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2.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 43(1): 14-22, ene.- fev. 2024. ilus, tab
Article in Spanish | IBECS | ID: ibc-229450

ABSTRACT

Objetivo Analizar la distribución corporal de la enfermedad Erdheim-Chester (ECD) y determinar la utilidad de la 2-[18F]FDG-PET/TC frente a otras técnicas de imagen. Asimismo, evaluar la agresividad y la extensión de la enfermedad según la presencia/ausencia de mutación BRAFV600E. Material y métodos Se revisaron las 2-[18F]FDG-PET/TC de todos los pacientes diagnosticados con ECD entre 2008 y 2021: en total, 19 pacientes. Los territorios afectados se clasificaron como detectables por PET/TC o detectables solamente por otras técnicas de imagen (gammagrafía ósea, TC con contraste yodado o RM). Se realizó análisis descriptivo y correlación de la mutación BRAF con los órganos afectados y SUVmáx mediante la prueba t de Student. Resultados De los 19 pacientes (14 hombres; edad media 60,3años), 11 presentaban la mutación BRAFV600E. Se detectaron un total de 127 territorios (64 órgano-sistemas) afectados utilizando las diferentes modalidades de imagen, de los cuales 112 fueron detectados por la PET/TC y 15 territorios adicionales fueron identificados únicamente por la RM cerebral y cardiaca. La presencia de mutación BRAFV600E se asoció con mayor afectación orgánica (p<0,05), sin diferencias en el SUVmáx (p>0,05). Conclusión La 2-[18F]FDG-PET/TC es una prueba de alto rendimiento diagnóstico en pacientes con ECD, detectando la mayoría de los territorios afectados. La RM fue la única prueba de imagen con hallazgos adicionales en territorios con alta captación fisiológica de 2-[18F]FDG (cerebral y cardíaca). La presencia de mutación del BRAFV600E se correlacionó con mayor extensión de la enfermedad (AU)


Objective To analyze the body distribution of Erdheim-Chester disease (ECD) and determine the utility of 2-[18F]FDG PET/CT compared to other imaging techniques. Additionally, to assess the aggressiveness and extent of the disease based on the presence/absence of the BRAFV600E mutation. Materials and methods The 2-[18F]FDG PET/CT scans of all patients diagnosed with ECD between 2008 and 2021 were reviewed, including 19 patients. The affected territories were classified as detectable by PET/CT or detectable only by other imaging techniques (bone scintigraphy, contrast-enhanced CT, or MRI). Descriptive analysis and correlation of the BRAF mutation with the affected organs and maximum SUV were performed using the Student's t-test. Results Out of the 19 patients (14 males; mean age 60.3years), 11 had the BRAFV600E mutation. A total of 127 territories (64 organ-systems) affected were identified using different imaging modalities, of which 112 were detected by PET/CT, and an additional 15 territories were solely identified by cerebral and cardiac MRI. The presence of BRAFV600E mutation was associated with greater organ involvement (P<.05) without differences in SUVmax (P>.05). Conclusion 2-[18F]FDG PET/CT is a highly effective diagnostic tool in patients with ECD, detecting the majority of affected territories. MRI was the only imaging modality with additional findings in territories showing high physiological uptake of 2-[18F]FDG (cerebral and cardiac). The presence of the BRAFV600E mutation correlated with a higher extent of the disease (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Erdheim-Chester Disease/diagnostic imaging , Positron Emission Tomography Computed Tomography , Fluorodeoxyglucose F18 , Radiopharmaceuticals , Retrospective Studies , Sensitivity and Specificity
4.
Article in English | MEDLINE | ID: mdl-37804884

ABSTRACT

OBJECTIVE: To analyze the body distribution of Erdheim-Chester disease (ECD) and determine the utility of 2-[18 F]FDG PET/CT compared to other imaging techniques. Additionally, to assess the aggressiveness and extent of the disease based on the presence/absence of the BRAFV600E mutation. MATERIALS AND METHODS: The 2-[18F]FDG-PET/CT scans of all patients diagnosed with ECD between 2008 and 2021 were reviewed, including 19 patients. The affected territories were classified as detectable by PET/CT or detectable only by other imaging techniques (bone scintigraphy, contrast-enhanced CT, or MRI). Descriptive analysis and correlation of the BRAF mutation with the affected organs and maximum SUV were performed using the Student's t-test. RESULTS: Out of the 19 patients (14 males; mean age 60.3 years), 11 had the BRAFV600E mutation. A total of 127 territories (64 organ-systems) affected were identified using different imaging modalities, of which 112 were detected by PET/CT, and an additional 15 territories were solely identified by cerebral and cardiac MRI. The presence of BRAFV600E mutation was associated with greater organ involvement (p < 0.05) without differences in SUVmax (p > 0.05). CONCLUSION: 2-[18F]FDG PET/CT is a highly effective diagnostic tool in patients with ECD, detecting the majority of affected territories. MRI was the only imaging modality with additional findings in territories showing high physiological uptake of 2-[18F]FDG (cerebral and cardiac). The presence of the BRAFV600E mutation correlated with a higher extent of the disease.


