Revista espanola de medicina nuclear e imagen molecular最新文献

英文中文

Natriuretic factors and inflammation biomarkers as predictors of survival in [¹⁷⁷Lu]Lu-DOTA-TATE therapy of neuroendocrine tumors.

Revista espanola de medicina nuclear e imagen molecular

Pub Date : 2025-04-06 DOI: 10.1016/j.remnie.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 = 0,005) in the subgroup of patients with grades 2-3, in addition to inflammatory indices NLR > 2 (HR: 3,87; p = 0,049) and PLR > 300 (HR: 11,88; p = 0,01) and higher tumor grade (HR: 6,45; p = 0,011). PLR > 300 (HR: 5,506; p = 0,003) was also associated with lower PFS. In contrast, higher levels of lymphocytes (HR: 0,21; p = 0,002), hemoglobin (HR: 0,65; p = 0,041) and hematocrit (HR: 0,862; p = 0,031) 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.

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引用次数: 0

State of the art and future perspectives of new radionuclides in Nuclear Medicine. Part II.

Revista espanola de medicina nuclear e imagen molecular

Pub Date : 2025-03-25 DOI: 10.1016/j.remnie.2025.500128

L Sancho, A Roteta, I Torres, M de Arcocha, R Ramos, M L Domínguez, J J Rosales, E Prieto, G Quincoces

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 four 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 (TAT), 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":"State of the art and future perspectives of new radionuclides in Nuclear Medicine. Part II.","authors":"L Sancho, A Roteta, I Torres, M de Arcocha, R Ramos, M L Domínguez, J J Rosales, E Prieto, G Quincoces","doi":"10.1016/j.remnie.2025.500128","DOIUrl":"10.1016/j.remnie.2025.500128","url":null,"abstract":"<p><p>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 four 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 (TAT), 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.</p>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":" ","pages":"500128"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Single metastasis of cutaneous malignant melanoma in the gallbladder detected with ¹⁸F-FDG PET/CT.

Revista espanola de medicina nuclear e imagen molecular

Pub Date : 2025-03-08 DOI: 10.1016/j.remnie.2025.500120

A Bota-Bota, M Pombo-López, I Martínez-Rodríguez, F Gómez-de la Fuente, J Jiménez-Bonilla, R Quirce

引用次数: 0

Utility of [18F]FDG PET/CT in the management of primary bone lymphoma.

Revista espanola de medicina nuclear e imagen molecular

Pub Date : 2025-03-08 DOI: 10.1016/j.remnie.2025.500126

M M Losada, I G Megías, R M Losada, L G R Robles, X B Chollet, R R Lasanta

引用次数: 0

Renal and pulmonary malakoplakia with mediastinal involvement simulating a synchronous neoplasm in PET/CT study with [18F]FDG.

Revista espanola de medicina nuclear e imagen molecular

Pub Date : 2025-03-08 DOI: 10.1016/j.remnie.2025.500124

J R Garcia, A Compte, S Romero, L Mont, L Pinilla, E Riera

引用次数: 0

Secondary intestinal amyloidosis visualized on a scintigraphy with [m99Tc]Tc-HMDP 使用[m99Tc]Tc-HMDP进行闪烁扫描时发现的继发性肠道淀粉样变性。

Revista espanola de medicina nuclear e imagen molecular

Pub Date : 2025-03-01 DOI: 10.1016/j.remnie.2024.500070

S. Bondia-Bescós , I.E. Sánchez-Rodríguez , A. Palomar-Muñoz , P. Notta , M. Cortés-Romera , L.M. Gràcia-Sánchez

引用次数: 0

Microparticle disease in hip prostheses: A case report 髋关节假体微粒病1例报告。

Revista espanola de medicina nuclear e imagen molecular

Pub Date : 2025-03-01 DOI: 10.1016/j.remnie.2024.500078

J.L. Díaz Moreno, I.E. Sánchez-Rodríguez, B. Hervás-Sanz, P. Notta-González, C. Martínez-Ramos, L. Gràcia-Sánchez

引用次数: 0

Clinical value of a negative [18F]F-PSMA PET/CT study in patients diagnosed with prostate cancer treated with prostatectomy with PSA rising below 1 ng/mL after radical prostatectomy, on the outcome of salvage radiotherapy 前列腺癌根治性前列腺切除术后PSA低于1 ng/mL诊断为前列腺癌患者的F-PSMA PET/CT阴性研究对补救性放疗预后的临床价值[18F]。

Revista espanola de medicina nuclear e imagen molecular

Pub Date : 2025-03-01 DOI: 10.1016/j.remnie.2025.500071

M. Cózar Santiago , J. García Garzón , A. Esteban Hurtado , J. Pastor Peiro , J. Ferrer Rebolleda

Objective

To assess the clinical value of [¹⁸F]F-PSMA negative PET/CT, in patients diagnosed with prostate cancer treated with prostatectomy with elevated PSA less than 1 ng/mL, on the outcome of salvage radiotherapy.

