Pub Date : 2025-06-03DOI: 10.1016/j.mednuc.2025.04.002
I. Sefraoui Khelil , M. Chakouri
Hyperthyroidism is a pathological condition marked by an excess of thyroid hormones in the bloodstream. The most common observed etiology is Graves’ disease. In order to establish the epidemiological profile of this disease in the Algerian west and evaluate its treatment in nuclear medicine, we conducted a retrospective, cross-sectional study from January 2014 to December 2023 at the University Hospital Establishment of Oran, including 180 folders of patients suffering from hyperthyroidism. We report a high prevalence of Graves’ disease (98.33%) with a notable female predominance of 72.88%. A peak incidence is noted across all genders between the ages of 31 and 50. In Algeria, radiotherapy with iodine 131 is generally indicated as a second line after antithyroid drugs treatment. In our study, one hundred and sixty-five patients have received radioactive activities administered empirically (extremes: 8–28 mCi). An activity below 15 mCi was administered to 67.27% of patients, between 15 mCi and 20 mCi to 30.3% of patients, and only 2.42% received an activity exceeding 20 mCi. A single dose was administered in 98.18% of cases, while only three patients (1.82%) received a second. Finally, the RAI therapy was successful in 85.83% of cases over a follow-up period ranged between 1 and 9 months. These observed results are promising and encourage healthcare professionals to consider the radiotherapy as an early treatment of Graves’ disease.
{"title":"Prise en charge de la maladie de Basedow dans l’Ouest algérien","authors":"I. Sefraoui Khelil , M. Chakouri","doi":"10.1016/j.mednuc.2025.04.002","DOIUrl":"10.1016/j.mednuc.2025.04.002","url":null,"abstract":"<div><div>Hyperthyroidism is a pathological condition marked by an excess of thyroid hormones in the bloodstream. The most common observed etiology is Graves’ disease. In order to establish the epidemiological profile of this disease in the Algerian west and evaluate its treatment in nuclear medicine, we conducted a retrospective, cross-sectional study from January 2014 to December 2023 at the University Hospital Establishment of Oran, including 180 folders of patients suffering from hyperthyroidism. We report a high prevalence of Graves’ disease (98.33%) with a notable female predominance of 72.88%. A peak incidence is noted across all genders between the ages of 31 and 50. In Algeria, radiotherapy with iodine 131 is generally indicated as a second line after antithyroid drugs treatment. In our study, one hundred and sixty-five patients have received radioactive activities administered empirically (extremes: 8–28 mCi). An activity below 15 mCi was administered to 67.27% of patients, between 15 mCi and 20 mCi to 30.3% of patients, and only 2.42% received an activity exceeding 20 mCi. A single dose was administered in 98.18% of cases, while only three patients (1.82%) received a second. Finally, the RAI therapy was successful in 85.83% of cases over a follow-up period ranged between 1 and 9 months. These observed results are promising and encourage healthcare professionals to consider the radiotherapy as an early treatment of Graves’ disease.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 5","pages":"Pages 278-283"},"PeriodicalIF":0.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120199","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 : 2025-05-01DOI: 10.1016/j.mednuc.2024.10.003
S. Gülbahar Ateş , S. Ateş , S. Günay , N. Çorakyer , G. Tatar
The clinical significance of the reverse distribution in 99m-Technetium sestamibi (99mTc-MIBI) myocardial perfusion scintigraphy is controversial. In clinical practice, it is often assumed as artefactual. This finding should be approached with caution. We report a case of a 72-year-old patient who exhibited reverse distribution in two-day stress/rest 99mTc-MIBI myocardial perfusion imaging protocol. The patient was diagnosed with non-ST elevation myocardial infarction on the day of rest imaging with scintigraphy.