Subject(s)
Erdheim-Chester Disease , Positron Emission Tomography Computed Tomography , Male , Humans , Middle Aged , Positron Emission Tomography Computed Tomography/methods , Erdheim-Chester Disease/diagnostic imaging , Erdheim-Chester Disease/genetics , Erdheim-Chester Disease/complications , Fluorodeoxyglucose F18 , Positron-Emission Tomography , Mutation
5.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 36(4): 233-240, jul.-ago. 2017. tab, ilus, graf
Article in Spanish | IBECS | ID: ibc-163740

ABSTRACT

Objetivo. Investigar la relación del valor máximo estandarizado de captación (SUVmáx) de la lesión ovárica con el subtipo histopatológico (I/II) y su implicación en la respuesta al tratamiento y en el pronóstico de las pacientes con carcinoma epitelial de ovario (CEO). Material y métodos. Análisis retrospectivo de 31 pacientes con CEO y 18F-FDG-PET/TC previo al tratamiento, determinándose el SUVmáx de la lesión ovárica y realizándose diagnóstico histopatológico del tumor y seguimiento clínico-radiológico. Se estudió la relación del SUVmáx con el tipo histológico (tipos I y II) y el estadio tumoral, así como la implicación de este y otros parámetros (histología, estadio) en la evolución de las pacientes (respuesta completa [RC], supervivencia global [SG], supervivencia libre de enfermedad [SLE], estado libre de enfermedad a los 12 meses [LE12m] y a los 24 meses [LE24m]). Resultados. El SUVmáx medio en lesiones tipo I fue menor que en las tipo II (6,3 y 9,3, respectivamente; p=0,03). Se obtuvo un valor de corte de SUVmáx de 7,1 en la identificación del CEO tipo II (sensibilidad: 77,8%; especificidad: 69,2%; AUC=0,748; p=0,02). No se halló relación significativa entre SUVmáx y estadio tumoral. Alcanzar RC fue más frecuente en estadios precoces; riesgo relativo (RR) de 1,64; p=0,003, en tumores tipo I y en los de menor SUVmáx. El estadio tumoral fue determinante en la SLE (p=0,04), en el LE24m (p=0,07) y en la SG (p=0,08). Observamos SLE más prolongadas y mayor porcentaje de pacientes LE24m en tumores tipo I (RR: 1,32; p=0,26). Conclusiones. El SUVmáx se relacionó con el tipo histológico del CEO. No se encontró relación entre la actividad glucolítica del tumor primario con la respuesta y el pronóstico (AU)


Objective. To investigate the relationship between maximum standardised uptake value (SUVmax) of ovarian lesions and histopathology subtypes, and their involvement in the response and prognosis of patients with epithelial ovarian carcinoma (EOC). Material and methods. A retrospective analysis of 31 patients with EOC and 18F-FDG-PET/CT before treatment, including an assessment of the SUVmax of ovarian lesion. Histopathological diagnosis and follow-up was performed. A study was made on the relationship between the SUVmax and histological type (type I and II) and tumour stage, as well as the role of various parameters (SUVmax, histology, stage) on the patient outcomes (complete response [CR], overall survival [OS], disease-free survival [DFS], and disease-free [DF] status, at 12 and 24 months). Results. The medium SUVmax in type I lesions was lower than in type II (6.3 and 9.3, respectively; P=.03). A 7.1 cut-off was set for SUVmax in order to identify type II EOC (sensitivity: 77.8%, specificity: 69.2%; AUC=0.748; P=.02). No significant relationship was found between tumour stage and SUVmax. CR was more common in early stages; relative risk (RR) of 1.64; P=.003, as well as in type I tumours and a lower SUVmax. Tumour stage was decisive in DFS (P=.04), LE24m (0.07) and OS (P=.08). Longer DFS and a higher percentage of DF 24m were observed in type I tumours (RR: 1.32; P=.26). Conclusions. SUVmax was related to EOC histology, so could predict the response and prognosis of these patients. No association was found between glycolytic activity of the primary tumor with the response and prognosis (AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Ovarian Neoplasms/therapy , Ovarian Neoplasms , Positron-Emission Tomography , Fluorodeoxyglucose F18/analysis , Neoplasm Staging/classification , Treatment Outcome , Prognosis , Retrospective Studies , Disease-Free Survival , Sensitivity and Specificity , Dimensional Measurement Accuracy , Neoadjuvant Therapy/methods , Cystadenocarcinoma, Serous
6.
Rev Esp Med Nucl Imagen Mol ; 36(4): 233-240, 2017.
Article in English, Spanish | MEDLINE | ID: mdl-28284928

