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1.
Rev Esp Med Nucl Imagen Mol ; 33(5): 293-5, 2014.
Article in English | MEDLINE | ID: mdl-24866051

ABSTRACT

A 61-year-old patient was diagnosed with squamous cell carcinoma of the penis (SCCP) and treated with partial penectomy (pT1,N0,M0,G2). Seven months later, a palpable adenopathy was found in the left inguinal region. An (18)F-FDG PET/CT exploration showed hypermetabolic lymphadenopathies in inguinal, pelvic, retroperitoneal regions, in both lung hila and in the left supraclavicular regions. At the end of the 4th cycle of chemotherapy (cisplatin+5FU) the patient developed numerous skin metastases at the root of the left thigh and a pleural effusion in the right lung. In a new exploration with (18)F-FDG PET/CT the number, size and metabolic activity of known lymphadenopathies decreased. Right pleural carcinomatosis and intense FDG uptake in cutaneous metastases were observed. Weeks later, the patient died. (18)F-FDG-PET/TC may be useful in patients with SCCP and metastatic inguinal lymphadenopathies, to assess the response to chemotherapy and to detect other unsuspected metastases in the rare cases of cutaneous metastases.


Subject(s)
Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/secondary , Fluorodeoxyglucose F18 , Multimodal Imaging , Penile Neoplasms/pathology , Positron-Emission Tomography , Radiopharmaceuticals , Skin Neoplasms/diagnosis , Skin Neoplasms/secondary , Tomography, X-Ray Computed , Humans , Male , Middle Aged
3.
Rev Esp Med Nucl Imagen Mol ; 32(6): 397-9, 2013.
Article in English | MEDLINE | ID: mdl-23867638

ABSTRACT

The widespread use of (18)F-FDG PET-CT scanning in oncological patients has allowed to demonstrate the existence of metabolically active brown fat, also called brown adipose tissue (BAT), in adult humans, and specifying its anatomical distribution in vivo. As physiological determinants to BAT (18)F-FDG uptake has been identified gender, age, temperature, and body mass index. We have observed extensive activation of the BAT, including the mesenteric region, in a patient with a catecholamine-secreting para-vesical paranganglioma. The extensive BAT activation could be secondary to adrenergic stimulation due to excess of circulating norepinephrine concentration.


Subject(s)
Adipose Tissue, Brown/metabolism , Fluorodeoxyglucose F18 , Multimodal Imaging , Paraganglioma/diagnosis , Paraganglioma/metabolism , Positron-Emission Tomography , Radiopharmaceuticals , Tomography, X-Ray Computed , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/metabolism , Catecholamines/metabolism , Humans , Male , Young Adult
4.
Rev Esp Med Nucl Imagen Mol ; 32(3): 187-9, 2013.
Article in Spanish | MEDLINE | ID: mdl-23153986

ABSTRACT

The diagnosis, localization and treatment of infected cysts in the kidney or liver of patients with autosomal dominant polycystic kidney disease (ADPKD) remain a clinical challenge. We report the findings of (18)F-FDG PET-CT in an ADPKD diagnosed patient who required renal transplantation five years before and in his follow up presented repeated episodes of bacteriemia without known focus on radiological tests performed. The (18)F-FDG PET-CT scan showed numerous hypermetabolic images with focal or ring-shaped morphology related to the content and the wall of some hepatic cysts. The increased metabolic activity was localized on segments VI and VII. We proceeded to drainage of one cyst in segment VI, removing 110 cc of purulent fluid which grew E. Coli BLEE. The (18)F-FDG PET/CT scan should be included in the diagnostic algorithm for detecting infected liver cysts in patients with ADPKD and fever of unknown origin.


