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Muñoz-Sánchez M, Molina-Garrido MJ, García Vicente AM, Soriano Rodríguez M, Amo Salas M, Olaverri Hernández A, Chacón Muñiz JI, Álvarez Cabellos R, Espinosa Aunión R, Ortega Ruipérez C, Martín Ordóñez F, Pena Pardo FJ, Jiménez Londoño GA, Val Pérez E, Santiago Crespo JA, Soriano Castrejón A. Abstract PD3-03: Determining the prognostic role of early and end-of-neoadjuvant chemotherapy 18F-FDG PET/CT in patients with locally advanced breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-pd3-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Aim: To investigate the use of 18F-FDG PET/CT at diagnosis and after end-of-treatment in the prediction of response to neoadjuvant chemotherapy (NAC) and its role in the prognosis of patients with locally advanced breast cancer (LABC).
Materials and Methods: One hundred thirty-two patients underwent a baseline FDG PET/ CT (PET-1) after the second course of chemotherapy (PET-2) and after the last course (PET-3).
Breast tumors were classified into molecular phenotypes and grouped into risk categories according to the biological prognostic factors obtained by immunohistochemistry.
PET/CT scans were semiquantitatively evaluated, obtaining the Δ% SUV1-2 and SUV1-3 in primary tumor and axillary lymph nodes to establish response groups attending to EORTC criteria. Moreover, a binary assessment was obtained classifying the studies as positive or negative.
Pathological response was determined both in breast and axillary lymph node specimens.
Overall survival (OS) and disease-free survival (DFS) were obtained during the follow-up.
ROC analysis was performed to determine a cutoff value of Δ% SUV1-2 and SUV1-3 for the prediction of response and prognosis.
Relations between molecular phenotypes, metabolic behavior, final pathological response, OS, and DFS were evaluated.
This prospective and multicenter study was approved by the local ethics committee of our institution and included 7 hospitals of our region.
Results: In binary analysis, only PET-3 was able to predict pathological response in lymph nodes. The cutoff values of %Δ SUV1-2 and %Δ SUV1-3 with the best sensitivity and specificity in the prediction of response in breast tumor were 62% (Se: 70% and Sp: 69%) and 84% (Se: 70%and Sp: 88%). A%ΔSUV1-3 of 74% in breast tumor was a predictor of DFS (AUC = 0.647; P = 0.037, Se: 52% and Sp: 66%). Kaplan- Meier analysis revealed significant relations between the binary lymph node assessment of PET-3 with OS (P = 0.016, χ2 = 5.78) and DFS (P = 0.003, χ2 = 9.10).
Conclusions: Among the multiple metabolic response variables in breast tumor and lymph nodes, end-of-treatment 18F-FDG PET/CT was a significant predictor of breast and lymph node response and patient prognosis. The molecular phenotypes and pathological lymph node response rate were independent predictors of OS and DFS. This stresses the potential of the biological influence over metabolic variables in the prognosis of patients. Metabolic response variables work better in their predictive and prognostic value in high-risk tumors.
Citation Format: Muñoz-Sánchez MdM, Molina-Garrido MJ, García Vicente AM, Soriano Rodríguez MdC, Amo Salas M, Olaverri Hernández A, Chacón Muñiz JI, Álvarez Cabellos R, Espinosa Aunión R, Ortega Ruipérez C, Martín Ordóñez F, Pena Pardo FJ, Jiménez Londoño GA, Val Pérez E, Santiago Crespo JA, Soriano Castrejón A. Determining the prognostic role of early and end-of-neoadjuvant chemotherapy 18F-FDG PET/CT in patients with locally advanced breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr PD3-03.
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Affiliation(s)
- MdM Muñoz-Sánchez
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - MJ Molina-Garrido
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - AM García Vicente
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - MdC Soriano Rodríguez
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - M Amo Salas
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - A Olaverri Hernández
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - JI Chacón Muñiz
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - R Álvarez Cabellos
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - R Espinosa Aunión
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - C Ortega Ruipérez
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - F Martín Ordóñez
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - FJ Pena Pardo
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - GA Jiménez Londoño
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - E Val Pérez
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - JA Santiago Crespo
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
| | - A Soriano Castrejón
- Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; University of Castilla-La Mancha, Ciudad Real, Spain; Medical Oncology Service. Hospital Universitario Virgen de la Salud, Toledo, Spain; Medical Oncology Section. Hospital La Mancha Centro, Alcazar de San Juan, Ciudad Real, Spain
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Pena Pardo FJ, García Vicente AM, Amo-Salas M, López-Fidalgo JF, Garrido Robles JA, de Ayala Fernández JÁ, del Saz Saucedo P, Muñoz Pasadas M, Soriano Castrejón A. Utility of 18F-FDG-PET/CT in patients suspected of paraneoplastic neurological syndrome: importance of risk classification. Clin Transl Oncol 2016; 19:111-118. [DOI: 10.1007/s12094-016-1511-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 04/09/2016] [Indexed: 12/26/2022]
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Garcia Vicente A, Soriano Castrejón A, Amo-Salas M, Lopez Fidalgo J, Muñoz Sanchez M, Alvarez Cabellos R, Espinosa Aunion R, Muñoz Madero V. Glycolytic activity in breast cancer using 18 F-FDG PET/CT as prognostic predictor: A molecular phenotype approach. Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2015.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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4
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García Vicente A, Soriano Castrejón A, Pruneda-González R, Fernández Calvo G, Muñoz Sánchez M, Álvarez Cabellos R, Espinosa Aunión R, Relea Calatayud F. Basal 18 F-FDG PET/CT as a predictive biomarker of tumor response for neoadjuvant therapy in breast cancer. Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2016.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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García Vicente AM, Soriano Castrejón A, Cruz Mora MÁ, Ortega Ruiperez C, Espinosa Aunión R, León Martín A, González Ageitos A, Van Gómez López O. Dual time point 2-deoxy-2-[18F]fluoro-D-glucose PET/CT: nodal staging in locally advanced breast cancer. Rev Esp Med Nucl Imagen Mol 2013; 33:1-5. [PMID: 23707190 DOI: 10.1016/j.remn.2013.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 03/21/2013] [Accepted: 03/22/2013] [Indexed: 12/01/2022]
Abstract
AIM To assess dual time point 2-deoxy-2-[(18)F]fluoro-D-glucose (18)(F)FDG PET-CT accuracy in nodal staging and in detection of extra-axillary involvement. MATERIAL AND METHODS Dual time point [(18)F] FDG PET/CT scan was performed in 75 patients. Visual and semiquantitative assessment of lymph nodes was performed. Semiquantitative measurement of SUV and ROC-analysis were carried out to calculate SUV(max) cut-off value with the best diagnostic performance. Axillary and extra-axillary lymph node chains were evaluated. RESULTS Sensitivity and specificity of visual assessment was 87.3% and 75%, respectively. SUV(max) values with the best sensitivity were 0.90 and 0.95 for early and delayed PET, respectively. SUV(max) values with the best specificity were 1.95 and 2.75, respectively. Extra-axillary lymph node involvement was detected in 26.7%. CONCLUSION FDG PET/CT detected extra-axillary lymph node involvement in one-fourth of the patients. Semiquantitative lymph node analysis did not show any advantage over the visual evaluation.
