18F-FDG-PET/CT in SARS-CoV-2 infection and its sequelae.

In recent months, much of the scientific efforts have focused on research on SARSCoV-2 infection and its consequences in humans. Still, many aspects remain unknown. It is known that the damage caused by SARS-CoV-2 is multifactorial and that its extension goes beyond lung inflammation and the acute phase, with the appearance of numerous complications and sequelae. To date, knowledge about the usefulness of 18F-FDG-PET/CT in the acute phase has been limited to the incidental detection of SARS-CoV-2 unsuspected pneumonia. Recent studies have been appearing collecting the findings of 18F-FDG-PET/CT in long COVID-19 or persistent COVID-19 state as well as the alterations caused after mass vaccination of the population in the metabolic studies. This work aims to review the existing literature focusing on these three issues and to briefly present our own preliminary experience.

[18F-FDG-PET/CT in SARS-CoV-2 infection and its sequelae]. / 18F-FDG-PET/TC ante la infección por SARS-CoV-2 y sus secuelas.

In recent months, much of the scientific efforts have focused on research on SARSCoV-2 infection and its consequences in humans. Still, many aspects remain unknown. It is known that the damage caused by SARS-CoV-2 is multifactorial and that its extension goes beyond lung inflammation and the acute phase, with the appearance of numerous complications and sequelae. To date, knowledge about the usefulness of 18F-FDG-PET/CT in the acute phase has been limited to the incidental detection of SARS-CoV-2 unsuspected pneumonia. Recent studies have been appearing collecting the findings of 18F-FDG- PET/CT in long COVID-19 or persistent COVID-19 state as well as the alterations caused after mass vaccination of the population in the metabolic studies. This work aims to review the existing literature focusing on these three issues and to briefly present our own preliminary experience.

Hallazgo incidental de un meningioma en placa en un paciente con adenocarcinoma de próstata / Incidental finding of a meningioma-en-plaque in a patient with prostate adenocarcinoma

Los meningiomas en placa se caracterizan por presentar un área de hiperostosis y constituyen un verdadero reto diagnóstico, sobre todo cuando se asocian a patologías de base, pudiendo imitar otras entidades clínicas. Presentamos un caso de un meningioma en placa de gran extensión como hallazgo gammagráfico casual en el seguimiento de un paciente con adenocarcinoma de próstata confirmado histológicamente. A propósito del caso discutimos el valor de la gammagrafía ósea en relación con otras técnicas de imagen(AU)

Meningiomas-en-plaques (MEP) are characterized by an area of hyperostosis and constitute a diagnostic challenge, especially when associated with other underlying conditions, and may mimic other clinical conditions. We present a case of a large MEP, which was an incidental finding on a scintigraphy study of a patient with prostate adenocarcinoma, this finding being histologically confirmed. In regards to the case, we discuss the utility of the bone scintigraphy (BS) in relationship to other imaging modalities(AU)

[Incidental finding of a meningioma-en-plaque in a patient with prostate adenocarcinoma]. / Hallazgo incidental de un meningioma en placa en un paciente con adenocarcinoma de próstata.

Meningiomas-en-plaques (MEP) are characterized by an area of hyperostosis and constitute a diagnostic challenge, especially when associated with other underlying conditions, and may mimic other clinical conditions. We present a case of a large MEP, which was an incidental finding on a scintigraphy study of a patient with prostate adenocarcinoma, this finding being histologically confirmed. In regards to the case, we discuss the utility of the bone scintigraphy (BS) in relationship to other imaging modalities.

[Usefulness of ventricular function values obtained using post-stress gated-SPECT in a diabetic population with clinical suspicion of ischaemic heart disease]. / Utilidad de los valores de función ventricular obtenidos mediante gated-SPECT post-estrés en población diabética con sospecha clínica de cardiopatía isquémica.

