ABSTRACT
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Subject(s)
Humans , Female , Aged, 80 and over , 3-Iodobenzylguanidine/analysis , 3-Iodobenzylguanidine/chemistry , Neoplasm Metastasis , Carcinoma/complications , Carcinoma , Thyroid Neoplasms , Thyroid Gland/pathology , Thyroid Gland , Radionuclide Imaging/methods , Abdomen/pathology , Abdomen , Nuclear Medicine/methodsSubject(s)
Carcinoma, Papillary, Follicular/diagnostic imaging , Carcinoma, Papillary, Follicular/secondary , Carcinoma, Papillary/diagnostic imaging , Carcinoma, Papillary/secondary , Iodine Radioisotopes/therapeutic use , Polycystic Kidney Diseases/diagnostic imaging , Radiopharmaceuticals/therapeutic use , Single Photon Emission Computed Tomography Computed Tomography , Sodium Iodide/therapeutic use , Thyroid Neoplasms/pathology , Whole Body Imaging , Aged, 80 and over , Carcinoma, Papillary/radiotherapy , Carcinoma, Papillary/surgery , Carcinoma, Papillary, Follicular/radiotherapy , Carcinoma, Papillary, Follicular/surgery , Diagnosis, Differential , False Positive Reactions , Female , Humans , Iodine Radioisotopes/pharmacokinetics , Neoplasms, Multiple Primary/surgery , Radiopharmaceuticals/pharmacokinetics , Radiotherapy, Adjuvant , Sodium Iodide/pharmacokinetics , Thyroid Hormones/therapeutic use , Thyroid Neoplasms/surgery , Thyroidectomy , Tissue Distribution , UltrasonographyABSTRACT
Los paragangliomas de cabeza y cuello son tumores neuroendocrinos poco frecuentes, que expresan receptores para la somatostatina (RSS) en su superficie celular, particularmente el subtipo 2. Por esta particularidad, en la Medicina Nuclear es posible obtener imágenes de los mismos mediante la utilización de análogos sintéticos de la somatostatina, principalmente el octreotide, el cual tras su radiomarcaje con 111In o 68Ga, permiten su visualización selectiva, bien por imágenes gammagráficas planares, SPECT-TC o PET-TC. De una serie de pacientes se seleccionan y presentan 3 casos que ilustran la utilidad de los estudios SPECT-TC con 111In-octreotide en el diagnóstico y seguimiento de este tipo de tumor: caracterización y diagnóstico inicial, estadificación y detección de recurrencia local o metástasis, y su valor añadido respecto a las imágenes anatómicas (resonancia magnética, tomografía computarizada, angiografía), por ejemplo en la diferenciación entre tejido funcional o cicatricial en los pacientes sometidos previamente a cirugía (AU)
Head and neck paragangliomas are rare neuroendocrine tumors expressing somatostatin receptors on their cell surface, particularly subtype 2. Due to this distinctive feature, images can be obtained in Nuclear Medicine using synthetic analogues of somatostatin, mainly octreotide, which allow selective display by planar scintigraphy, SPECT-CT or PET-CT imaging after radiolabeling with 111In or 68Ga. Three cases have been selected and presented from a series of patients that illustrate the utility of SPECT-CT studies with 111In-octreotide in the diagnosis and monitoring of this type of tumor. These are characterization at initial diagnosis, staging, and detection of local recurrence or metastasis, with added value with respect to anatomical images (nuclear magnetic resonance, computed axial tomography, angiography), for example in the differentiation between functional tissue or scar in patients who had previously undergone surgery (AU)
Subject(s)
Female , Humans , Middle Aged , Tomography, Emission-Computed, Single-Photon/methods , Tomography, Emission-Computed, Single-Photon , Paraganglioma/complications , Paraganglioma , Neuroendocrine Tumors , Fluorodeoxyglucose F18 , Somatostatin , Nuclear Medicine/methods , Nuclear Medicine/trends , Radionuclide Imaging/methodsABSTRACT
Head and neck paragangliomas are rare neuroendocrine tumors expressing somatostatin receptors on their cell surface, particularly subtype 2. Due to this distinctive feature, images can be obtained in Nuclear Medicine using synthetic analogues of somatostatin, mainly octreotide, which allow selective display by planar scintigraphy, SPECT-CT or PET-CT imaging after radiolabeling with (111)In or (68)Ga. Three cases have been selected and presented from a series of patients that illustrate the utility of SPECT-CT studies with (111)In-octreotide in the diagnosis and monitoring of this type of tumor. These are characterization at initial diagnosis, staging, and detection of local recurrence or metastasis, with added value with respect to anatomical images (nuclear magnetic resonance, computed axial tomography, angiography), for example in the differentiation between functional tissue or scar in patients who had previously undergone surgery.