{"title":"Reverse distribution in two-day stress/rest 99mTc-MIBI myocardial perfusion scintigraphy: A case report","authors":"S. Gülbahar Ateş , S. Ateş , S. Günay , N. Çorakyer , G. Tatar","doi":"10.1016/j.mednuc.2024.10.003","DOIUrl":"10.1016/j.mednuc.2024.10.003","url":null,"abstract":"<div><div>The clinical significance of the reverse distribution in 99m-Technetium sestamibi (99mTc-MIBI) myocardial perfusion scintigraphy is controversial. In clinical practice, it is often assumed as artefactual. This finding should be approached with caution. We report a case of a 72-year-old patient who exhibited reverse distribution in two-day stress/rest 99mTc-MIBI myocardial perfusion imaging protocol. The patient was diagnosed with non-ST elevation myocardial infarction on the day of rest imaging with scintigraphy.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 209-212"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924743","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 : 2025-05-01DOI: 10.1016/j.mednuc.2024.12.063
H. Yin, H. Shi
Glomus tumors are neoplasms originating from glomus bodies in the dermis or subcutis of the extremities and are mostly benign. Malignant lung glomic tumors are extremely rare. Here, we report a case of a 31-year-old man who presented with hemoptysis for 1 month. Chest CT scan demonstrated a malignant tumor in the parahilar region of the right upper lobe. A bronchoscopic biopsy was performed and diagnosed as atypical carcinoid tumor. Staging 68Ga-DOTATATE PET/CT depicted a tumor with intense tracer uptake in the right pulmonary hilum, with no other lesions. Postoperatively, the mass was diagnosed as a primary malignant lung glomic tumor.
{"title":"68Ga-DOTATATE PET/CT findings in primary malignant lung glomic tumor","authors":"H. Yin, H. Shi","doi":"10.1016/j.mednuc.2024.12.063","DOIUrl":"10.1016/j.mednuc.2024.12.063","url":null,"abstract":"<div><div>Glomus tumors are neoplasms originating from glomus bodies in the dermis or subcutis of the extremities and are mostly benign. Malignant lung glomic tumors are extremely rare. Here, we report a case of a 31-year-old man who presented with hemoptysis for 1 month. Chest CT scan demonstrated a malignant tumor in the parahilar region of the right upper lobe. A bronchoscopic biopsy was performed and diagnosed as atypical carcinoid tumor. Staging <sup>68</sup>Ga-DOTATATE PET/CT depicted a tumor with intense tracer uptake in the right pulmonary hilum, with no other lesions. Postoperatively, the mass was diagnosed as a primary malignant lung glomic tumor.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 213-214"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924744","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 : 2025-05-01DOI: 10.1016/j.mednuc.2025.01.187
I.E. Çetin, S.A. Tuzcu
Objective
In this study, we aimed to compare the calculated SUV values supratentorial and infratentorial areas, and to investigate the effects of BMI differences on brain glucose uptake, in order to evaluate the possible effects of this on the brain in overweight and obese patients who underwent whole body FDG PET/CT study. In addition, we aimed to evaluate the effect of possible treatment supra-infratentorial uptake values.
Method
This study included 736 patients who underwent whole-body PET/CT imaging in the last six months to diagnose, stage, respond to treatment, restage, and determine recurrent metastases. Possible effects of body mass index on the brain in overweight and obese patients were measured via SUVmax and SUVmean values of supratentorial-infratentorial regions and analysing their correlation with body mass index.
Results
The group of patients with high BMI, supratentorial SUVmax, supratentorial SUVmean, infratentorial SUVmax, and infratentorial SUVmean were significantly higher (P < 0.0001). When evaluated according to the imaging indication, considering diagnostic and non-diagnostic indications (response to treatment, recurrence-metastasis investigation, restaging), no statistically significant difference was achieved between the two groups regarding mean age, gender and BMI. However, in the group where PET/CT was performed for diagnostic purposes, supratentorial SUVmax, supratentorial SUVmean, infratentorial SUVmax, and infratentorial SUVmean were statistically significantly lower (P < 0.0001).
Conclusion
Regarding the outcomes of this research, supratentorial SUVmax, supratentorial SUVmean, infratentorial SUVmax, and infratentorial SUVmean were statistically significantly higher in obese patients compared to other individuals.
