</em>=.009) and GLCM-sum variance (<em>P</em>=.004) were found as independent predictors of BCR in the multivariate analysis.</div></div><div><h3>Conclusion</h3><div>Tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET is associated with a high risk of BCR in PCa patients who underwent definitive therapies.</div></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"43 6","pages":"Article 500032"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.remn.2024.500057
B. Hervás-Sanz , I.E. Sánchez-Rodríguez , A. Fernández-Ortega , P. Perlaza-Jiménez , M. Cortés-Romera , J. Suils-Ramón
{"title":"Papel de la [18F]FDG PET/TC en la valoración del carcinoma ductal infiltrante de mama inflamatorio: a propósito de un caso","authors":"B. Hervás-Sanz , I.E. Sánchez-Rodríguez , A. Fernández-Ortega , P. Perlaza-Jiménez , M. Cortés-Romera , J. Suils-Ramón","doi":"10.1016/j.remn.2024.500057","DOIUrl":"10.1016/j.remn.2024.500057","url":null,"abstract":"","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"43 6","pages":"Article 500057"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.remn.2024.500051
J.R. Infante, A. Utrera, A. Baena, R. Barco, A. Martínez, C. Durán, P. Jiménez, J. Serrano
Aim
Gastric emptying scintigraphy is used to assess patients with symptoms of dyspepsia or gastroparesis. An alteration of fundus accommodation may explain these symptoms. The aim of this study was to determine the accommodation in gastric emptying scintigraphy studies performed in our institution.
Material and methods
50 patients (43 children) referred for gastric emptying assessment were evaluated. After fasting for 8 hours, and following international guidelines, egg labeling was performed with 37 mBq of [99mTc]Tc-DTPA and administration of standardized food. Areas of interest were defined in the stomach at different times, and the corresponding retention percentages were calculated. Considering the image at time zero, gastric accommodation was qualitatively and quantitatively assessed, calculating the ratio between proximal stomach counts and total counts.
Results
Of the 50 patients studied, 32 had normal emptying, 10 had slowed emptying and 8 had accelerated emptying. Within the group of patients with normal emptying, 8 had altered accommodation (25%) and another 8 in the group with abnormal emptying (44%). Applying the ROC curve analysis to quantitative values, the most appropriate cut-off value was 0.785 with p< 0.001, sensitivity 82.4% and specificity 100%.
Conclusion
Gastric emptying scintigraphy in addition to determining motility, made it possible to assess both qualitatively and quantitatively the distribution of the radiotracer in the stomach and thus, indirectly, the accommodation in the fundus. It provided added diagnostic information in a simple manner, without protocol changes and allowing more specific treatments to be assessed.
{"title":"Determinación de la acomodación fúndica en gammagrafía de vaciamiento gástrico. Valoración de su utilidad clínica","authors":"J.R. Infante, A. Utrera, A. Baena, R. Barco, A. Martínez, C. Durán, P. Jiménez, J. Serrano","doi":"10.1016/j.remn.2024.500051","DOIUrl":"10.1016/j.remn.2024.500051","url":null,"abstract":"<div><h3>Aim</h3><div>Gastric emptying scintigraphy is used to assess patients with symptoms of dyspepsia or gastroparesis. An alteration of fundus accommodation may explain these symptoms. The aim of this study was to determine the accommodation in gastric emptying scintigraphy studies performed in our institution.</div></div><div><h3>Material and methods</h3><div>50 patients (43 children) referred for gastric emptying assessment were evaluated. After fasting for 8<!--> <!