Concordancia entre SPECT portátil y la gammagrafía convencional para detección de ganglio centinela en cáncer de mama / Concordance between freehand SPECT and conventional scintigraphy for sentinel lymph node detection in breast cancer

Introducción: La SPECT portátil puede ser una técnica de imagen útil para la planificación preoperatoria de la biopsia selectiva del ganglio centinela (BSGC) ya que permite la localización del ganglio centinela (GC) mediante imágenes tomográficas en 3D y en tiempo real y determina su profundidad, después de unos minutos de exploración. El objetivo del estudio fue evaluar la correlación entre el número de GC detectados entre las imágenes de la SPECT portátil y la linfogammagrafía (LG). Materiales y métodos: Cien pacientes con diagnóstico de cáncer de mama infiltrante y sin evidencia clínica de afectación ganglionar, se sometieron prospectivamente a una BSGC. El estudio preoperatorio incluyó imágenes de SPECT portátil a los 15 min tras la inyección y de LG a los 25 y 60-90 min (precoz y tardía). Se analizó el acuerdo observado y se realizó un estudio de concordancia entre el número de GC detectados con SPECT portátil y LG. Resultados: El acuerdo observado en la detección de GC entre SPECT portátil y LG precoz fue del 72%; entre SPECT portátil y LG tardía del 85%, y entre la LG precoz y la tardía de un 87%. En el estudio de concordancia se registró una concordancia moderada entre la SPECT portátil y la LG precoz (coeficiente kappa: 0,42); una concordancia moderada-alta entre la SPECT portátil y la LG tardía (coeficiente kappa: 0,60), y una concordancia de moderada-alta entre la LG precoz y la tardía (coeficiente kappa: 0,70), sin diferencias significativas entre ellos (valor p=0,16). Conclusión: La SPECT portátil presentó una concordancia moderada-alta con los estudios de imagen convencional y podría ser una alternativa válida para el estudio prequirúrgico de la BSGC en el cáncer de mama.(AU)

Introduction: Freehand SPECT can be a useful imaging technique for preoperative planning of sentinel lymph node biopsy (SLNB) as it allows localization of the sentinel node by 3D and real-time tomographic imaging and determines its depth after a few minutes of scanning. The aim of the study was to evaluate the correlation between the number of detected SNs between freehand SPECT images and lymphoscintigraphy (LS). Materials and methods: One hundred patients with a diagnosis of invasive breast cancer and no clinical evidence of lymph node involvement prospectively underwent SLNB. The preoperative study included freehand SPECT imaging at 15min after injection and LS imaging at 25 and 60–90min after injection (early and late). The observed agreement was analyzed and a concordance study was performed between the number of SNs detected with freehand SPECT and LS. Results: The observed agreement in the detection of SNs between freehand SPECT and early LS was 72%; between freehand SPECT and late LS was 85%; and between early and late LS was 87%. In the concordance study, there was moderate concordance between freehand SPECT and early LS (kappa coefficient: 0.42); moderate-high concordance between freehand SPECT and late LS (kappa coefficient: 0.60); and moderate-high concordance between early and late LS (kappa coefficient: 0.70), with no significant differences between them (p-value=0.16). Conclusion: Freehand SPECT showed a moderate-high concordance with conventional imaging studies and could be a valid alternative for the presurgical study of SLNB in breast cancer.(AU)

Concordance between freehand SPECT and conventional scintigraphy for sentinel lymph node detection in breast cancer.

INTRODUCTION: Freehand SPECT can be a useful imaging technique for preoperative planning of sentinel lymph node biopsy (SLNB) as it allows localization of the sentinel node by 3D and real-time tomographic imaging and determines its depth after a few minutes of scanning. The aim of the study was to evaluate the correlation between the number of detected SNs between freehand SPECT images and lymphoscintigraphy (LS). MATERIALS AND METHODS: 100 patients with a diagnosis of invasive breast cancer and no clinical evidence of lymph node involvement prospectively underwent SLNB. The preoperative study included freehand SPECT imaging at 15min after injection and LS imaging at 25 and 60-90min after injection (early and late). The observed agreement was analyzed and a concordance study was performed between the number of SNs detected with freehand SPECT and LS. RESULTS: The observed agreement in the detection of SNs between freehand SPECT and early LS was 72%; between freehand SPECT and late LS was 85%; and between early and late LS was 87%. In the concordance study, there was moderate concordance between freehand SPECT and early LS (kappa coefficient: 0.42); moderate-high concordance between freehand SPECT and late LS (kappa coefficient: 0.60); and moderate-high concordance between early and late LS (kappa coefficient: 0.70), with no significant differences between them (p-value=0.16). CONCLUSION: Freehand SPECT showed a moderate-high concordance with conventional imaging studies and could be a valid alternative for the presurgical study of SLNB in breast cancer.

