F García García, N Cassinello Fernández, J Rodríguez Romera, R Martí Fernández, M Lapeña Rodríguez, R Alfonso Ballester, R Díaz Expósito, J Ortega Serrano
{"title":"PET-TC [<sup>18</sup>F]F-choline and intraoperative PTH in the surgical treatment of the primary hyperparathyroidism without preoperative location.","authors":"F García García, N Cassinello Fernández, J Rodríguez Romera, R Martí Fernández, M Lapeña Rodríguez, R Alfonso Ballester, R Díaz Expósito, J Ortega Serrano","doi":"10.1016/j.remnie.2024.500066","DOIUrl":"10.1016/j.remnie.2024.500066","url":null,"abstract":"<p><strong>Background and objectives: </strong>To assess the feasibility of performing selective parathyroidectomy without intraoperative parathyroid hormone (PTHio) determination when first-line preoperative localization tests (ultrasonography and [<sup>99m</sup>Tc]Tc-MIBI) are negative and/or discordant, and second-line [<sup>18</sup>F]F-Colina PET-CT, is positive.</p><p><strong>Materials and methods: </strong>Retrospective cohort study, including patients with negative or discordant ultrasound and MIBI scans and positive [<sup>18</sup>F]F-Colina PET-CT, who underwent selective parathyroidectomy between 2019 and 2022. Groups were compared based on PTHio determination. Study variables were: gender, mean age, biochemical cure assessed by PTH value (pg/mL) and corrected calcium by albumin (mg/dL) at 6 months post-surgery follow-up, and histopathological analysis.</p><p><strong>Results: </strong>The final sample included 42 patients. At 6 months post-surgery, in the PTHio group (20 patients), PTH values were 64.50 pg/mL and calcium 9.30 pg/mL, with 19 adenomas and 1 hyperplasia found. In the non-PTHio group (22 patients), PTH values were 61 pg/mL and calcium 9.37 pg/mL, with 22 adenomas found. No statistically significant differences were found between both groups.</p><p><strong>Conclusions: </strong>Based on the results obtained in our patient cohort, selective parathyroidectomy could be considered with negative or discordant first-line tests and positive [<sup>18</sup>F]F-Colina PET-CT, without intraoperative PTH determination.</p>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":" ","pages":"500066"},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335486","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}
M Simó, O Persiva, L Sánchez, J B Montoro, I Sansano, A Vázquez, F Ascanio, C Alemán
{"title":"Association of PET/CT and VATS findings with histology analysis in the study of pleural effusions.","authors":"M Simó, O Persiva, L Sánchez, J B Montoro, I Sansano, A Vázquez, F Ascanio, C Alemán","doi":"10.1016/j.remnie.2024.500059","DOIUrl":"https://doi.org/10.1016/j.remnie.2024.500059","url":null,"abstract":"<p><strong>Introduction: </strong>Histological analysis of the pleura obtained by video-assisted thoracoscopic surgery (VATS) is the best diagnostic technique in the study of neoplastic pleural effusions. This study evaluates the relationship between Positron Emission Tomography (PET)/Computed Tomography (CT) and VATS findings, the result of the first pleural biopsy, and the final diagnosis of malignancy or non-malignancy.</p><p><strong>Methods: </strong>Prospective study of consecutive patients with pleural effusions undergoing PET/CT and VATS from October 2013 to December 2023. The following variables were recorded: PET/CT score (nodular pleural thickening, pleural nodules with standardized uptake value (SUV) > 7.5, lung mass or extra pleural malignancy, mammary lymph node with SUV > 4.5 and cardiomegaly); VATS data (drained volume, visceral and parietal pleural thickening, nodules or masses, septa, plaques, fluid appearance, trapped lung, and suspected diagnosis of the procedure), as well as the histological study of the first pleural biopsy (benign or malignant) and the final diagnosis of benign or malignant pleural effusion. A logistic regression study of the variables was performed.</p><p><strong>Results: </strong>95.8% of the patients with PET/CT and pleuroscopy not suggestive of malignancy had non-malignant histological findings, while 93.2% of the patients with PET/CT and pleuroscopy suggestive of malignancy had malignant histological findings. PET/CT, pleuroscopy, and the result of the first pleural biopsy showed a significant association with the final diagnosis of pleural effusion.</p><p><strong>Conclusions: </strong>There is a strong association between PET/CT findings, VATS and pleural histology.</p>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":" ","pages":"500059"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305206","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}