-->hours, and following international guidelines, egg labeling was performed with 37 mBq of [<sup>99</sup>mTc]Tc-DTPA and administration of standardized food. Areas of interest were defined in the stomach at different times, and the corresponding retention percentages were calculated. Considering the image at time zero, gastric accommodation was qualitatively and quantitatively assessed, calculating the ratio between proximal stomach counts and total counts.</div></div><div><h3>Results</h3><div>Of the 50 patients studied, 32 had normal emptying, 10 had slowed emptying and 8 had accelerated emptying. Within the group of patients with normal emptying, 8 had altered accommodation (25%) and another 8 in the group with abnormal emptying (44%). Applying the ROC curve analysis to quantitative values, the most appropriate cut-off value was 0.785 with p<<!--> <!-->0.001, sensitivity 82.4% and specificity 100%.</div></div><div><h3>Conclusion</h3><div>Gastric emptying scintigraphy in addition to determining motility, made it possible to assess both qualitatively and quantitatively the distribution of the radiotracer in the stomach and thus, indirectly, the accommodation in the fundus. It provided added diagnostic information in a simple manner, without protocol changes and allowing more specific treatments to be assessed.</div></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"43 6","pages":"Article 500051"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.remn.2024.500061
N. Filizoglu , S. Ozguven , F. Dede , H.T. Turoglu , T.Y. Erdil
{"title":"Metástasis suprarrenal solitaria de cáncer de mama en PET/TC con [68Ga]Ga-DOTA-TATE","authors":"N. Filizoglu , S. Ozguven , F. Dede , H.T. Turoglu , T.Y. Erdil","doi":"10.1016/j.remn.2024.500061","DOIUrl":"10.1016/j.remn.2024.500061","url":null,"abstract":"","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"43 6","pages":"Article 500061"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.remn.2024.500047
Miriam Guerra-Gómez , Ana Rodríguez-Pajuelo , Laura Brero-Sánchez, Juan Ignacio Cuenca-Cuenca, Rosa María Álvarez-Pérez, José María Freire-Macías, José Manuel Jiménez-Hoyuela García
Purpose
The aim of this study was to determine the agreement between three observers with different levels of experience using the Prostate-Specific Membrane Antigen Reporting and Data System (PSMA-RADS 2.0) criteria and the molecular imaging Tumour, Node, Metastasis (miTNM) system for the interpretation of PET-PSMA with fluorine F 18 piflufolastat in males with prostate cancer.
Materials and methods
PET-PSMA images from 114 prostate cancer patients were blindly reported twice by three different observers at intervals of 8 weeks. The evaluations were performed according to the miTNM and PSMA-RADS 2.0 criteria. We used Fleiss’ Kappa to analyse inter and intraobserver agreements.
Results
Moderate overall agreement was obtained in the assessment of the PET-PSMA results (Fleiss’k = 0.53; 95% CI 0.45-0.62; p < 0.001), with significant agreement in the miT, miN and miM reports. There was a substantial level of agreement in the reporting of prostatic disease and lymphatic involvement (Fleiss’k = 0.66 and 0.65), being lower than that observed in the reporting of metastatic disease (Fleiss’k = 0.86), especially in the M0 group (Fleiss’k = 0.99). Upon re-evaluation of the images, observer 1 had moderate overall agreement for miT (Fleiss’k = 0.51) and substantial agreement for miN and miM (Fleiss’k 0.75 and 0.63, respectively).
Conclusions
The use of a structured scoring system such as PSMA-RADS 2.0, as well as the miTNM classification system in the interpretation of PET-PSMA images in prostate cancer patients, provides a highly reproducible report format. High levels of interobserver and intraobserver agreement are found, especially when ruling out disease, which supports its use in routine clinical practice.