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Affiliation(s)
- A M García Vicente
- Nuclear Medicine Department, University General Hospital, Ciudad Real, Spain.
| | - A Soriano Castrejón
- Nuclear Medicine Department, University General Hospital, Ciudad Real, Spain
| | - M Á Cruz Mora
- Oncology Department, Virgen de la Salud Hospital, Toledo, Spain
| | | | - R Espinosa Aunión
- Oncology Department, La Mancha Centro Hospital, Alcázar de San Juan, Ciudad Real, Spain
| | - A León Martín
- Investigation Unit, University General Hospital, Ciudad Real, Spain
| | - A González Ageitos
- Oncology Department, Nuestra Sra. del Prado Hospital, Talavera de la Reina, Toledo, Spain
| | - O Van Gómez López
- Nuclear Medicine Department, University General Hospital, Ciudad Real, Spain
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García Vicente AM, Soriano Castrejón A, Relea Calatayud F, Muñoz Madero V, Molina Garrido MJ, León Martín AA, Cordero García JM, Pilkington Woll JP, Chacón López-Muñiz I, Palomar Muñoz A. 18F-FDG semi-quantitative parameters and biological prognostic factors in locally advanced breast cancer. Rev Esp Med Nucl Imagen Mol 2012; 31:308-14. [PMID: 23084013 DOI: 10.1016/j.remn.2011.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 12/11/2011] [Accepted: 12/14/2011] [Indexed: 10/28/2022]
Abstract
AIM To analyse the correlation between (18)F-FDG uptake assessed by PET/CT in locally advanced breast tumours and histopathological and immunohistochemical prognostic factors. MATERIAL AND METHODS Thirty-six women with breast cancer were prospectively evaluated. PET/CT was requested in the initial staging previous to adjuvant chemotherapy (multicentric study). All the patients underwent an (18)F-FDG PET/CT with a dual-time-point acquisition. Both examinations were evaluated qualitatively and semiquantitatively with calculation of SUVmax values in PET-1 (SUV-1) and in PET-2 (SUV-2) and the percentage variation of the standard uptake values (retention index) between PET-1 and PET-2. Clinical and metabolic stages were assessed according to TNM classification. The biological prognostic parameters, such as the steroid receptor status, p53 and c-erbB-2 expression, proliferation rate (Ki-67), and grading were determined from tissue of the primary tumour. Metabolic and biological parameters were correlated. RESULTS A positive relationship was found between semiquantitative metabolic parameters and biological parameters. SUV-1 and SUV-2 values did not show significant statistical correlation (p<.05) except for the clinical tumour size. About the biological parameters, retention index showed the best results with positive and significant relation (p<.05) with estrogen and progesterone receptor status and Ki-67. Isolated SUV values did not show significant relation to these parameters. CONCLUSION Retention index showed the best relation with biological parameters compared to isolated SUVmax values. These data suggest that SUV change over time is a prognostic marker.
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Affiliation(s)
- A M García Vicente
- Nuclear Medicine Department, University General Hospital, Ciudad Real, Spain.
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Cordero García JM, López de la Manzanara Cano CA, García Vicente AM, Garrido Esteban RA, Palomar Muñoz A, Talavera Rubio MP, Pilkington Woll JP, González García B, Soriano Castrejón A. Study of the sentinel node in endometrial cancer at early stages: preliminary results. Rev Esp Med Nucl Imagen Mol 2012; 31:243-8. [PMID: 23067525 DOI: 10.1016/j.remn.2011.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 11/04/2011] [Accepted: 11/12/2011] [Indexed: 01/11/2023]
Abstract
AIM To investigate the applicability of the sentinel lymph node biopsy technique in early stages of endometrial cancer. MATERIAL AND METHODS A prospective study that included consecutive patients with a histological diagnosis of clinical state I endometrial carcinoma was performed. Two doses of 2 mCi (74 MBq) of (99m)Tc-albumin nanocolloid were injected in the uterine cervix, and planar and SPECT-CT images were obtained at one hour, and at 24 hours if no migration of the tracer was observed. Methylene blue dye was also injected into the cervix immediately prior to the surgery. A gamma probe was used during the surgical procedure for sentinel lymph node identification. In all cases, a hysterectomy, double adnexectomy and pelvic lymphadenectomy were performed, carrying out a histological analysis (hematoxylin-eosin) of the sentinel lymph nodes and the lymphadenectomy specimen. RESULTS We included 19 patients, with a final diagnoses of endometrioid carcinoma (18 cases) and endometrial stromal sarcoma (1 case). At least one sentinel lymph node was identified in 17 of them (89.5% detection rate). Twenty-nine sentinel lymph nodes were identified during surgery, all of them negative for neoplastic infiltration. No metastatic invasion was found in the pelvic lymphadenectomy specimens as well. CONCLUSIONS The sentinel lymph node biopsy technique seems to be a reliable tool in nodal staging of endometrial cancer at early stages, with an acceptable detection rate and high histological correlation. The low prevalence of lymphatic spread in this group of patients and the encouraging results obtained could make the sentinel lymph node an alternative to routine complete lymphadenectomy.
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Affiliation(s)
- J M Cordero García
- Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, Cuidad Real, Spain.
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Cordero García J, López de la Manzanara Cano C, García Vicente A, Garrido Esteban R, Palomar Muñoz A, Talavera Rubio M, Pilkington Woll J, González García B, Soriano Castrejón A. Study of the sentinel node in endometrial cancer at early stages: Preliminary results. Rev Esp Med Nucl Imagen Mol 2012. [DOI: 10.1016/j.remnie.2012.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cordero García J, Palomar Muñoz A, Delgado Portela M, García Vicente A, Pilkington Woll J, Poblete García V, Bellón Guardia M, Pardo García R, Rabadán Ruiz L, Soriano Castrejón A. Prevalence of Micrometastases and Isolated Tumor Cells in the Sentinel Node in Early Stage Breast Cancer. Rev Esp Med Nucl Imagen Mol 2012. [DOI: 10.1016/j.remngl.2011.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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García Vicente A, Bellón Guardia M, Soriano Castrejón A, Calle Primo C, Cordero García J, Palomar Muñoz A, Pilkington Woll J, Talavera Rubio M, Hernández Ruiz B. 18F-FDG-PET/CT in the surveillance of patients with lymphoma: Detection of asymptomatic recurrences. Rev Esp Med Nucl Imagen Mol 2012. [DOI: 10.1016/j.remngl.2011.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Soriano Castrejón A. [An exciting period, "the best is always to come"]. Rev Esp Med Nucl 2011; 30:265-266. [PMID: 21871341 DOI: 10.1016/j.remn.2011.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 07/18/2011] [Indexed: 05/31/2023]
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Cordero García JM, Palomar Muñoz A, Delgado Portela M, García Vicente AM, Pilkington Woll JP, Poblete García VM, Bellón Guardia ME, Pardo García R, Rabadán Ruiz L, Soriano Castrejón A. [Prevalence of micrometastases and isolated tumor cells in the sentinel node at early stage breast cancer]. Rev Esp Med Nucl Imagen Mol 2011; 31:78-82. [PMID: 21658817 DOI: 10.1016/j.remn.2011.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 04/19/2011] [Accepted: 04/21/2011] [Indexed: 11/17/2022]
Abstract
AIM To analyze the prevalence of isolated tumor cells (ITC) and micrometastases in the sentinel node of early stage breast cancer. MATERIAL AND METHODS A total of 234 patients diagnosed of breast cancer, stages T1 or T2, with no axillary involvement detected by palpation or ultrasound-FNA, were studied. The sentinel node (SN) was identified by lymphoscintigraphy and removed in the operating room. Serial sections and immunohistochemical staining were then performed, classifying them as negative (SN-), negative with ITC (SN-ITC), positive with micrometastases (SN+mic) and positive with macrometastases (SN+mac). A complete axillary lymphadenectomy (CAL) was carried out in those cases with micro- or macrometastases, the former being classified as negative (CAL-), positive with micrometatases (CAL+mic), and positive with macrometastases (CAL+mac). The follow-up ranged from 6-71 months. RESULTS ITC were found in 12 patients (5.1%) and micrometastases in 24 (10.3%). Thus, a total of 36 patients were affected by some of these conditions (15.4%). In the group with micrometastases, the result of CAL was CAL- in 19/24 (79.1%), CAL+mic in 2 (8.3%) and CAL+mac in 3 (12.5%). No axillary recurrences have occurred up to date. CONCLUSIONS ITC and micrometastases were found in the sentinel node in a significant percentage of patients in the early stages of breast cancer. The low percentage of further axillary invasion in the group of micrometastases may open up the possibility of avoiding CAL in favor of other adjuvant treatments (chemotherapy, radiotherapy).