OBJECTIVE: To assess the clinical usefulness of left ventricular function values obtained using post-stress myocardial perfusion gated-SPECT in diabetic patients with suspected ischaemic heart disease (IHD). MATERIALS AND METHODS: Sixty-one patients with diabetes mellitus (DM), with clinical suspicion of IHD and no previous history of heart disease were studied. Ergometric or pharmacological post-stress myocardial perfusion gated-SPECT was performed on all patients. The relationship between the ejection fraction values and ventricular volumes, and the perfusion study results, final diagnosis, severity of the perfusion defects and the clinical evolution was studied. The mean follow-up time was 14 months. RESULTS; All the ventricular function values independently showed significant differences between the groups with a normal and pathological perfusion study, and between groups with a final diagnosis of IHD and non-IHD. After multivariate logistic regression, the end-diastolic volume (EDV) was the only value which showed a statistical association with the pathological perfusion study, its severity and the final diagnosis of IHD. No statistical association was observed between the ventricular function values and the occurrence of cardiac events. CONCLUSIONS: All the ventricular function values obtained by gated-SPECT added diagnostic information to the post-stress myocardial perfusion study in the diabetic population with suspected IHD; however, only EDV showed a statistical association with the pathological perfusion study, severity of defects and the final diagnosis of IHD.

Utilidad de los valores de función ventricular obtenidos mediante gated-SPECT post-estrés en población diabética con sospecha clínica de cardiopatía isquémica / Usefulness of ventricular function values obtained using post-stress gated-SPECT

Objetivo. Evaluar la utilidad clínica aportada por los valores de función ventricular izquierda obtenidos mediante gated-SPECT (tomografía computarizada por emisión de fotón único) de perfusión miocárdica post-estrés en pacientes diabéticos con sospecha de cardiopatía isquémica (CI). Material y métodos. Se estudiaron 61 pacientes diagnosticados de diabetes mellitus (DM), con sospecha clínica de CI y sin antecedentes de cardiopatía. A todos se les realizó gated-SPECT de perfusión miocárdica post-estrés ergométrico o farmacológico. Se estudió la relación entre los valores de fracción de eyección y los volúmenes ventriculares con los resultados del estudio de perfusión, el diagnóstico final, la severidad de los defectos de perfusión y la evolución clínica. El tiempo medio de seguimiento fue de 14 meses. Resultados. Todos los valores de función ventricular mostraron, aisladamente, diferencias significativas entre los grupos con estudio de perfusión normal y patológico, y entre los grupos con diagnóstico final de CI y no CI. Tras regresión logística multivariante, el volumen telediastólico (VTD) fue el único valor que mostró asociación estadística con la obtención de un estudio patológico de perfusión, con la severidad del mismo y con el diagnóstico final de CI. No se observó asociación estadística entre los valores de función ventricular y la presencia de eventos cardíacos. Conclusiones. Todos los valores de función ventricular obtenidos mediante gated-SPECT añaden información diagnóstica al estudio de perfusión miocárdica post-estrés en la población diabética con sospecha de CI; sin embargo, sólo el VTD muestra asociación estadística con la obtención de un estudio patológico de perfusión, con la severidad del mismo y con el diagnóstico final de CI

Objective. To assess the clinical usefulness of left ventricular function values obtained using post-stress myocardial perfusion gated-SPECT in diabetic patients with suspected ischaemic heart disease (IHD). Materials and methods. Sixty-one patients with diabetes mellitus (DM), with clinical suspicion of IHD and no previous history of heart disease were studied. Ergometric or pharmacological post-stress myocardial perfusion gated-SPECT was performed on all patients. The relationship between the ejection fraction values and ventricular volumes, and the perfusion study results, final diagnosis, severity of the perfusion defects and the clinical evolution was studied. The mean follow-up time was 14 months. Results. All the ventricular function values independently showed significant differences between the groups with a normal and pathological perfusion study, and between groups with a final diagnosis of IHD and non-IHD. After multivariate logistic regression, the end-diastolic volume (EDV) was the only value which showed a statistical association with the pathological perfusion study, its severity and the final diagnosis of IHD. No statistical association was observed between the ventricular function values and the occurrence of cardiac events. Conclusions. All the ventricular function values obtained by gated-SPECT added diagnostic information to the post-stress myocardial perfusion study in the diabetic population with suspected IHD; however, only EDV showed a statistical association with the pathological perfusion study, severity of defects and the final diagnosis of IHD

[Value of 99mTc-labelled red cells in the detection of pulmonary haemorrhage]. / Valor de la gammagrafía con hematíes marcados con 99mTc en la detección de hemorragia pulmonar.

The use of 99mTc-labelled red cells is very extensive in the detection of haemorrhages of gastrointestinal origin. However, not only is it useful in haemorrhages in this location, but it may also be of use in other locations such as pulmonary haemorrhage. We should not forget that this is a non-invasive diagnostic method, useful in localising possible pulmonary bleeding which causes symptoms of haemoptysis, without having to resort to invasive tests such as angiography, or prior to this, to have approximate knowledge of the location of the bleeding area. We present the case of a patient with a haemoptysis picture where the use of scintigraphy with labelled red cells detected the location of the bleeding site, directing towards subsequent surgery, and a final diagnosis of haemoptysis due to pulmonary carcinoma.