Subject(s)
Cysts/complications , Cysts/diagnosis , Escherichia coli Infections/complications , Escherichia coli Infections/diagnosis , Fever of Unknown Origin/etiology , Fluorodeoxyglucose F18 , Liver Diseases/complications , Liver Diseases/diagnosis , Multimodal Imaging , Polycystic Kidney, Autosomal Dominant/complications , Polycystic Kidney, Autosomal Dominant/diagnosis , Positron-Emission Tomography , Radiopharmaceuticals , Tomography, X-Ray Computed , Cysts/microbiology , Humans , Liver Diseases/microbiology , Male , Middle Aged
6.
Rev Esp Med Nucl Imagen Mol ; 31(4): 213-5, 2012.
Article in Spanish | MEDLINE | ID: mdl-23067689

ABSTRACT

The most common cause of metastatic involvement of axillary lymph nodes in women is ipsilateral breast cancer. The definition of occult breast malignancy has changed over time. Nowadays, it is considered to exist when it coincides with an isolated metastatic axillary abnormal lymph node in the absence of a palpable tumor in the ipsilateral breast, non-diagnostic breast tumor mammography and no detection of other malignancies outside the breast which could potentially affect the axillary nodes. The value of (18)F-FDG PET/CT scan in these patients has not been established, but it could be useful in those patients with a non-diagnostic MRI. It is not uncommon in (18)F-FDG PET/CT studies to identify incidental hypermetabolic focal image in the thyroid. The high prevalence of cancer in these lesions makes it recommendable to perform a US study and/or FNAP biopsy.


Subject(s)
Breast Neoplasms/diagnostic imaging , Carcinoma, Ductal, Breast/secondary , Carcinoma, Papillary/diagnostic imaging , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Incidental Findings , Lymphatic Metastasis/diagnostic imaging , Multimodal Imaging , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Unknown Primary/diagnostic imaging , Positron-Emission Tomography , Radiopharmaceuticals , Thyroid Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Aged , Axilla , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/diagnostic imaging , Female , Fluorine Radioisotopes/pharmacokinetics , Fluorodeoxyglucose F18/pharmacokinetics , Hemorrhage/pathology , Humans , Nipples/pathology , Radiopharmaceuticals/pharmacokinetics
7.
Rev Esp Med Nucl Imagen Mol ; 31(2): 89-92, 2012.
Article in Spanish | MEDLINE | ID: mdl-21620527

ABSTRACT

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare entity that accounts for less than 5% of the cases of Hodgkin lymphoma (HL) with morphological, immunophenotypical, genetic and clinical behavior traits different from the classic HL. In a minority of patients, the NLPHL course is complicated by a transformation to a non-Hodgkin diffuse large B-cell lymphoma (NHDLBCL) with prognostic and therapeutic implications. Early metabolic changes observed by (18)F-FDG PET in patients with HL and NHL, after 1-3 cycles of chemotherapy, predict the final response to treatment and progression-free survival. In the case we are presenting herein, whether NLPHL is transformed to NHDLBCL or the two types of lymphoma co-exist in the same patient, the (18)F-FDG PET/CT scan was crucial for the identification of tumor resistance to first line chemotherapy and to guide a second biopsy decision and therefore modify the chemotherapy regimen.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Hodgkin Disease/drug therapy , Lymphoma, Large B-Cell, Diffuse/diagnostic imaging , Multimodal Imaging , Positron-Emission Tomography , Radiopharmaceuticals , Splenic Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Antibodies, Monoclonal, Murine-Derived/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/pharmacology , Biomarkers, Tumor , Biopsy , Bleomycin/administration & dosage , Bleomycin/pharmacology , Cyclophosphamide/administration & dosage , Dacarbazine/administration & dosage , Dacarbazine/pharmacology , Disease Progression , Doxorubicin/administration & dosage , Doxorubicin/pharmacology , Drug Resistance, Neoplasm , Hodgkin Disease/diagnostic imaging , Hodgkin Disease/pathology , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Lymphoma, Large B-Cell, Diffuse/pathology , Male , Middle Aged , Neoplasms, Multiple Primary/diagnostic imaging , Prednisone/administration & dosage , Prognosis , Rituximab , Splenic Neoplasms/drug therapy , Splenic Neoplasms/pathology , Ultrasonography, Interventional , Vinblastine/administration & dosage , Vinblastine/pharmacology , Vincristine/administration & dosage
11.
Rev Esp Med Nucl ; 29(6): 304-7, 2010.
Article in Spanish | MEDLINE | ID: mdl-20869792

