Diagnostic yield of baseline and follow-up PET/CT studies in ablative therapy for non-small cell lung cancer.

Although they have proven effectiveness, radiofrequency and microwave ablation techniques have a high rate of partial responses. Diagnostic studies that anticipate the changes in morphology are essential for earlier detection of residual viable tumor tissue or local recurrences to identify patients who will benefit from a new treatment. Our study has determined the diagnostic yield of PET/CT studies at baseline and follow-up and adequate time between them and the ablation intervention. Seven patients with single tumor lesion with a total of 8 ablations were included. CT and PET/CT studies were performed at baseline and follow-up after ablation. Average times between PET studies at baseline and follow-up and the ablative therapy were 1.8 and 3.4 months, respectively. Mean scores in metabolic activities of the PET at baseline and follow-up were 7.6 and 4.3g/ml of SUVmax, respectively. The Dual Time Point technique helped to identify viable tissue after ablation in 3 cases. Follow-up PET/CT studies have conditioned the various treatment strategies adopted by clinical oncologists. The high yield of the PET/CT study including the Dual Time Point technique may be considered as a study replacement of initial and follow-up Contrast-Enhanced CT before and after treatment with RFA and AMO, this achieving considerable reduction in the exposure to high radiation levels. We propose conducting the first PET/CT follow-up study at 3 months of the RFA and AMO.

18F-FDG-PET/CT in lymphoma: two decades of experience.

The use of (18)F-FDG-PET/CT has changed the management of patients with lymphoma for the last two decades. This technique improves initial staging of the disease, making a prognostic approach and appropriate treatment planning, as well as monitoring therapy response of lymphoma. However, there are still controversial issues in medical literature that impact on daily clinical practice. This comprehensive literature review summarizes the current information regarding the potential use of (18)F-FDG-PET/CT in patients with lymphoma, highlighting the main applications and the current dilemmas for the nuclear medicine physicians at the time of the evaluation of these studies, trying to standardize criteria for its assessment, particularly in restaging and therapy monitoring.

Pharmacokinetic study of a high-purity factor IX concentrate (Factor IX Grifols) with a 6-month follow up in previously treated patients with severe haemophilia B.

Optimal replacement treatment in haemophilia B patients requires a good understanding of the pharmacokinetics of factor IX (FIX). The aim of this study was to compare the pharmacokinetic profile of Factor IX Grífols, a highly purified human FIX concentrate with two specific pathogen inactivation/removal steps, to that of available FIX preparations. The study was an open, non-randomized trial including 25 male subjects older than 12 years of age with severe haemophilia B. Pharmacokinetic profile of the FIX preparation regularly used by the subjects was determined as control. Pharmacokinetic profile of Factor IX Grifols was determined twice, one 7-15 days after control assessment and second after a 6 months period had elapsed. Results showed that all products had peak plasma levels of FIX:C within 30 min. Mean recovery was 1.3 +/- 0.3 IU dL(-1) per IU kg(-1) for Factor IX Grifols and 1.0 +/- 0.3 IU dL(-1) per IU kg(-1) for control products (P < 0.001). The mean terminal half-life (t(1/2)) for Factor IX Grifols was 26.7 h and 26.8 h for control product. Pharmacokinetic parameters after 6 months of treatment with Factor IX Grifols did not statistically differ from the parameters obtained with the first infusion. There were no adverse events related to Factor IX Grifols for the duration of the study. In conclusion, Factor IX Grifols has adequated pharmacokinetic properties comparable to the control plasma-derived FIX and these parameters remain stable after 6 months of treatment. Factor IX Grifols can be an effective and safe plasma-derived FIX concentrate for replacement therapy in haemophilia B patients.

[Clinical utility of (18)F-DOPA-PET in movement disorders. A systematic review]. / Utilidad clínica de la (18)FDOPA-PET en trastornos del movimiento. Una revisión sistemática.