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Axilla
- Biopsy, Fine-Needle
- Breast Neoplasms/diagnosis
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Lobular/epidemiology
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/therapy
- Chemotherapy, Adjuvant
- Female
- Follow-Up Studies
- Humans
- Lymph Node Excision
- Lymphatic Metastasis/diagnostic imaging
- Lymphatic Metastasis/pathology
- Middle Aged
- Neoplasm Micrometastasis/diagnosis
- Neoplasm Micrometastasis/pathology
- Neoplasm Staging
- Palpation
- Prevalence
- Radiography, Interventional
- Radionuclide Imaging
- Radiotherapy, Adjuvant
- Sentinel Lymph Node Biopsy
- Ultrasonography, Interventional
- Unnecessary Procedures
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Affiliation(s)
- J M Cordero García
- Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, España.
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García Vicente AM, Núñez García A, Palomar Muñoz A, Pilkington Woll JP, Bellón Guardia ME, González García B, Soriano Castrejón A. [18F-FDG PET/CT with retrograde filling of the urinary bladder in the assessment of malignant pelvic disease]. ACTA ACUST UNITED AC 2011; 30:71-6. [PMID: 21334772 DOI: 10.1016/j.remn.2010.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Revised: 09/29/2010] [Accepted: 10/26/2010] [Indexed: 10/18/2022]
Abstract
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 (18)F-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.
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Affiliation(s)
- A M García Vicente
- Servicio de Medicina Nuclear, Hospital General de Ciudad Real, Ciudad Real, Spain.
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Bellón Guardia ME, Pérez Romasanta L, García Vicente AM, Talavera Rubio MP, Palomar Muñoz A, González García B, Poblete García VM, Soriano Castrejón A. [Utility of PET-CT on radiotherapy planning of head and neck cancer. Our initial experience]. ACTA ACUST UNITED AC 2010; 29:157-64. [PMID: 20494489 DOI: 10.1016/j.remn.2010.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 03/09/2010] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To describe the methods used for the incorporation of FDG-PET-CT on radiotherapy planning of patients with head and neck cancer and also to evaluate the impact of FDG-PET-CT on staging and tumor volume definition. MATERIAL AND METHODS A prospective study in which 20 patients with head and neck tumor submitted for radiotherapy treatment were included. All underwent a whole body PET- CT (GE DSTE 16) for staging and restaging, also acquiring an additional 3h delayed PET image with diagnostic CT parameters for planning. A CT scan with diagnostic protocol, tabletop available for radiotherapy treatment and the same personalized head-shoulder mask were used in the latter. Lymph node involvement and/or distant involvement were evaluated, considering the changes in staging. We also evaluated the differences in volumes obtained between the different techniques. The threshold value used for delineating PET gross tumor volume (GTV) was empirically established and ranged from 20-40% of the maximum SUV. RESULTS Radiotherapy planning was performed with PET-CT in 20 patients between October 2007 to September 2008. A total of 29 lesions (18 primary lesions because 2 patients were excluded as no tumor was observed on the PET CT images, and 11 nodes). The most frequent location was oropharynx (5 patients). Mean maxSUV of the 29 lesions was 14.4 (range 5.0 and 26.4). No statistically significant differences were found between the GTV PET and GTV CT (mean 21.9cm³ and 19.3cm³, respectively). PET-CT modified the staging in 20% of the patients, with a diagnostic and therapeutic impact of 50 and 25%, respectively. CONCLUSION The incorporation of PET-CT in routine radiotherapy planning is a promising technique that requires close collaboration between the nuclear medicine and radiotherapy oncology departments. PET-CT achieves better staging in patients and has a significant diagnostic and therapeutic impact. The use of the hybrid technique avoids problems arising from co-registry as well as a second examination for planning with the consequent advantage for the patient. Nonetheless, more prospective and randomized studies with pathology specimens are needed to evaluate the real impact in the tumor volume definition.
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Affiliation(s)
- M E Bellón Guardia
- Servicio de Medicina Nuclear, Hospital General de Ciudad Real, Ciudad Real, España.
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15
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Palomar Muñoz A, García Vicente A, Talavera Rubio M, Pilkington Woll J, Poblete García V, Bellón Guardia M, León Martín A, Cordero García J, Soriano Castrejón A. Impacto diagnóstico y terapéutico de la 18F-FDG-PET/TAC en pacientes con sospecha de recidiva de cáncer de mama. ACTA ACUST UNITED AC 2010; 29:100-8. [DOI: 10.1016/j.remn.2010.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 02/17/2010] [Indexed: 10/19/2022]
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Talavera Rubio MP, García Vicente AM, Domínguez Ferreras E, Calle Primo C, Poblete García VM, Hernández Ruiz B, Bellón Guardia M, Palomar Muñoz A, Cepedello Boiso I, Pilkington Woll P, González García B, Cordero García JM, Molino Trinidad C, Soriano Castrejón A. [PET-CT with intravenous contrast in the evaluation of patients with lymphoma. Contribution to diagnostic indications]. Rev Esp Med Nucl 2009; 28:235-41. [PMID: 19922840 DOI: 10.1016/j.remn.2009.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 04/28/2009] [Indexed: 01/29/2023]
Abstract
AIM To define the utility of intravenous contrast administration in the PET-CT (PET-CTc) in patients with lymphoma in order to determine its possible indications. MATERIAL AND METHODS 78 patients with lymphoma were prospectively evaluated. All underwent simultaneous PET-CTc scans in a hybrid system for staging (8), evaluation of response to treatment (29), suspicion of recurrence (9) and complete remission control (48). The PET scan was acquired by a conventional method and the diagnostic CT scan was performed according to radiological protocol. Both examinations were evaluated blinded and independently, analyzing 28 anatomical locations in order to determine the degree of agreement. Final diagnosis was established by the clinician based on the histological study, results of other diagnostic techniques or clinical follow-up. RESULTS The final result of both techniques were concordant in 87/94 studies (92.5%). A total of 158 (36 FP) pathological locations were detected with PET-CT and 189 (71 FP) with CTc, with 72 locations being discordant between both techniques. Global sensitivity, specificity, PPV and NPV were 93%, 98%, 77% and 99%; and 94%, 97%, 62% and 99%, respectively. CONCLUSIONS Administration of intravenous contrast does not seem to provide any advantage in the determination of nodal and extranodal disease in lymphoma patients. The low prevalence of disease probably accounts for the limited PPV of both techniques. An increase of our sample size, with a greater homogeneity of the groups, should offer more reliable results.
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Affiliation(s)
- M P Talavera Rubio
- Servicio de Medicina Nuclear, Hospital General Ciudad Real, Ciudad Real, España.
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García Vicente A, Soriano Castrejón A, Talavera Rubio P, Poblete García V, Palomar Muñoz A, Cepedello Boiso I, González García B, Cordero García J, Bellón Guardia M, Pilkington Woll J. 18F-FDG PET-TAC y sincronización respiratoria: efecto en la detección y catalogación de lesiones pulmonares. ACTA ACUST UNITED AC 2009; 28:181-7. [DOI: 10.1016/s0212-6982(09)00009-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Accepted: 03/04/2009] [Indexed: 11/25/2022]
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18
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Ruiz Solís S, Maure Rico M, Cortés Romera M, Poblete García VM, Rodríguez Alfonso B, Talavera Rubio P, Palomar Muñoz A, García Vicente AM, Martínez Delgado C, Soriano Castrejón A. [Usefulness of ventricular function values obtained using post-stress gated-SPECT in a diabetic population with clinical suspicion of ischaemic heart disease]. Rev Esp Med Nucl 2008; 27:340-349. [PMID: 18817663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To assess the clinical usefulness of left ventricular function values obtained using post-stress myocardial perfusion gated-SPECT in diabetic patients with suspected ischaemic heart disease (IHD). MATERIALS AND METHODS Sixty-one patients with diabetes mellitus (DM), with clinical suspicion of IHD and no previous history of heart disease were studied. Ergometric or pharmacological post-stress myocardial perfusion gated-SPECT was performed on all patients. The relationship between the ejection fraction values and ventricular volumes, and the perfusion study results, final diagnosis, severity of the perfusion defects and the clinical evolution was studied. The mean follow-up time was 14 months. RESULTS; All the ventricular function values independently showed significant differences between the groups with a normal and pathological perfusion study, and between groups with a final diagnosis of IHD and non-IHD. After multivariate logistic regression, the end-diastolic volume (EDV) was the only value which showed a statistical association with the pathological perfusion study, its severity and the final diagnosis of IHD. No statistical association was observed between the ventricular function values and the occurrence of cardiac events. CONCLUSIONS All the ventricular function values obtained by gated-SPECT added diagnostic information to the post-stress myocardial perfusion study in the diabetic population with suspected IHD; however, only EDV showed a statistical association with the pathological perfusion study, severity of defects and the final diagnosis of IHD.
