Pub Date : 2025-05-15DOI: 10.1016/j.remn.2025.500127
S. Huang , M.S. Fang , M. Zhao , F. Li
Introduction
Fever can affect the identification and efficacy evaluation of tumors on the 18F-FDG PET/CT, and this effect can be reduced by referring to normal tissue metabolism.The aim of the study was to analyze the influence of fever on glucose metabolism in the mediastinal blood pool, liver, spleen, and bone marrow utilizing PET/CT quantitative parameter SUV normalized by lean body mass(SUL).
Materials and methods
30 patients with fever of unknown origin and 24 patients for tumor screening with normal body temperature within 3 weeks, who underwent 18F-FDG PET/CT in our department, were analysed retrospectively. The SULmax and SULmean of the mediastinal blood pool, liver, spleen, and bone marrow were respectively measured in the two groups, and the differences between the two groups were compared by independent sample t test or Wilcoxon-Mann-Whitney test.
Results
The SULmax and SULmean of the liver in the fever group were lower than those in the control group (P = .001, .013). The SULmax and SULmean of spleen and bone marrow in the fever group were higher than in the control group (all P < .05). The SULmax of the mediastinal blood pool in the fever group was lower than that in the control group (P = .007), but there was no significant difference in SULmean of the mediastinal between the fever group and the control group (T = 1.181, P = .221).
Conclusion
The fever can affect the glucose metabolism in internal organs. But there was no significant difference in the SULmean of mediastinal blood pool. Perhaps the SULmean of the blood pool can be invoked as a calibration parameter in the evaluation of efficacy in tumor patients with fever.
{"title":"Influencia de la fiebre en el 18F-FDG PET/TC in vivo utilizando un parámetro cuantitativo SUL","authors":"S. Huang , M.S. Fang , M. Zhao , F. Li","doi":"10.1016/j.remn.2025.500127","DOIUrl":"10.1016/j.remn.2025.500127","url":null,"abstract":"<div><h3>Introduction</h3><div>Fever can affect the identification and efficacy evaluation of tumors on the <sup>18</sup>F-FDG PET/CT, and this effect can be reduced by referring to normal tissue metabolism.The aim of the study was to analyze the influence of fever on glucose metabolism in the mediastinal blood pool, liver, spleen, and bone marrow utilizing PET/CT quantitative parameter SUV normalized by lean body mass(SUL).</div></div><div><h3>Materials and methods</h3><div>30 patients with fever of unknown origin and 24<!--> <!-->patients for tumor screening with normal body temperature within 3<!--> <!-->weeks, who underwent <sup>18</sup>F-FDG PET/CT in our department, were analysed retrospectively. The SUL<sub>max</sub> and SUL<sub>mean</sub> of the mediastinal blood pool, liver, spleen, and bone marrow were respectively measured in the two groups, and the differences between the two groups were compared by independent sample t test or Wilcoxon-Mann-Whitney test.</div></div><div><h3>Results</h3><div>The SUL<sub>max</sub> and SUL<sub>mean</sub> of the liver in the fever group were lower than those in the control group (<em>P</em> <!-->=<!--> <!-->.001, .013). The SUL<sub>max</sub> and SUL<sub>mean</sub> of spleen and bone marrow in the fever group were higher than in the control group (all <em>P</em> <!--><<!--> <!-->.05). The SUL<sub>max</sub> of the mediastinal blood pool in the fever group was lower than that in the control group (<em>P</em> <!-->=<!--> <!-->.007), but there was no significant difference in SUL<sub>mean</sub> of the mediastinal between the fever group and the control group (T<!--> <!-->=<!--> <!-->1.181, <em>P</em> <!-->=<!--> <!-->.221).</div></div><div><h3>Conclusion</h3><div>The fever can affect the glucose metabolism in internal organs. But there was no significant difference in the SUL<sub>mean</sub> of mediastinal blood pool. Perhaps the SUL<sub>mean</sub> of the blood pool can be invoked as a calibration parameter in the evaluation of efficacy in tumor patients with fever.</div></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"44 5","pages":"Article 500127"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908539","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 : 2025-05-13DOI: 10.1016/j.remn.2025.500162
A. Ricaurte Fajardo , V. Marulanda Corzo , S. Ruder , D.R. Cardoza-Ochoa , C.E. Granados , D. Yadav , D. Lopez , M. Fatima , S. Dutruel , E. O’Dwyer , J.R. Osborne , S.T. Tagawa , S. Huicochea Castellanos
Prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy has reshaped the treatment landscape for metastatic castration-resistant prostate cancer (mCRPC), offering new therapeutic possibilities beyond conventional approaches. Among the most promising strategies is lutetium-177 PSMA-617, which has shown significant benefits in overall survival and durable PSA responses, as demonstrated in several clinical trials.