ABSTRACT

The case of a 51 years-old woman with high fever, asthenia and weight loss of three weeks of evolution is presented. She had a personal history of breast cancer and liver metastases. The physical examination showed small painless enlarged lymph nodes in both latero-cervical chains. The blood analysis showed 9200 leukocytes with 69% of lymphocytes and elevated liver enzymes. Serological determinations as well as repeated blood and urine culture were negatives, only the anti-CMV IgM determination being positive. The CEA tumor marker was slightly elevated. PET/CT demonstrated hypermetabolic enlarged lymph nodes in the bilateral cervical chains and in celiac region, hepatosplenomegaly and diffusely increased ¹8F-FDG uptake in the spleen. These alterations were associated with CMV infection. Her evolution was favorable, and she was diagnosed of CMV mononucleosis. The appropriate clinical and immunological diagnosis of IM in patients aged over 40 years is important to avoid unnecessary diagnostic procedures.


Subject(s)
Cytomegalovirus Infections/diagnostic imaging , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Infectious Mononucleosis/diagnostic imaging , Positron-Emission Tomography , Postoperative Complications/diagnostic imaging , Radiopharmaceuticals , Tomography, X-Ray Computed , Antibodies, Viral/blood , Antineoplastic Agents, Hormonal/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Ductal, Breast/drug therapy , Carcinoma, Ductal, Breast/secondary , Carcinoma, Ductal, Breast/surgery , Combined Modality Therapy , Cytomegalovirus/immunology , Female , Goserelin/administration & dosage , Hepatectomy/methods , Humans , Immunocompromised Host , Immunoglobulin M/blood , Liver Neoplasms/secondary , Liver Neoplasms/surgery , Mastectomy, Radical , Middle Aged , Postoperative Complications/virology , Tamoxifen/administration & dosage
15.
Rev Esp Med Nucl ; 25(1): 31-4, 2006.
Article in Spanish | MEDLINE | ID: mdl-16540009

ABSTRACT

We present the case of a 34-year-old woman diagnosed of an adenosquamous carcinoma of the uterine cervix, stage IIB of the FIGO classification (International Federation of Gynecology and Obstetrics), treated with quimiotherapy, radiotheraphy and brachytheraphy with posterior hysterectomy. A recurrence of the disease was suspected due to the progressive rise of CEA levels. A PET/CT revealed abnormal foci in both ovaries, that had been transposed to avoid lesions due to radiation, and in a left para-aortic adenopathy. The diagnosis of recurrence in these sites was confirmed by biopsy. PET with FDG (F18-fluorodeoxyglucose) is useful in the staging of primary tumour and in the detection of recurrence in uterine cervical carcinoma, with better sensitivity and specificity than CT and MRI. PET/CT improves anatomic resolution and helps to resolve the origin of unclear foci like in the case presented in which ovaries were not in their normal situation due to transposition.