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Affiliation(s)
- S Ruiz Solís
- Servicio de Medicina Nuclear. Hospital General de Ciudad Real. Ciudad Real. España.
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19
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Talavera Rubio MP, Ruiz Solís S, García Vicente AM, Soriano Castrejón A, Poblete García VM, Cortés Romera M. [Value of 99mTc-labelled red cells in the detection of pulmonary haemorrhage]. ACTA ACUST UNITED AC 2008; 27:274-6. [PMID: 18682154 DOI: 10.1157/13124637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The use of 99mTc-labelled red cells is very extensive in the detection of haemorrhages of gastrointestinal origin. However, not only is it useful in haemorrhages in this location, but it may also be of use in other locations such as pulmonary haemorrhage. We should not forget that this is a non-invasive diagnostic method, useful in localising possible pulmonary bleeding which causes symptoms of haemoptysis, without having to resort to invasive tests such as angiography, or prior to this, to have approximate knowledge of the location of the bleeding area. We present the case of a patient with a haemoptysis picture where the use of scintigraphy with labelled red cells detected the location of the bleeding site, directing towards subsequent surgery, and a final diagnosis of haemoptysis due to pulmonary carcinoma.
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Affiliation(s)
- M P Talavera Rubio
- Servicio de Medicina Nuclear, Hospital General de Ciudad Real, Ciudad Real, España.
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20
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García Vicente AM, Soriano Castrejón A, Martínez Delgado C, Ruíz Solís S, Talavera Rubio MP, Poblete García VM, Palomar Muñoz A, Cortés Romera M, Rodríguez Alfonso B. [Study of physician satisfaction as a quality criterion in Nuclear Medicine]. Rev Esp Med Nucl 2008; 27:22-28. [PMID: 18208778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To determine the perception and satisfaction level of referring physicians requesting scans as final users of the Nuclear Medicine Department. MATERIAL AND METHODS A self-administered questionnaire was designed; it was composed of 10 closed questions (5 categorised and 5 with numerical scale) and 3 open questions. The indicators evaluated were: physician's information about available tests, test indications and diagnostic information, accessibility, delay in the examination and reception of the diagnostic report, usefulness of diagnostic information and overall satisfaction with the department. Two hundred and fifteen questionnaires were sent. RESULTS Seventy eight questionnaires were returned, so the response index was 36.3 %. The 44.6 % of physicians surveyed considered that they had sufficient information about the tests and 59.5 % were satisfied with the indications and diagnostic information. The accessibility was 7 or more out of 10 for 78.5 %. The 64.9 % of physicians considered the delay in performing examinations to be correct but the satisfaction was lower in the delay between performance and reception of the diagnostic report. The diagnostic information was considered useful by 81.9 % and relevant in the management of patients by 70.5 % of the participants surveyed. The overall satisfaction was > or = 7 out of 10 in 86.8 %. CONCLUSIONS Overall satisfaction was high, although the level of knowledge about available tests and the delay between test performance and report reception could be improved.
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Cortés Romera M, Talavera Rubio M, García Vicente A, Ruiz Solís S, Poblete García V, Rodríguez Alfonso B, Palomar Muñoz A, Soriano Castrejón A. ¿Se solicitan las gammagrafías óseas en pacientes oncológicos según criterios clínicos reconocidos? ACTA ACUST UNITED AC 2007. [DOI: 10.1157/13109143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Cortés Romera M, Talavera Rubio MP, García Vicente AM, Ruiz Solís S, Poblete García VM, Rodríguez Alfonso B, Palomar Muñoz A, Soriano Castrejón A. [Are bone scintigraphy examinations requested in oncologic patients according to established indications?]. Rev Esp Med Nucl 2007; 26:286-93. [PMID: 17910837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To determine the percentage of bone scintigraphy examinations (BS) requested according to established indications and to assess the clinical impact of the scintigraphic results. MATERIAL AND METHODS A retrospective study was performed including BS in 117 patients (70 women and 47 men) carried out in our department during the year 2001. All patients had a primary extraosseous malignancy. The correctness of the indication of each study requested was analyzed according to established criteria from the literature. BS results were classified as positive, negative, and equivocal for metastatic disease. RESULTS 96 out of the 117 BS were performed in patients affected with the most prevalent primary malignancies: breast (57), prostate (21), and lung (18). The remaining studies were included in a miscellaneous group (gynecological [3], colorectal [4], oropharyngeal [4], and renal malignancies [4]; lymphoma [2], melanoma [2], hemangioendothelioma [1]; and cancer of the bladder [1] or pancreas [1]). Ninety-nine (85 %) of the 117 BS performed met the criteria for appropriate indication. The indication was correct in 75 % of breast, 90 % of prostate (19/21), and 100 % of lung cancers. The indication was correct in 90 % of the cases in the miscellaneous group. BS were positive in 21 patients (20 of which were confirmed). BS were equivocal in 24 patients (in 5 of whom bone metastases were confirmed). BS were negative in 72 patients (one of whom had bone metastases). The BS findings changed staging in 9 % (9/99) of the correctly indicated cases. CONCLUSION Most BS (85 %) were indicated according to the established criteria and the clinical impact was greater in this group.
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Affiliation(s)
- M Cortés Romera
- Servicio de Medicina Nuclear, Hospital General de Ciudad Real, España.
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García Vicente AM, Soriano Castrejón A, Martínez Delgado C, Poblete García VM, Ruiz Solís S, Cortés Romera M, Rodado Marina S, Talavera Rubio MP, Palomar Muñoz MA. [Patient satisfaction as quality indicator in a nuclear medicine department]. Rev Esp Med Nucl 2007; 26:146-52. [PMID: 17524308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To assess patient satisfaction and dissatisfaction with a Nuclear Medicine department. MATERIAL AND METHODS A questionnaire was designed with 9 closed questions, 1 with a numerical scale (1-10) and 1 with an open question for suggestions. The questions included different quality dimensions of the department related with waiting time for the scan, information, facilities, attention manner with department staff and global satisfaction (numerical scale, 1-10). Dissatisfaction was determined by analyzing the written complaints for the last 6 years. RESULTS A total of 671 questionnaires were obtained, 58 % of those surveyed being women. The mean age of patients was 56.5 (+/- 16.26). The information provided was correct in 81.7 % of cases. Equipment and facilities were correct for 74.5 % of patients. Waiting list and waiting time were correct for 70 % and 66.4 % respectively. The attention manner of the department staff was the most satisfactory dimension (98.7 %). Global satisfaction was positive (> or = 7 out of 10) in 82.8 % of the patients. 29 complaints were received. Most of them were based on waiting list (12) and disagreement with assistance (9). CONCLUSIONS Global satisfaction was high in most of patients. Waiting time was the dimension with the lowest level of satisfaction and subsidiary of improvement plans. The primary spontaneous complain by our patients was due to the waiting list.
