Pub Date : 2024-01-01DOI: 10.1016/j.remn.2023.10.002
Sergi Vidal-Sicart , Elena Goñi , Isaac Cebrecos , Mª Eugenia Rioja , Andrés Perissinotti , Catalina Sampol , Oscar Vidal , David Saavedra-Pérez , Ada Ferrer , Carles Martí , José Ferrer Rebolleda , Mª José García Velloso , Jhon Orozco-Cortés , Berta Díaz-Feijóo , Aida Niñerola-Baizán , Renato Alfredo Valdés Olmos
Since its origins, nuclear medicine has faced technological changes that led to modifying operating modes and adapting protocols. In the field of radioguided surgery, the incorporation of preoperative scintigraphic imaging and intraoperative detection with the gamma probe provided a definitive boost to sentinel lymph node biopsy to become a standard procedure for melanoma and breast cancer.
The various technological innovations and consequent adaptation of protocols come together in the coexistence of the disruptive and the gradual. As obvious examples we have the introduction of SPECT/CT in the preoperative field and Drop-in probes in the intraoperative field. Other innovative aspects with possible application in radio-guided surgery are based on the application of artificial intelligence, navigation and telecare.
{"title":"Innovación continuada en cirugía radioguiada de precisión","authors":"Sergi Vidal-Sicart , Elena Goñi , Isaac Cebrecos , Mª Eugenia Rioja , Andrés Perissinotti , Catalina Sampol , Oscar Vidal , David Saavedra-Pérez , Ada Ferrer , Carles Martí , José Ferrer Rebolleda , Mª José García Velloso , Jhon Orozco-Cortés , Berta Díaz-Feijóo , Aida Niñerola-Baizán , Renato Alfredo Valdés Olmos","doi":"10.1016/j.remn.2023.10.002","DOIUrl":"10.1016/j.remn.2023.10.002","url":null,"abstract":"<div><p>Since its origins, nuclear medicine has faced technological changes that led to modifying operating modes and adapting protocols. In the field of radioguided surgery, the incorporation of preoperative scintigraphic imaging and intraoperative detection with the gamma probe provided a definitive boost to sentinel lymph node biopsy to become a standard procedure for melanoma and breast cancer.</p><p>The various technological innovations and consequent adaptation of protocols come together in the coexistence of the disruptive and the gradual. As obvious examples we have the introduction of SPECT/CT in the preoperative field and Drop-in probes in the intraoperative field. Other innovative aspects with possible application in radio-guided surgery are based on the application of artificial intelligence, navigation and telecare.</p></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139300320","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 : 2024-01-01DOI: 10.1016/j.remn.2023.09.006
L. Foppiani , F. Fiz , M. Dezzana , M. Massollo , G. Bottoni , A. Piccardo
{"title":"¿Es yodorrefractario? Los primeros rastreos con yodo-131 tras el tratamiento y los primeros rastreos diagnósticos con yodo-123 pueden subestimar la carga de enfermedad metastásica en el cáncer de tiroides: a propósito de un caso","authors":"L. Foppiani , F. Fiz , M. Dezzana , M. Massollo , G. Bottoni , A. Piccardo","doi":"10.1016/j.remn.2023.09.006","DOIUrl":"10.1016/j.remn.2023.09.006","url":null,"abstract":"","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139188660","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 : 2024-01-01DOI: 10.1016/j.remn.2023.08.005
M. Pudis , A. Palomar Muñoz , X. Solanich Moreno , J.J. Robles Barba , G. Rocamora Blanch , L. Rodríguez Bel , J.A. Narváez , M. Cortés Romera
Objective
To analyze the body distribution of Erdheim-Chester disease (ECD) and determine the utility of 2-[18F]FDG PET/CT compared to other imaging techniques. Additionally, to assess the aggressiveness and extent of the disease based on the presence/absence of the BRAFV600E mutation.
