[Iatrogenic lung microembolism detected by 18FDG PET/CT]. / Microembolia pulmonar iatrogénica detectada mediante 18F-FDG PET/TC.

We present the cases of two oncology patients: a male with Hodgkin's disease after completion of chemotherapy, and a woman recently diagnosed of melanoma, who underwent positron emission tomography/computed tomography (PET/CT) with 18F-FDG for therapeutic monitoring and initial staging, respectively. In both cases, hypermetabolic foci of 18F-FDG in lung parenchyma were found, without morphologic abnormalities in CT. These findings would have been consistent with lung pathology in the absence of any anatomic correlation. Combined PET/CT interpretation was of lung microembolisms probably originated at the injection site.

[Renal angiomyolipoma and fever: assessment with isotopic renogram and 67Ga scintigraphy]. / Angiomiolipoma renal y fiebre: valoración mediante renograma isotópico y gammagrafía con 67Ga.

A 26 year-old woman with tuberous sclerosis who came to the Emergency Department with high fever, bilious vomit, right hemiabdomen pain and syncope during 2 weeks. Laboratory analyses show hemoglobin 6.7 g/dl, creatinine 1.5 mg/dl and leukocytes 30,000. Abdominal CT is performed because of suspicion of active bleeding in right hemiabdomen, following rupture of right angiomyolipoma, treated by selective arterial embolization. She was referred to the Nuclear Medicine Department to perform a 67Gallium scintigraphy for the detection of infection, and static and dynamic renal scintigraphy for evaluation of the renal morphology and function.

[Follow-up of children and young adults with differentiated thyroid cancer treated with radioiodine]. / Seguimiento de niños y jóvenes adultos con cáncer diferenciado de tiroides (CDT) tratados con radioyodo.

This is a retrospective study carried out in a group of 30 patients with differentiated thyroid cancer (age at diagnosis equal to or less than twenty years old). The aim of the study is to evaluate outcome after 131I therapy. Patients were classified into three groups on the basis of initial surgery, pathology and scintigraphic results: group I (thyroid extent), group II (locoregional extent), and group III (distant metastatic disease). Clinical parameters, 131I scans, serum thyroglobulin determinations and 131I therapeutic administered doses were evaluated in the follow-up. Some other complementary techniques such as chest X-ray and pulmonary function tests are also described. Scintigraphic absence of thyroid tissue has been observed in 83% of the cases; high thyroglobulin level is still detectable in 34% of the patients as a single evidence of disease, and 21% remain without any abnormal clinical, scintigraphic or analytical findings. Total doses administered have increased in groups I, II and III respectively, and have also been inversely proportional to the extension of lymph node surgery. At present, all the patients are alive and in good general condition. According to the results obtained, we conclude that children and young adults with DTC should undergo periodical 131I therapeutic doses in case of positive scans (once total thyroidectomy has been realized, with or without lymph node resection depending on the extension of disease). In our experience, the use of radioiodine is effective and safe in the follow-up of children and youngs with DTC.

The diagnostic value of Tc-99m human polyclonal immunoglobulin imaging compared to Tc-99m HMPAO labeled leukocytes in inflammatory bowel disease.

The aim of this study was to establish the usefulness of Tc-99m human polyclonal immunoglobulin (HIG) imaging in a group of patients who were suspected of having inflammatory bowel disease (IBD). The authors performed 30 scans (15 with Tc-99m HMPAO leukocytes and 15 with Tc-99m HIG) on 15 patients with IBD. Ten patients had Crohn's disease and five had ulcerative colitis. The sensitivity of Tc-99m HIG scintigraphy for detecting IBD was 33%, while the sensitivity of Tc-99m HMPAO leukocyte imaging was 100%. The Tc-99m HMPAO leukocyte imaging also detected a larger number of affected segments and provided better image quality of the extent of disease than Tc-99m HIG. On the basis of these results, the authors believe that Tc-99m HIG imaging is not a useful technique in the evaluation of patients with IBD, in the identification of location, or the extension or degree of disease activity.

MCA serum determination in breast carcinoma patients for the diagnosis of bone metastases.

Serum MCA levels were determined in 173 consecutive patients with breast cancer in order to assess the clinical utility of MCA for the detection of bone metastases. Bone pathology was diagnosed by scintigraphy, radiology and clinical follow-up. Metastases were found in 37 patients, benign lesions in 25, and in 111 no bone lesions were found. Eighteen of the 173 bone scans were considered indeterminate for metastases. Based on the receiver-operating characteristic curves (ROC) analysis, the cut-off level for MCA was set at 20 U/ml. Only in 4 of the 37 patients with bone metastases MCA was below 20 U/ml. All 4 patients had completed their chemotherapy course within six months before MCA determination. Only in 6 patients of the 136 without bone metastases MCA levels were above 20 U/ml. Of the 18 patients with indeterminate bone scans, 15 had benign lesions and all of them had MCA levels below 20 U/ml. MCA determination is a sensitive method for the detection of bone metastases in breast carcinoma. We encourage the use of this procedure for the selection of high-risk groups or as a complementary method for the interpretation of bone scintigraphy.