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Affiliation(s)
- A M García Vicente
- Servicio de Medicina Nuclear, Unidad de Investigación, Hospital General de Ciudad Real, Ciudad Real, Spain
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Ruiz Solís S, Rodado Marina S, Soriano Castrejón A, Cortés Romera M, Poblete García VM, García Vicente AM, Talavera Rubio P, Martínez C. [Clinical and prognostic value of X-ray based attenuation correction in post-stress myocardial perfusion SPECT]. Rev Esp Med Nucl 2007; 26:77-89. [PMID: 17386234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVE The purpose of the study was to validate the X-ray-based attenuation correction technique applied to post-stress myocardial perfusion single photon emission computed tomography (SPECT). MATERIALS AND METHODS Fifty-six patients with clinically suspected ischemic heart disease and no history of myocardial infarction or coronary revascularization were studied. All patients underwent a myocardial perfusion SPECT after exercise (38) or pharmacological stress (18). Mean clinical follow-up time was 18.6 months. Studies were assessed after reconstruction using the filtered back projection technique and after application of the X-ray-based attenuation correction technique, and the results obtained were related to the final clinical diagnosis. RESULTS Eleven uncorrected studies were normal, while 45 studies showed perfusion defects. After attenuation correction, absence of significant perfusion defects was observed in 24 cases (42.9 % of all cases), and ischemic heart disease was finally ruled out in 22 cases. A greater study normalization rate was seen in men (p = 0.048; odds ratio = 2,923), but this fact was not shown to be significantly correlated to the following variables: pre-test probability of ischemic heart disease, body mass index greater than 30, presence of cardiovascular risk factors or otherwise, and age. CONCLUSIONS Application of the X-ray-based attenuation correction technique would have allowed for obviating the conduct of a resting perfusion study in 42.9 % of patients without apparently changing the diagnostic safety of the test. This fact was seen more frequently in men. This method seems to be both safe and time- and cost-effective.
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Affiliation(s)
- S Ruiz Solís
- Servicio de Medicina Nuclear, Hospital General de Ciudad Real, España.
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Poblete García V, García Vicente A, Soriano Castrejón A, Beato Fernández L, García-Vilches I, Rodríguez-Cano T, Cortés Romera M, Ruiz Solís S, Rodado Marina S, Talavera Rubio M. Valoración del flujo cortical cerebral mediante SPECT de perfusión cerebral en pacientes con diagnóstico de trastornos de la conducta alimentaria. ACTA ACUST UNITED AC 2007. [DOI: 10.1157/13097377] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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26
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Poblete García VM, García Vicente A, Soriano Castrejón A, Beato Fernández L, García-Vilches I, Rodríguez-Cano T, Cortés Romera M, Ruiz Solís S, Rodado Marina S, Talavera Rubio MP. [Assessment of cortical brain blood flood by brain perfusion spect in patients with a diagnosis of eating behavior disorders]. Rev Esp Med Nucl 2007; 26:11-8. [PMID: 17286944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To evaluate cortical brain blood flow by 99mTc-HMPAO SPECT in patients with Eating Disorders (ED): restrictive anorexia (RA) and purgative bulimia (PB). MATERIAL AND METHOD The study included 7 women with diagnostic criteria of RA and 12 with PB. The control group was made up of 12 healthy women. All subjects underwent brain 99mTc-HMPAO SPECT. The SPECT studies were quantified, yielding semiquantitative indexes relating to cerebellar activity in different regions. Body dissatisfaction was assessed by means of the BSQ (Body Shape Questionnaire). The results were analyzed with the ANOVA variance and had a statistical significance of p < 0.05. RESULTS Mean BSQ scores were 98.28 (range 71-159) in the RA group, 145.05 (range 73-191) in the PB group, and 57.4 (range 37-88) in the control group. All patients in the sample (i.e., both RA and PB) showed global cerebral hypoperfusion versus the controls, although the difference only reached statistical significance in the RA group in the left parietal lobe (p = 0.02) and in the right (p = 0.004) and left temporal lobes (p = 0.015). In the PB group, the significantly hypoperfused regions were the right (p < 0.001) and left (p = 0.008) superior frontal lobe, the right inferior frontal lobe (p = 0.042), the right (p = 0.042) and left (p = 0.002) parietal lobes, and the right temporal lobe (p = 0.002). CONCLUSION The results obtained showed that patients with ED had cerebral hypoperfusion compared with healthy subjects. This pattern is common in parietotemporal regions for both PB and AR although with temporal and parietal predominance in RA and PB, respectively. In addition, patients with PB had frontal region involvement.
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García Vicente AM, Vaamonde Cano J, Soriano Castrejón A, Martínez Delgado C, Talavera Rubio P, Poblete García VM, Ruiz Solís S, Rodado Marina S, Cortés Romera M. [Utility of 123-I ioflupane SPECT in the assessment of patients with Parkinsonian syndrome and cerebral vasculopathy]. ACTA ACUST UNITED AC 2006; 24:392-403. [PMID: 16324516 DOI: 10.1016/s0212-6982(05)74184-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess the utility of 123-I Ioflupane SPECT (IS) in the identification of the origin of Parkinsonism (vascular or idiopathic) in patients with cerebral vasculopathy (CV) demonstrated by morphological imaging techniques. Also, to assess the therapeutic impact. MATERIALS AND METHODS 42 patients (16 males and 26 females) with a Parkinsonian syndrome were studied. Average age was 78.7 years (50-88). A dose of 185 MBq of 123 I-Ioflupane was injected in all subjects. SPECT imaging was obtained 5 hours later. All patients had a CT and/or MRI. The final diagnoses, after a minimal follow-up of 12 months, was established by a neurologist expert in movement disorders, based on clinical and imaging features and response to treatment. RESULTS 14 patients were diagnosed of functional vascular Parkinsonism by alteration of association pathways, 3 of structural vascular Parkinsonism (SVP) with anatomical and functional vascular lesion in striatum, 14 of Parkinson's disease (PD) with CV, 2 of mixed Parkinsonism (PD + SVP) and 9 with others diagnoses different to the previous. The result of IS changed the treatment in 7/42 patients. CONCLUSION The IS can have a complementary role to clarify the etiology of Parkinsonism in patients with cerebral vasculopathy. Interpretation of functional and anatomical images within the clinical context of each patient is necessary.
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Rodado Marina S, Poblete García VM, García Vicente AM, Ruiz Solís S, Talavera Rubio MP, Cortés Romera M, Soriano Castrejón A. [Myocardial perfusion SPECT with 99mTc-tetrofosmin and thoracic SPECT with Gallium-67 SPECT in a patient with chest pain and a history of sarcoidosis]. Rev Esp Med Nucl 2006; 25:35-9. [PMID: 16540010 DOI: 10.1157/13083348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
We present the case of a 54-year-old male patient, with history of diagnosed sarcoidosis some years ago and myocardial involvement, who being asymptomatic, shows chest pain because of which he goes to the emergency room of the hospital. During the first hours of his admission the pain relieves with nonsteroidal antiinflammatory medication, an electrocardiogram demonstrates changes of early repolarisation with pericardial involvement, the enzymes don't rise and the echocardiogram reveals a slight pericardial effusion. The differential diagnosis is between a chest pain due to ischemia, and the secondary to myopericarditis in the clinical context of a sarcoidosis. Myocardial perfusion rest SPECT is required which is compatible with lateral acute myocardial infarction (AMI) with extension to inferior wall. A coronary angiography was carried out and showed two vessels disease (RCA and Cx), PTCA and stent were carried out successfully. During the admission a thoracic scintigraphy and SPECT with gallium -67 showed an uptake in lateral wall of left ventricle (LV). Nothing about active sarcoidosis was found.
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Affiliation(s)
- S Rodado Marina
- Servicio de Medicina Nuclear, Hospital General de Ciudad Real, Ciudad Real.