INTRODUCTION: (18)F-fluorodopa ((18)F-DOPA) is a functional tracer of presynaptic dopaminergic neuron terminations in the nigrostriatal system. This review is aimed to assess the efficacy of (18)F-DOPA-PET in the diagnosis and evaluation of the progression of Parkinson's Disease (PD) and in the differential diagnosis with other Parkinsonism Syndromes. METHODS: A review was made of the literature by searching six databases and selecting the most relevant articles according to strict inclusion and exclusion criteria. The study data were systematically extracted and included in evidence tables. RESULTS: Of the 1478 registries recovered through the search of the literature, 48 studies were extracted. Of these, only 13 were included in the systematic review. It was observed in all of them that PD is manifested by a lower striatal uptake of (18)F-DOPA, especially in the putamen with posterior predominance. Prospective studies have shown that there is loss of uptake with disease progression. One article described regional differences in (18)F-DOPA striatal pattern between PD, multisystem atrophy (MSA) and progressive supranuclear palsy (PSP). Cognitive impairment in PD seems to be related with (18)F-DOPA abnormal uptake in some regions of frontal cortex and caudate nucleus. CONCLUSION: (18)F-DOPA-PET seems to be useful for the diagnosis and evaluation of PD progression. However, the evidence is not conclusive regarding its utility in the differential diagnosis with other Parkinsonism Syndromes and in the differentiation between ex novo and advanced PD.

Utilidad clínica de la 18FDOPA-PET en trastornos del movimiento. Una revisión sistemática / Clinical utility of 18F-DOPA-PET in movement disorders. A systematic review

Introducción: El radiofármaco 18F-fluorodopa (18FDOPA) es un marcador de la funcionalidad de las terminaciones neuronales dopaminérgicas presinápticas del sistema nigroestriado. El objetivo de esta revisión es determinar la eficacia del 18FDOPA en el diagnóstico y valoración de la progresión de la enfermedad de Parkinson (EP), así como en el diagnóstico diferencial con otros síndromes parkinsonianos. Métodos: Revisión de la literatura consultando seis bases de datos y seleccionando los artículos más relevantes según unos estrictos criterios de inclusión y exclusión. Los datos de los estudios fueron extraídos de forma sistemática e incluidos en tablas de evidencia. Resultados: En la búsqueda bibliográfica se recuperaron 1.478 registros, de los que se extrajeron 48 trabajos incluyendo finalmente sólo 13 estudios en la revisión sistemática. En todos ellos se observa que la EP se manifiesta por una menor captación estriatal de 18FDOPA, especialmente en el putamen, y de predominio posterior. Los estudios prospectivos muestran la pérdida de captación con la progresión de la enfermedad. Un estudio señala diferencias en el patrón regional de afectación entre la EP, la parálisis supranuclear progresiva (PSP) y la atrofia multisistémica (AMS). La afectación cognitiva en la EP parece relacionada con alteraciones en la fijación de 18FDOPA en determinadas regiones del córtex frontal y en el caudado. Conclusiones: La 18FDOPA parece útil para el diagnóstico y valoración de la progresión de la EP; sin embargo, la evidencia no es concluyente respecto a su utilidad en el diagnóstico diferencial con otros síndromes parkinsonianos, así como en la diferenciación entre EP ex novo y avanzada(AU)

Introduction: 18F-fluorodopa (18F-DOPA) is a functional tracer of presynaptic dopaminergic neuron terminations in the nigrostriatal system. This review is aimed to assess the efficacy of 18F-DOPA-PET in the diagnosis and evaluation of the progression of Parkinson's Disease (PD) and in the differential diagnosis with other Parkinsonism Syndromes. Methods: A review was made of the literature by searching six databases and selecting the most relevant articles according to strict inclusion and exclusion criteria. The study data were systematically extracted and included in evidence tables. Results: Of the 1478 registries recovered through the search of the literature, 48 studies were extracted. Of these, only 13 were included in the systematic review. It was observed in all of them that PD is manifested by a lower striatal uptake of 18F-DOPA, especially in the putamen with posterior predominance. Prospective studies have shown that there is loss of uptake with disease progression. One article described regional differences in 18F-DOPA striatal pattern between PD, multisystem atrophy (MSA) and progressive supranu-clear palsy (PSP). Cognitive impairment in PD seems to be related with 18F-DOPA abnormal uptake in some regions of frontal cortex and caudate nucleus. Conclusion: 18F-DOPA-PET seems to be useful for the diagnosis and evaluation of PD progression. However, the evidence is not conclusive regarding its utility in the differential diagnosis with other Parkinsonism Syndromes and in the differentiation between ex novo and advanced PD(AU)