Subject(s)
Head and Neck Neoplasms/diagnostic imaging , Paraganglioma, Extra-Adrenal/diagnostic imaging , Single Photon Emission Computed Tomography Computed Tomography , Carotid Body Tumor/diagnostic imaging , Carotid Body Tumor/surgery , Cicatrix/diagnosis , Diagnosis, Differential , Female , Glomus Tympanicum Tumor/chemistry , Glomus Tympanicum Tumor/diagnostic imaging , Glomus Tympanicum Tumor/surgery , Head and Neck Neoplasms/chemistry , Head and Neck Neoplasms/surgery , Humans , Indium Radioisotopes , Lymphatic Metastasis/diagnostic imaging , Male , Middle Aged , Neoplasm Recurrence, Local/diagnosis , Neoplasm, Residual , Octreotide/analogs & derivatives , Paraganglioma, Extra-Adrenal/chemistry , Paraganglioma, Extra-Adrenal/secondary , Paraganglioma, Extra-Adrenal/surgery , Postoperative Complications/diagnosis , Radiopharmaceuticals , Receptors, Somatostatin/analysisABSTRACT
Objetivo: Evaluar la contribución, y por tanto el impacto clínico-quirúrgico, de la SPECT/CT en la localización preoperatoria del ganglio centinela en pacientes con cáncer de mama. Pacientes y métodos: Revisión de las 240 linfogammagrafías de ganglio centinela realizadas en pacientes con cáncer de mama. Se realizaron un total de 30 SPECT/CT complementarias a las imágenes planares. Procedimiento: administración perilesional de 4 dosis de 99mTc-nanocoloides de albúmina, adquisición de imágenes precoces-tardías con técnica planar y posterior tomografía de emisión (SPECT) y transmisión (CT) con baja dosis en casos seleccionados. Localización intraoperatoria y exéresis de ganglios, completando el procedimiento según indicaciones de cada caso. Resultados: Visualización en las imágenes del 100% de los ganglios en los 30 pacientes, observando 4 casos únicamente por SPECT/CT. Ubicación anatómica exacta según profundidad y relación con otras estructuras del 100% de los ganglios en la tomografía. Migración a 14 ganglios extra-axilares, incluyendo 6 que fueron localizados por equipo híbrido. La SPECT/CT determinó correctamente el número de los ganglios, objetivando un mayor número no visualizados en las imágenes planares. Interpretación errónea por artefacto de contaminación aclarado por el equipo híbrido. Conclusión: Aunque el número de pacientes es limitado, se demostró que la identificación y localización del ganglio centinela con SPECT/CT supera a los observados en la gammagrafía convencional. Así mismo, se evidenció una exactitud mejor de la prueba en la identificación de los ganglios extra-axilares(AU)
Objective: To assess the contribution, therefore the clinical and surgical impact of SPECT/CT in the preoperative localization of the sentinel node in patients with breast cancer. Patients and methods: Review of the 240 sentinel node lymphoscintigraphy performed in patients with breast cancer. A total of 30 SPECT/CT was performed complementary to the planar images. Procedure: four doses of 99mTc-albumin nanocolloid were perilesional injected; acquisition of early-late images with planar technique, and subsequent emission tomography (SPECT) and low dose transmission (CT) in selected cases. Intraoperative localization and excision of lymph nodes, completing the procedure as indicated in each case. Results: One hundred per cent of the nodes in the 30 patients were visualized on the images, only 4 cases observed by SPECT/CT. Precise anatomical localization, as depth and relationship to other structures of 100% of the nodes in the scan. Migration to 14 extra-axillary nodes, including 6 that were found by the hybrid method. SPECT/CT correctly identified the number of nodes, detecting a higher number not observed previously on planar images. Misinterpretation by artefacts of contamination was excluded using the tomography technique. Conclusion: Although the number of patients is limited, we demonstrated a better identification and localization of the sentinel node with SPECT/CT than those observed in conventional scintigraphy. Also, we found a better accuracy of the test identifying extra-axillary nodes(AU)