ABSTRACT

OBJECTIVE: To investigate the relationship between maximum standardised uptake value (SUVmax) of ovarian lesions and histopathology subtypes, and their involvement in the response and prognosis of patients with epithelial ovarian carcinoma (EOC). MATERIAL AND METHODS: A retrospective analysis of 31 patients with EOC and 18F-FDG-PET/CT before treatment, including an assessment of the SUVmax of ovarian lesion. Histopathological diagnosis and follow-up was performed. A study was made on the relationship between the SUVmax and histological type (type I and II) and tumour stage, as well as the role of various parameters (SUVmax, histology, stage) on the patient outcomes (complete response [CR], overall survival [OS], disease-free survival [DFS], and disease-free [DF] status, at 12 and 24 months). RESULTS: The medium SUVmax in type I lesions was lower than in type II (6.3 and 9.3, respectively; P=.03). A 7.1 cut-off was set for SUVmax in order to identify type II EOC (sensitivity: 77.8%, specificity: 69.2%; AUC=0.748; P=.02). No significant relationship was found between tumour stage and SUVmax. CR was more common in early stages; relative risk (RR) of 1.64; P=.003, as well as in type I tumours and a lower SUVmax. Tumour stage was decisive in DFS (P=.04), LE24m (0.07) and OS (P=.08). Longer DFS and a higher percentage of DF 24m were observed in type I tumours (RR: 1.32; P=.26). CONCLUSIONS: SUVmax was related to EOC histology, so could predict the response and prognosis of these patients. No association was found between glycolytic activity of the primary tumor with the response and prognosis.


Subject(s)
Neoplasms, Glandular and Epithelial/diagnostic imaging , Ovarian Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Ovarian Epithelial , Combined Modality Therapy , Disease-Free Survival , Female , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Middle Aged , Models, Biological , Neoadjuvant Therapy , Neoplasms, Glandular and Epithelial/etiology , Neoplasms, Glandular and Epithelial/pathology , Neoplasms, Glandular and Epithelial/therapy , Ovarian Neoplasms/etiology , Ovarian Neoplasms/pathology , Ovarian Neoplasms/therapy , Ovariectomy , Prognosis , Radiopharmaceuticals , Retrospective Studies
9.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 34(6): 383-386, nov.-dic. 2015. ilus, tab
Article in English | IBECS | ID: ibc-146714

ABSTRACT

99mTc-tetrofosmin single photon emission computed tomography (99mTc-tetrofosmin SPECT) has an important role in the assessment of coronary artery disease. Despite being its main indication, this study does not only evaluate myocardial perfusion, but much more. Moreover, during the SPECT acquisition, the field area covered includes many important organs of the thorax and abdomen, so extracardiac abnormalities can be observed. The correct etiologic diagnosis of them is only possible if we understand how 99mTc-tetrofosmin works and make a comprehensive investigation of the clinical history of the patient (AU)


La tomografía con 99mTc-tetrofosmin (99mTc-tetrofosmin SPECT) desempeña un papel fundamental en la evaluación de la enfermedad coronaria. A pesar de que esta es su principal indicación, debemos recordar que estos estudios no evalúan únicamente la perfusión miocárdica, sino mucho más. Además, durante la adquisición de la SPECT, el campo incluye gran parte del tórax y abdomen, por lo que podemos observar enfermedad extracardíaca en las regiones incluidas. Llegar a un correcto diagnóstico etiológico de esas alteraciones solo es posible si entendemos cómo funciona el 99mTc-tetrofosmin y realizamos una exhaustiva investigación de los antecedentes e historia clínica del paciente (AU)