{"title":"Outcome and incidence of hypothyroidism in low-dose radioactive iodine treatment for hyperthyroidism.","authors":"Ku-Hung Lin, Jiun-Chang Wu, Ming-Che Wu","doi":"10.1016/j.remnie.2024.500056","DOIUrl":"https://doi.org/10.1016/j.remnie.2024.500056","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to analyze the outcome of low-dose radioactive iodine (RAI) treatment for hyperthyroidism, disclose whether age and gender influence the outcome and determine the incidence and onset time of hypothyroidism following low-dose RAI.</p><p><strong>Material and methods: </strong>A total of 158 patients who received doses less than 370 Mbq RAI were enrolled in the study. Treatment outcome and incidence of hypothyroidism were compared between different gender (45 male vs.113 female), age (77 patients ≥45 years old vs. 81 patients <45 years old) and dose (39 patients receiving higher doses RAI vs. 119 receiving lower dose with a cutoff of 222 MBq) groups. Treatment outcomes were categorized into post-treatment hypothyroidism, treatment failure (persistent hyperthyroidism), and euthyroidism. In those becoming hypothyroid, time to develop hypothyroidism was calculated for cumulative incidences over time.</p><p><strong>Results: </strong>Out of 158 patients, 47 (29.7%) developed hypothyroidism, 101 (63.9%) had treatment failure, and 10 (6.3%) remained euthyroid after treatment. Response rates (33.6% vs. 43.5%, p = 0.260) and hypothyroidism incidences (26.9% vs. 38.5%, p = 0.170) did not differ significantly between lower and higher dose groups, neither between lower and higher age groups (p = 0.69 in response rates and p = 0.75 in hypothyroidism incidence). Females exhibited higher response rates (42.5% vs. 20.0%, p = 0.008) and hypothyroidism incidence (46.3% vs. 13.3%, p = 0.004) compared to males. Hypothyroidism onset occurred at a mean of 24.0 ± 29.2 months, and the cumulative incidences over time were 47% and 60% in six and twelve months, respectively.</p><p><strong>Conclusions: </strong>Low-dose RAI has a low response rate for treating hyperthyroidism. Although there may be a lower incidence of hypothyroidism following low-dose RAI compared to high-dose RAI, hypothyroidism may occur early after treatment. Besides, females have higher response rates but more incidence of hypothyroidism. The balance between the risks and benefits of using low-dose RAI should be taken into deliberate consideration.</p>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":" ","pages":"500056"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305208","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}
J.R. Garcia, A. Compte, J. Pastor, S. Mourelo, L. Mont, P. Bassa, E. Llinares, M. Soler, E. Valls, T. Blanch, E. Riera
{"title":"To evaluate the detection rate of local and whole-body recurrence by integrated [18F]F-PSMA-1007 PET/MR assessment of prostate cancer patients treated with prostatectomy with very low biochemical recurrence (<0.5 ng/ml). Therapeutic implications","authors":"J.R. Garcia, A. Compte, J. Pastor, S. Mourelo, L. Mont, P. Bassa, E. Llinares, M. Soler, E. Valls, T. Blanch, E. Riera","doi":"10.1016/j.remnie.2024.500037","DOIUrl":"10.1016/j.remnie.2024.500037","url":null,"abstract":"<div><h3>Objective</h3><p>To analyse the efficacy of integrated assessment of [<sup>18</sup>F]F-PSMA-1007 PET/MRI on the early detection of local recurrence (LR) for prostate cancer patients with PSA levels <0.5<!--> <!-->ng/ml after radical prostatectomy.</p><p>To assess the location of recurrence so that therapy may be tailored to patient.</p></div><div><h3>Methods</h3><p>Prospective study including 35 patients with prostate cancer (PCa), who were referred for a [<sup>18</sup>F]F-PSMA-1007 PET/MR after prostatectomy with a very initial PSA value increase (PSA<!--> <!--><<!--> <!-->0,5<!--> <!-->ng/ml).</p><p>Simultaneous acquisition in a PET/MRI hybrid equipment (SIGNA-GE), 1<!--> <!-->h after administration of 370%<!--> <!-->±<!--> <!-->10% MBq of [<sup>18</sup>F]F-PSMA-1007:</p><p>Prostate selective imaging (20<!--> <!-->min): multiparametric PET<!--> <!-->+<!--> <!-->MRI (MRImp): DIXON, T1, T2, diffusion sequences post-gadolinium administration.</p><p>Whole body image (30<!--> <!-->min): PET<!--> <!-->+<!--> <!-->MRI: DIXON, T1, T2, diffusion, STIR sequences.</p><p>A nuclear physician and a radiologist jointly reviewed the studies:</p><p>In order to assess LR, the “Prostate Imaging for Recurrence Reporting” system was used on MRI, as well as the Likert scale on the PET prostate imaging.</p><p>The remaining lesions were classified as N1 and M1a.