Valor de la gammagrafía con hematíes marcados con 99mTc en la detección de hemorragia pulmonar / Value of 99mTc-labelled red cells in the detection of pulmonary haemorrhage

El uso de hematíes marcados con 99mTc está muy extendido en la detección de hemorragias de origen gastrointestinal. Pero no sólo es útil en hemorragias en esta localización, también puede serlo en otras localizaciones como sería la hemorragia pulmonar. No debemos olvidar que es un método diagnóstico no invasivo, útil para localizar posibles sangrados pulmonares causantes de cuadros de hemoptisis sin tener que recurrir a pruebas invasivas como sería la angiografía, o de forma previa a ésta para tener un conocimiento aproximado de la localización de la zona de sangrado. Presentamos el caso de un paciente con cuadro de hemoptisis donde el uso de la gammagrafía con hematíes marcados detectó la localización del punto de sangrado, orientando a una actuación quirúrgica posterior, siendo el diagnóstico final el de hemoptisis por carcinoma pulmonar

The use of 99mTc-labelled red cells is very extensive in the detection of haemorrhages of gastrointestinal origin. However, not only is it useful in haemorrhages in this location, but it may also be of use in other locations such as pulmonary haemorrhage. We should not forget that this is a non-invasive diagnostic method, useful in localising possible pulmonary bleeding which causes symptoms of haemoptysis, without having to resort to invasive tests such as angiography, or prior to this, to have approximate knowledge of the location of the bleeding area. We present the case of a patient with a haemoptysis picture where the use of scintigraphy with labelled red cells detected the location of the bleeding site, directing towards subsequent surgery, and a final diagnosis of haemoptysis due to pulmonary carcinoma (AU)

[Study of physician satisfaction as a quality criterion in Nuclear Medicine]. / Estudio de satisfacción de facultativos como criterio de calidad en Medicina Nuclear.

OBJECTIVE: To determine the perception and satisfaction level of referring physicians requesting scans as final users of the Nuclear Medicine Department. MATERIAL AND METHODS: A self-administered questionnaire was designed; it was composed of 10 closed questions (5 categorised and 5 with numerical scale) and 3 open questions. The indicators evaluated were: physician's information about available tests, test indications and diagnostic information, accessibility, delay in the examination and reception of the diagnostic report, usefulness of diagnostic information and overall satisfaction with the department. Two hundred and fifteen questionnaires were sent. RESULTS: Seventy eight questionnaires were returned, so the response index was 36.3 %. The 44.6 % of physicians surveyed considered that they had sufficient information about the tests and 59.5 % were satisfied with the indications and diagnostic information. The accessibility was 7 or more out of 10 for 78.5 %. The 64.9 % of physicians considered the delay in performing examinations to be correct but the satisfaction was lower in the delay between performance and reception of the diagnostic report. The diagnostic information was considered useful by 81.9 % and relevant in the management of patients by 70.5 % of the participants surveyed. The overall satisfaction was > or = 7 out of 10 in 86.8 %. CONCLUSIONS: Overall satisfaction was high, although the level of knowledge about available tests and the delay between test performance and report reception could be improved.

Estudio de satisfacción de facultativos como criterio de calidad en Medicina Nuclear / Study of physician satisfaction as a quality criterion in Nuclear Medicine

Objetivo. Obtener un conocimiento de la percepción y grado de satisfacción de los facultativos peticionarios de pruebas gammagráficas como usuarios finales del Servicio de Medicina Nuclear. Material y métodos. Se confeccionó un cuestionario auto-administrado compuesto por 10 preguntas cerradas (5 categorizadas y 5 de escala numérica) y 3 preguntas abiertas. Se valoraron como indicadores: la información de los facultativos acerca de nuestra cartera de servicios, indicaciones e información diagnóstica de las pruebas, accesibilidad, demora en la realización de la exploración y recepción del informe diagnóstico, utilidad de la información diagnóstica emitida y grado de satisfacción global con el servicio. Se enviaron 215 encuestas. Resultados. Setenta y ocho encuestas fueron devueltas, lo que constituyó un índice de respuesta del 36,3 %. El 44,6 % de los encuestados opinó tener suficiente información acerca de las pruebas y el 59,5 % sobre las indicaciones e información diagnóstica de las mismas. El grado de accesibilidad de los facultativos del servicio fue de >= 7 puntos sobre 10 para el 78,5 %. El 64,9 % de los facultativos consideró correcta la demora en la realización de exploraciones pero la satisfacción fue menor (39,2 %) para la valoración de la demora entre la realización y la recepción del informe diagnóstico. El 81,9 % de los encuestados calificó la información diagnóstica aportada por nuestras pruebas como útil y el 70,5 % como relevante en el manejo de sus pacientes. El grado de satisfacción global fue >= 7 sobre 10 para el 86,8 %. Conclusiones. La satisfacción global fue alta, aunque el nivel de conocimiento de los facultativos peticionarios acerca de las técnicas disponibles y la demora percibida por los mismos entre la realización y la recepción del informe diagnóstico son aspectos mejorables