Aportación de la gammagrafía intraoperatoria en la detección del adenoma paratiroideo intratiroideo / Contribution of intraoperative scintigraphy to the detection of intrathyroidal parathyroid adenoma

Los adenomas paratiroideos intratiroideos (API) representan una causa rara de hiperparatiroidismo primario cuya localización dificulta la adecuada extirpación quirúrgica. Presentamos el caso de una paciente diagnosticada de adenoma paratiroideo por gammagrafía prequirúrgica en la que finalmente durante la paratiroidectomía la localización de la lesión fue intratiroidea. Consideramos que la aportación de la gammagrafía paratiroidea intraquirúrgica con 99mTc-MIBI mediante gammacámara portátil es muy útil en la extirpación de los adenomas paratiroideos e imprescindible en el caso concreto de los API (AU)

The intrathyroidal parathyroid adenomas (IPA) represent a rare cause of primary hyperparathyroidism whose location difficults appropriate surgical removal. We present the case of a patient diagnosed of parathyroid adenoma by presurgical scintigraphy in which finally during the parathyroidectomy, the lesion location was intrathyroidal. We consider that the intrasurgical parathyroid scintigraphy with 99mTc-MIBI by portable gammacamera is useful in the parathyroid adenomas removal and essential in the case of IPA (AU)

[Contribution of intraoperative scintigraphy to the detection of intrathyroidal parathyroid adenoma]. / Aportación de la gammagrafía intraoperatoria en la detección del adenoma paratiroideo intratiroideo.

The intrathyroidal parathyroid adenomas (IPA) represent a rare cause of primary hyperparathyroidism whose location difficults appropriate surgical removal. We present the case of a patient diagnosed of parathyroid adenoma by presurgical scintigraphy in which finally during the parathyroidectomy, the lesion location was intrathyroidal. We consider that the intrasurgical parathyroid scintigraphy with (99m)Tc-MIBI by portable gammacamera is useful in the parathyroid adenomas removal and essential in the case of IPA.

[Interstitial nephritis demonstrated by 67Ga-citrate scintigraphy within a diagnosis of fever of unknown origin]. / Nefritis intersticial demostrada mediante gammagrafía con 67Ga-citrato en el contexto de fiebre de origen desconocido.

We present a clinical case of a 54-year-old woman that was admitted in our hospital with the diagnosis of fever of unknown origin. All the laboratory tests and imaging techniques did not manage to establish the fever's aetiology until a (67)Ga-citrate scan was performed and kidney uptake was observed, which lead to the clinical suspicion of drug-induced interstitial nephritis. The renal biopsy confirmed the diagnosis. This finding allowed corticoid therapy and cure.

Nefritis intersticial demostrada mediante gammagrafía con 67Ga-citrato en el contexto de fiebre de origen desconocido / Interstitial nephritis demonstrated by 67Ga-citrate scintigraphy within a diagnosis of fever of unknown origin

Exponemos el caso de una paciente mujer de 54 años que ingresó en nuestro hospital para estudio de fiebre de origen desconocido.Todas las pruebas de laboratorio y de imagen no lograron establecer la causa de la fiebre y, al realizar una gammagrafía con 67Ga-citrato, se objetivó captación patológica en los riñones, lo que llevó a la sospecha clínica de nefritis intersticial inducida por medicamentos. La biopsia renal confirmó el diagnóstico. Este hallazgo permitió el tratamiento con corticoides y la curación de la enferma(AU)

We present a clinical case of a 54-year-old woman that was admitted in our hospital with the diagnosis of fever of unknown origin.All the laboratory tests and imaging techniques did not manage to establish the fever's aetiology until a 67Ga-citrate scan was performed and kidney uptake was observed, which lead to the clinical suspicion of drug-induced interstitial nephritis. The renal biopsy confirmed the diagnosis. This finding allowed corticoid therapy and cure(AU)

Study of the adrenergic heart innervation with iodine 123-metaiodobenzylguanidine in heart failure before transplantation.

BACKGROUND: The incidence and prevalence of heart failure (HF) are constantly increasing. Heart failure depends on pump failure, inflammatory tracers, and the neurohormonal system. At advanced stages, the only treatment is heart transplantation (HT). We studied myocardial innervation in patients before HT. MATERIALS AND METHODS: The study included 15 patients (11 men and 4 women; age range, 18-69 years) with a diagnosis of New York Heart Association class III-IV or IV HF. Planar thoracic images were obtained, at 15 minutes and 4 hours after injection of 10 mCi of iodine 123-metaiodobenzylguanidine ((123)I-MIBG). Adrenal activity was measured quantitatively using a heart-to-mediastinum count ratio and a myocardial washout rate. Pathologic results were considered if heart-to-mediastinum count ratio was less than 1.8 and washout rate was more than 35%. RESULTS: The qualitative analysis revealed decreased (123)I-MIBG myocardial uptake in all patients. Using the quantitative scale, patients were classified into four groups, as follows: group 1, physiologic innervation, no patients; group 2, mild myocardial adrenergic involvement, one patient (6.7%); group 3, moderate myocardial adrenergic involvement, five patients (33.3%); and group 4, severe myocardial adrenergic involvement, 9 patients (60%). The washout rate was pathologic in 11 of the 15 patients (73.3%). CONCLUSIONS: Scintigraphy using (123)I-MIBG is a useful method to evaluate prognosis in patients with advanced HF and can be used to assess transplantation priorities. It will be necessary to study a larger number of patients to confirm these findings.

Gammagrafía paratiroides 99mTc-sestamibi en paciente con hiperparatiroidismo secundario recidivante tras paratiroidectomía total y autotrasplante / 99mTc-sestamibi parathyroid scintigraphy in patient with secondary recurrent hyperparathyroidism after total parathyroidectomy and self-transplant

No disponible