Revista Espanola De Medicina Nuclear最新文献

Transient apical dysfunction syndrome (TADS) is frequently misdiagnosed as an acute coronary syndrome (ACS). It is characterized by electrocardiographic alterations and elevated myocardial necrosis markers, accompanied by hypokinesia, akinesia or anteroapical dyskinesia, in absence of significant coronary disorders. It generally resolves in days or weeks with individualized support measures. We present the case of a female patient referred to our service for a myocardial perfusion imaging study due to a history suggestive of an acute coronary syndrome after a stressful event.

We present the case of a patient with breast cancer who underwent selective sentinel lymph node biopsy. An intramammary sentinel lymph node was identified with SPECT/CT in the preoperative lymphoscintigraphy. We describe our diagnostic and therapeutic procedure regarding this finding and the literature review to evaluate the clinical significance of their identification and metastases, especially in regards to more appropriate axillary management. Further studies with more statistical significance are necessary to elucidate the most suitable attitude when an intramammary sentinel lymph node is identified with the lymphoscintigraphy.

Aim

To evaluate the utility of ^18FFDG-PET for patients diagnosed of differentiated thyroid carcinoma who present risk of disease and invaluable levels of thyroglobulin (Tg) by the presence of antibodies antithyroglobulin (AbTg).

Material and methods

Retrospective study of 7 women of 40 years old and histological diagnosis of differentiated thyroid cancer (7 papillary tumours) that were sent to our department for the accomplishment of^18FFDG-PET study because of suspicion of disease, due to ¹³¹I negative and high levels of AbTg, between the year 2002 and 2007. 11 PET scans were obtained after the intravenous injection of 370-434 MBq of ^18FFDG in normoglycemia conditions and previous administration of muscle relaxant, hydration and diuretic. The results of ^18FFDG-PET scans were confirmed by pathologic examination or clinical outcome and radiographic examination for more than 24 months.

Results

The prevalence of recurrence in our population was 57.14%. All patients presented levels of Tg lower than 3 ng/dl and AbTg superior to 200 UI/ml. Three patients had precedent thyroiditis. Out of 11 scans performed 3 of them were negative and 8 cases were found positive. It ruled out the existence of disease in three patients and localized the presence of recurrence in 4 patients.

Conclusion

^18FFDG-PET

CONCLUSION: 18F-FDG-PET is a useful diagnostic tool for the detection of recurrence as well as to rule out the existence of disease with a high accuracy, in patients with differentiated thyroid carcinoma with ¹³¹I whole body scan negative but with pathological elevation of antithyroglobulin antibodies.

Objective

The purpose of this work has been to determine the prognostic value of normal thallium-201 myocardial perfusion scintigraphy (MPS) in patients who had suffered myocardial infarction in the three months prior to the examination.

Material and methods

A stress test followed by ²⁰¹Tl Gated SPECT was performed. A follow-up was made of 63 patients with normal perfusion scintigraphy. According to the MPS results, the patients were divided into 2 groups. Group I (n = 63; 57% males, age 65 ± 12), patients with normal MPS, and group II (n = 60; 81% males, age 64 ± 10), patients with abnormal MPS. The appearance of a new infarction or cardiac death occurring during this period (63 ± 3 months) was analyzed. The appearance of events was related with the cardiovascular risk factors, perfusion study and ventricular function.

Results

Five events occurred in group I in 4 patients: 3 new infarctions and 2 cardiac deaths. In group II, there were 18 events in 14 patients: 8 new infarctions and 10 cardiac deaths (p < 0,0001). The events were related with age, time from MPS, diabetes, size of perfusion defect and post stress ventricular ejection fraction. Mean survival en group I was 108 months (103–112) and in group II 97 (88–107) (p = 0,01).

Conclusion

Patients with normal MPS had fewer major events than patients with abnormal MPS. The size of MPS has been related with the appearance of events. A depressed post-stress left ventricular ejection fraction has a poor prognosis.

¹⁸F-FDOPA is an amino acid analogue used to evaluate presynaptic dopaminergic activity, which has aroused great interest in neuro-oncology. We have evaluated five ¹⁸F-FDOPA PET studies of patients referred for study of parkinsonian syndrome. Two subjects had previously treated high-grade brain tumors, one nonspecific brain injury, and 2 subjects presented unexpected tumoral lesions. For all lesions SUVmax, time to SUVmax and tumor-to-normal grey matter SUVmax rate (T/N) were calculated, and 90 minutes ¹⁸F-FDOPA kinetics were analyzed. Tumor lesions corresponded to three malignant neurocytomas, one meningioma, one pineocytoma and one intrasinusal hemangioma. Both malignant and benign tumors exhibited high uptake of ¹⁸F-FDOPA well above the normal cortex. However, the analysis of the curve uptake displayed characteristic patterns that facilitate the characterization of tumor lesions. A dual phase maximum uptake was observed, with an early 10 minutes uptake in malignant lesions, and a late 60 to 90 minutes uptake in benign or low grade lesions.

Aim

To assess the role of PET/CT with retrograde filling of urinary bladder (RFUB) in the assessment of pelvic malignancy in patients with urothelial or gynecological tumors.

Material and methods

A retrospective longitudinal analysis based on 62 studies belonging to 52 patients was performed. All of them had a history of pelvic malignancy (29 urothelial and 23 gynecological) and 42 had undergone previous treatments. All patients underwent a standard PET/CT protocol. Inclusion criteria were radiological alterations in pelvic organs or increased urinary activity of ¹⁸F-FDG that hindered evaluation of the pelvic structures. Pathological pelvic locations were assessed as the additional value of PET/CT with RFUB. The pathologic lesions were histologically or clinically evaluated with a minimum follow-up of 12 months.

Results

Pelvic malignancy was confirmed in 33 cases, 16 of which were of urothelial origin. A total of 35/62 studies showed a pathologic PET/CT in pelvis, 4 of them were false positive and 2 false negative. In 19 cases, malignancy was detected in the bladder wall, 16 of which were true positive. No false negative was detected. Regarding standard imaging acquisition, RFUB helped to confirm or rule out bladder and/or gynecological disease in 54 cases.

Conclusion

Retrograde bladder filling is a highly recommended technique in the assessment of malignant pelvic disease, especially of bladder origin.