{"title":"Concordancia interobservador e intraobservador en PET/TC [18F]DCFPyL según los criterios TNM molecular y PSMA-RADS 2.0","authors":"Miriam Guerra-Gómez , Ana Rodríguez-Pajuelo , Laura Brero-Sánchez, Juan Ignacio Cuenca-Cuenca, Rosa María Álvarez-Pérez, José María Freire-Macías, José Manuel Jiménez-Hoyuela García","doi":"10.1016/j.remn.2024.500047","DOIUrl":"10.1016/j.remn.2024.500047","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to determine the agreement between three observers with different levels of experience using the Prostate-Specific Membrane Antigen Reporting and Data System (PSMA-RADS 2.0) criteria and the molecular imaging Tumour, Node, Metastasis (miTNM) system for the interpretation of PET-PSMA with fluorine F 18 piflufolastat in males with prostate cancer.</p></div><div><h3>Materials and methods</h3><p>PET-PSMA images from 114 prostate cancer patients were blindly reported twice by three different observers at intervals of 8 weeks. The evaluations were performed according to the miTNM and PSMA-RADS 2.0 criteria. We used Fleiss’ Kappa to analyse inter and intraobserver agreements.</p></div><div><h3>Results</h3><p>Moderate overall agreement was obtained in the assessment of the PET-PSMA results (Fleiss’k<!--> <!-->=<!--> <!-->0.53; 95% <span>C</span>I 0.45-0.62; p <<!--> <!-->0.001), with significant agreement in the miT, miN and miM reports. There was a substantial level of agreement in the reporting of prostatic disease and lymphatic involvement (Fleiss’k<!--> <!-->=<!--> <!-->0.66 and 0.65), being lower than that observed in the reporting of metastatic disease (Fleiss’k<!--> <!-->=<!--> <!-->0.86), especially in the M0 group (Fleiss’k<!--> <!-->=<!--> <!-->0.99). Upon re-evaluation of the images, observer 1 had moderate overall agreement for miT (Fleiss’k<!--> <!-->=<!--> <!-->0.51) and substantial agreement for miN and miM (Fleiss’k 0.75 and 0.63, respectively).</p></div><div><h3>Conclusions</h3><p>The use of a structured scoring system such as PSMA-RADS 2.0, as well as the miTNM classification system in the interpretation of PET-PSMA images in prostate cancer patients, provides a highly reproducible report format. High levels of interobserver and intraobserver agreement are found, especially when ruling out disease, which supports its use in routine clinical practice.</p></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"43 5","pages":"Article 500047"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.remn.2024.500019
P. Sahafi , S. Soltani , K. Aryana , A. Aghaee
{"title":"Captación de 99mTc-FAPI en un caso raro de carcinoma de uraco metastásico","authors":"P. Sahafi , S. Soltani , K. Aryana , A. Aghaee","doi":"10.1016/j.remn.2024.500019","DOIUrl":"10.1016/j.remn.2024.500019","url":null,"abstract":"","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"43 5","pages":"Article 500019"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.remn.2024.500037
J.R. Garcia, A. Compte, J. Pastor, S. Mourelo, L. Mont, P. Bassa, E. Llinares, M. Soler, E. Valls, T. Blanch, E. Riera
Objective
To analyse the efficacy of integrated assessment of [18F]F-PSMA-1007 PET/MRI on the early detection of local recurrence (LR) for prostate cancer patients with PSA levels < 0.5 ng/ml after radical prostatectomy.
To assess the location of recurrence so that therapy may be tailored to patient.
Methods
Prospective study including 35 patients with prostate cancer (PCa), who were referred for a [18F]F-PSMA-1007 PET/MR after prostatectomy with a very initial PSA value increase (PSA < 0,5 ng/ml).
Simultaneous acquisition in a PET/MRI hybrid equipment (SIGNA-GE), 1 hour after administration of 370 ± 10% MBq of [18F]F-PSMA-1007:
Whole body image (30 min): PET+MRI: DIXON,T1,T2,diffusion,STIR sequences.
A Nuclear Physician and a Radiologist jointly reviewed the studies:
In order to assess LR, the ‘Prostate Imaging for Recurrence Reporting’ system was used on MRI, as well as the Likert scale on the PET prostate imaging.
The remaining lesions were classified as N1 and M1a.
Results
PET/MRI was positive in 25 patients (71.4%) and negative in 10 patients (28.6%).
RL was detected in 15 patients (42.9%): in 2 (5.7%) MRI was superior; in 3 (8.6%) PET was superior; integrated PET/MRI showed improved results in 5 patients (14.3%) for the detection of LR.
Location of recurrences: LR in 11 patients (44.0%); N1 in 10 (40.0%); LR+N1(8.0%) in 2; LR+N1+M1a in 2 (8.0%).