At the same time, the development of novel radionuclides such as actinium-225 has opened the door to more potent treatments capable of overcoming prior resistance, particularly in patients previously exposed to beta emitters. The use of PSMA PET imaging and the identification of predictive biomarkers have helped refine patient selection, contributing to a more personalized approach. Comparative studies with agents like cabazitaxel have further supported the safety and effectiveness of this strategy.
This article provides a critical overview of clinical advances in PSMA-targeted radionuclide therapy, examines emerging combination treatments, reviews the development of alpha-emitting agents, and highlights the role of personalized dosimetry in clinical practice, underlining the growing importance of this therapeutic modality across different stages of prostate cancer.
{"title":"Revolucionando el tratamiento del cáncer de próstata: la terapia dirigida al antígeno prostático específico en el enfoque moderno terapéutico","authors":"A. Ricaurte Fajardo , V. Marulanda Corzo , S. Ruder , D.R. Cardoza-Ochoa , C.E. Granados , D. Yadav , D. Lopez , M. Fatima , S. Dutruel , E. O’Dwyer , J.R. Osborne , S.T. Tagawa , S. Huicochea Castellanos","doi":"10.1016/j.remn.2025.500162","DOIUrl":"10.1016/j.remn.2025.500162","url":null,"abstract":"<div><div>Prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy has reshaped the treatment landscape for metastatic castration-resistant prostate cancer (mCRPC), offering new therapeutic possibilities beyond conventional approaches. Among the most promising strategies is lutetium-177 PSMA-617, which has shown significant benefits in overall survival and durable PSA responses, as demonstrated in several clinical trials.</div><div>At the same time, the development of novel radionuclides such as actinium-225 has opened the door to more potent treatments capable of overcoming prior resistance, particularly in patients previously exposed to beta emitters. The use of PSMA PET imaging and the identification of predictive biomarkers have helped refine patient selection, contributing to a more personalized approach. Comparative studies with agents like cabazitaxel have further supported the safety and effectiveness of this strategy.</div><div>This article provides a critical overview of clinical advances in PSMA-targeted radionuclide therapy, examines emerging combination treatments, reviews the development of alpha-emitting agents, and highlights the role of personalized dosimetry in clinical practice, underlining the growing importance of this therapeutic modality across different stages of prostate cancer.</div></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"44 5","pages":"Article 500162"},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908665","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 : 2025-04-17DOI: 10.1016/j.remn.2025.500140
P. Dauden-Onate , C. Gamila Wakfie-Corieh , R.M. Couto-Caro , M.L. Suarez-Solis , C. Benavente-Cuesta , M.N. Cabrera-Martín
{"title":"[18F]FDG PET/TC en la sospecha de linfoma primario del SNC: evaluación del compromiso sistémico y guía para biopsia","authors":"P. Dauden-Onate , C. Gamila Wakfie-Corieh , R.M. Couto-Caro , M.L. Suarez-Solis , C. Benavente-Cuesta , M.N. Cabrera-Martín","doi":"10.1016/j.remn.2025.500140","DOIUrl":"10.1016/j.remn.2025.500140","url":null,"abstract":"","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"44 5","pages":"Article 500140"},"PeriodicalIF":1.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907015","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 : 2025-04-11DOI: 10.1016/j.remn.2025.500125
D. Mut Surmeli
{"title":"Re: «Evaluación del papel de la sarcopenia y los parámetros [18F]FDG PET/TC en el pronóstico del adenocarcinoma ductal pancreático»","authors":"D. Mut Surmeli","doi":"10.1016/j.remn.2025.500125","DOIUrl":"10.1016/j.remn.2025.500125","url":null,"abstract":"","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"44 3","pages":"Article 500125"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868933","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 : 2025-04-07DOI: 10.1016/j.remn.2025.500138
A. Piñeiro Donis , L. Menéndez-Muros , J.L. Villa-Palacios , E. Triviño-Ibáñez , M.A. Muros-Fuentes
Objective
To analyze the prognostic value of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and other biomarkers of inflammation in patients with neuroendocrine tumors (NETs) treated with [177Lu]Lu-DOTA-TATE (Lutathera®). The prognostic value of histological characteristics of the tumor was also analyzed.