Method

We prospectively included 98 patients diagnosed with prostate cancer treated with prostatectomy with biochemical recurrence [mean PSA 0.51 ng/mL (range 0.17–1.0 ng/mL)] who were referred for an [¹⁸F]F-PSMA -PET/CT study.

The [¹⁸F]F-PSMA -PET/CT scan was negative in 53/98 patients (54.09%). Differences were analysed between those patients who were or were not candidates for pelvic salvage radiotherapy (PSRT) decided upon multidisciplinary committee and patient consent, with a minimum follow-up time for 1 year. Response to treatment was defined as a 50% reduction in PSA levels. Recurrence was ascertained upon clinical, analytical and imaging follow-up outcomes.

Results

54.7% (29/53) of the patients with a negative [¹⁸F]F-PSMA -PET/CT underwent PSRT.

Of these, 93.1% (27/29) patients demonstrated response to treatment (PSMA false negatives).

The remaining two patients showed fluctuating PSA levels without detecting disease on the [¹⁸F]F-PSMA -PET/CT follow-up study.

45.3% (24/53) of patients with negative [¹⁸F]F-PSMA -PET/CT did not undergo PSRT.

Of these, progressive PSA elevation was observed in 62.5% (15/24) (PSMA false negatives), localising recurrence on the [¹⁸F]F-PSMA -PET/CT follow-up study in 4 patients.

The remaining 9 patients (37.5%) showed fluctuating PSA levels without detecting disease on the [¹⁸F]F-PSMA -PET/CT follow-up study.

Our series confirmed 42 (42.85%) [¹⁸F]F-PSMA -PET/CT false negatives cases.

Conclusion

Patients diagnosed with prostate cancer with post-prostatectomy biochemical recurrence and a negative [¹⁸F]F-PSMA -PET/CT study are likely to benefit from pelvic salvage radiotherapy, with response seen in 93.1% of our cases.

目的：探讨[18F]F-PSMA阴性PET/CT对前列腺癌行前列腺切除术且PSA升高小于1 ng/mL患者补救性放疗预后的临床价值。方法：我们前瞻性地纳入98例诊断为前列腺癌并行前列腺切除术并生化复发的患者[平均PSA 0.51 ng/mL（范围0.17-1.0 ng/mL）]，并转介进行[18F]F-PSMA -PET/CT研究。[18F]F-PSMA -PET/CT扫描阴性53/98例（54.09%）。经多学科委员会和患者同意决定是否接受盆腔保留放疗（PSRT）的患者之间进行差异分析，随访时间至少为1年。对治疗的反应被定义为PSA水平降低50%。根据临床、分析和影像学随访结果确定复发。结果：54.7%（29/53）的[18F]F-PSMA -PET/CT阴性患者行PSRT。其中，93.1%（27/29）患者表现出对治疗的反应（PSMA假阴性）。其余2例患者在[18F]F-PSMA -PET/CT随访研究中显示PSA水平波动，但未发现疾病。45.3%（24/53）的F-PSMA -PET/CT阴性[18F]患者未行PSRT。其中，62.5%（15/24）的患者出现进行性PSA升高（PSMA假阴性），4例患者在[18F]F-PSMA -PET/CT随访研究中定位复发。其余9例（37.5%）患者在[18F]F-PSMA -PET/CT随访研究中显示PSA水平波动，但未发现疾病。我们确认了42例（42.85%）[18F]F-PSMA -PET/CT假阴性病例。结论：诊断为前列腺癌的前列腺切除术后生化复发且F-PSMA -PET/CT阴性的患者可能受益于盆腔补救性放疗，93.1%的病例有反应。

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引用次数: 0

"Utility of PET/CT with [18F] F-fluorocholine in assessing the response to antiandrogenic therapy in patients with prostate cancer."

Revista espanola de medicina nuclear e imagen molecular

Pub Date : 2025-03-01 DOI: 10.1016/j.remnie.2025.500083

K. Quintero , E. Vila , L. Ferrer-Mileo , D. Vas , Maria J. Ribal , M. Garcia-Herreros , N. Navarro , M. Tormo-Ratera , C. Aversa , A. Vilaseca , A. Farré-Melero , D. Fuster , P. Paredes , grupo de Medicina Nuclear Clínic Barcelona (MNCB)

Objective

To evaluate the correlation between response assessment measured by PET/CT with [¹⁸F] F-fluorocholine (Choline PET/CT) and serum levels of PSA in patients with prostate cancer under antiandrogenic treatment.

