ABSTRACT
En el trabajo se ofrecen argumentos para la selección de un ciclotrón de 18 MeV en protones, en su variante Twin. Estará dedicado solo a reacciones nucleares con dichas partículas a los efectos de asegurar el suministro en Cuba de radionúclidos para la tomografía de emisión positrónica (PET) (fundamentalmente ), así como en perspectiva Iodo- para tomografía de emisión de fotón simple (SPECT). Se dan datos que indican la posibilidad de suministrar -FDG al menos a cinco centros PET. Ello posibilitará el acceso de Cuba a una de las más avanzadas tecnología de imagen, el PET/TAC, con el consiguiente beneficio para la atención a pacientes afectados de cáncer y enfermedades cardiovasculares y neurológicas
The work provides arguments for the selection of 18 MeV cyclotron in protons, in its Twin variant. It will be used only for nuclear reactions with these particles in order to ensure the supply of radionuclides in Cuba, for the positron emission tomography ( mainly) as well as for single photon emission computed tomography (, for example), in the future. Data indicating the possibility of supplying -FDG to at least five PET centers are given. This shall allow Cuba to access the one of the most advanced imaging technology, with the consequent benefit for patients suffering from cancer, cardiovascular and neurological diseases
ABSTRACT
Objetivo: Evaluar la prevalencia de metástasis musculares (MM) no sospechadas en pacientes con enfermedad maligna conocida, estudiados con tomografía por emisión de positrones integrada con tomografía computada con flúor-18 deoxiglucosa (18F-FDG PET/TC). Materiales y métodos: Se analizaron retrospectivamente 2953 18F-FDG PET/TC, identificando las MM. Se registraron los tumores primarios, el número y localización de las MM y el SUV máximo en cada caso. Fueron incluidos pacientes oncológicos con histología conocida y múltiples lesiones secundarias. Se utilizó el examen 18F-FDG PET/TC como método de referencia para detectar metástasis. Resultados: Se identificaron MM en 33 pacientes (prevalencia: 1,12%) entre los 18 y 88 años de edad. Los tumores primarios incluyeron: riñón en 7 casos, mama en 5, melanoma en 4, pulmón en 3, ovario en 3, tiroides en 3, sarcomas en 3, región colorrectal en 2, vejiga en 2 y endometrio en 1. Se encontraron 96 MM en 33 pacientes: 24 en muslo, 15 en glúteo, 13 en pared torácica, 10 en psoasilíaco,10 en músculos paravertebrales, 7 en pared abdominal, 7 en pierna, 4 en brazo y 6 en otras localizaciones (pelvis, cuello, etc.). Las MM afectaban un solo músculo en 22/33 pacientes y varios en 11/33. El patrón de captación más frecuente fue el foco hipermetabólico, con SUV máximo entre 1,5 y 34. Discusión: Nuestra muestra incluye un número importante de casos comparada con la literatura y coincide con los hallazgos de otros autores en la incidencia y localización de las MM. Conclusión: Las MM son infrecuentes y pueden pasar inadvertidas. Es posible detectarlas con 18F-FDG PET/TC como focos hipercaptantes únicos o múltiples.
Objective: To assess the prevalence of unsuspected muscle metastases (MM) in patients with known malignant disease, examined with 18F-fuorodeoxyglucose positron emission tomography integrated with computed tomography (18F-FDG PET/CT). Materials and methods: A total of 2,953 18F-FDG PET/CT examinations were retrospectively analysed, looking for cases with MM. Primary neoplasm, number and location of MM and SUV max were recorded on each patient. Oncology patients with known histology and multiple secondary lesions were included. The 18F-FDG PET/CT was the reference method for detection of metastases. Results: MM were observed in 33 patients (prevalence: 1.12%) aged between 18 and 88 years. The primary tumours included: kidney in 7 cases, breast in 5, melanoma in 4, lung in 3, ovary in 3, thyroid in 3, sarcomas in 3, colorectal in 2, bladder in 2, and endometrial in 1. A total of 96 MM were observed in 33 patients, and located in: thigh muscles 24, gluteal 15, chest wall 13, iliopsoas 10, paravertebral muscles 10, abdominal wall 7, leg 7, arm 4, and other locations 6 (pelvis, neck, etc.). MM affected only one muscle in 22/33 patients and several muscles in 11/33. Hypermetabolic focus was the most frequent uptake pattern, with SUV max between 1.5 and 34. Discussion: Our series has a significant number of cases, and is consistent with other authors on the incidence and location of MM. Conclusion: MM are uncommon and may be overlooked. MM may be detected with 18F-FDG PET/CT as single or multiple hypermetabolic foci.