{"title":"Comparison of brain uptake values in FDG PET-CT study based on body mass index values","authors":"I.E. Çetin, S.A. Tuzcu","doi":"10.1016/j.mednuc.2025.01.187","DOIUrl":"10.1016/j.mednuc.2025.01.187","url":null,"abstract":"<div><h3>Objective</h3><div>In this study, we aimed to compare the calculated SUV values supratentorial and infratentorial areas, and to investigate the effects of BMI differences on brain glucose uptake, in order to evaluate the possible effects of this on the brain in overweight and obese patients who underwent whole body FDG PET/CT study. In addition, we aimed to evaluate the effect of possible treatment supra-infratentorial uptake values.</div></div><div><h3>Method</h3><div>This study included 736 patients who underwent whole-body PET/CT imaging in the last six months to diagnose, stage, respond to treatment, restage, and determine recurrent metastases. Possible effects of body mass index on the brain in overweight and obese patients were measured via SUV<sub>max</sub> and SUV<sub>mean</sub> values of supratentorial-infratentorial regions and analysing their correlation with body mass index.</div></div><div><h3>Results</h3><div>The group of patients with high BMI, supratentorial SUV<sub>max</sub>, supratentorial SUV<sub>mean</sub>, infratentorial SUV<sub>max</sub>, and infratentorial SUV<sub>mean</sub> were significantly higher (<em>P</em> <!--><<!--> <!-->0.0001). When evaluated according to the imaging indication, considering diagnostic and non-diagnostic indications (response to treatment, recurrence-metastasis investigation, restaging), no statistically significant difference was achieved between the two groups regarding mean age, gender and BMI. However, in the group where PET/CT was performed for diagnostic purposes, supratentorial SUV<sub>max</sub>, supratentorial SUV<sub>mean</sub>, infratentorial SUV<sub>max</sub>, and infratentorial SUV<sub>mean</sub> were statistically significantly lower (<em>P</em> <!--><<!--> <!-->0.0001).</div></div><div><h3>Conclusion</h3><div>Regarding the outcomes of this research, supratentorial SUV<sub>max</sub>, supratentorial SUV<sub>mean</sub>, infratentorial SUV<sub>max</sub>, and infratentorial SUV<sub>mean</sub> were statistically significantly higher in obese patients compared to other individuals.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 202-208"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924742","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 : 2025-05-01DOI: 10.1016/j.mednuc.2024.05.001
G. Mutevelizade, Y. Parlak, B.C. Bozdemir, C. Sezgin, G. Gumuser, E. Sayit
Introduction
The purpose of this study was to evaluate the relationship between pre-ablative 99mTc-pertechnetate scintigraphy, and therapeutic iodine-131 (131I) whole-body scan (TxWBS), with ablation status and to investigate the possible predictive factors for successful ablation in differentiated thyroid carcinoma (DTC) patients.
Materials and methods
A total of 330 DTC patients underwent 99mTc-pertechnetate scintigraphy after thyroidectomy. Uptake values were determined using the region-of-interest technique. All patients had neck ultrasonography and TxWBS. Both scintigraphic scans were interpreted visually and qualitatively. The ablation status was evaluated with a diagnostic 131I whole-body scan.
Results
The success rate for residual thyroid ablation was 88.8%. The sensitivity, specificity, accuracy, PPV, and NPV of 99mTc-Pertechnetate scintigraphy were 82.4%, 87.5%, 82.7%, 99.2%, and 20.2%, respectively. Pre-ablative TG values and 99mTc uptake (%) were significantly lower in successfully ablated patients. The 99mTc uptake was determined as a significant predictive factor for ablation success (P = 0.000). The optimal 99mTc uptake cut-off value of 0.75% was demonstrated for successful ablation. There were significant positive correlations between the visual and the calculated uptake (%) of residual tissues on both scintigraphic scans, Considering the number of remnant tissue foci, significant positive correlations were found between 99mTc-Pertechnetate scintigraphy, TxWBS, and USG.
Conclusion
Pre-ablative 99mTc-Pertechnetate uptake (%) value of the remnant tissue can predict the ablation status in DTC patients. 99mTc-Pertechnetate scintigraphy, which is an easily applicable and accessible imaging method, has maintained its place in the postoperative and pre-ablative period in DTC patients over the years and has not lost any of its value.