Patients and methods
Prospective study of a cohort of patients with advanced and metastatic NETs treated with [177Lu]Lu-DOTA-TATE. Before the administration of doses, NT-proBNP, hemoglobin, hematocrit, C-reactive protein, leukocytes, lymphocytes, neutrophils, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been determined. Overall survival (OS) and progression free survival (PFS) were calculated, using the Kaplan-Meier method, and curves were compared with a log-rank test. To determine the predictor variables of OS, a Cox regression model was fitted.
Results
48 NET patients treated with [177Lu]Lu-DOTA-TATE. Median OS was 96 months and PFS was 29 months. Factors associated with lower OS were: NTproBNP values > 300 pg/mL (HR: 10.5; P = .005) in the subgroup of patients with grades 2-3, in addition to inflammatory indices NLR > 2 (HR: 3.87; P = .049) and PLR > 300 (HR: 11.88; P = .01) and higher tumor grade (HR: 6.45; P = .011). PLR > 300 (HR: 5.506; P = .003) was also associated with lower PFS. In contrast, higher levels of lymphocytes (HR: 0.21; P = .002), hemoglobin (HR: 0.65; P = .041) and hematocrit (HR: 0.862; P = .031) were associated with higher OS, without significant changes in PFS.
Conclusion
In patients with NETs treated with [177Lu]Lu-DOTA-TATE, the determination of natriuretic factors (NT-ProBNP) and other inflammatory biomarkers may be useful as predictors of survival and prognostic factors.
目的分析脑利钠肽n端原激素（NT-proBNP）及其他炎症生物标志物在应用[177Lu]Lu-DOTA-TATE （Lutathera®）治疗神经内分泌肿瘤（NETs）患者中的预后价值。并分析肿瘤的组织学特征对预后的影响。患者和方法一组接受[177Lu]Lu-DOTA-TATE治疗的晚期和转移性NETs患者的前瞻性研究。给药前，测定NT-proBNP、血红蛋白、红细胞压积、c反应蛋白、白细胞、淋巴细胞、中性粒细胞、中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）。采用Kaplan-Meier法计算总生存期（OS）和无进展生存期（PFS），并用log-rank检验比较曲线。为确定OS的预测变量，拟合Cox回归模型。结果48例NET患者采用[177Lu]Lu-DOTA-TATE治疗。中位OS为96个月，PFS为29个月。与较低OS相关的因素有：2-3级患者亚组NTproBNP值>； 300 pg/mL (HR: 10.5; P = 0.005)，炎症指数NLR >； 2 （HR: 3.87; P = 0.049）和PLR >； 300 （HR: 11.88; P = 0.01）和较高的肿瘤分级（HR: 6.45; P = 0.011）。PLR > 300 （HR: 5.506; P = 0.003）也与较低的PFS相关。相比之下，淋巴细胞（HR: 0.21, P = 0.002）、血红蛋白（HR: 0.65, P = 0.041）和红细胞压积（HR: 0.862, P = 0.031）水平升高与OS升高相关，PFS无显著变化。结论在接受[177Lu]Lu-DOTA-TATE治疗的NETs患者中，利钠因子（NT-ProBNP）和其他炎症生物标志物的测定可能有助于预测生存和预后因素。
{"title":"Factores natriuréticos y biomarcadores de inflamación como predictores de supervivencia en la terapia con [177Lu]Lu-DOTA-TATE de los tumores neuroendocrinos","authors":"A. Piñeiro Donis , L. Menéndez-Muros , J.L. Villa-Palacios , E. Triviño-Ibáñez , M.A. Muros-Fuentes","doi":"10.1016/j.remn.2025.500138","DOIUrl":"10.1016/j.remn.2025.500138","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the prognostic value of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and other biomarkers of inflammation in patients with neuroendocrine tumors (NETs) treated with [<sup>177</sup>Lu]Lu-DOTA-TATE (Lutathera®). The prognostic value of histological characteristics of the tumor was also analyzed.