Subject(s)
Aged , Humans , Male , Technetium , Evaluation Studies as Topic , Tomography, Emission-Computed, Single-Photon/instrumentation , Tomography, Emission-Computed, Single-Photon/methods , Tomography, Emission-Computed, Single-Photon , Myocardial Perfusion Imaging/methods , Incidental Findings , Chest Pain/etiology , Chest Pain , Carcinoma, Squamous Cell , Heart Defects, Congenital
10.
Rev Esp Med Nucl Imagen Mol ; 34(6): 383-6, 2015.
Article in English, Spanish | MEDLINE | ID: mdl-25937520

ABSTRACT

(99m)Tc-tetrofosmin single photon emission computed tomography ((99m)Tc-tetrofosmin SPECT) has an important role in the assessment of coronary artery disease. Despite being its main indication, this study does not only evaluate myocardial perfusion, but much more. Moreover, during the SPECT acquisition, the field area covered includes many important organs of the thorax and abdomen, so extracardiac abnormalities can be observed. The correct etiologic diagnosis of them is only possible if we understand how (99m)Tc-tetrofosmin works and make a comprehensive investigation of the clinical history of the patient.


Subject(s)
Artifacts , Bile Reflux/diagnostic imaging , Gastroplasty , Medical History Taking , Myocardial Perfusion Imaging , Organophosphorus Compounds/pharmacokinetics , Organotechnetium Compounds/pharmacokinetics , Postoperative Complications/diagnostic imaging , Radiopharmaceuticals/pharmacokinetics , Single Photon Emission Computed Tomography Computed Tomography , Aged , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/secondary , Carcinoma, Squamous Cell/surgery , Chest Pain/etiology , Esophageal Neoplasms/surgery , Esophagectomy , False Positive Reactions , Gastrointestinal Contents , Humans , Male , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/surgery , Positron Emission Tomography Computed Tomography , Tissue Distribution
11.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 32(2): 81-85, mar.-abr. 2013.
Article in Spanish | IBECS | ID: ibc-110360

ABSTRACT

Objetivo. Nuestro objetivo fue analizar todos los volantes peticionarios rechazados de PET-TAC, el motivo primario de solicitud y el impacto de no realizar esta exploración en el manejo de los pacientes. Material y métodos. Revisamos retrospectivamente todos los volantes peticionarios de PET-TAC recibidos y cancelados en nuestro servicio desde enero de 2007 a junio de 2011. Los motivos de cancelación fueron situación del paciente, por solicitud del facultativo peticionario, debido a requerimiento del paciente y según criterio del médico nuclear. Los volantes de PET-TAC fueron clasificados según el motivo primario de solicitud. La evolución clínica de los pacientes fue valorada mediante un seguimiento clínico de hasta 6 meses tras la solicitud de la PET-TAC. Resultados. Treinta y nueve estudios fueron cancelados debido a situación clínica del paciente (principalmente estado avanzado de la enfermedad), 46 debido a requerimiento del facultativo peticionario, 18 por petición del paciente y 74 volantes fueron rechazados según el criterio del médico nuclear. Treinta y cuatro pacientes con solicitud de PET-TAC rechazada tenían antecedente neoplásico. Los motivos primarios de solicitud a ser contestados más prevalentes fueron: evaluación de nódulos pulmonares (20) y lesiones óseas (13). En relación a los nódulos pulmonares, solo 4 pacientes tuvieron antecedente neoplásico previo y su tamaño fue inferior a 5mm. El rechazo de estudios PET-TAC no causó impacto alguno en la evolución natural de la enfermedad de los pacientes. Conclusión. Este procedimiento evitó PET-TAC innecesarios reduciendo costes y radiación sin ningún detrimento en los pacientes (AU)


Aim. Our objective was to analyze all the rejected PET/CT-request forms (rf), its primary question to be answered and the impact of not performing the PET/CT studies for the management of the patients. Material and methods. We retrospectively reviewed all the cancelled PET/CT-rf received in our department from January 2007 to June 2011. The reasons for cancelling were patient clinical status, request from referring physician, patient request and criteria of nuclear medicine physician. PET/CT-rf were classified according to the primary question to be answered. The clinical evolution of patients was followed up for 6 months after PET/CT was requested. Results. Thirty-nine studies were cancelled due to the patient clinical situation (mainly advanced state of neoplastic disease), 46 due to request from referring physician, 18 by patient request and 74 PET/CT-rf were rejected due to nuclear medicine physician criteria. Thirty-four patients with a rejected PET/CT had known neoplastic history. The more prevalent primary questions to be answered were: evaluation of pulmonary (20) and bone lesions (13). Regarding pulmonary nodules, only 4 patients had previous neoplastic disease and their size was less than 5mm. The rejection of PET/CT studies did not cause any impact in the natural evolution of the disease of the patients. Conclusion. This procedure avoided unnecessary PET/CT scans reducing expenses and radiation without any detriment in the patients (AU)