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Cortés Romera M, Pardo García R, Soriano Castrejón A, García Vicente A, Ruiz Díaz M, Poblete García VM, Carbajo Vicente M, Rodado Marina S, Ruiz Solís S, Talavera Rubio P. Localización radioguiada de lesiones ocultas de mama (ROLL). ACTA ACUST UNITED AC 2005; 24:374-9. [PMID: 16324513 DOI: 10.1016/s0212-6982(05)74181-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To obtain correct location of occult breast lesions by radiopharmaceutical methods. MATERIAL AND METHODS Sixty-one patients whose ages ranged from 32 to 83 years (average: 57), with non-palpable breast lesions detected by mammography were studied. Six of them had a background of previous breast cancer. Sixty-three lesions were found. The lesions were classified into 34 clusters of microcalcifications, 25 nodules and 4 others parenchymal distortions. All patients received one dose of 0.3-0.5 mCi (11.1-18.5 MBq) of macroaggregates of 99mTc-labelled human serum albumin (99mTc-MAA) into the lesion under stereotactic mammographic or ultrasonography guidance. Anterior and lateral scintigraphic images were acquired in order to verify the correct location of the radiopharmaceutical. Intraoperative location of the lesion was performed using a gammaprobe. In case of microcalcifications, the entire removal of the lesion was verified by X-ray of the specimen. RESULTS Placement of the radiotracer was good in 60 of 63 (95.2%) cases. Sixty-one lesions were completely removed. Pathological examination revealed 29 (47.6%) breast cancers and 32 (52.4%) benign lesions. CONCLUSION Radioguided occult breast lesion location by radiopharmaceutical methods is a simple, safe and well-tolerated method by patients.
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Affiliation(s)
- M Cortés Romera
- Servicio de Medicina Nuclear, Complejo Hospitalario de Ciudad Real, Ciudad Real.
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Poblete García V, García Vicente A, Ruíz Solís S, Martínez Delgado C, Vaamonde J, Rodado Marina S, Cortés Romera M, Talavera Rubio M, Ibáñez R, Soriano Castrejón A. [SPECT with 123I-IBZM: utility in differential diagnosis of degenerative Parkinsonisms and establishment of quantification method]. ACTA ACUST UNITED AC 2005; 24:234-43. [PMID: 16122407 DOI: 10.1157/13076641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To assess utility of SPECT with 123I-Iolopride ( 123I-IBZM) in the differential diagnosis of patients with Parkinsonian symptoms and try to establish an adequate quantification method. MATERIAL AND METHOD We analyzed a total of 34 patients who underwent a study with 123I-IBZM SPECT. Studies were analyzed qualitatively (visually) and quantitatively, using different quantification methods. We used different sums of slices (2, 3, 4, and 7 slices) with different cortical regions as a reference (frontal and occipital regions). Results were analyzed statistically. The final diagnosis of patients was established by two neurologists, specialized in movement disorders. RESULTS Studies were visually assessed as normal in 24 cases and as pathologic in the other 10 cases. Scintigraphic studies had an adequate diagnostic correlation in 33 of the 34 patients. Four of the 8 methods used in the quantification were statistically significant in the differentation between normal and pathological. The use of different cortical brain regions as reference did not improve differentation between normal and pathologic studies. Global quantitative assessment of the studies showed that normal studies had higher values than pathological ones, with important overlapping between both categories. CONCLUSIONS 123I-IBZM SPECT is an effective diagnostic tool in the establishment of the differential diagnosis in patients with Parkinson's disease and Parkinson-Plus. Quantification of these studies had limited utility since the overlapping of index values between normal and pathological restricts their use in individual cases.
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Affiliation(s)
- Vm Poblete García
- Servicio de Medicina Nuclear, Hospital Ntra, Sra. de Alarcos, Ciudad Real, Spain
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Ruiz Solís S, Montero Gaspar M, García Vicente AM, Rodado Marina S, Poblete García VM, Cortés Romero M, Talavera Rubio P, Soriano Castrejón A. [Positive exercise test and normal exercise myocardial perfusion SPECT. Clinical significance]. Rev Esp Med Nucl 2005; 24:174-84. [PMID: 15847784 DOI: 10.1157/13073788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE To establish, in our area, the clinical significance of a normal exercise myocardial perfusion study, in patients with an ischemic response of the exercise test. MATERIAL AND METHODS A retrospective study was carried out in our Service for the last four years. We studied 45 patients (41 women and 4 men) with an ischemic response of the exercise test and normal myocardial perfusion SPECT, during a mean follow-up of 13,2 months. We considered the final clinical diagnosis according to clinical evolution, therapy outcome and coronary angiography results. RESULTS The presence of positive exercise test and normal SPECT was predominant in women (93.3%). In 35 patients (77.8%), the final diagnosis was chest pain of probable non-coronary origin (not secondary to coronary artery disease): 18 patients were diagnosed of hypertensive cardiomyopathy, 3 of valvulopathy, 2 of vasospastic angina, 1 of hypertrophic obstructive cardiomyopathy, 1 of microvascular angina, 1 of angina due to arrhythmia, and 9 patients diagnosed of atypical chest pain due to functional or non-cardiac origin. In 10 patients (22.2%), the final diagnosis was chest pain of probable coronary origin. We did not observe any major cardiac events (cardiac death and nonfatal myocardial infarction) during the follow-up period. CONCLUSIONS Patients with chest pain, positive exercise test and normal SPECT have an excellent prognosis within an intermediate follow-up period. 77.8% of patients were diagnosed of chest pain of non-coronary origin. The most common cause of non-coronary chest pain was hypertensive cardiomyopathy (51.4%), followed by functional or non-cardiac chest pain (28.6%).
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Affiliation(s)
- S Ruiz Solís
- Servicios de Medicina Nuclear, Hospital Alarcos, Complejo Hospitalario de Ciudad Real, 13002 Ciudad Real.
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García Vicente AM, Vaamonde Cano J, Poblete García VM, Rodado Marina S, Cortés Romera M, Ruiz Solís S, Ibáñez Alonso R, Soriano Castrejón A. [Utility of dopamine transporter imaging (123-I Ioflupane SPECT) in the assessment of movement disorders]. ACTA ACUST UNITED AC 2005; 23:245-52. [PMID: 15207208 DOI: 10.1016/s0212-6982(04)72294-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of our work was to assess the diagnostic impact of 123-I Ioflupane SPECT in patients with tremor and some other sign of Parkinsonisms in regards to its categorization in Parkinsonisms with involvement/indemnity of presynaptic dopaminergic neurons as well as to establish a differential diagnosis between essential tremor (ET) and degenerative Parkinsonism. METHODS 105 patients were included, 45 for differential diagnosis between Parkinsonism and ET, 52 to determine the origin of their Parkinsonism (degenerative vs secondary) and 8 with an established diagnosis, 5 Parkinson's disease and 3 ET. A dose of 185 MBq of Ioflupane 1-123 was administered and tomographic study acquired at 5 hours. After reconstruction, transaxial views were assessed by three observers. In all the patients, the diagnosis was established by a neurologist specialized in movement disorders, according to the symptoms, course, response to treatment and result of Ioflupane I-123. RESULTS 42 patients were diagnosed of degenerative Parkinsonism (PD or Parkinsonism plus) and 63 of ET or secondary Parkinsonism. We obtained a values of sensitivity, specificity, PPV, NPV and accuracy of 93 %, 100 %, 100 %, 97 % and 97 % respectively. 123-I Ioflupane SPECT changed the treatment in 18 % of our patients. CONCLUSIONS 123-I Ioflupane SPECT is a test of great value to establish the differential diagnosis between Parkinsonism vs ET and secondary vs degenerative Parkinsonism.
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Affiliation(s)
- A M García Vicente
- Servicio de Medicina Nuclear, Complejo Hospitalario Nuestra Sra. de Alarcos, Ciudad Real.
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Poblete García VM, Ruíz Solís S, García Vicente A, Berbel García A, Rodado Marina S, Cortés Romera M, Soriano Castrejón A. [Differential diagnosis between Mesulam's aphasia and aphasia secondary to ischemic disorder by brain perfusion SPECT]. Rev Esp Med Nucl 2005; 24:48-52. [PMID: 15701347 DOI: 10.1157/13070358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Two cases with aphasic dysfunction with similar clinical features and structural neuroimaging studies results are presented. In these cases, brain perfusion SPECT was the most useful complementary study in the differential diagnosis of two pathologies with different etiologies: primary progressive aphasia or Mesulam's aphasia and aphasia secondary to a stroke.