Objective. To determine the perception and satisfaction level of referring physicians requesting scans as final users of the Nuclear Medicine Department. Material and methods. A self-administered questionnaire was designed; it was composed of 10 closed questions (5 categorised and 5 with numerical scale) and 3 open questions. The indicators evaluated were: physician's information about available tests, test indications and diagnostic information, accessibility, delay in the examination and reception of the diagnostic report, usefulness of diagnostic information and overall satisfaction with the department. Two hundred and fifteen questionnaires were sent. Results. Seventy eight questionnaires were returned, so the response index was 36.3 %. The 44.6 % of physicians surveyed considered that they had sufficient information about the tests and 59.5 % were satisfied with the indications and diagnostic information. The accessibility was 7 or more out of 10 for 78.5 %. The 64.9 % of physicians considered the delay in performing examinations to be correct but the satisfaction was lower in the delay between performance and reception of the diagnostic report. The diagnostic information was considered useful by 81.9 % and relevant in the management of patients by 70.5 % of the participants surveyed. The overall satisfaction was >= 7 out of 10 in 86.8 %. Conclusions. Overall satisfaction was high, although the level of knowledge about available tests and the delay between test performance and report reception could be improved

[Are bone scintigraphy examinations requested in oncologic patients according to established indications?]. / Se solicitan las gammagrafías óseas en pacientes oncológicos según criterios clínicos reconocidos?

OBJECTIVE: To determine the percentage of bone scintigraphy examinations (BS) requested according to established indications and to assess the clinical impact of the scintigraphic results. MATERIAL AND METHODS: A retrospective study was performed including BS in 117 patients (70 women and 47 men) carried out in our department during the year 2001. All patients had a primary extraosseous malignancy. The correctness of the indication of each study requested was analyzed according to established criteria from the literature. BS results were classified as positive, negative, and equivocal for metastatic disease. RESULTS: 96 out of the 117 BS were performed in patients affected with the most prevalent primary malignancies: breast (57), prostate (21), and lung (18). The remaining studies were included in a miscellaneous group (gynecological [3], colorectal [4], oropharyngeal [4], and renal malignancies [4]; lymphoma [2], melanoma [2], hemangioendothelioma [1]; and cancer of the bladder [1] or pancreas [1]). Ninety-nine (85 %) of the 117 BS performed met the criteria for appropriate indication. The indication was correct in 75 % of breast, 90 % of prostate (19/21), and 100 % of lung cancers. The indication was correct in 90 % of the cases in the miscellaneous group. BS were positive in 21 patients (20 of which were confirmed). BS were equivocal in 24 patients (in 5 of whom bone metastases were confirmed). BS were negative in 72 patients (one of whom had bone metastases). The BS findings changed staging in 9 % (9/99) of the correctly indicated cases. CONCLUSION: Most BS (85 %) were indicated according to the established criteria and the clinical impact was greater in this group.

¿Se solicitan las gammagrafías óseas en pacientes oncológicos según criterios clínicos reconocidos? / Are bone scintigraphy examinations requested in oncologic patients according to established indications?