{"title":"Predicting thyroid cancer ablation success: Pre-ablative 99mTc-Pertechnetate and post-ablative 131I scan comparison","authors":"G. Mutevelizade, Y. Parlak, B.C. Bozdemir, C. Sezgin, G. Gumuser, E. Sayit","doi":"10.1016/j.mednuc.2024.05.001","DOIUrl":"10.1016/j.mednuc.2024.05.001","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this study was to evaluate the relationship between pre-ablative <sup>99m</sup>Tc-pertechnetate scintigraphy, and therapeutic iodine-131 (<sup>131</sup>I) whole-body scan (TxWBS), with ablation status and to investigate the possible predictive factors for successful ablation in differentiated thyroid carcinoma (DTC) patients.</div></div><div><h3>Materials and methods</h3><div>A total of 330 DTC patients underwent <sup>99m</sup>Tc-pertechnetate scintigraphy after thyroidectomy. Uptake values were determined using the region-of-interest technique. All patients had neck ultrasonography and TxWBS. Both scintigraphic scans were interpreted visually and qualitatively. The ablation status was evaluated with a diagnostic <sup>131</sup>I whole-body scan.</div></div><div><h3>Results</h3><div>The success rate for residual thyroid ablation was 88.8%. The sensitivity, specificity, accuracy, PPV, and NPV of <sup>99m</sup>Tc-Pertechnetate scintigraphy were 82.4%, 87.5%, 82.7%, 99.2%, and 20.2%, respectively. Pre-ablative TG values and <sup>99m</sup>Tc uptake (%) were significantly lower in successfully ablated patients. The <sup>99m</sup>Tc uptake was determined as a significant predictive factor for ablation success (<em>P</em> <!-->=<!--> <!-->0.000). The optimal <sup>99m</sup>Tc uptake cut-off value of 0.75% was demonstrated for successful ablation. There were significant positive correlations between the visual and the calculated uptake (%) of residual tissues on both scintigraphic scans, Considering the number of remnant tissue foci, significant positive correlations were found between <sup>99m</sup>Tc-Pertechnetate scintigraphy, TxWBS, and USG.</div></div><div><h3>Conclusion</h3><div>Pre-ablative <sup>99m</sup>Tc-Pertechnetate uptake (%) value of the remnant tissue can predict the ablation status in DTC patients. <sup>99m</sup>Tc-Pertechnetate scintigraphy, which is an easily applicable and accessible imaging method, has maintained its place in the postoperative and pre-ablative period in DTC patients over the years and has not lost any of its value.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 179-186"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924739","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 : 2025-05-01DOI: 10.1016/j.mednuc.2024.07.001
D. Villemonte de la Clergerie , G. Vellieux , M-O. Habert , V. Navarro , A. Kas
Lance-Adams syndrome, also known as “chronic post-anoxic myoclonus”, is a rare syndrome characterised by intention and action myoclonus following cerebral anoxia, leading to major disability. The cortical or subcortical origin of the myoclonus is still debated. Answering this question would open up new avenues of translational research to gain a better understanding of the pathophysiology of this syndrome and better guide the therapeutic management of patients. In addition to a neurological examination, the initial diagnostic work-up includes a biological work-up, electrophysiological investigations and brain imaging to rule out diGerential diagnoses. Cerebral MRI is the reference imaging technique. In the literature, more than a third of patients have a normal MRI. MRI is used to rule out a vascular cause and to look for atrophy or neuronal damage. Few data are available in the literature on the role of nuclear medicine. To date, 13 cases have been published using 18F-FDG PET and 4 using cerebral perfusion scintigraphy. Abnormalities of cortical and/or subcortical perfusion or metabolism are reported in 65% of cases; they are limited to the neocortex in 23% and aGect the cerebellum in 12% of cases. In this article, we present three patients who underwent cerebral 18F-FDG PET scans for Lance-Adams syndrome with normal MRI. The results of these examinations are discussed and compared with the data found in the literature.