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Affiliation(s)
- V M Poblete García
- Servicio de Medicina Nuclear, Hospital Nuestra Señora de Alarcos, Ciudad Real
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Ruiz Solís S, García Vicente A, Rodado Marina S, de la Torre M, Cortés Romero M, Poblete García V, Soriano Castrejón A. [Diagnosis of the infectious complications of continuous ambulatory peritoneal dialysis by 99mTc-HMPAO labelled leukocytes]. ACTA ACUST UNITED AC 2004; 23:403-13. [PMID: 15625057 DOI: 10.1016/s0212-6982(04)72329-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To assess the utility of abdominal scintigraphy with 99mTc-HMPAO labelled leukocytes in the diagnosis of infectious complications of continuous ambulatory peritoneal dialysis (CAPD). MATERIAL AND METHODS 17 patients in CAPD were evaluated (35 studies). They were divided into three groups: group control in asymptomathic patients (5), group of studies in patients with suspicion of exit site infection/catheter tunnel (18) and group of studies in patients with clinical suspicion of peritonitis (12). All patients underwent abdominal scintigraphy with 99mTc-HMPAO labelled leukocytes. The results were compared to final clinical diagnosis, assessing the exit site or dialysis liquid external aspect, material or exit site secretion culture and clinical follow up. RESULTS In the case studied, we obtained high sensitivity and specificity values for the exit site infection diagnosis (83 % and 75 % respectively), and a sensitivity of 100 % in the diagnosis of peritonitis as well. We detected a case of catheter tunnel infection confirmed by culture. No pathological uptake was observed in any control case. CONCLUSIONS Abdominal scintigraphy with 99mTc-HMPAO labelled leukocytes allows the early diagnosis of infectious complications of CAPD, and the control of treatment response, avoiding its unnecessary prolongation.
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Affiliation(s)
- S Ruiz Solís
- Servicio de Medicina Nuclear, Complejo Hospitalario Nuestra Señora de Alarcos, Ciudad Real.
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Rodado Marina S, Aguirre Sánchez-Covisa M, García Vicente AM, Poblete García VM, Ruiz Solís S, Cortés Romera M, Soriano Castrejón A. [Contribution of the scintigraphy with iodocholesterol (I-COL) to the diagnosis and characterization of silent adrenal masses]. ACTA ACUST UNITED AC 2004; 23:166-73. [PMID: 15153359 DOI: 10.1016/s0212-6982(04)72277-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the role of the adrenal cortical scintigraphy with 131-I Norcholesterol (I-COL) in the diagnosis and characterization of silent adrenal masses. METHODS We selected 57 patients who underwent an adrenal scintigraphy with I-COL, 36 women and 21 men (mean aged: 62.5 years), and who were classified into two groups: Group I or Incidentalomas, 39 patients without signs or symptoms of adrenal disease in whom an adrenal mass is incidentally discovered during a CT or ultrasound scan; and a second group or Group II, 18 patients with history of cancer in whom an adrenal mass is discovered. We defined the following Scintigraphic patterns in relationship with the CT: Normal, concordant unilateral (CU) or exclusive; discordant unilateral (DU); concordant asymmetrical (CA) or prevalent; discordant asymmetrical (DA) and nonvisualization (NV). The final diagnosis was obtained with clinical, analytical, and radiological evaluation and in some cases surgery. RESULTS In Group I, the diagnoses were: 17 adrenal masses without criteria of malignancy or hormonal overproduction (the Scintigraphic patterns were 10 CA, 5 normal and 2 CU), 9 Subclinical Cushing's syndrome (4 CU, 4 CA and 1 normal), 5 adenomas (all CU), 3 adrenal primary carcinomas, with no uptake in the scintigraphy, and 5 were other diagnoses. In group II, 14 patients had benign masses (all patterns were normal or concordant) and 4 patients metastases (3 discordant and 1 NV patterns). The follow-up time was at least one year. CONCLUSIONS The adrenal cortical scintigraphy with I-COL provides us information on the functional status of silent adrenal masses and it is an useful tool to distinguish benign from malignant lesions; for this reason we considered that it must be integrated in the diagnostic algorithm as a complement to other techniques.
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Affiliation(s)
- S Rodado Marina
- Servicio de Medicina Nuclear, Hospital Nuestra Señora de Alarcos, Ciudad Real, Spain
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Poblete García VM, García Vicente A, Rodado Marina S, Ruíz Solís S, Martínez Delgado C, Cortés Romera M, Soriano Castrejón A. [Additional utility of the ventilation scintigraphy and chest X-ray in the diagnosis of pulmonary thromboembolism]. Rev Esp Med Nucl 2004; 23:78-89. [PMID: 15000937 DOI: 10.1016/s0212-6982(04)72260-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
AIM To evaluate the utility of ventilation scintigraphy and chest X-ray in the assessment of the lung perfusion scintigraphy and to evaluate the utility of clinical findings in the diagnosis of pulmonary thromboembolism. MATERIAL AND METHODS A total of 100 patients who underwent a ventilation-perfusion scintigraphy due to suspicion of pulmonary thromboembolism were studied retrospectively. Three observers evaluated scintigraphic findings, blind to the other data on the patient. They consecutively added ventilation scintigraphy and chest X-ray to the perfusion study, making a consensus interpretation. Clinical findings were also evaluated. Sensitivity, specificity, positive and negative predictive values and global value test were calculated, using the final diagnosis presented by the patients on discharge as the gold standard. The Kappa statistics index was used to evaluate the degree of agreement between the three observers and the correlation between clinical and scintigraphic findings. RESULTS On adding the information of the ventilation to the perfusion study, specificity increased and sensitivity decreased. Kappa statistics between observers also increased. The chest X-ray did not significantly change the scintigraphic results. Little correlation was found between the clinical and scintigraphic findings, this association being greater in low probability studies. CONCLUSIONS We think that the performance of the ventilation study has great value in the interpretation of perfusion studies. The chest X-rays did not significantly change the scintigraphic results. Clinical data are important to establish pre-test probability and in their integration with the scintigraphy information.
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Affiliation(s)
- V M Poblete García
- Servicio de Medicina Nuclear, Hospital Nuestra Señora de Alarcos, Ciudad Real
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Rodado Marina S, García Vicente AM, Poblete García VM, Soriano Castrejón A. [Results of treatment with calculated doses of radioiodine depending on gland size and morphology in graves' disease. Analysis of variables]. Rev Esp Med Nucl 2003; 22:76-81. [PMID: 12646095 DOI: 10.1016/s0212-6982(03)72149-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the efficacy of the administered doses of Radioiodine (RAI) in the treatment of patients with hyperthyroidism in Graves' disease, calculated on the basis of gland size and morphology (assessment by palpation and scintigraphy), analyzing which variables influence the final result of our sample, and on the early development of hypothyroidism. METHODS 99 patients treated with RAI between april 1996 and november 2000 were evaluated retrospectively, 77 women and 22 men, mean age 44 years (range: 18-76). 67 patients received treatment with oral antithyroid drugs. The administered dose range was: 185-629 MBq. Mean follow-up time was 13.4 months. Success was defined as elimination of hyperthyroidism; and early hypothyroidism which appeared in the six months after therapy. RESULTS 30 patients remained with euthyroidism, 53 patients had hypothyroidism and 16 had recurrent hyperthyroidism. A total of 84% of the patients were controlled with one dose of RAI. Only the time of evolution influenced the final results. The rest of the variables (gender, age, doses and antithyroid drugs) did not influence them. No relationship was found between the appearance of early/late hypothyroidism and the administered doses. A certain tendency was found for early hypothyroidism to appear in the youngest patients (p = 0.111). CONCLUSIONS The administered doses in our department have been shown to be effective in controlling thyrotoxicosis. In our sample, only time of evolution influenced on the final results of the patients. Only the age factor showed a certain tendency in the evolution to early/late hypothyroidism.