</div></div><div><h3>Patients and methods</h3><div>Prospective study of a cohort of patients with advanced and metastatic NETs treated with [<sup>177</sup>Lu]Lu-DOTA-TATE. Before the administration of doses, NT-proBNP, hemoglobin, hematocrit, C-reactive protein, leukocytes, lymphocytes, neutrophils, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been determined. Overall survival (OS) and progression free survival (PFS) were calculated, using the Kaplan-Meier method, and curves were compared with a log-rank test. To determine the predictor variables of OS, a Cox regression model was fitted.</div></div><div><h3>Results</h3><div>48 NET patients treated with [<sup>177</sup>Lu]Lu-DOTA-TATE. Median OS was 96<!--> <!-->months and PFS was 29<!--> <!-->months. Factors associated with lower OS were: NTproBNP values<!--> <!-->><!--> <!-->300<!--> <!-->pg/mL (HR: 10.5; <em>P</em> <!-->=<!--> <!-->.005) in the subgroup of patients with grades<!--> <!-->2-3, in addition to inflammatory indices NLR<!--> <!-->><!--> <!-->2 (HR: 3.87; <em>P</em> <!-->=<!--> <!-->.049) and PLR<!--> <!-->><!--> <!-->300 (HR: 11.88; <em>P</em> <!-->=<!--> <!-->.01) and higher tumor grade (HR: 6.45; <em>P</em> <!-->=<!--> <!-->.011). PLR<!--> <!-->><!--> <!-->300 (HR: 5.506; <em>P</em> <!-->=<!--> <!-->.003) was also associated with lower PFS. In contrast, higher levels of lymphocytes (HR: 0.21; <em>P</em> <!-->=<!--> <!-->.002), hemoglobin (HR: 0.65; <em>P</em> <!-->=<!--> <!-->.041) and hematocrit (HR: 0.862; <em>P</em> <!-->=<!--> <!-->.031) were associated with higher OS, without significant changes in PFS.</div></div><div><h3>Conclusion</h3><div>In patients with NETs treated with [<sup>177</sup>Lu]Lu-DOTA-TATE, the determination of natriuretic factors (NT-ProBNP) and other inflammatory biomarkers may be useful as predictors of survival and prognostic factors.</div></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"44 5","pages":"Article 500138"},"PeriodicalIF":1.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908668","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 : 2025-04-05DOI: 10.1016/j.remn.2025.500128
L. Sancho , A. Roteta , I. Torres , M. de Arcocha , R. Ramos , M.L. Domínguez , J.J. Rosales , E. Prieto , G. Quincoces , en nombre del Grupo de Oncología de la SEMNim
The state of the art and future perspectives of new radionuclides in Nuclear Medicine continue to evolve, driven by the development of isotopes with innovative applications in theragnostics.
In this second part of the continuing education series, the clinical and therapeutic applications of terbium, actinium, and bismuth are analyzed in depth. The use of the 4 terbium isotopes (terbium-149, terbium-152, terbium-155, and terbium-161) is described, offering a versatile system for both diagnosis and treatment due to their chemical similarity to lutetium-177, along with the challenges related to their production and availability. Additionally, actinium-225, a powerful alpha-emitting radionuclide, is reviewed for its growing role in targeted alpha therapy, particularly in prostate cancer and neuroendocrine tumors. Finally, bismuth-213, derived from actinium-225, is analyzed for its short half-life, making it a viable option for localized and selective therapies.
Despite technical and production challenges, these radionuclides are driving the evolution of precision medicine, expanding therapeutic and diagnostic possibilities in Nuclear Medicine.