Subject(s)
Carcinoma, Adenosquamous/secondary , Lymphatic Metastasis/diagnosis , Ovarian Neoplasms/secondary , Positron-Emission Tomography , Tomography, X-Ray Computed , Adult , Antineoplastic Agents, Alkylating/therapeutic use , Brachytherapy , Carcinoma, Adenosquamous/diagnostic imaging , Carcinoma, Adenosquamous/therapy , Carcinoma, Squamous Cell/diagnosis , Cisplatin/therapeutic use , Combined Modality Therapy , Female , Humans , Hysterectomy , Lymphatic Metastasis/diagnostic imaging , Ovarian Neoplasms/diagnostic imaging , Ovarian Neoplasms/pathology , Radiotherapy, Adjuvant , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/therapy
16.
Rev Esp Med Nucl ; 24(5): 297-304, 2005.
Article in Spanish | MEDLINE | ID: mdl-16194461

ABSTRACT

AIMS: To evaluate the response to Sm153-EDTMP treatment in patients with metastatic bone pain and the existence of differences in the response according to the scintigraphic pattern (99mTc-MDP) and the primary tumor. MATERIAL AND METHODS: We have evaluated the response to Sm153-EDTMP treatment in 32 patients (17 male and 15 female) who received 38 doses (1 mCi/kg). The primary tumor was prostate cancer in 15 patients, breast in 13, lung in 2, intestinal carcinoid in one and unknown in one. Two types of response were considered: a) effective and b) non-effective. Patients were classified into 3 groups according to the metastatic pattern: 1) Superscan (SS), 2) Generalized metastases (GM) and 3) Regional metastases (RM). RESULTS: There was effective response in 24 doses (63.15%) and non-effective in 14 (36.84%). The mean duration of the response was 12.08 weeks. Patients with GM pattern showed 16 effective responses (76.19%) and 5 non-effective (23.8%). In SS pattern there were 6 effective responses (60%) and 4 non-effective (40%) and 2 effective (28.57%) and 5 non-effective (71.53%) in RM pattern. These differences did not reach statistical significance (p > 0.05). We did not find differences in the response between prostate cancer (12 effective and 6 non-effective) and breast cancer (10 effective and 6 non-effective) (p = 0.79968). CONCLUSIONS: Sm153-EDTMP treatment is efficacious in patients with metastatic bone pain with effective response in 63.15% of the treatments. The response percentage was lower in patients with RM pattern but the differences did not reach statistical significance. There were no differences in the response between prostate and breast cancer patients.


Subject(s)
Analgesia , Analgesics, Non-Narcotic/therapeutic use , Bone Neoplasms/secondary , Organometallic Compounds/therapeutic use , Organophosphorus Compounds/therapeutic use , Pain/drug therapy , Adult , Aged , Aged, 80 and over , Bone Neoplasms/diagnostic imaging , Female , Humans , Male , Middle Aged , Pain/etiology , Radionuclide Imaging
17.
Rev Esp Med Nucl ; 24(4): 278-92, 2005.
Article in Spanish | MEDLINE | ID: mdl-16122413
18.
Clin Nucl Med ; 30(5): 308-11, 2005 May.
Article in English | MEDLINE | ID: mdl-15827397

ABSTRACT

PURPOSE: We report a case of a rectal carcinoid tumor that was treated using endoscopic resection. This case highlights the usefulness of using somatostatin receptor scintigraphy in the postresection endoscopy of the tumor and the intraoperative use of a gamma probe detector for the surgical resection of metastatic adenopathy that had not been detected using computed tomography (CT) scanning. METHODS: The patient was studied using CT scanning, somatostatin receptor scintigraphy (SRS), and rectal endoscopic ultrasonography (EUS). A gamma probe detector was scheduled for use during the subsequent surgical intervention. RESULTS: The SRS demonstrated a pelvic metastatic lymphatic node that had not been detected on CT scanning. Additional EUS did not show regional metastatic lymph nodes. Histopathology following removal of retroperitoneal and presacral lymphatic nodes confirmed the diagnosis of metastatic carcinoid tumor. At follow up at 6 months, SRS and rectoscopy were normal. CONCLUSION: Somatostatin receptor scintigraphy is very useful in identifying the presence of lymph node metastases, even with a small rectal carcinoid tumor. This is of considerable importance when scheduling surgery and the CT and EUS are normal. The use of an intraoperative gamma-probe detector assists in the surgical excision of the metastatic lymphatic nodes, especially because they had been detected only using SRS, and when their exact location is uncertain.