{"title":"Que peut nous apprendre l’étude du métabolisme cérébral en TEP au 18F-FDG du syndrome de Lance-Adams ?","authors":"D. Villemonte de la Clergerie , G. Vellieux , M-O. Habert , V. Navarro , A. Kas","doi":"10.1016/j.mednuc.2024.07.001","DOIUrl":"10.1016/j.mednuc.2024.07.001","url":null,"abstract":"<div><div>Lance-Adams syndrome, also known as “chronic post-anoxic myoclonus”, is a rare syndrome characterised by intention and action myoclonus following cerebral anoxia, leading to major disability. The cortical or subcortical origin of the myoclonus is still debated. Answering this question would open up new avenues of translational research to gain a better understanding of the pathophysiology of this syndrome and better guide the therapeutic management of patients. In addition to a neurological examination, the initial diagnostic work-up includes a biological work-up, electrophysiological investigations and brain imaging to rule out diGerential diagnoses. Cerebral MRI is the reference imaging technique. In the literature, more than a third of patients have a normal MRI. MRI is used to rule out a vascular cause and to look for atrophy or neuronal damage. Few data are available in the literature on the role of nuclear medicine. To date, 13 cases have been published using 18F-FDG PET and 4 using cerebral perfusion scintigraphy. Abnormalities of cortical and/or subcortical perfusion or metabolism are reported in 65% of cases; they are limited to the neocortex in 23% and aGect the cerebellum in 12% of cases. In this article, we present three patients who underwent cerebral 18F-FDG PET scans for Lance-Adams syndrome with normal MRI. The results of these examinations are discussed and compared with the data found in the literature.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 187-194"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924740","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 : 2025-05-01DOI: 10.1016/j.mednuc.2024.10.010
D. Bessac , J. Todeschi , A. Coca , C. Bund , I.J. Namer
Introduction
Intracranial hypotension, primarily characterized by orthostatic headaches, is caused by cerebrospinal fluid (CSF) leakage in almost all cases. Although clinical symptoms can sometimes go unnoticed due to their fluctuating and subjective nature, CSF leakage can cause significant morbidity and potentially lead to irreversible disability. The aim of our study was to evaluate the diagnostic efficacy of radionuclide cisternography in patients presenting with signs of intracranial hypotension where cerebrospinal MRI did not identify the area of leakage.
Materials and methods
This was a retrospective, descriptive, monocentric study involving 35 patients. A standardized 2-day acquisition protocol was used for radionuclide cisternography following intrathecal injection of 111In-DTPA via suboccipital or lumbar puncture.
Results
All 35 patients showed indirect signs of CSF leakage on radionuclide cisternography, compared to 71.4% on MRI. In 15 patients (42.8%), the site of the CSF leak was localized: 1 in the ethmoid bone, 2 adjacent to an osteosynthesis screw, and the remaining 12 at the cervicothoracic junction. These 15 patients received appropriate treatment, resulting in significant clinical improvement: 5 through microsurgery, 2 via injection of biological glue, and 8 with a targeted epidural blood patch.
Conclusion
This study demonstrates that radionuclide cisternography, although a technique developed around fifty years ago, remains relevant today as it can localize the site of a CSF leak not identified by conventional MRI, whether in cases of post-traumatic, post-surgical, or spontaneous leaks. The development of new radiotracers for PET is expected to further enhance detection sensitivity by improving spatial resolution.