{"title":"Estado del arte y perspectivas futuras de nuevos radionúclidos en Medicina Nuclear: Parte II","authors":"L. Sancho , A. Roteta , I. Torres , M. de Arcocha , R. Ramos , M.L. Domínguez , J.J. Rosales , E. Prieto , G. Quincoces , en nombre del Grupo de Oncología de la SEMNim","doi":"10.1016/j.remn.2025.500128","DOIUrl":"10.1016/j.remn.2025.500128","url":null,"abstract":"<div><div>The state of the art and future perspectives of new radionuclides in Nuclear Medicine continue to evolve, driven by the development of isotopes with innovative applications in theragnostics.</div><div>In this second part of the continuing education series, the clinical and therapeutic applications of terbium, actinium, and bismuth are analyzed in depth. The use of the 4<!--> <!-->terbium isotopes (terbium-149, terbium-152, terbium-155, and terbium-161) is described, offering a versatile system for both diagnosis and treatment due to their chemical similarity to lutetium-177, along with the challenges related to their production and availability. Additionally, actinium-225, a powerful alpha-emitting radionuclide, is reviewed for its growing role in targeted alpha therapy, particularly in prostate cancer and neuroendocrine tumors. Finally, bismuth-213, derived from actinium-225, is analyzed for its short half-life, making it a viable option for localized and selective therapies.</div><div>Despite technical and production challenges, these radionuclides are driving the evolution of precision medicine, expanding therapeutic and diagnostic possibilities in Nuclear Medicine.</div></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"44 3","pages":"Article 500128"},"PeriodicalIF":1.6,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869302","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 : 2025-04-03DOI: 10.1016/j.remn.2025.500132
G. Rodríguez Cabalé , E. Rodríguez Cabalé , V. Pubul Núñez , Á. Ruibal Morell
Background
Coronary artery disease is a complex, multifactorial process with high prevalence and morbidity-mortality. Single photon emission computed tomography (SPECT) myocardial perfusion imaging synchronized with the electrocardiogram (gated-SPECT) is a non-invasive imaging technique that has demonstrated high sensitivity and specificity for diagnosis and staging. To better predict the risk of adverse events, it is necessary to analyze the simultaneous behavior of clinical elements and diagnostic tests, a type of study that is scarce in the current literature. This research evaluated the relationship between clinical characteristics and gated-SPECT myocardial perfusion parameters with progression to cardiac death; subsequently, a model was built to predict the risk of such an outcome.
Methods
An observational, longitudinal, and retrospective study was conducted with 2 230 patients who underwent this test due to suspected coronary artery disease. Clinical characteristics, test parameters, and progression to cardiac death were collected and the relationships between them were studied. A logistic regression model was built to study the relationships between the variables and their influence on the probability of progression to cardiac death.
Results
Clinical characteristics associated with a higher probability of cardiac death were male sex (OR = 5.104, P = 0.004), peripheral arterial disease (OR = 7.175, P < 0.001), and diabetes mellitus (OR = 3.159, P = 0.013). The gated-SPECT parameters associated with a higher risk of this outcome were VTS ≥70 ml (OR = 12.257, P < 0.001), EF < 50% (OR = 10.757, P < 0.001), VTD ≥140 ml (OR = 8.884, P < 0.001), ventricular dilation (OR = 8.959, P < 0.001), and reversible defects (OR = 7.454, P = 0.001). Fixed defects, parietal motility abnormalities, the presence of both reversible and fixed defects, and the hyperdynamic gated state were also associated with a higher risk of cardiac death but with lower ORs.
The logistic regression model showed good overall performance and high ability to determine progression to cardiac death, close to perfect predictive capacity (AUC = 0.9656).
Conclusions
It is necessary to employ total cardiovascular risk models that include results from diagnostic tests such as gated-SPECT. The constructed model demonstrated good overall performance and is a valid proposal for predicting the risk of death due to cardiac causes.