Materials and methods
The 2-[18F]FDG PET/CT scans of all patients diagnosed with ECD between 2008 and 2021 were reviewed, including 19 patients. The affected territories were classified as detectable by PET/CT or detectable only by other imaging techniques (bone scintigraphy, contrast-enhanced CT, or MRI). Descriptive analysis and correlation of the BRAF mutation with the affected organs and maximum SUV were performed using the Student's t-test.
Results
Out of the 19 patients (14 males; mean age 60.3 years), 11 had the BRAFV600E mutation. A total of 127 territories (64 organ-systems) affected were identified using different imaging modalities, of which 112 were detected by PET/CT, and an additional 15 territories were solely identified by cerebral and cardiac MRI. The presence of BRAFV600E mutation was associated with greater organ involvement (P < .05) without differences in SUVmax (P > .05).
Conclusion
2-[18F]FDG PET/CT is a highly effective diagnostic tool in patients with ECD, detecting the majority of affected territories. MRI was the only imaging modality with additional findings in territories showing high physiological uptake of 2-[18F]FDG (cerebral and cardiac). The presence of the BRAFV600E mutation correlated with a higher extent of the disease.
{"title":"El papel de la PET/TC con 2-[18F]FDG en la enfermedad de Erdheim-Chester","authors":"M. Pudis , A. Palomar Muñoz , X. Solanich Moreno , J.J. Robles Barba , G. Rocamora Blanch , L. Rodríguez Bel , J.A. Narváez , M. Cortés Romera","doi":"10.1016/j.remn.2023.08.005","DOIUrl":"10.1016/j.remn.2023.08.005","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the body distribution of Erdheim-Chester disease (ECD) and determine the utility of 2-[<sup>18</sup>F]FDG PET/CT compared to other imaging techniques. Additionally, to assess the aggressiveness and extent of the disease based on the presence/absence of the BRAF<sup>V600E</sup> mutation.</p></div><div><h3>Materials and methods</h3><p>The 2-[<sup>18</sup>F]FDG PET/CT scans of all patients diagnosed with ECD between 2008 and 2021 were reviewed, including 19 patients. The affected territories were classified as detectable by PET/CT or detectable only by other imaging techniques (bone scintigraphy, contrast-enhanced CT, or MRI). Descriptive analysis and correlation of the BRAF mutation with the affected organs and maximum SUV were performed using the Student's t-test.</p></div><div><h3>Results</h3><p>Out of the 19 patients (14 males; mean age 60.3<!--> <!-->years), 11 had the BRAF<sup>V600E</sup> mutation. A total of 127 territories (64 organ-systems) affected were identified using different imaging modalities, of which 112 were detected by PET/CT, and an additional 15 territories were solely identified by cerebral and cardiac MRI. The presence of BRAF<sup>V600E</sup> mutation was associated with greater organ involvement (<em>P</em> <!--><<!--> <!-->.05) without differences in SUVmax (<em>P</em> <!-->><!--> <!-->.05).</p></div><div><h3>Conclusion</h3><p>2-[<sup>18</sup>F]FDG PET/CT is a highly effective diagnostic tool in patients with ECD, detecting the majority of affected territories. MRI was the only imaging modality with additional findings in territories showing high physiological uptake of 2-[<sup>18</sup>F]FDG (cerebral and cardiac). The presence of the BRAF<sup>V600E</sup> mutation correlated with a higher extent of the disease.</p></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139393564","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 : 2024-01-01DOI: 10.1016/j.remn.2023.08.001
C. Gutiérrez-Villamil , C. Zuluaga-Arbeláez , G. Hernández , N. Hernández-Hidalgo , V. Marín-Oyaga
Introduction
The non-invasive diagnostic study of cardiovascular risk in patients who are going to undergo liver transplantation is not clear, especially in asymptomatic patients. Regarding myocardial perfusion scintigraphy (MPS), it has been thought that the impaired vasodilator reserve in these patients may reduce its performance. The objective is to assess the role of the MPS in the pre-surgical evaluation of patients who are going to undergo liver transplantation.
Material and methods
Retrospective, descriptive and observational study was designed. All adult patients undergoing liver transplantation between 2017 and 2021 who had previous MPS were included. The findings of MPS were described and correlated with the findings of invasive angiography and with the appearance or not of peri- and post-transplant cardiovascular events.