Objetivos. Determinar el porcentaje de gammagrafías óseas (GO) solicitadas, según indicaciones consensuadas y valorar el impacto clínico del resultado gammagráfico.Material y métodos. Se realizó un estudio retrospectivo de 117 GO (70 mujeres y 47 varones) que fueron realizadas en nuestro servicio en el 2001. Todos tenían cáncer primario extraóseo. Para evaluar la correcta indicación de las GO solicitadas se analizaron los criterios según la literatura. Los resultados gammagráficos se clasificaron en: positivo, negativo ydudoso para metástasis. Resultados. De las 117 GO estudiadas, 96 pertenecieron a los cánceres más prevalentes (57 de mama, 21 de próstata y 18 de pulmón). El resto se incluyeron en el grupo miscelánea (3 ginecológicos, 4 colorrectal, 3 orofaringe, 4 renales, 2 linfomas, 2 melanomas, uno de páncreas, uno de vejiga y un hemangioendotelioma).El 85 % de las GO solicitadas tenían criterios consensuados de indicación. La indicación fue adecuada en el 75 % del cáncer de mama, en el 90 % del cáncer de próstata y en todos los de cáncer de pulmón. En el de miscelánea hubo correcta indicación en el 90%. La GO fue positiva en 21 pacientes, confirmándose mediante otras técnicas en 20, y en 24 la GO fue dudosa, correspondiendo a metástasis en 5. La GO fue negativa en 72 pacientes, confirmándose en uno metástasis óseas. El resultado de la GO representó un cambio de estadiaje en un 9% (9/99) de los casos correctamente indicados. Conclusión. La mayor parte de las GO se solicitaron según criterios consensuados (85 %) y fue en este grupo en el que se comprobó su impacto clínico

Objective. To determine the percentage of bone scintigraphy examinations (BS) requested according to established indications and to assess the clinical impact of the scintigraphic results. Material and methods. A retrospective study was performed including BS in 117 patients (70 women and 47 men) carried out in our department during the year 2001. All patients had a primary extraosseous malignancy. The correctness of the indication of each study requested was analyzed according to established criteria from the literature. BS results were classified as positive, negative, and equivocal for metastatic disease. Results. 96 out of the 117 BS were performed in patients affected with the most prevalent primary malignancies: breast (57), prostate (21), and lung (18). The remaining studies were included in a miscellaneous group (gynecological [3], colorectal [4], oropharyngeal [4], and renal malignancies [4]; lymphoma [2], melanoma [2], hemangioendothelioma [1]; and cancer of the bladder [1] or pancreas [1]). Ninety-nine (85 %) of the 117 BS performed met the criteria for appropriate indication. The indication was correct in 75 % of breast, 90 % of prostate (19/21), and 100 % of lung cancers. The indication was correct in 90 % of the cases in the miscellaneous group. BS were positive in 21 patients (20 of which were confirmed). BS were equivocal in 24 patients (in 5 of whom bone metastases were confirmed). BS were negative in 72 patients (one of whom had bone metastases). The BS findings changed staging in 9% (9/99) of the correctly indicated cases. Conclusion. Most BS (85 %) were indicated according to the established criteria and the clinical impact was greater in this group

La satisfacción del usuario como indicador de calidad en un servicio de Medicina Nuclear / Patient satisfaction as quality indicator in a nuclear medicine department

Objetivo. Valorar el grado de satisfacción e insatisfacción del paciente con el servicio de Medicina Nuclear. Material y métodos. Se diseñó un cuestionario compuesto por 9 preguntas cerradas, una de escala numérica y otra pregunta abierta que recogió comentarios y sugerencias. Las preguntas consideraron diferentes dimensiones de calidad del servicio relacionadas con el tiempo de espera en la realización de la exploración, información, instalaciones, trato recibido por el personal del servicio y satisfacción global (escala numérica 1-10). El grado de insatisfacción se estableció mediante el análisis de quejas escritas recibidas en los últimos 6 años. Resultados. Se obtuvieron 671 cuestionarios. El 58 % de los encuestados fueron mujeres. La edad media fue de 56,5 años (DE: 16,26). La información suministrada fue correcta para el 81,7 % de los encuestados. El equipamiento y las instalaciones fueron satisfactorios para el 74,5 % de los pacientes. La lista de espera y el tiempo de espera fueron correctos para el 70 % y el 66,4 % respectivamente. El trato correcto fue el parámetro más favorablemente valorado (98,7 %). La satisfacción global fue positiva (mas menos 7 sobre 10) para el 82,8 % de los pacientes. Se recibieron un total de 29 quejas. La mayoría se basó en aspectos relacionados con la lista de espera (12) y disconformidad con la asistencia (9). Conclusiones. El grado de satisfacción fue alto en la mayoría de los pacientes. El tiempo de espera constituyó el parámetro con menor satisfacción y, por lo tanto, subsidiario demejora. La principal queja espontánea referida por nuestros pacientes fue la lista de espera