</p></div><div><h3>Results</h3><p>PET/MRI was positive in 25 patients (71,4%) and negative in 10 patients (28,6%).</p><p>RL was detected in 15 patients (42.9%): in 2 (5.7%) MRI was superior; in 3 (8.6%) PET was superior; integrated PET/MRI showed improved results in 5 patients (14.3%) for the detection of LR.</p><p>Location of recurrences: LR in 11 patients (44.0%); N1 in 10 (40.0%); LR<!--> <!-->+<!--> <!-->N1 (8.0%) in 2; LR<!--> <!-->+<!--> <!-->N1<!--> <!-->+<!--> <!-->M1a in 2 (8.0%).</p><p>In 20 patients (80%) the PET/MRI findings allowed radioguided radiotherapy implementation (11 on LR, and 9 on N1), whereas hormonal treatment was decided in 5 patients (20%) due to multimetastases/spread disease.</p></div><div><h3>Conclusion</h3><p>[<sup>18</sup>F]F-PSMA-1007 PET/MRI has a 71.4% recurrence detection rate after prostatectomy with PSA<!--> <!--><<!--> <!-->0.5<!--> <!-->ng/ml. Its combined PET and MRI study increases the detection of LR by 14.3%, with a high N1<!--> <!-->+<!--> <!-->M1a detection rate (56%), allowing radioguided radiotherapy in 80% of patients.</p></div>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"43 5","pages":"Article 500037"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141622075","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}
J. Muñoz-Iglesias , A. Rodríguez-Fernández , P. Paredes-Barranco , M. Rodríguez-Fraile , A. Gómez-Grandef , M. Simó-Perdigó , J. Castell-Conesa
{"title":"PSMA PET/CT quick procedure guide","authors":"J. Muñoz-Iglesias , A. Rodríguez-Fernández , P. Paredes-Barranco , M. Rodríguez-Fraile , A. Gómez-Grandef , M. Simó-Perdigó , J. Castell-Conesa","doi":"10.1016/j.remnie.2024.500045","DOIUrl":"10.1016/j.remnie.2024.500045","url":null,"abstract":"<div><p>The application of PET/CT with radiopharmaceuticals targeting PSMA is significantly transforming the diagnostic and therapeutic strategies of patients with prostate cancer. In Spain, the availability and access to positron-emitting radiopharmaceuticals targeting Prostate-Specific Membrane Antigen (PSMA) have significantly changed in recent months. These changes are affecting their use in diagnostic procedures. As a result, its use within diagnostic protocols for patients with prostate cancer is undergoing significant modifications. In this collective and cooperative document, the authors have selected the most robust evidence accumulated to date to generate a clinical guide to achieve appropriate use of this technology. A format that presents the most frequent clinical situations and the patient profiles in which PSMA PET/CT plays a significant role or will do so in the immediate future has been chosen. It should be taken into account that regulatory restrictions mediate the current indications for its use in Spain, as well as its current cost and the production capacity of radiopharmaceuticals. The guideline presents a review of the established methodology for optimized imaging with each of the radiopharmaceutical variants targeting PSMA and recommendations for structured and accurate reporting of metabolic findings in combination with CT.</p></div>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"43 5","pages":"Article 500045"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879998","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}
M. Guerra-Gómez, A. Rodríguez-Pajuelo, L. Brero-Sánchez, J.I. Cuenca-Cuenca, R.M. Álvarez-Pérez, J.M. Freire-Macías, J.M. Jiménez-Hoyuela García
{"title":"Interobserver and intraobserver agreement in PET/CT with [18F]DCFPyL according to TNM molecular and PSMA-RADS 2.0 criteria","authors":"M. Guerra-Gómez, A. Rodríguez-Pajuelo, L. Brero-Sánchez, J.I. Cuenca-Cuenca, R.M. Álvarez-Pérez, J.M. Freire-Macías, J.M. Jiménez-Hoyuela García","doi":"10.1016/j.remnie.2024.500047","DOIUrl":"10.1016/j.remnie.2024.500047","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to determine the agreement between three observers with different levels of experience using the PSMA-RADS 2.0 criteria and the miTNM system for the interpretation of PET-PSMA with [<sup>18</sup>F]DCFPyL in males with prostate cancer.</p></div><div><h3>Materials and Methods</h3><p>PET-PSMA images from 114 prostate cancer patients were blindly reported twice by three different observers at intervals of 8 weeks. The evaluations were performed according to the molecular imaging TNM (miTNM) and PSMA-RADS 2.0 criteria. We used Fleiss’ Kappa to analyse inter and intraobserver agreements.