Subject(s)
Humans , Male , Female , Positron Emission Tomography Computed Tomography/methods , Positron Emission Tomography Computed Tomography/standards , Positron Emission Tomography Computed Tomography , Retrospective Studies , Positron Emission Tomography Computed Tomography/economics
12.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 32(1): 37-39, ene.-feb. 2013. ilus
Article in Spanish | IBECS | ID: ibc-108339

ABSTRACT

La PET-TC con 18F-Colina (FCH) posee un mayor rendimiento en la valoración de pacientes con cáncer de próstata que la 18F-FDG; no obstante, al igual que esta, tampoco es un radiotrazador específico tumoral. Presentamos cuatro estudios PET-TC realizados con 18F-FCH donde obtuvimos hallazgos falsos positivos catalogados correctamente tras la valoración con la TC, parámetros clínicos y/o análisis histológico (AU)


The 18F-choline PET-CT (FCH) has better performance in the assessment of patients with prostate cancer than 18F-FDG. However, similarly, it is also not a tumor specific radiotracer. We present four 18F-FCH PET-CT scans in which false positive findings were correctly assessed after evaluation with CT, clinical parameters and/or histological analysis (AU)


Subject(s)
Humans , Male , Middle Aged , False Positive Reactions , Positron Emission Tomography Computed Tomography/instrumentation , Positron Emission Tomography Computed Tomography/methods , Fluorodeoxyglucose F18 , Prostatic Neoplasms , Sensitivity and Specificity , Positron Emission Tomography Computed Tomography/trends , Prostate/pathology , Prostate , Carcinoma , Radiopharmaceuticals
13.
Rev Esp Med Nucl Imagen Mol ; 32(2): 81-5, 2013 Mar.
Article in English | MEDLINE | ID: mdl-22726672

ABSTRACT

AIM: Our objective was to analyze all the rejected PET/CT-request forms (rf), its primary question to be answered and the impact of not performing the PET/CT studies for the management of the patients. MATERIAL AND METHODS: We retrospectively reviewed all the cancelled PET/CT-rf received in our department from January 2007 to June 2011. The reasons for cancelling were patient clinical status, request from referring physician, patient request and criteria of nuclear medicine physician. PET/CT-rf were classified according to the primary question to be answered. The clinical evolution of patients was followed up for 6 months after PET/CT was requested. RESULTS: Thirty-nine studies were cancelled due to the patient clinical situation (mainly advanced state of neoplastic disease), 46 due to request from referring physician, 18 by patient request and 74 PET/CT-rf were rejected due to nuclear medicine physician criteria. Thirty-four patients with a rejected PET/CT had known neoplastic history. The more prevalent primary questions to be answered were: evaluation of pulmonary (20) and bone lesions (13). Regarding pulmonary nodules, only 4 patients had previous neoplastic disease and their size was less than 5mm. The rejection of PET/CT studies did not cause any impact in the natural evolution of the disease of the patients. CONCLUSION: This procedure avoided unnecessary PET/CT scans reducing expenses and radiation without any detriment in the patients.


Subject(s)
Multimodal Imaging/statistics & numerical data , Positron-Emission Tomography/statistics & numerical data , Referral and Consultation/statistics & numerical data , Tomography, X-Ray Computed/statistics & numerical data , Unnecessary Procedures/statistics & numerical data , Humans , Retrospective Studies
14.
Rev Esp Med Nucl Imagen Mol ; 32(2): 70-6, 2013 Mar.
Article in Spanish | MEDLINE | ID: mdl-22759992