Objective. To assess patient satisfaction and dissatisfaction with a Nuclear Medicine department.Material and methods. A questionnaire was designed with 9 closed questions, 1 with a numerical scale (1-10) and 1 with an open question for suggestions. The questions included different quality dimensions of the department related with waiting time for the scan, information, facilities, attention manner with department staff and global satisfaction (numerical scale, 1-10). Dissatisfaction was determined by analyzing the written complaints for the last 6 years. Results. A total of 671 questionnaires were obtained, 58% of those surveyed being women. The mean age of patients was 56.5 (mas menos 16.26). The information provided was correct in 81.7 % of cases. Equipment and facilities were correct for 74.5 % of patients. Waiting list and waiting time were correct for 70 % and 66.4% respectively. The attention manner of the department staff was the most satisfactory dimension (98.7 %). Global satisfaction was positive (7 out of 10) in 82.8 % of the patients. 29 complaints were received. Most of them were based on waiting list (12) and disagreement with assistance (9). Conclusions. Global satisfaction was high in most of patients. Waiting time was the dimension with the lowest level of satisfaction and subsidiary of improvement plans. The primary spontaneous complain by our patients was due to the waiting list

Estudio de los receptores de somatostatina en una masa mesentérica poscirugía / No disponible

No disponible

No disponible

[Patient satisfaction as quality indicator in a nuclear medicine department]. / La satisfacción del usuario como indicador de calidad en un servicio de Medicina Nuclear.

OBJECTIVE: To assess patient satisfaction and dissatisfaction with a Nuclear Medicine department. MATERIAL AND METHODS: A questionnaire was designed with 9 closed questions, 1 with a numerical scale (1-10) and 1 with an open question for suggestions. The questions included different quality dimensions of the department related with waiting time for the scan, information, facilities, attention manner with department staff and global satisfaction (numerical scale, 1-10). Dissatisfaction was determined by analyzing the written complaints for the last 6 years. RESULTS: A total of 671 questionnaires were obtained, 58 % of those surveyed being women. The mean age of patients was 56.5 (+/- 16.26). The information provided was correct in 81.7 % of cases. Equipment and facilities were correct for 74.5 % of patients. Waiting list and waiting time were correct for 70 % and 66.4 % respectively. The attention manner of the department staff was the most satisfactory dimension (98.7 %). Global satisfaction was positive (> or = 7 out of 10) in 82.8 % of the patients. 29 complaints were received. Most of them were based on waiting list (12) and disagreement with assistance (9). CONCLUSIONS: Global satisfaction was high in most of patients. Waiting time was the dimension with the lowest level of satisfaction and subsidiary of improvement plans. The primary spontaneous complain by our patients was due to the waiting list.

[Clinical and prognostic value of X-ray based attenuation correction in post-stress myocardial perfusion SPECT]. / Valor clínico y pronóstico de la corrección de atenuación con rayos X en la SPECT de perfusión miocárdica post-estrés.

OBJECTIVE: The purpose of the study was to validate the X-ray-based attenuation correction technique applied to post-stress myocardial perfusion single photon emission computed tomography (SPECT). MATERIALS AND METHODS: Fifty-six patients with clinically suspected ischemic heart disease and no history of myocardial infarction or coronary revascularization were studied. All patients underwent a myocardial perfusion SPECT after exercise (38) or pharmacological stress (18). Mean clinical follow-up time was 18.6 months. Studies were assessed after reconstruction using the filtered back projection technique and after application of the X-ray-based attenuation correction technique, and the results obtained were related to the final clinical diagnosis. RESULTS: Eleven uncorrected studies were normal, while 45 studies showed perfusion defects. After attenuation correction, absence of significant perfusion defects was observed in 24 cases (42.9 % of all cases), and ischemic heart disease was finally ruled out in 22 cases. A greater study normalization rate was seen in men (p = 0.048; odds ratio = 2,923), but this fact was not shown to be significantly correlated to the following variables: pre-test probability of ischemic heart disease, body mass index greater than 30, presence of cardiovascular risk factors or otherwise, and age. CONCLUSIONS: Application of the X-ray-based attenuation correction technique would have allowed for obviating the conduct of a resting perfusion study in 42.9 % of patients without apparently changing the diagnostic safety of the test. This fact was seen more frequently in men. This method seems to be both safe and time- and cost-effective.