</p></div><div><h3>Results</h3><p>Moderate overall agreement was obtained in the assessment of the PET-PSMA results (Fleiss'k = 0.53; 95% CI 0.45−0.62; p < 0.001), with significant agreement in the miT, miN and miM reports. There was a substantial level of agreement in the reporting of prostatic disease and lymphatic involvement (Fleiss'k = 0.66 and 0.65), being lower than that observed in the reporting of metastatic disease (Fleiss'k = 0.86), especially in the M0 group (Fleiss'k = 0.99). Upon re-evaluation of the images, observer 1 had moderate overall agreement for miT (Fleiss'k = 0.51) and substantial agreement for miN and miM (Fleiss'k 0.75 and 0.63, respectively).</p></div><div><h3>Conclusions</h3><p>The use of a structured scoring system such as PSMA-RADS 2.0, as well as the miTNM classification system in the interpretation of PET-PSMA images in prostate cancer patients, provides a highly reproducible report format. High levels of interobserver and intraobserver agreement are found, especially when ruling out disease, which supports its use in routine clinical practice.</p></div>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"43 5","pages":"Article 500047"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914893","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}
J.R. Garcia , R. Olivero , I. Arrieta-Aldea , J.A. Romero , E. Riera , E. Cañas-Ruano , N. Garrido , J. Du , R. Guerri
{"title":"Association between cardiovascular inflammation and alterations in immune system induced by HIV infection detected on [18F]FDG PET/MRI","authors":"J.R. Garcia , R. Olivero , I. Arrieta-Aldea , J.A. Romero , E. Riera , E. Cañas-Ruano , N. Garrido , J. Du , R. Guerri","doi":"10.1016/j.remnie.2024.500042","DOIUrl":"10.1016/j.remnie.2024.500042","url":null,"abstract":"<div><h3>Objective</h3><p>To assess by [<sup>18</sup>F]FDG PET/MR the biomarkers of HIV-induced inflammation at baseline and 1 year post-antiretroviral therapy (ART).</p></div><div><h3>Methods</h3><p>Prospective study, 14 patients, newly diagnosed HIV-positive, asymptomatic.</p><p>[<sup>18</sup>F]FDG PET/MRI (PET/MR-3.0T, Signa.GE) whole body and heart was performed, baseline and 1 year post-ART.</p><p>Qualitative vascular assessment (hepatic reference). Quantitative assessment (SUVmax) of the whole body. T1 and T2 value estimation in 16 myocardial segments.</p></div><div><h3>Results</h3><p>Baseline CMR showed in 3 (21.4%) a decreased LVEF, normalising post-TAR. Fibrosis was ruled out (T1), with no signs of myocardial oedema (T2) at baseline or post-TAR.</p><p>Four (28.6%) showed baseline vascular [<sup>18</sup>F]FDG uptake, two in ascending thoracic aorta and two in ascending and descending thoracic aorta, normalising post-TAR.</p><p>All (100%) showed basal lymph-nodes activity; supra (n:14) and infradiaphragmatic (n:13), laterocervical (n:14) and inguinal (n:13), with variable number of territories (9 patients >6;64.3%). Post-ART, 7 patients (50%) showed resolution and the other 7 reduction in extension (0 patients >5): 7 supra (100%) and 2 infradiaphragmatic (28.6%), 5 in the axilla and 2 in the groin.</p><p>All (100%) had persistent basal adenoid uptake post-ART, 9 (64.3%) splenic all resolved post-ART and 7 (50.5%) gastric, persistent 3 post-ART.</p></div><div><h3>Conclusions</h3><p>Cardiovascular biomarkers by [<sup>18</sup>F]FDG PET/MR have shown baseline 28.6% of patients with large vessel activity and 21.4% with low LVEF, normalising post-ART.</p><p>Inflammatory/immune biomarkers showed baseline activity in 100% of lymph-nodes, 100% adenoids, 64.3% splenic and 50.5% gastric. Post-TAR the reduction was 50% lymph-nodes, 0% adenoid, 100% splenic and 57.1% gastric.</p></div>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"43 5","pages":"Article 500042"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914892","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}
{"title":"99mTc-FAPI uptake in a rare case of metastatic urachal carcinoma","authors":"","doi":"10.1016/j.remnie.2024.500019","DOIUrl":"10.1016/j.remnie.2024.500019","url":null,"abstract":"","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"43 5","pages":"Article 500019"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184978","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}
{"title":"99mTc-MDP bone scintigraphy and 18F-FDG PET/CT findings of osteosarcoma with widespread calcified extraskeletal metastases","authors":"","doi":"10.1016/j.remnie.2024.500022","DOIUrl":"10.1016/j.remnie.2024.500022","url":null,"abstract":"","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"43 5","pages":"Article 500022"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184979","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}