ABSTRACT

OBJECTIVE: To compare two different methods for the interpretation of interim PET/CT (PET/CT-i) in lymphomas, and to establish which one best predicts a complete metabolic response (CMR) in the PET/CT study at the end of treatment (PET/CT-et). MATERIAL AND METHODS: Retrospective longitudinal analysis of the PET/CT studies for staging (PET/CT-s), PET/CT-i and PET/CT-et of 65 patients, 35 Hodgkin's lymphoma (HL) and 30 Non-HL. The PET/CT-i was performed between the second and fourth chemotherapy cycle. It was interpreted using two different criteria: qualitative criteria (5 point visual scale), semiquantitative criteria (percentage difference between the lesion with more SUVmax in the PET/CT-s and PET/CT-i). We analyzed the likelihood of obtaining a CMR in the PET/CT-et according to the results obtained on the PET/CT-i with these two criteria. RESULTS: We obtained sensitivity (S), specificity (Sp), positive predictive values (PPV), negative predictive values (NPV) and likelihood ratio (LR) for the qualitative/semiquantitative method of 91%/80%, 76.2%/67%, 88.9%/83.3%, 80%/60.9% and 32%/7.8%, respectively, to predict a CMR in the PET/CT-et. There were no statistically significant differences between the LR of both methods (p=0.1942). CONCLUSION: We found clear differences in S, Sp, PPV and NPV between both interpretation criteria for the PET/CT-i to predict a CMR in the PET/CT-et. Nevertheless, we cannot confirm the superiority of the qualitative method over the semiqualitative method for this purpose as no statistically significance differences were found in their LR in our study.


Subject(s)
Hodgkin Disease/diagnosis , Hodgkin Disease/metabolism , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/metabolism , Positron-Emission Tomography , Tomography, X-Ray Computed , Adolescent , Adult , Aged , Aged, 80 and over , Evaluation Studies as Topic , Female , Hodgkin Disease/drug therapy , Humans , Longitudinal Studies , Lymphoma, Non-Hodgkin/drug therapy , Male , Middle Aged , Predictive Value of Tests , Remission Induction , Reproducibility of Results , Retrospective Studies , Young Adult
15.
Rev Esp Med Nucl Imagen Mol ; 32(1): 1-7, 2013 Jan.
Article in Spanish | MEDLINE | ID: mdl-23177340

ABSTRACT

OBJECTIVE: To describe the process of implementing a quality management system according to UNE-EN-ISO 9001:2008 standard in a Nuclear Medicine Department. MATERIAL AND METHOD: In February 2008, the committee on internal quality of the Department was established, naming a responsible physician. The general operating plan was drawn up, following the requirements established by the ISO 9001:2008 standard. It defined the scope of the standard, defining, preparing and transcribing the various activities of our Department. Four training sessions were carried out. RESULTS: A total of nine general and two specific procedures were documented in which all the activities performed in our Department were included. Personnel records of each worker were created, including their profiles and training plan. A record of the equipment and service providers was created, as well as issues with the latter. Satisfaction surveys were obtained from external (patients) and internal customers (faculty applicants). Targets for improvement and activity markers were established. Two audits were performed to complete the process, one internal and one external. The Department was accredited in April 2010. CONCLUSION: The quality accreditation process is a tool that requires reflection on how we do things and how they can be improved. It makes it possible to measure what we do, to analyze and introduce improvement measures, and therefore, to achieve a higher level of quality in the service we provide our customers. The involvement of the Department workers with a commitment to team performance was essential.


Subject(s)
Hospital Departments/standards , Nuclear Medicine , Total Quality Management
16.
Rev Esp Med Nucl Imagen Mol ; 32(1): 37-9, 2013 Jan.
Article in Spanish | MEDLINE | ID: mdl-23177342

ABSTRACT

The (18)F-choline PET-CT (FCH) has better performance in the assessment of patients with prostate cancer than (18)F-FDG. However, similarly, it is also not a tumor specific radiotracer. We present four (18)F-FCH PET-CT scans in which false positive findings were correctly assessed after evaluation with CT, clinical parameters and/or histological analysis.


Subject(s)
Choline/analogs & derivatives , Fluorine Radioisotopes , Multimodal Imaging , Positron-Emission Tomography/methods , Prostatic Neoplasms/diagnosis , Tomography, X-Ray Computed/methods , False Positive Reactions , Humans , Male
17.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 31(6): 308-314, nov.-dic. 2012. tab, ilus
Article in English | IBECS | ID: ibc-105645