Valor clínico y pronóstico de la corrección de atenuación con rayos X en la SPECT de perfusión miocárdica post-estrés / Valor clínico y pronóstico de la corrección de atenuación con rayos X en la SPECT de perfusión miocárdica post-estrés

Objetivo. El propósito del estudio fue validar la técnica de corrección de atenuación con rayos X, aplicada a la tomografía por emisión de fotón único (SPECT) de perfusión miocárdica post-estrés. Material y métodos. Se estudiaron 56 pacientes con sospecha clínica de cardiopatía isquémica y sin antecedentes de infarto de miocardio ni de revascularización coronaria. A todos se les realizó una tomografía por emisión de fotón único (SPECT) de perfusión miocárdica post-estrés ergométrico (38) o farmacológico (18). El tiempo medio de seguimiento clínico fue de 18,6 meses. Se valoraron los estudios tras su reconstrucción mediante la técnica de retroproyección filtrada, y después de aplicar la técnica de corrección de atenuación con rayos X. Los resultados obtenidos se relacionaron con el diagnóstico clínico final. Resultados. Once estudios no corregidos fueron normales y 45 mostraron defectos de perfusión. Tras la corrección de atenuación, se observó la ausencia de defectos significativos de perfusión en 24 casos (42,9 % del total) y finalmente se descartó cardiopatía isquémica en 22. Se observó una mayor frecuencia de normalización del estudio en hombres (p = 0,048; odds ratio = 2.923), pero este hecho no mostró correlación significativa con las siguientes variables: probabilidad pre-test de cardiopatía isquémica, índice de masa corporal superior a 30, presencia o ausencia de factores de riesgo cardiovascular y edad del paciente. Conclusiones. La aplicación de la técnica de corrección de atenuación con rayos X hubiera permitido obviar la realización de un estudio de perfusión de reposo en el 42,9 % de los pacientes, sin modificarse aparentemente la seguridad diagnóstica del test. Este hecho se observó con mayor frecuencia en hombres. El método parece ser seguro, así como tiempo y coste-efectivo

Materials and methods. Fifty-six patients with clinically suspected ischemic heart disease and no history of myocardial infarction or coronary revascularization were studied. All patients underwent a myocardial perfusion SPECT after exercise (38) or pharmacological stress (18). Mean clinical follow-up time was 18.6 months. Studies were assessed after reconstruction using the filtered back projection technique and after application of the X-ray-based attenuation correction technique, and the results obtained were related to the final clinical diagnosis. Results. Eleven uncorrected studies were normal, while 45 studies showed perfusion defects. After attenuation correction, absence of significant perfusion defects was observed in 24 cases (42.9 % of all cases), and ischemic heart disease was finally ruled out in 22 cases. A greater study normalization rate was seen in men (p = 0.048; odds ratio = 2,923), but this fact was not shown to be significantly correlated to the following variables: pre-test probability of ischemic heart disease, body mass index greater than 30, presence of cardiovascular risk factors or otherwise, and age. Conclusions. Application of the X-ray-based attenuation correction technique would have allowed for obviating the conduct of a resting perfusion study in 42.9 % of patients without apparently changing the diagnostic safety of the test. This fact was seen more frequently in men. This method seems to be both safe and time- and cost-effective

[Assessment of cortical brain blood flood by brain perfusion spect in patients with a diagnosis of eating behavior disorders]. / Valoración del flujo cortical cerebral mediante SPECT de perfusión cerebral en pacientes con diagnóstico de trastornos de la conducta alimentaria.

OBJECTIVE: To evaluate cortical brain blood flow by 99mTc-HMPAO SPECT in patients with Eating Disorders (ED): restrictive anorexia (RA) and purgative bulimia (PB). MATERIAL AND METHOD: The study included 7 women with diagnostic criteria of RA and 12 with PB. The control group was made up of 12 healthy women. All subjects underwent brain 99mTc-HMPAO SPECT. The SPECT studies were quantified, yielding semiquantitative indexes relating to cerebellar activity in different regions. Body dissatisfaction was assessed by means of the BSQ (Body Shape Questionnaire). The results were analyzed with the ANOVA variance and had a statistical significance of p < 0.05. RESULTS: Mean BSQ scores were 98.28 (range 71-159) in the RA group, 145.05 (range 73-191) in the PB group, and 57.4 (range 37-88) in the control group. All patients in the sample (i.e., both RA and PB) showed global cerebral hypoperfusion versus the controls, although the difference only reached statistical significance in the RA group in the left parietal lobe (p = 0.02) and in the right (p = 0.004) and left temporal lobes (p = 0.015). In the PB group, the significantly hypoperfused regions were the right (p < 0.001) and left (p = 0.008) superior frontal lobe, the right inferior frontal lobe (p = 0.042), the right (p = 0.042) and left (p = 0.002) parietal lobes, and the right temporal lobe (p = 0.002). CONCLUSION: The results obtained showed that patients with ED had cerebral hypoperfusion compared with healthy subjects. This pattern is common in parietotemporal regions for both PB and AR although with temporal and parietal predominance in RA and PB, respectively. In addition, patients with PB had frontal region involvement.