Results
There were a total of 188 transplanted patients (mean age: 57 years, SD: 12), 178 had previous myocardial perfusion, 82 (46%) patients had no cardiovascular risk factors, and 5 (2.8%) had a history of coronary disease.
Of the MPS, 177 were with dipyridamole stress performed on average 10 months before transplantation. Only 17/178 (9.5%) studies were abnormal. The mean follow-up was 38 months (SD: 10). Of the patients with normal MPS, only 2 (1.2%) presented cardiovascular events, both with studies performed more than 2 years before the procedure. There were no deaths of cardiovascular origin.
Conclusions
MPS is a safe and reliable technique for cardiovascular assessment of patients who are candidates for liver transplantation, given the low rate of false negatives during follow-up.
{"title":"Gammagrafía de perfusión miocárdica en la evaluación del riesgo cardiovascular en el trasplante hepático de adultos","authors":"C. Gutiérrez-Villamil , C. Zuluaga-Arbeláez , G. Hernández , N. Hernández-Hidalgo , V. Marín-Oyaga","doi":"10.1016/j.remn.2023.08.001","DOIUrl":"10.1016/j.remn.2023.08.001","url":null,"abstract":"<div><h3>Introduction</h3><p>The non-invasive diagnostic study of cardiovascular risk in patients who are going to undergo liver transplantation is not clear, especially in asymptomatic patients. Regarding myocardial perfusion scintigraphy (MPS), it has been thought that the impaired vasodilator reserve in these patients may reduce its performance. The objective is to assess the role of the MPS in the pre-surgical evaluation of patients who are going to undergo liver transplantation.</p></div><div><h3>Material and methods</h3><p>Retrospective, descriptive and observational study was designed. All adult patients undergoing liver transplantation between 2017 and 2021 who had previous MPS were included. The findings of MPS were described and correlated with the findings of invasive angiography and with the appearance or not of peri- and post-transplant cardiovascular events.</p></div><div><h3>Results</h3><p>There were a total of 188 transplanted patients (mean age: 57 years, SD: 12), 178 had previous myocardial perfusion, 82 (46%) patients had no cardiovascular risk factors, and 5 (2.8%) had a history of coronary disease.</p><p>Of the MPS, 177 were with dipyridamole stress performed on average 10 months before transplantation. Only 17/178 (9.5%) studies were abnormal. The mean follow-up was 38 months (SD: 10). Of the patients with normal MPS, only 2 (1.2%) presented cardiovascular events, both with studies performed more than 2<!--> <!-->years before the procedure. There were no deaths of cardiovascular origin.</p></div><div><h3>Conclusions</h3><p>MPS is a safe and reliable technique for cardiovascular assessment of patients who are candidates for liver transplantation, given the low rate of false negatives during follow-up.</p></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135388393","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 : 2024-01-01DOI: 10.1016/j.remn.2023.09.003
J.R. Garcia, A. Compte, M. Kauak, P. Bassa, E. Llinares, E. Valls
{"title":"Diagnóstico por PET con 18F-FDG de mastitis bilateral uniorgánica relacionada con IgG4","authors":"J.R. Garcia, A. Compte, M. Kauak, P. Bassa, E. Llinares, E. Valls","doi":"10.1016/j.remn.2023.09.003","DOIUrl":"10.1016/j.remn.2023.09.003","url":null,"abstract":"","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135811671","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 : 2024-01-01DOI: 10.1016/j.remn.2023.11.003
E. Noriega-Álvarez , B. Rodríguez-Alfonso , C. Merino Argumánez , L. Domínguez Gadea , V. Peiró-Valgañón
Polymyalgia rheumatica (PMR) is an inflammatory joint disease that presents in patients older than 50 years with prolonged morning pain and stiffness in the shoulder and hip joints and neck. The lack of specific clinical findings, laboratory signs, biomarkers and established imaging methods makes it difficult to diagnose patients with this disease. 18F-FDG PET/CT is a functional imaging technique that is an established tool in oncology and has also proven useful in the field of inflammatory diseases. The aim of this paper is to present literature evidence on the use of molecular imaging methods such as PET/CT for early diagnosis, assessment of disease activity and therapeutic response in PMR. At the same time, the advantages, disadvantages and contraindications of other methods are considered.