ABSTRACT

Objetivo. Analizar la correlación entre la captación de 18FFDG valorada por la PET-TC en cáncer de mama localmente avanzado y factores pronósticos histopatológicos e inmunohistoquímicos. Material y métodos. Se valoraron prospectivamente 36 mujeres con cáncer de mama. La PET-TC fue requerida en la estadificación previamente al tratamiento quimioterápico (estudio multicéntrico). A todas se les realizó una PET-TC con 18FFDG en 2 fases. Ambas fueron valoradas cualitativa y semicuantitativamente con cálculo del SUVmax en la PET-1 (SUV-1) y en la PET-2 (SUV-2) así como el índice de retención. Los estadios clínicos y metabólicos fueron evaluados siguiendo la clasificación TNM. Se determinaron los parámetros biológicos pronósticos del tumor primario, como el estado de los receptores esteroideos, la expresión del p53 y c-erbB-2, el índice de proliferación (Ki-67) y el grado histológico. Los parámetros biológicos e histológicos fueron correlacionados. Resultados. Se encontró una relación positiva entre los parámetros metabólicos semicuantitativos y los biológicos. Los valores de SUV-1 y SUV-2 no mostraron una correlación estadísticamente significativa excepto para el tamaño clínico tumoral. Acerca de los parámetros biológicos, el índice de retención mostró los mejores resultados con relación positiva y significativa (p<0,05) con el estado de los receptores estrogénicos y progestágenos y el Ki-67. Los valores aislados del SUV no mostraron relación significativa con esos parámetros. Conclusión. El índice de retención mostró la mayor relación con los parámetros biológicos comparados con los valores aislados de SUVmax. Estos datos sugieren que el cambio del SUV es un marcador pronóstico(AU)


Aim. To analyse the correlation between 18F-FDG uptake assessed by PET/CT in locally advanced breast tumours and histopathological and immunohistochemical prognostic factors. Material and methods. Thirty-six women with breast cancer were prospectively evaluated. PET/CT was requested in the initial staging previous to adjuvant chemotherapy (multicentric study). All the patients underwent an 18F-FDG PET/CT with a dual-time-point acquisition. Both examinations were evaluated qualitatively and semiquantitatively with calculation of SUVmax values in PET-1 (SUV-1) and in PET-2 (SUV-2) and the percentage variation of the standard uptake values (retention index) between PET-1 and PET-2. Clinical and metabolic stages were assessed according to TNM classification. The biological prognostic parameters, such as the steroid receptor status, p53 and c-erbB-2 expression, proliferation rate (Ki-67), and grading were determined from tissue of the primary tumour. Metabolic and biological parameters were correlated. Results. A positive relationship was found between semiquantitative metabolic parameters and biological parameters. SUV-1 and SUV-2 values did not show significant statistical correlation (p<.05) except for the clinical tumour size. About the biological parameters, retention index showed the best results with positive and significant relation (p<.05) with estrogen and progesterone receptor status and Ki-67. Isolated SUV values did not show significant relation to these parameters. Conclusion. Retention index showed the best relation with biological parameters compared to isolated SUVmax values. These data suggest that SUV change over time is a prognostic marker(AU)


Subject(s)
Humans , Female , Fluorodeoxyglucose F18 , Prognosis , Breast Neoplasms , Immunohistochemistry/methods , Immunohistochemistry , Prospective Studies , /classification , Breast Neoplasms/drug therapy , Neoplasms, Multiple Primary
18.
Rev Esp Med Nucl Imagen Mol ; 31(6): 308-14, 2012.
Article in English | MEDLINE | ID: mdl-23084013

ABSTRACT

AIM: To analyse the correlation between (18)F-FDG uptake assessed by PET/CT in locally advanced breast tumours and histopathological and immunohistochemical prognostic factors. MATERIAL AND METHODS: Thirty-six women with breast cancer were prospectively evaluated. PET/CT was requested in the initial staging previous to adjuvant chemotherapy (multicentric study). All the patients underwent an (18)F-FDG PET/CT with a dual-time-point acquisition. Both examinations were evaluated qualitatively and semiquantitatively with calculation of SUVmax values in PET-1 (SUV-1) and in PET-2 (SUV-2) and the percentage variation of the standard uptake values (retention index) between PET-1 and PET-2. Clinical and metabolic stages were assessed according to TNM classification. The biological prognostic parameters, such as the steroid receptor status, p53 and c-erbB-2 expression, proliferation rate (Ki-67), and grading were determined from tissue of the primary tumour. Metabolic and biological parameters were correlated. RESULTS: A positive relationship was found between semiquantitative metabolic parameters and biological parameters. SUV-1 and SUV-2 values did not show significant statistical correlation (p<.05) except for the clinical tumour size. About the biological parameters, retention index showed the best results with positive and significant relation (p<.05) with estrogen and progesterone receptor status and Ki-67. Isolated SUV values did not show significant relation to these parameters. CONCLUSION: Retention index showed the best relation with biological parameters compared to isolated SUVmax values. These data suggest that SUV change over time is a prognostic marker.