{"title":"Apport de la cisternographie isotopique dans la recherche de fuite du liquide céphalorachidien","authors":"D. Bessac , J. Todeschi , A. Coca , C. Bund , I.J. Namer","doi":"10.1016/j.mednuc.2024.10.010","DOIUrl":"10.1016/j.mednuc.2024.10.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Intracranial hypotension, primarily characterized by orthostatic headaches, is caused by cerebrospinal fluid (CSF) leakage in almost all cases. Although clinical symptoms can sometimes go unnoticed due to their fluctuating and subjective nature, CSF leakage can cause significant morbidity and potentially lead to irreversible disability. The aim of our study was to evaluate the diagnostic efficacy of radionuclide cisternography in patients presenting with signs of intracranial hypotension where cerebrospinal MRI did not identify the area of leakage.</div></div><div><h3>Materials and methods</h3><div>This was a retrospective, descriptive, monocentric study involving 35 patients. A standardized 2-day acquisition protocol was used for radionuclide cisternography following intrathecal injection of <sup>111</sup>In-DTPA via suboccipital or lumbar puncture.</div></div><div><h3>Results</h3><div>All 35 patients showed indirect signs of CSF leakage on radionuclide cisternography, compared to 71.4% on MRI. In 15 patients (42.8%), the site of the CSF leak was localized: 1 in the ethmoid bone, 2 adjacent to an osteosynthesis screw, and the remaining 12 at the cervicothoracic junction. These 15 patients received appropriate treatment, resulting in significant clinical improvement: 5 through microsurgery, 2 via injection of biological glue, and 8 with a targeted epidural blood patch.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that radionuclide cisternography, although a technique developed around fifty years ago, remains relevant today as it can localize the site of a CSF leak not identified by conventional MRI, whether in cases of post-traumatic, post-surgical, or spontaneous leaks. The development of new radiotracers for PET is expected to further enhance detection sensitivity by improving spatial resolution.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 195-201"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924741","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 : 2025-03-01DOI: 10.1016/j.mednuc.2025.01.015
L. Comas , A. Paillard , J. Chhim , O. Boukhennoufa , J.M. Nicod , N. Zerhouni , H. Boulahdour
Introduction
Les fractures du scaphoïde constituent les fractures du carpe les plus courantes. Parfois difficiles à détecter sur des radiographies, il est nécessaire de recourir à d’autres techniques d’imagerie, comme la scintigraphie osseuse, pour confirmer le diagnostic. Des études antérieures ont montré qu’un rapport de 2 entre la région d’intérêt positionnée sur l’os et le côté controlatéral, réalisé sur une image planaire, permettait d’identifier la présence d’une fracture. Nous avons développé un programme permettant de quantifier ces données à partir d’images pseudo-planaires en utilisant des images anatomiques pour positionner les régions d’intérêt (ROI).
Matériels et méthodes
Une étude rétrospective a été menée sur 30 patients suspectés de fracture du scaphoïde. Trois séries d’images ont été analysées : planaires, tomographiques et de tomodensitométrie (TDM). Une image « pseudo-planaire » a été générée à partir des images tomographiques en additionnant les coupes coronales. Un traitement similaire a été appliqué aux images de TDM, en additionnant uniquement les intensités de Hounsfield correspondant à la fenêtre osseuse. Les opérateurs ont ensuite réalisé une quantification sur l’image planaire en traçant une ROI sur l’os avec la fixation la plus importante et en reportant cette ROI par symétrie sur le côté controlatéral. Sur les images pseudo-planaires, la même technique a été utilisée, mais en utilisant l’image anatomique pour placer les ROI.
Résultats
Les résultats confirment que le seuil pour identifier une fracture est de 2, aussi bien sur les images tomographiques que planaires. Ce facteur est associé aux meilleures sensibilité et spécificité, respectivement, de 100 % et 93 % lorsque la scintigraphie planaire est utilisée comme référence. La répétabilité a été mesurée sur une série de 10 mesures par calcul du coefficient de variation. Ce coefficient est inférieur à 5 % pour toutes les mesures. La reproductibilité a été étudiée à l’aide de l’indice Kappa de Cohen, calculé entre trois opérateurs ayant chacun réalisé des mesures sur 30 cas. En mode planaire, cet indice dépasse 0,80 tandis qu’en mode tomographique, il est supérieur à 0,93.
Conclusion
L’utilisation des images pseudo-planaires TEMP et TDM permet de réaliser une quantification efficace pour détecter les fractures du poignet, offrant une bonne répétabilité et une meilleure reproductibilité entre différents observateurs. Ces résultats sont à confirmer sur une population plus large.