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Affiliation(s)
- S Rodado Marina
- Servicio de Medicina Nuclear, Hospital Nuestra Señora de Alarcos, Ciudad Real
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Poblete García VM, Rodado Marina S, García Vicente A, Soriano Castrejón A. [Benign myocardial uptake of 99mTc-HMDP in prostate carcinoma: based on three cases]. Rev Esp Med Nucl 2003; 22:35-9. [PMID: 12550032 DOI: 10.1016/s0212-6982(03)72139-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We present three cases of patients with prostate carcinoma who underwent total body bone scintigraphy with 99mTc-Hydroxymethylene diphosphonate (99mTc-HMDP), showing myocardial uptake. Complementary diagnostic examinations were performed in these patients: cardiac (electrocardiogram and echocardiography), analysis of plasma electrolytes, including calcium, review of personal background of each patient to rule out associated disease which could have produced this uptake. No evidence of associated disease was found, processes such as heart disease, amyloidosis, hyperparathyroidism, previous chemotherapy or radiotherapy being rule out. Thus, we conclude that the myocardial uptake was secondary to the prostate carcinoma.
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Affiliation(s)
- V M Poblete García
- Unidad de Medicina Nuclear, Hospital Ntra Sra de Alarcos, Ciudad Real, Spain
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García Vicente A, Soriano Castrejón A, González R, Rodado Marina S, Poblete García VM. [Comparative study of CEA antibody scan and computed tomography scan in the follow-up of patients with colorectal cancer]. Rev Esp Med Nucl 2002; 21:349-55. [PMID: 12236910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
OBJECTIVE To assess the utility of nuclear imaging with labelled monoclonal antibody against CEA immu-4 Fab' (CEA-scan) and the computed tomography (CT) in the follow-up of colorectal cancer after therapy and his accuracy in the detection of recurrent disease. MATERIALS AND METHODS 48 studies underwent to 45 patients (25 men and 20 women) with an average age of 64, diagnosed and treated of colorectal cancer, 5 hours after the intravenous administration of 1.25 mg of arcitumomab (CEA-scan) labelled with 945 MBq of 99mTc. The reasons to request the CEA-scan were signs compatible with active disease in 15 cases, post-therapy control in asyntomatic patients in 17 and suspicious of recurrence in 16. Histological confirmation of the lesions was obtained in 12 patients and the rest was assessed by an average of evolution time of 26 months, CT and blood CEA levels. RESULTS The values of sensitivity, specificity, PPV and NPV obtained for the CEA- scan were of 91%, 76%, 77% y 90% respectively; 78%, 80%, 78% y 80% respectively for the CT and 65%, 42%, 88% y 74% respectively for the blood CEA levels. The CEA-scan and blood CEA levels combination showed the best results 100%, 95%, 93% y 100% respectively. CONCLUSION We did not find any correlation between blood CEA levels and CEA-scan results. The CEA-scan showed the highest sensitivity an NPV. The combination of different techniques showed better results than an individual valoration.
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Affiliation(s)
- A García Vicente
- Complejo Hospitalario Nuestra Señora de Alarcos, Ciudad Real, Spain
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González R, García Vicente A, Soriano Castrejón A, Rodado Marina S, Poblete García V. Estudio comparativo del anticuerpo monoclonal anti-CEA IMMU-4 Fab y tomografía axial computerizada en el seguimiento de pacientes con cáncer colorrectal. ACTA ACUST UNITED AC 2002. [DOI: 10.1016/s0212-6982(02)72106-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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García Vicente A, Soriano Castrejón A, Rodado Marina S, Martín J, Hernández J. [Minimally invasive parathyroid surgery with 99mTc-sestamibi scintigraphy and probe-radioguided surgery: preliminary results]. Rev Esp Med Nucl 2000; 19:403-8. [PMID: 11060269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE The most common pathological finding in patients with sporadic primary hyperparathyroidism is a single adenoma. The success of parathyroid surgery is determined by the identification and removal of the responsible adenoma. The aim of our study was to minimize interventional techniques, hospital stay and overall costs of patients with parathyroid adenoma who do not require a complete neck examination. METHODS Seven patients with biochemically confirmed hyperparathyroidism were included in our study. All the patients underwent 99mTc-Tetrofosmin and 99mTc-Pertecnetate neck scans in the days prior to the surgery. On the day of the operation, we administrated a dose of 740-925 MBq 99mTc-sestamibi. The scintigraphy study and radioguided surgery examination were performed with a 10 mm hand-held gamma probe at 2-3 hours of the administration. The counts were measured in the four neck quadrants. RESULTS We identified seven adenomas and six were removed with a 2 cm incision. The removal of the adenoma resulted in a decline in radioactivity in that quadrant, these being comparable in all the neck quadrants. Ex vivo counts identified parathyroid tissue from fat and lymph node. The histopathologic exam and a decrease of the intact PTHi levels at 30 and 60 minutes after removal of the adenoma confirmed the correct surgery. CONCLUSIONS Radioguided parathyroid surgery allows for a minimally invasive unilateral neck examination with a small scar and better cosmetic results, reduces operative and anesthetic times, requires minimal times spent in the hospital and achieves a reduction in overall cost.
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Martín J, Hernández J, García Vicente A, Soriano Castrejón A, Rodado Marina S. Cirugía paratiroidea mínimamente invasiva con gammagrafía con 99mTc-sestamibi y cirugía radioguiada con sonda: resultados preliminares. ACTA ACUST UNITED AC 2000. [DOI: 10.1016/s0212-6982(00)71901-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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García Vicente A, García Del Castillo E, Soriano Castrejón A, Alonso Farto J. [Olfactory esthesioneuroblastoma: scintigraphic expression of somatostatin receptors]. Rev Esp Med Nucl 1999; 18:367-70. [PMID: 10562667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Esthesioneuroblastoma is an uncommon tumor originating in the upper nasal cavity and constitutes 3% of all intranasal neoplasms. Few references exist about the expression of somatostatin receptors in these tumors. Our case demonstrates a good correlation between the somatostatin receptor scintigraphy and magnetic resonance imaging.
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Affiliation(s)
- A García Vicente
- Unidad de Medicina Nuclear, Complejo Hospitalario de Ciudad Real, Ciudad Real, 13002, España
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García Vicente A, Soriano Castrejón A, Alonso Farto J, Soler E, García del Castillo E. [Merkel cell carcinoma. Utility of scintigraphy with 111In-DTPA-pentetreotide]. Rev Esp Med Nucl 1999; 18:287-91. [PMID: 10481112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Merkel cell carcinoma (MCC) is an unusual malignant primary skin tumor, having a high incidence of local recurrent, and regional and distant metastasis. Due to its capacity to express somatostatin receptors, it can be detected in vivo with 111In-pentetreotide scintigraphy (Ostreoscan). We present a case of a MCC whose scintigraphy revealed regional metastases of a primary frontal cutaneous tumor that had been removed previously. The results verified a good correlation with clinical, radiological an histopathological findings.
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MESH Headings
- Aged
- Biomarkers, Tumor/analysis
- Carcinoma, Merkel Cell/diagnosis
- Carcinoma, Merkel Cell/diagnostic imaging
- Carcinoma, Merkel Cell/pathology
- Carcinoma, Merkel Cell/secondary
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Squamous Cell/diagnosis
- Diagnostic Errors
- Humans
- Indium Radioisotopes
- Lentigo/diagnosis
- Lymphatic Metastasis/diagnostic imaging
- Male
- Neoplasm Invasiveness
- Neoplasm Proteins/analysis
- Parotid Neoplasms/diagnostic imaging
- Parotid Neoplasms/secondary
- Pentetic Acid
- Phosphopyruvate Hydratase/analysis
- Skin Neoplasms/diagnosis
- Skin Neoplasms/diagnostic imaging
- Skin Neoplasms/pathology
- Somatostatin/analogs & derivatives
- Tomography, Emission-Computed, Single-Photon
- Tomography, X-Ray Computed
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Affiliation(s)
- A García Vicente
- Unidad de Medicina Nuclear, Complejo Hospitalario de Ciudad Real, Ciudad Real, 13002, España
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