{"title":"Desenmascarando la polimialgia reumática, papel de la Medicina Nuclear","authors":"E. Noriega-Álvarez , B. Rodríguez-Alfonso , C. Merino Argumánez , L. Domínguez Gadea , V. Peiró-Valgañón","doi":"10.1016/j.remn.2023.11.003","DOIUrl":"10.1016/j.remn.2023.11.003","url":null,"abstract":"<div><p>Polymyalgia rheumatica (PMR) is an inflammatory joint disease that presents in patients older than 50 years with prolonged morning pain and stiffness in the shoulder and hip joints and neck. The lack of specific clinical findings, laboratory signs, biomarkers and established imaging methods makes it difficult to diagnose patients with this disease. 18F-FDG PET/CT is a functional imaging technique that is an established tool in oncology and has also proven useful in the field of inflammatory diseases. The aim of this paper is to present literature evidence on the use of molecular imaging methods such as PET/CT for early diagnosis, assessment of disease activity and therapeutic response in PMR. At the same time, the advantages, disadvantages and contraindications of other methods are considered.</p></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138615739","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 : 2024-01-01DOI: 10.1016/j.remn.2023.08.007
M. Ochoa-Figueroa , C. Valera-Soria , C. Pagonis , M. Ressner , P. Norberg , V. Sanchez-Rodriguez , J. Frias-Rose , E. Good , A. Davidsson
Purpose
To evaluate the diagnostic performance of a novel deep learning attenuation correction software (SAPCA) for myocardial perfusion imaging (MPI) using a cadmium-zinc-telluride (CZT) cardio dedicated camera with invasive coronary angiography (ICA) correlation for the diagnosis of coronary artery disease (CAD) in a high-risk population.
Methods
Retrospective study of 300 patients (196 males [65%], mean age 68 years) from September 2014 to October 2019 undergoing MPI, followed by ICA and evaluated by means of quantitative angiography software, within six months after the MPI. The mean pre-test probability score for coronary disease according to the European Society of Cardiology criteria was 37% for the whole cohort. The MPI was performed in a dedicated CZT cardio camera (D-SPECT® Spectrum Dynamics) with a two-day protocol, according to the European Association of Nuclear Medicine guidelines. MPI was retrospectively evaluated with and without the SAPCA.
Results
The overall diagnostic accuracy of MPI without SAPCA to identify patients with any obstructive CAD at ICA was 87%, Sensitivity 94%, Specificity 57%, positive predictive value 91% and negative predictive value 64%. Using SAPCA the overall diagnostic accuracy was 90%, sensitivity 91%, specificity 86%, positive predictive value 97% and negative predictive value 66%.
Conclusion
Use of the novel SAPCA enhances performance of the MPI using the CZT D-SPECT® camera and achieves improved results, especially avoiding artefacts and reducing the number of false positive results.