背景冠状动脉疾病是一个复杂的、多因素的过程，具有高患病率和发病率-死亡率。单光子发射计算机断层扫描（SPECT）与心电图同步心肌灌注成像（门控SPECT）是一种非侵入性成像技术，在诊断和分期方面具有很高的灵敏度和特异性。为了更好地预测不良事件的风险，有必要分析临床因素和诊断试验的同时行为，这是目前文献中很少的一类研究。本研究评估临床特征和门控spect心肌灌注参数与心源性死亡进展的关系；随后，建立了一个模型来预测这种结果的风险。方法对2 230例疑似冠状动脉疾病患者进行观察性、纵向和回顾性研究。收集临床特征、试验参数及心源性死亡进展情况，并研究它们之间的关系。建立logistic回归模型，研究各变量之间的关系及其对心源性死亡进展概率的影响。结果男性（OR = 5.104, P = 0.004）、外周动脉疾病（OR = 7.175, P < 0.001）和糖尿病（OR = 3.159, P = 0.013）与心源性死亡概率较高相关。与该结果较高风险相关的门控spect参数为VTS≥70 ml （OR = 12.257, P < 0.001）、EF < 50% （OR = 10.757, P < 0.001）、VTD≥140 ml （OR = 8.884, P < 0.001）、心室扩张（OR = 8.959, P < 0.001）和可逆缺陷（OR = 7.454, P = 0.001）。固定缺陷、顶叶运动异常、可逆缺陷和固定缺陷的存在以及高动力门控状态也与心脏死亡的高风险相关，但与较低的ORs相关。logistic回归模型整体表现良好，对心源性死亡进展的预测能力较高，接近完美预测能力（AUC = 0.9656）。结论采用包括门控spect等诊断试验结果在内的总心血管风险模型是必要的。所构建的模型整体性能良好，是预测心脏原因死亡风险的有效建议。
{"title":"Modelo para predecir riesgo de fallecimiento de causa cardíaca según características clínicas y parámetros del gated-SPECT de perfusión miocárdica","authors":"G. Rodríguez Cabalé , E. Rodríguez Cabalé , V. Pubul Núñez , Á. Ruibal Morell","doi":"10.1016/j.remn.2025.500132","DOIUrl":"10.1016/j.remn.2025.500132","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery disease is a complex, multifactorial process with high prevalence and morbidity-mortality. Single photon emission computed tomography (SPECT) myocardial perfusion imaging synchronized with the electrocardiogram (gated-SPECT) is a non-invasive imaging technique that has demonstrated high sensitivity and specificity for diagnosis and staging. To better predict the risk of adverse events, it is necessary to analyze the simultaneous behavior of clinical elements and diagnostic tests, a type of study that is scarce in the current literature. This research evaluated the relationship between clinical characteristics and gated-SPECT myocardial perfusion parameters with progression to cardiac death; subsequently, a model was built to predict the risk of such an outcome.</div></div><div><h3>Methods</h3><div>An observational, longitudinal, and retrospective study was conducted with 2 230 patients who underwent this test due to suspected coronary artery disease. Clinical characteristics, test parameters, and progression to cardiac death were collected and the relationships between them were studied. A logistic regression model was built to study the relationships between the variables and their influence on the probability of progression to cardiac death.</div></div><div><h3>Results</h3><div>Clinical characteristics associated with a higher probability of cardiac death were male sex (OR<!--> <!-->=<!--> <!-->5.104, <em>P</em> <!-->=<!--> <!-->0.004), peripheral arterial disease (OR<!--> <!-->=<!--> <!-->7.175, <em>P</em> <!--><<!--> <!-->0.001), and diabetes mellitus (OR<!--> <!-->=<!--> <!-->3.159, <em>P</em> <!-->=<!--> <!-->0.013). The gated-SPECT parameters associated with a higher risk of this outcome were VTS ≥70<!--> <!-->ml (OR<!--> <!-->=<!--> <!-->12.257, <em>P</em> <!--><<!--> <!-->0.001), EF <<!--> <!-->50% (OR<!--> <!-->=<!--> <!-->10.757, <em>P</em> <!--><<!--> <!-->0.001), VTD ≥140<!--> <!-->ml (OR<!--> <!-->=<!--> <!-->8.884, <em>P</em> <!--><<!--> <!-->0.001), ventricular dilation (OR<!--> <!-->=<!--> <!-->8.959, <em>P</em> <!--><<!--> <!-->0.001), and reversible defects (OR<!--> <!-->=<!--> <!-->7.454, <em>P</em> <!-->=<!--> <!-->0.001). Fixed defects, parietal motility abnormalities, the presence of both reversible and fixed defects, and the hyperdynamic gated state were also associated with a higher risk of cardiac death but with lower ORs.</div><div>The logistic regression model showed good overall performance and high ability to determine progression to cardiac death, close to perfect predictive capacity (AUC<!--> <!-->=<!--> <!-->0.9656).</div></div><div><h3>Conclusions</h3><div>It is necessary to employ total cardiovascular risk models that include results from diagnostic tests such as gated-SPECT. The constructed model demonstrated good overall performance and is a valid proposal for predicting the risk of death due to cardiac causes.</div></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"44 5","pages":"Article 500132"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908667","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 : 2025-03-10DOI: 10.1016/j.remn.2024.500089
P. Mínguez Gabiña , T. Monserrat Fuertes , B. Santos Zorrozua , A. Esteban Figueruelo , M.A. Astudillo Sarmiento , A. Peña Fuentes , I. Vinagre Pérez , E. Rodeño Ortiz de Zarate , I.L. Fernández Tercero
Purpose
The main objectives were to study differences between the first and the fourth cycle in dosimetry variables in patients treated for neuroendocrine tumours with four cycles of [177Lu]Lu-DOTA-TATE, as well as to look for absorbed dose–effect correlations aiming to help individualise and optimise this therapy for future patients.