Valoración del flujo cortical cerebral mediante SPECT de perfusión cerebral en pacientes con diagnóstico de trastornos de la conducta alimentaria / Assessment of cortical brain blood flood by brain perfusion spect in patients with a diagnosisof eating behavior disorders

Objetivo. Valorar el flujo cortical cerebral mediante 99mTc-HMPAO SPECT en pacientes con trastornos de la conducta alimentaria (TCA): anorexia restrictiva (AR) y bulimia purgativa (BP). Material y método. Se estudiaron 7 mujeres con criterios de AR y 12 de BP. Se constituyó un grupo control de 12 mujeres sanas, realizando un estudio de SPECT cerebral con 99mTc-HMPAO. Se obtuvieron índices semicuantitativos respecto a cerebelo en regiones frontales superiores, inferiores, parietales, temporales y occipitales. Se valoró la insatisfacción corporal con el BSQ (Body Shape Questionnaire). El análisis de los datos se realizó utilizando la varianza de un factor (ANOVA), con un nivel de significación estadística de p < 0,05. Resultados. Los valores medios obtenidos en el BSQ fueron de 98,28 (71-159) en el grupo de las AR, de 145,05 (73-191) en las BP y de 57,4 (37-88) en el grupo control. En sujetos normales se evidenció un predominio fisiológico de la perfusión en hemisferio derecho, más evidente en lóbulos temporales (11 %). Se evidenció una menor actividad global en todas las regiones corticales en el conjunto de los pacientes respecto al grupo control, aunque sólo significación estadística en lóbulo parietal izquierdo (p = 0,02), y lóbulos temporales derecho (p = 0,004) e izquierdo (p = 0,015) en las AR, y en lóbulos frontal superior derecho (p < 0,001) e izquierdo (p = 0,008), frontal inferior derecho (p = 0,042), parietales derecho (p = 0,042) e izquierdo (p = 0,002) y temporal derecho (p = 0,002) en las BP. Conclusión. Las pacientes con TCA mostraron una significativa hipoperfusión cortical respecto al grupo control en regiones parietotemporales, con predominio en lóbulo temporal en AR y en parietal en BP. Además, las pacientes con BP mostraron afectación concomitante de regiones frontales

Objective. To evaluate cortical brain blood flow by 99mTc-HMPAO SPECT in patients with Eating Disorders (ED): restrictive anorexia (RA) and purgative bulimia (PB). Material and method. The study included 7 women with diagnostic criteria of RA and 12 with PB. The control group was made up of 12 healthy women. All subjects underwent brain 99mTc-HMPAO SPECT. The SPECT studies were quantified, yielding semiquantitative indexes relating to cerebellar activity in different regions. Body dissatisfaction was assessed by means of the BSQ (Body Shape Questionnaire). The results were analyzed with the ANOVA variance and had a statistical significance of p < 0.05. Results. Mean BSQ scores were 98.28 (range 71-159) in the RA group, 145.05 (range 73-191) in the PB group, and 57.4 (range 37-88) in the control group. All patients in the sample (i.e., both RA and PB) showed global cerebral hypoperfusion versus the controls, although the difference only reached statistical significance in the RA group in the left parietal lobe (p = 0.02) and in the right (p = 0.004) and left temporal lobes (p = 0.015). In the PB group, the significantly hypoperfused regions were the right (p < 0.001) and left (p = 0.008) superior frontal lobe, the right inferior frontal lobe (p = 0.042), the right (p = 0.042) and left (p = 0.002) parietal lobes, and the right temporal lobe (p = 0.002). Conclusion. The results obtained showed that patients with ED had cerebral hypoperfusion compared with healthy subjects. This pattern is common in parietotemporal regions for both PB and AR although with temporal and parietal predominance in RA and PB, respectively. In addition, patients with PB had frontal region involvement