Subject(s)
Carcinoid Tumor/diagnostic imaging , Carcinoid Tumor/secondary , Lymph Node Excision/methods , Lymph Nodes/diagnostic imaging , Neoplasm Recurrence, Local/diagnostic imaging , Octreotide/analogs & derivatives , Pentetic Acid/analogs & derivatives , Rectal Neoplasms/diagnostic imaging , Rectal Neoplasms/surgery , Surgery, Computer-Assisted/methods , Carcinoid Tumor/surgery , Female , Gamma Cameras , Humans , Intraoperative Care/methods , Lymph Nodes/surgery , Lymphatic Metastasis , Middle Aged , Neoplasm Recurrence, Local/secondary , Neoplasm Recurrence, Local/surgery , Radionuclide Imaging , Radiopharmaceuticals
20.
Rev Esp Med Nucl ; 23(6): 394-402, 2004.
Article in Spanish | MEDLINE | ID: mdl-15625056

ABSTRACT

OBJECTIVE: The aim of this study has been to retrospectively assess the usefulness of 111In-DTPAOC scintigraphy in the detection of bone metastases (BM) in patients diagnosed of carcinoid tumour (CaT). MATERIALS AND METHODS: Between June 1995 and April 2003 78 111In-DTPAOC studies were consecutively performed in 58 patients, 31 females and 27 males, 28 to 73 years old, with a histological diagnosis of CaT. Moreover, whole body bone scans (BS) using 99mTc-MDP were performed in 13 of these patients. The patients were classified into three groups: Group A: Initial CaT staging (n = 23); Group B: CaT staging after surgery (n = 14); and Group C: Post-treatment CaT re-staging (n = 29). In this last group, 6 patients of group A and 2 patients of group B were included. In only 2 patients the diagnoses of bone metastases were established before the 111In-DTPAOC scan. RESULTS: Twenty six (44.8 %9 of the 58 patients with CaT had metastatic disease: 15 patients with hepatic metastases, associated with BM in 4 of them, 10 patients with hepatic and extra-hepatic metastases, abdominal and/or thoracic, associated with BM in 4 and in one patient, the BMs were the only metastases detected. The global incidence of BM in patients diagnosed with CaT was 15.5 % (9/58), whereas the incidence of BM in patients with metastasic disease was 34.6 % (9/26). Significant differences (p = 0.0035) were found on the incidence of BM in patients with or without hepatic metastases. In 4 patients, BMs were detected during the initial staging (group A), whereas in 5 patients, BMs were detected during the post-treatment re-staging (group C). During diagnosis, 4 of the 9 patients with BM had bone pain. BM were multiples in 8 patients, affecting axial skeleton in 4 and axial and appendicular skeleton in 4. One patient had a diffuse infiltration of bone marrow. BS was positive in 8 of the 9 patients with BM. In these 8 patients with abnormal BS, 111In-DTPAOC scintigraphy provides similar information to the BS in one patient, shows a greater number of bone lesions in 3, whereas BS was superior in 5 patients. Four of the patients with BM died between 6 and 47 months after diagnosis (mean: 29.7 months). CONCLUSIONS: BMs are preferably located on axial skeleton, can be asymptomatic and are associated with hepatic metastases. Although the 111In-DTPAOC scintigraphy is able to detect some BM earlier than BS, the information provided by both studies is complementary. In patients with CaT, any invasive therapy on the hepatic metastases make it necessary to exclude extrahepatic metastases, including bone ones, and the somatostatin receptor scintigraphy is the diagnostic method of choice.


Subject(s)
Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Carcinoid Tumor/diagnostic imaging , Carcinoid Tumor/secondary , Receptors, Somatostatin , Adult , Aged , Female , Humans , Male , Middle Aged , Radionuclide Imaging , Retrospective Studies
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