Material and methods
SPECT based dosimetry of tumour lesions and kidneys was performed in the first and the fourth cycles of the [177Lu]Lu-DOTA-TATE treatments for 17 patients from 2020 to 2023. Clinical variables of interest were collected in order to look for correlations with some dosimetry variables. Statistical analysis was performed using the R software.
Results
Regarding dosimetry variables, for lesions a significant decrease in absorbed dose, mass and initial activity between the first and fourth cycles was observed. For kidneys, a significant increase in absorbed dose was observed. Effective decay constants did not significantly change neither for lesions nor for kidneys. The relative decrease in lesion masses correlated with their total absorbed dose. Total absorbed doses to kidneys were well below the toxicity limits mostly used in this therapy. Relative decr
ease in lesion absorbed doses was significantly lower for tumour primary sites in ileum and jejunum compared to those in pancreas. Moreover, radiological response correlated with clinical response.
Conclusions
The results seem to indicate that the current treatment scheme could be optimised in order to obtain better treatment outcomes.
{"title":"Análisis de variables dosimétricas y clínicas en el tratamiento de los tumores neuroendocrinos con [177Lu]Lu-DOTA-TATE","authors":"P. Mínguez Gabiña , T. Monserrat Fuertes , B. Santos Zorrozua , A. Esteban Figueruelo , M.A. Astudillo Sarmiento , A. Peña Fuentes , I. Vinagre Pérez , E. Rodeño Ortiz de Zarate , I.L. Fernández Tercero","doi":"10.1016/j.remn.2024.500089","DOIUrl":"10.1016/j.remn.2024.500089","url":null,"abstract":"<div><h3>Purpose</h3><div>The main objectives were to study differences between the first and the fourth cycle in dosimetry variables in patients treated for neuroendocrine tumours with four cycles of [<sup>177</sup>Lu]Lu-DOTA-TATE, as well as to look for absorbed dose–effect correlations aiming to help individualise and optimise this therapy for future patients.</div></div><div><h3>Material and methods</h3><div>SPECT based dosimetry of tumour lesions and kidneys was performed in the first and the fourth cycles of the [<sup>177</sup>Lu]Lu-DOTA-TATE treatments for 17 patients from 2020 to 2023. Clinical variables of interest were collected in order to look for correlations with some dosimetry variables. Statistical analysis was performed using the R software.</div></div><div><h3>Results</h3><div>Regarding dosimetry variables, for lesions a significant decrease in absorbed dose, mass and initial activity between the first and fourth cycles was observed. For kidneys, a significant increase in absorbed dose was observed. Effective decay constants did not significantly change neither for lesions nor for kidneys. The relative decrease in lesion masses correlated with their total absorbed dose. Total absorbed doses to kidneys were well below the toxicity limits mostly used in this therapy. Relative decr</div><div>ease in lesion absorbed doses was significantly lower for tumour primary sites in ileum and jejunum compared to those in pancreas. Moreover, radiological response correlated with clinical response.</div></div><div><h3>Conclusions</h3><div>The results seem to indicate that the current treatment scheme could be optimised in order to obtain better treatment outcomes.</div></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":"44 3","pages":"Article 500089"},"PeriodicalIF":1.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868613","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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