{"title":"Rendimiento diagnóstico de un nuevo software de aprendizaje profundo para corrección de atenuación en la imagen de perfusión miocárdica utilizando una cámara CZT cardiodedicada. Experiencia en la práctica clínica","authors":"M. Ochoa-Figueroa , C. Valera-Soria , C. Pagonis , M. Ressner , P. Norberg , V. Sanchez-Rodriguez , J. Frias-Rose , E. Good , A. Davidsson","doi":"10.1016/j.remn.2023.08.007","DOIUrl":"10.1016/j.remn.2023.08.007","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the diagnostic performance of a novel deep learning attenuation correction software (SAPCA) for myocardial perfusion imaging (MPI) using a cadmium-zinc-telluride (CZT) cardio dedicated camera with invasive coronary angiography (ICA) correlation for the diagnosis of coronary artery disease (CAD) in a high-risk population.</p></div><div><h3>Methods</h3><p>Retrospective study of 300 patients (196 males [65%], mean age 68 years) from September 2014 to October 2019 undergoing MPI, followed by ICA and evaluated by means of quantitative angiography software, within six months after the MPI. The mean pre-test probability score for coronary disease according to the European Society of Cardiology criteria was 37% for the whole cohort. The MPI was performed in a dedicated CZT cardio camera (D-SPECT® Spectrum Dynamics) with a two-day protocol, according to the European Association of Nuclear Medicine guidelines. MPI was retrospectively evaluated with and without the SAPCA.</p></div><div><h3>Results</h3><p>The overall diagnostic accuracy of MPI without SAPCA to identify patients with any obstructive CAD at ICA was 87%, Sensitivity 94%, Specificity 57%, positive predictive value 91% and negative predictive value 64%. Using SAPCA the overall diagnostic accuracy was 90%, sensitivity 91%, specificity 86%, positive predictive value 97% and negative predictive value 66%.</p></div><div><h3>Conclusion</h3><p>Use of the novel SAPCA enhances performance of the MPI using the CZT D-SPECT® camera and achieves improved results, especially avoiding artefacts and reducing the number of false positive results.</p></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2253654X23000999/pdfft?md5=ac425003d569f3463a52db4caf144231&pid=1-s2.0-S2253654X23000999-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139303285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1016/j.remn.2023.05.003
L. Li , H. Wang , F. Li, L. Xiao, Y. Li
{"title":"PET/TC con [18F]FDG en una infección diseminada por micobacterias de origen no tuberculoso en un paciente con sida","authors":"L. Li , H. Wang , F. Li, L. Xiao, Y. Li","doi":"10.1016/j.remn.2023.05.003","DOIUrl":"10.1016/j.remn.2023.05.003","url":null,"abstract":"","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55118798","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 : 2023-11-01DOI: 10.1016/j.remn.2023.05.005
B.B. Demirel , S. Gülbahar Ateş , E. Atasever Akkaş , F. Göksel , G. Uçmak
Background
The aim of this study was to evaluate the prognostic significance of volumetric metabolic parameters of pre-treatment PET/CT along with clinical characteristics in patients with non-metastatic nasopharyngeal carcinoma.
Material and methods
Seventy-nine patients with nasopharyngeal carcinoma underwent F18-FDG PET/CT for pretreatment evaluation and included in this study. The patient features (patient age, tumor histopathology, T and N stage, size of primary tumor and the largest cervical lymph node) and PET parameters were analyzed: maximum, mean and peak standardized uptake values (SUVmax, SUVmean, SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumor and largest cervical lymph node. After treatment, patients were evaluated for disease progression and mortality. Survival analysis for progression-free survival (PFS) and over-all survival (OS) was performed with Kaplan–Meier method using PET findings and clinical characteristics.
Results
The median follow-up duration was 29.7 months (range 3–125 months). Among clinical characteristics, no parameters had significance association for PFS. Primary tumor-MTV and cervical lymphnode-MTV were independent prognostic factors for PFS (p = 0.025 and p = 0.004, respectively). Patients with primary tumor-MTV > 19.4 and patients with lymph node-MTV > 3.4 had shorter PFS. For OS, age and the size of the lymph node were independent prognostic factor (p = 0.031 and p = 0.029). Patients with age over 54 years and patients with lymph node size > 1 cm were associated with decreased OS.
Conclusion
Primary tumor-MTV and lymph node-MTV on pre-treatment PET/CT are significant prognostic factors for long-term PFS in non-metastatic nasopharyngeal carcinoma. We consider that measuring MTV as volume-based metabolic parameter on pretreatment PET/CT may contribute decision of treatment intensity and individualized risk stratification and may improve long-term PFS. Additionally, age and the size of lymph node are independent prognostic factors for mortality.