Subject(s)
Breast Neoplasms/diagnostic imaging , Carcinoma, Ductal, Breast/diagnostic imaging , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Multimodal Imaging , Positron-Emission Tomography , Radiopharmaceuticals , Tomography, X-Ray Computed , Adult , Biomarkers, Tumor/analysis , Breast Neoplasms/chemistry , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Carcinoma, Ductal, Breast/chemistry , Carcinoma, Ductal, Breast/drug therapy , Carcinoma, Ductal, Breast/pathology , Carcinoma, Ductal, Breast/surgery , Carcinoma, Lobular/chemistry , Carcinoma, Lobular/diagnostic imaging , Carcinoma, Lobular/drug therapy , Carcinoma, Lobular/pathology , Carcinoma, Lobular/surgery , Chemotherapy, Adjuvant , Estrogens , Female , Humans , Ki-67 Antigen/analysis , Lymphatic Metastasis , Middle Aged , Neoadjuvant Therapy , Neoplasm Grading , Neoplasms, Hormone-Dependent/chemistry , Neoplasms, Hormone-Dependent/diagnostic imaging , Neoplasms, Hormone-Dependent/drug therapy , Neoplasms, Hormone-Dependent/pathology , Neoplasms, Hormone-Dependent/surgery , Progesterone , Prognosis , Prospective Studies , Receptor, ErbB-2/analysis , Receptors, Estrogen/analysis , Receptors, Progesterone/analysis , Tumor Burden
19.
Rev Esp Med Nucl Imagen Mol ; 31(5): 243-8, 2012 Sep.
Article in English, Spanish | MEDLINE | ID: mdl-23067525

ABSTRACT

AIM: To investigate the applicability of the sentinel lymph node biopsy technique in early stages of endometrial cancer. MATERIAL AND METHODS: A prospective study that included consecutive patients with a histological diagnosis of clinical state I endometrial carcinoma was performed. Two doses of 2 mCi (74 MBq) of (99m)Tc-albumin nanocolloid were injected in the uterine cervix, and planar and SPECT-CT images were obtained at one hour, and at 24 hours if no migration of the tracer was observed. Methylene blue dye was also injected into the cervix immediately prior to the surgery. A gamma probe was used during the surgical procedure for sentinel lymph node identification. In all cases, a hysterectomy, double adnexectomy and pelvic lymphadenectomy were performed, carrying out a histological analysis (hematoxylin-eosin) of the sentinel lymph nodes and the lymphadenectomy specimen. RESULTS: We included 19 patients, with a final diagnoses of endometrioid carcinoma (18 cases) and endometrial stromal sarcoma (1 case). At least one sentinel lymph node was identified in 17 of them (89.5% detection rate). Twenty-nine sentinel lymph nodes were identified during surgery, all of them negative for neoplastic infiltration. No metastatic invasion was found in the pelvic lymphadenectomy specimens as well. CONCLUSIONS: The sentinel lymph node biopsy technique seems to be a reliable tool in nodal staging of endometrial cancer at early stages, with an acceptable detection rate and high histological correlation. The low prevalence of lymphatic spread in this group of patients and the encouraging results obtained could make the sentinel lymph node an alternative to routine complete lymphadenectomy.


Subject(s)
Carcinoma, Endometrioid/secondary , Endometrial Neoplasms/diagnostic imaging , Endometrial Stromal Tumors/secondary , Lymphatic Metastasis/diagnostic imaging , Multimodal Imaging , Positron-Emission Tomography , Sentinel Lymph Node Biopsy , Tomography, X-Ray Computed , Adult , Aged , Aged, 80 and over , Carcinoma, Endometrioid/diagnostic imaging , Carcinoma, Endometrioid/surgery , Endometrial Neoplasms/pathology , Endometrial Neoplasms/surgery , Endometrial Stromal Tumors/diagnostic imaging , Endometrial Stromal Tumors/surgery , Female , Humans , Laparoscopy , Lymph Node Excision , Middle Aged , Pilot Projects , Radiopharmaceuticals , Technetium Tc 99m Aggregated Albumin
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