Methodology

A retrospective study included patients with CRPC (castration-resistant prostate cancer) and HSPC (hormone sensitive prostate cancer) treated with enzalutamide, abiraterone, or apalutamide between June 2018 and July 2021, who underwent baseline and a follow-up Choline PET/CT. The difference in maximum SUVmax (ΔSUV) between both studies and the PSA value before and at follow-up were recorded. The response to treatment was compared by PSA vs. PET, assessing their association, agreement, and correlation.

Results

Thirty patients were included (median age 74 years, range 68–78), 12 with CSPC and 18 with CRPC; 22 had nodal disease, and 15 had active bone disease. The average time between pre-treatment and follow-up PET/CT was 11 months (range 3.5–23).

Patients with extra-nodal metastatic disease at the beginning of treatment showed a higher correlation between PSA and ΔSUV (OR 4.375). In patients with bone disease at the start of treatment, 80% were classified as non-responders on PET response assessment, while only 40% were non-responders by PSA.

The correlation between PET and PSA was mild (Kendall’s tau_b 0.26), and the classification into Responders/Non-responders had only slight agreement (Cohen’s kappa 0.30).

Conclusion

Choline PET/CT shows low concordance with the PSA values obtained during the follow-up of response to anti-androgen therapy, especially in patients with bone involvement.

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引用次数: 0

Assessment of pulmonary nodules using [18F]-FDG PET/CT in deep inspiration breath-hold 在深吸气时使用 [18F]-FDG PET/CT 评估肺结节。

Revista espanola de medicina nuclear e imagen molecular

Pub Date : 2025-03-01 DOI: 10.1016/j.remnie.2024.500074

M.S. Casallas Cepeda, S. Salcedo Córtes, I. Gómez Fernández, J. Orcajo Rincón, L. Reguera Berenguer, E.J. Ardila Manjarrez, J.J. Ardila Mantilla, V. Castillo Morales, J. Gúzman Cruz, D. Zamudio Rodríguez, A. Marí Hualde, J.E. Montalvá Pastor, S. Álvarez Lara, J.C. Alonso Farto

The characterization of pulmonary nodules (PN) is a primary indication for [¹⁸F]-FDG PET/CT. However, respiratory movements hinder this characterization, especially for PN located in the lower lobes. Various methods have been developed to improve image resolution.

Objective

Our objective was to compare the diagnostic efficacy of [¹⁸F]-FDG PET/CT in deep inspiration breath-hold (DIBH) versus free-breathing corrected by software, in the evaluation of PN.

Methods

We prospectively analyzed 51 patients to assess PN using [¹⁸F]-FDG PET/CT in DIBH and free-breathing corrected by software. A total of 84 nodules with an average size of 10 mm were analyzed, with pathological anatomy or medical treatment decide by a multidisciplinary tumor board used as reference.

Results

A total of 84 PN were evaluated, comparing those in DIBH versus free-breathing, finding statistically significant differences in SUVmax values P(< 0.05) (mean SUVmax 3.7 in free-breathing vs. 5.33 in DIBH). When analyzed by location in lobes, we did not find statistically significant differences, though there was a trend towards higher SUVmax values in the lower lobes. [¹⁸F]-FDG PET/CT in DIBH showed high sensitivity (95%) and negative predictive value (NPV) (92%), indicating it may be a promising tool for PN characterization.

Conclusions

The acquisition of [¹⁸F]-FDG PET/CT in DIBH significantly improves the sensitivity and diagnostic efficacy in the assessment of PN. Although no statistically significant differences were found based on location, there is a potential benefit for the lower lobes. These findings could support its use in clinical practice.

肺结节（PN）的定性是[18F]-FDG PET/CT 的主要适应症。然而，呼吸运动阻碍了这一特征的确定，尤其是位于下叶的肺结节。目前已开发出多种方法来提高图像分辨率：我们的目的是比较[18F]-FDG PET/CT 在深吸气屏气（DIBH）状态下与经软件校正的自由呼吸状态下对 PN 的诊断效果：我们对 51 例患者进行了前瞻性分析，使用 DIBH 和经软件校正的自由呼吸[18F]-FDG PET/CT 评估 PN。共分析了 84 个平均大小为 10 毫米的结节，并以多学科肿瘤委员会的病理解剖或医学治疗决定作为参考：结果：共评估了 84 个 PN，比较了 DIBH 和自由呼吸下的 PN，发现两者的 SUVmax 值（p 18F]-FDG PET/CT 在 DIBH 下显示出较高的灵敏度（95%）和阴性预测值（NPV）（92%），表明它可能是 PN 特征描述的一种有前途的工具：结论：在 DIBH 中采集[18F]-FDG PET/CT 可显著提高 PN 评估的灵敏度和诊断效果。虽然根据部位的不同没有发现明显的统计学差异，但下叶有潜在的获益。这些发现可支持其在临床实践中的应用。

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