Subject(s)
Humans , Male , Female , Fluorodeoxyglucose F18 , Neoplasms, Unknown Primary/diagnosis , Positron Emission Tomography Computed Tomography , Neoplasm Metastasis , Positron Emission Tomography Computed Tomography/instrumentationABSTRACT
Introdução A artrite reumatoide (AR) é uma doença caracterizada pela inflamação da membrana sinovial. Diversos autores têm investigado o papel da tomografia por emissão de pósitrons (PET) com flúor-18 (FDG-18F) na AR. Objetivos Revisão sistemática da literatura atual sobre o papel do PET com FDG-18F no diagnóstico, determinação da atividade da doença e avaliação da resposta ao tratamento em pacientes com AR. Métodos Foram realizadas buscas nas bases de dados Medline, Biblioteca Cochrane, Lilacs, Pubmed e Scopus nos idiomas português, inglês e espanhol, utilizando as palavras-chave «artrite reumatoide¼, «sinovite¼, «FDG¼, «PET¼, «metabolismo glicolítico¼ e «atividade da doença¼. Resultados 142 artigos foram inicialmente identificados, dos quais apenas 40 relacionavam-se diretamente ao tema. Foram selecionados 12 artigos originais e três relatos de caso que preenchiam os critérios de inclusão. Discussão A presença de fibroblastos e macrófagos ativados no pannus é responsável pela intensa captação periarticular de FDG-18F. Os padrões de captação não permitem o diagnóstico diferencial com outras artrites. A intensidade de captação e o número de articulações envolvidas são parâmetros metabólicos de atividade da doença que apresentam boa correlação com os índices compostos. Estudos longitudinais de PET têm se mostrado úteis na avaliação da resposta ao tratamento com anti-TNF. Quando realizado precocemente, PET pode predizer a resposta terapêutica. Conclusão Embora o real papel dessa nova técnica na investigação da AR ainda não esteja estabelecido, PET com FDG-18F é uma ferramenta ...
Introduction Rheumatoid arthritis (RA) is a disease characterized by inflammation of the synovial membrane. Several authors have investigated the role of positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (18F-FDG) in RA. Objectives To systematically review the current literature on the role of 18F-FDG PET in the diagnosis, determination of disease activity and assessment of treatment response in patients with RA. Methods Searches were conducted in Medline, Cochrane Library, Lilacs, Pubmed and Scopus in Portuguese, English and Spanish languages, using the keywords «rheumatoid arthritis¼, «synovitis¼, «FDG¼, «PET¼, «glycolytic metabolism¼ and «disease activity¼. Results One hundred and forty-two articles were initially identified, of which only 40 were related directly to the subject. Twelve original articles and three case reports that met the inclusion criteria were selected. Discussion The presence of activated macrophages and fibroblasts in pannus are responsible for the intense periarticular uptake of 18F-FDG. The uptake patterns do not allow the differential diagnosis with other arthritides. The uptake intensity and the number of joints involved are metabolic parameters of disease activity that correlate well with the composite indices. Longitudinal studies of PET have proven useful in assessing the response to treatment with anti-TNF. When performed early, PET can predict the therapeutic response. Conclusion Although the actual role of this new technique for the investigation of RA is not yet established, 18F-FDG PET is a promising tool in determining the activity and prediction of response to treatment of patients with RA. .