肩胛骨骨折是鲤鱼最常见的骨折。有时很难在x光片上发现,需要使用其他成像技术,如骨扫描来确认诊断。先前的研究表明,在平面图像上,骨头上感兴趣的区域与控制侧的比例为2,可以识别骨折的存在。我们开发了一个程序,允许从伪平面图像量化这些数据,使用解剖图像定位感兴趣区域(ROI)。对30例疑似肩胛骨骨折患者进行回顾性研究。分析了三组图像:平面图、断层扫描和CT扫描(TDM)。通过将日冕切片相加,从断层扫描图像中生成了一个“伪平面”图像。类似的处理也应用于TDM图像,只添加与骨窗相对应的豪斯菲尔德强度。然后,操作员在平面图像上进行量化,在最重要的固定骨上绘制ROI,并在控制侧对称地报告ROI。在伪平面图像上,使用了相同的技术,但使用解剖图像来放置ROI。结果证实,无论是在断层扫描还是平面图像上,识别裂缝的阈值都是2。当使用平面闪烁法作为参考时,该因子分别与100%和93%的最佳灵敏度和特异性相关。通过计算变异系数,通过一系列10次测量来测量重复性。所有措施的这一比率都低于5%。使用科恩卡帕指数(Kappa de Cohen Index)对重复性进行了研究,该指数由三名操作员计算,每个操作员对30个案例进行了测量。在平面模式下,该指数高于0.80,而在断层扫描模式下,该指数高于0.93。使用TEMP和TDM伪平面图像可以有效地量化手腕骨折,从而在不同的观察者之间提供良好的可重复性和更好的再现性。这些发现在更广泛的人群中得到了证实。
{"title":"Quantification en scintigraphie osseuse du poignet : apport des images « pseudo-planaires »","authors":"L. Comas , A. Paillard , J. Chhim , O. Boukhennoufa , J.M. Nicod , N. Zerhouni , H. Boulahdour","doi":"10.1016/j.mednuc.2025.01.015","DOIUrl":"10.1016/j.mednuc.2025.01.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Les fractures du scaphoïde constituent les fractures du carpe les plus courantes. Parfois difficiles à détecter sur des radiographies, il est nécessaire de recourir à d’autres techniques d’imagerie, comme la scintigraphie osseuse, pour confirmer le diagnostic. Des études antérieures ont montré qu’un rapport de 2 entre la région d’intérêt positionnée sur l’os et le côté controlatéral, réalisé sur une image planaire, permettait d’identifier la présence d’une fracture. Nous avons développé un programme permettant de quantifier ces données à partir d’images pseudo-planaires en utilisant des images anatomiques pour positionner les régions d’intérêt (ROI).</div></div><div><h3>Matériels et méthodes</h3><div>Une étude rétrospective a été menée sur 30 patients suspectés de fracture du scaphoïde. Trois séries d’images ont été analysées : planaires, tomographiques et de tomodensitométrie (TDM). Une image « pseudo-planaire » a été générée à partir des images tomographiques en additionnant les coupes coronales. Un traitement similaire a été appliqué aux images de TDM, en additionnant uniquement les intensités de Hounsfield correspondant à la fenêtre osseuse. Les opérateurs ont ensuite réalisé une quantification sur l’image planaire en traçant une ROI sur l’os avec la fixation la plus importante et en reportant cette ROI par symétrie sur le côté controlatéral. Sur les images pseudo-planaires, la même technique a été utilisée, mais en utilisant l’image anatomique pour placer les ROI.</div></div><div><h3>Résultats</h3><div>Les résultats confirment que le seuil pour identifier une fracture est de 2, aussi bien sur les images tomographiques que planaires. Ce facteur est associé aux meilleures sensibilité et spécificité, respectivement, de 100 % et 93 % lorsque la scintigraphie planaire est utilisée comme référence. La répétabilité a été mesurée sur une série de 10 mesures par calcul du coefficient de variation. Ce coefficient est inférieur à 5 % pour toutes les mesures. La reproductibilité a été étudiée à l’aide de l’indice Kappa de Cohen, calculé entre trois opérateurs ayant chacun réalisé des mesures sur 30 cas. En mode planaire, cet indice dépasse 0,80 tandis qu’en mode tomographique, il est supérieur à 0,93.</div></div><div><h3>Conclusion</h3><div>L’utilisation des images pseudo-planaires TEMP et TDM permet de réaliser une quantification efficace pour détecter les fractures du poignet, offrant une bonne répétabilité et une meilleure reproductibilité entre différents observateurs. Ces résultats sont à confirmer sur une population plus large.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 2","pages":"Page 127"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521237","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 : 2025-03-01DOI: 10.1016/j.mednuc.2025.01.006
G. Mani, K. Ben Ahmed, R. Ghannem, Z.E. Missaoui, I. Jardak, K. Chtourou
Introduction
Le cancer de l’œsophage, associé à un pronostic sombre, requiert des outils d’imagerie performants pour optimiser la prise en charge. La tomographie par émission de positons (TEP) au 18F-FDG est un examen clé pour le bilan d’extension, le suivi thérapeutique et la détection des récidives. Cette étude analyse rétrospectivement l’apport de cet examen dans notre centre.