{"title":"Valor pronóstico de los parámetros metabólicos volumétricos del tumor primario y ganglios linfáticos en el PET/TC pretratamiento en el carcinoma nasofaríngeo","authors":"B.B. Demirel , S. Gülbahar Ateş , E. Atasever Akkaş , F. Göksel , G. Uçmak","doi":"10.1016/j.remn.2023.05.005","DOIUrl":"10.1016/j.remn.2023.05.005","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was to evaluate the prognostic significance of volumetric metabolic parameters of pre-treatment PET/CT along with clinical characteristics in patients with non-metastatic nasopharyngeal carcinoma.</p></div><div><h3>Material and methods</h3><p>Seventy-nine patients with nasopharyngeal carcinoma underwent F18-FDG PET/CT for pretreatment evaluation and included in this study. The patient features (patient age, tumor histopathology, T and N stage, size of primary tumor and the largest cervical lymph node) and PET parameters were analyzed: maximum, mean and peak standardized uptake values (SUVmax, SUVmean, SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumor and largest cervical lymph node. After treatment, patients were evaluated for disease progression and mortality. Survival analysis for progression-free survival (PFS) and over-all survival (OS) was performed with Kaplan–Meier method using PET findings and clinical characteristics.</p></div><div><h3>Results</h3><p>The median follow-up duration was 29.7 months (range 3–125 months). Among clinical characteristics, no parameters had significance association for PFS. Primary tumor-MTV and cervical lymphnode-MTV were independent prognostic factors for PFS (p = 0.025 and p = 0.004, respectively). Patients with primary tumor-MTV > 19.4 and patients with lymph node-MTV > 3.4 had shorter PFS. For OS, age and the size of the lymph node were independent prognostic factor (p = 0.031 and p = 0.029). Patients with age over 54 years and patients with lymph node size > 1 cm were associated with decreased OS.</p></div><div><h3>Conclusion</h3><p>Primary tumor-MTV and lymph node-MTV on pre-treatment PET/CT are significant prognostic factors for long-term PFS in non-metastatic nasopharyngeal carcinoma. We consider that measuring MTV as volume-based metabolic parameter on pretreatment PET/CT may contribute decision of treatment intensity and individualized risk stratification and may improve long-term PFS. Additionally, age and the size of lymph node are independent prognostic factors for mortality.</p></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55118842","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 : 2023-11-01DOI: 10.1016/j.remn.2023.09.001
V. Peiró-Valgañón , A. Guardiola-Arévalo , A. López Fernández , E. Llorente Herrero , M.T. Martín Fernández-Gallardo
Pancreatic cancer is a disease with a poor prognosis, and overall survival has improved the least in the last 40 years of all cancers.
Locally advanced pancreatic adenocarcinoma, without distant metastasis but with limiting vascular involvement, constitutes almost one third of these patients. This group is the focus of most research efforts to introduce treatments to increase surgical salvage rates and/or survival, with two main objectives: local control and prevention of systemic progression.
Intratumoural treatment with phosphorus-32 microparticles, guided by echoendoscopy and combined with standard chemotherapy may have significant and clinically relevant benefits in these patients, and therefore a valuable treatment option in a disease where there is an urgent need to develop new therapies to help improve outcomes.
{"title":"Un reto multidisciplinar: tratamiento con fósforo-32 en el carcinoma de páncreas localmente avanzado","authors":"V. Peiró-Valgañón , A. Guardiola-Arévalo , A. López Fernández , E. Llorente Herrero , M.T. Martín Fernández-Gallardo","doi":"10.1016/j.remn.2023.09.001","DOIUrl":"https://doi.org/10.1016/j.remn.2023.09.001","url":null,"abstract":"<div><p>Pancreatic cancer is a disease with a poor prognosis, and overall survival has improved the least in the last 40 years of all cancers.</p><p>Locally advanced pancreatic adenocarcinoma, without distant metastasis but with limiting vascular involvement, constitutes almost one third of these patients. This group is the focus of most research efforts to introduce treatments to increase surgical salvage rates and/or survival, with two main objectives: local control and prevention of systemic progression.</p><p>Intratumoural treatment with phosphorus-32 microparticles, guided by echoendoscopy and combined with standard chemotherapy may have significant and clinically relevant benefits in these patients, and therefore a valuable treatment option in a disease where there is an urgent need to develop new therapies to help improve outcomes.</p></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71772966","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}