[Histological prediction of cerebral tumors using SPECT with 201T1]. / Predicción histológica de los tumores cerebrales mediante SPECT con 201T1.

INTRODUCTION AND OBJECTIVE: SPECT with 201Tl provides information regarding the degree of malignancy of cerebral tumours, their possible relapses, the differentiation of necrotic tissue in the tumours following chemotherapy or radiotherapy and permits differentiation into zones of various grades of histological malignancy. MATERIAL AND METHODS: We carried out a prospective analysis of the usefulness of SPECT with 201Tl for the histological prognosis of cerebral tumours. For one year 68 patients diagnosed (on CT and/or MR) as having an expansive cerebral lesion were studied. The early uptake (ICP) and retention (R) indices were calculated, and these results correlated with the morbid anatomy (AP) findings and the results obtained with surgery and stereotactic biopsy. Four patients were excluded due to lack of AP results. RESULTS: Significant differences were found between the ICP of grade I-II astrocytomas (1.34 +/- 0.52) and glioblastomas multiformes (2.56 +/- 0.57), between the ICP of meningiomas (4.53 +/- 1.68) and metastases (2.45 +/- 0.58) and between those of meningiomas and all glial tumours. With regard to IR, we saw significant differences between the figures for meningiomas (0.63 +/- 0.13) and meningiomas with malignant relapses (0.94 +/- 0.17) and between metastases (0.8 +/- 0.03) and all glial tumours. CONCLUSIONS: From our study, it may be concluded that rapid, high captation of 201Tl (high ICP) with a slow fall (high IR), is associated with a process showing malignancy on histological study (malignant relapse of meningioma, glioblastoma multiforme, metastasis), whilst high take-up (high ICP) with rapid elimination (low IR) corresponds to a benign hypervascularized tumour (meningioma).

[Gastric uptake of gallium67 in the human immunodeficiency virus infection]. / Captación gástrica de Galio67 en la infección por virus de la inmunodeficiencia humana.

Nowadays, the human immunodeficiency virus infection (HIV) is a chronic disease. In the frequent clinical situations with fever, lymph nodes and loss weight it is necessary to determine their etiology, for establishing a specific treatment. Gastrointestinal opportunistic infections or gastric lymphomatous or sarcomatous process, which can accumulate Ga67, may be present in the patient with acquired immunodeficiency syndrome. We report 2 cases with gastric uptake in which endoscopy and biopsy was obtained. In the first one, with previous treatment with omeprazol and almalgate for gastroesophagic reflux, endoscopy and biopsy were normal and in the second patient an Helicobacter pylori infection was diagnosed. We think that gastric uptake of Ga67 in HIV patients, must indicate to the clinician to rule out associated pathologies.

[Cardiac radionuclide scanning with 99mTc-MIBI-SPECT in acute myocardial infarction]. / Gammagrafía cardiaca con 99mTc-MIBI-SPECT en el infarto agudo de miocardio.

Several studies point out the importance of what is called rescue angioplasty or fibrinolysis (FB) when thrombolysis has been ineffective in acute myocardial infaction (AMI). Therefore, it is necessary to make use of new methods to asses reperfusion and to safely establish that such a treatment has not been effective. We present a work which is based on the assessment of patients with acute coronary heart disease: AMI patients treated with FB (N = 48), without FB (N = 15), unstable angina (N = 9); after determining cardiac imaging gammagraphies 99mTc-isonitrile-single-photon emission computed tomography (MIBI-SPECT) pre and post treatment, to assess myocardium at risk (MR), salvage (MS) and the existence or not of gammagraphic reperfusion. Unstable angina patients show a myocardial perfusion that is similar to AMI patients. However, in the case of unstable angina, perfusion is practically of a 100% 48 hours later, having almost completely saved the myocardium at risk (MS/MR = 81.5% +/- 27.7%), and with a non-existent residual myocardium (3.2% +/- 5.8%). In AMI patients treated with FB the salvage myocardium was higher [8.3 vs 3.0; p < 0.05). Considering that an improvement in perfusion defect (MS/MR)] higher than 30% can be viewed as an effective reperfusion, we can see that all the patients with unstable angina show reperfusion, the percentage in the AMI group treated with FB being 45.8%, and the percentage in the AMI group under conventional treatment being just 6.7%. Gammagraphy with 99mTc-MIBI-SPECT at admission allowed assessing regional perfusion in AMI patients during the early stage of their evolution. With a second exploration we could determine the amount of salvage myocardium and the existence of secondary reperfusion to FB treatment.

[Nuclear medicine in Spain: high technology 2013]. / Medicina nuclear en España: alta tecnología 2013.

This article details the high technology equipment in Spain obtained through a survey sent to the three main provider companies of equipment installed in Spain. The geographical distribution of high technology by Autonomous Communities and its antiquity have been analyzed.

Renal uptake of 67Ga-citrate in renal amyloidosis due to familiar Mediterranean fever.

Renal uptake of 67Ga-citrate is described in a patient with biopsy-proven amyloidosis of the kidneys, due to Familiar Mediterranean Fever. After administration 150 MBq (4 mCi) 67Ga-citrate, scans were done at 48, 72, and 120 h. Intense uptake was noted in both kidneys. A renal biopsy done 5 days after the 67Ga-citrate scan revealed a pattern typical of amyloidosis. Gallium scanning can be useful in patients with fever of unknown origin. Renal amyloidosis can be considered when renal uptake of 67Ga-citrate associated with nephrotic syndrome is observed.