Matériels et méthodes
Nous avons inclus 18 patients ayant bénéficié de 27 TEP au FDG L’examen est réalisé selon le protocole classique avec injection de 3 MBq/kg.
Résultats
L’âge médian était de 62 ans (27–83 ans) avec un sex-ratio de 2 hommes pour 1 femme. Les indications étaient : bilan d’extension initial chez 13 patients, recherche de récidive chez 5 patients et suivi post-thérapeutique chez 9 patients. Les carcinomes épidermoïdes représentaient 72 % des cas. Dans le bilan d’extension initial, les localisations tumorales prédominantes étaient le tiers inférieur de l’œsophage (61 %) avec un SUVmax variant de 4,2 à 31,6 (médiane : 14). Des foyers métastasiques hypermétaboliques osseuses et pulmonaires ont été identifiés chez 4 patients parmi 13. Pour la recherche des récidives, la TEP FDG était positive chez deux patients avec des foyers hépatiques et ganglionnaires. L’évaluation thérapeutique post-radiochimiothérapie a montré une réponse métabolique complète chez 1 patient, partielle chez 5 patients et une progression chez 3 patients.
Conclusion
La TEP au FDG demeure indispensable dans la prise en charge des cancers de l’œsophage, en apportant des informations déterminantes pour le staging, la recherche de récidive et l’évaluation thérapeutique. Ces résultats soutiennent la nécessité d’études prospectives pour affiner son rôle dans les recommandations cliniques.
{"title":"Apport de la TEP au FDG dans le cancer de l’œsophage","authors":"G. Mani, K. Ben Ahmed, R. Ghannem, Z.E. Missaoui, I. Jardak, K. Chtourou","doi":"10.1016/j.mednuc.2025.01.006","DOIUrl":"10.1016/j.mednuc.2025.01.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Le cancer de l’œsophage, associé à un pronostic sombre, requiert des outils d’imagerie performants pour optimiser la prise en charge. La tomographie par émission de positons (TEP) au 18F-FDG est un examen clé pour le bilan d’extension, le suivi thérapeutique et la détection des récidives. Cette étude analyse rétrospectivement l’apport de cet examen dans notre centre.</div></div><div><h3>Matériels et méthodes</h3><div>Nous avons inclus 18 patients ayant bénéficié de 27 TEP au FDG L’examen est réalisé selon le protocole classique avec injection de 3<!--> <!-->MBq/kg.</div></div><div><h3>Résultats</h3><div>L’âge médian était de 62 ans (27–83 ans) avec un sex-ratio de 2 hommes pour 1 femme. Les indications étaient : bilan d’extension initial chez 13 patients, recherche de récidive chez 5 patients et suivi post-thérapeutique chez 9 patients. Les carcinomes épidermoïdes représentaient 72 % des cas. Dans le bilan d’extension initial, les localisations tumorales prédominantes étaient le tiers inférieur de l’œsophage (61 %) avec un SUVmax variant de 4,2 à 31,6 (médiane : 14). Des foyers métastasiques hypermétaboliques osseuses et pulmonaires ont été identifiés chez 4 patients parmi 13. Pour la recherche des récidives, la TEP FDG était positive chez deux patients avec des foyers hépatiques et ganglionnaires. L’évaluation thérapeutique post-radiochimiothérapie a montré une réponse métabolique complète chez 1 patient, partielle chez 5 patients et une progression chez 3 patients.</div></div><div><h3>Conclusion</h3><div>La TEP au FDG demeure indispensable dans la prise en charge des cancers de l’œsophage, en apportant des informations déterminantes pour le staging, la recherche de récidive et l’évaluation thérapeutique. Ces résultats soutiennent la nécessité d’études prospectives pour affiner son rôle dans les recommandations cliniques.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 2","pages":"Pages 123-124"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521281","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}