A new era for Nuclear Medicine neuroimaging in Spain: Where do we start from in Spain? / Nuevos tiempos para la neuroimagen de Medicina Nuclear en España: ¿de dónde partimos?

OBJECTIVE: To determine the status of neuroimaging studies of Nuclear Medicine in Spain during 2013 and first quarter of 2014, in order to define the activities of the neuroimaging group of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). MATERIAL AND METHODS: A questionnaire of 14 questions was designed, divided into 3 parts: characteristics of the departments (equipment and professionals involved); type of scans and clinical indications; and evaluation methods. The questionnaire was sent to 166 Nuclear Medicine departments. RESULTS: A total of 54 departments distributed among all regions completed the questionnaire. Most departments performed between 300 and 800 neuroimaging examinations per year, representing more than 25 scans per month. The average pieces of equipment were three; half of the departments had a PET/CT scanner and SPECT/CT equipment. Scans performed more frequently were brain SPECT with 123I-FP-CIT, followed by brain perfusion SPECT and PET with 18F-FDG. The most frequent clinical indications were cognitive impairment followed by movement disorders. For evaluation of the images most sites used only visual assessment, and for the quantitative assessment the most used was quantification by region of interest. CONCLUSIONS: These results reflect the clinical activity of 2013 and first quarter of 2014. The main indications of the studies were cognitive impairment and movement disorders. Variability in the evaluation of the studies is among the challenges that will be faced in the coming years.

[Radionuclide cisternography in spontaneous intracranial hypotension syndrome]. / Cisternogammagrafía en el síndrome de hipotensión endocraneal espontánea.

UNLABELLED: Spontaneous intracranial hypotension (SHI) due to cerebrospinal fluid (CSF) leaks is a clinical entity that is being increasingly recognized. Orthostatic headache is the cardinal clinical manifestation of this disorder. PATIENTS AND METHOD: Seven patients were studied retrospectively because of postural headache associated with low CSF pressure. In all patients, radionuclide cisternography as well as CT and/or MRI were performed. Radionuclide cisternography was obtained after intrathecal injection of radioisotope into the lumbar subarachnoide space. Images were obtained at 30 minutes, 2 and 4 hours after the injection. Pledgets were inserted into the nose and were considered positive for the presence of CSF when the count index of the pledgets regarding a blood sample was > or = 2:1. Criteria of spontaneous SHI was the early appearance of bladder activity with decrease in the distribution in the cerebral convexity and/or visualization of activity in the paraspinal areas. RESULTS: In 5 of the 7 patients scintigraphic abnormalities were found. CONCLUSION: Radionuclide cisternography is a reliable diagnostic method to diagnose SHI.

[Utility of the hepatic grammagraphy with red blood cells marked with 99mTC in the differential diagnosis between cavernous hemangioma and hepatocarcinoma: based on one clinical case]. / Utilidad de la gammagrafía hepática con hematíes marcados con 99mTc en el diagnóstico diferencial entre hepatocarcinoma y hemangioma cavernoso: a propósito de un caso clínico.

The tomographic red blood cell imaging is useful in the investigation the cavernous hemangioma of the liver (specificity: 100%). In all positive studies, with negative cytology for malignancy, and absence of complications (bleeding, growth, etc.) It'll could adopt conservation aptness.