In 20 patients (80%) the PET/MRI findings allowed radioguided radiotherapy implementation (11 on LR, and 9 on N1), whereas hormonal treatment was decided in 5 patients (20%) due to multimetastases/spread disease.
Conclusion
[18F]F-PSMA-1007 PET/MRI has a 71.4% recurrence detection rate after prostatectomy with PSA < 0.5 ng/ml. Its combined PET and MRI study increases the detection of LR by 14.3%, with a high N1+M1a detection rate (56%), allowing radioguided radiotherapy in 80% of patients.
{"title":"Evaluación de la tasa de detección de la recidiva local y de cuerpo completo mediante la valoración integrada de la PET/RM con [18F]F-PSMA-1007 de pacientes con cáncer de próstata tratados con prostatectomía con recidiva bioquímica muy baja (< 0,5 ng/ml). Implicaciones terapéuticas","authors":"J.R. Garcia, A. Compte, J. Pastor, S. Mourelo, L. Mont, P. Bassa, E. Llinares, M. Soler, E. Valls, T. Blanch, E. Riera","doi":"10.1016/j.remn.2024.500037","DOIUrl":"10.1016/j.remn.2024.500037","url":null,"abstract":"<div><h3>Objective</h3><p>To analyse the efficacy of integrated assessment of [<sup>18</sup>F]F-PSMA-1007 PET/MRI on the early detection of local recurrence (LR) for prostate cancer patients with PSA levels <<!--> <!-->0.5<!--> <!-->ng/ml after radical prostatectomy.</p><p>To assess the location of recurrence so that therapy may be tailored to patient.</p></div><div><h3>Methods</h3><p>Prospective study including 35 patients with prostate cancer (PCa), who were referred for a [<sup>18</sup>F]F-PSMA-1007 PET/MR after prostatectomy with a very initial PSA value increase (PSA<!--> <!--><<!--> <!-->0,5<!--> <!-->ng/ml).</p><p>Simultaneous acquisition in a PET/MRI hybrid equipment (SIGNA-GE), 1<!--> <!-->hour after administration of 370<!--> <!-->±<!--> <!-->10% MBq of [<sup>18</sup>F]F-PSMA-1007:</p><p>Prostate selective imaging (20<!--> <!-->min): Multiparametric PET+MRI (MRImp): DIXON,T1,T2,diffusion sequences post-Gadolinium administration.</p><p>Whole body image (30<!--> <!-->min): PET+MRI: DIXON,T1,T2,diffusion,STIR sequences.</p><p>A Nuclear Physician and a Radiologist jointly reviewed the studies:</p><p>In order to assess LR, the ‘Prostate Imaging for Recurrence Reporting’ system was used on MRI, as well as the Likert scale on the PET prostate imaging.</p><p>The remaining lesions were classified as N1 and M1a.</p></div><div><h3>Results</h3><p>PET/MRI was positive in 25 patients (71.4%) and negative in 10 patients (28.6%).</p><p>RL was detected in 15 patients (42.9%): in 2 (5.7%) MRI was superior; in 3 (8.6%) PET was superior; integrated PET/MRI showed improved results in 5 patients (14.3%) for the detection of LR.</p><p>Location of recurrences: LR in 11 patients (44.0%); N1 in 10 (40.0%); LR+N1(8.0%) in 2; LR+N1+M1a in 2 (8.0%).</p><p>In 20 patients (80%) the PET/MRI findings allowed radioguided radiotherapy implementation (11 on LR, and 9 on N1), whereas hormonal treatment was decided in 5 patients (20%) due to multimetastases/spread disease.</p></div><div><h3>Conclusion</h3><p>[<sup>18</sup>F]F-PSMA-1007 PET/MRI has a 71.4% recurrence detection rate after prostatectomy with PSA<!--> <!--><<!--> <!-->0.5<!--> <!-->ng/ml. Its combined PET and MRI study increases the detection of LR by 14.3%, with a high N1+M1a detection rate (56%), allowing radioguided radiotherapy in 80% of patients.</p></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"43 5","pages":"Article 500037"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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