RESUMEN
After the implementation of the European Space for Higher Education, the contents of the Radiology and Physical Medicine Area that were taught in the Medicine Degree have also been incorporated into the new degrees of Dentistry, Nursing, Physiotherapy, Podiatry, and, to a lesser extent, Pharmacy, Occupational Therapy, Logopedia, and Biomedical Engineering As a whole, the basic concepts of radiology and radiological protection are taught in Murcia in 5 different degrees with a total of 52.5 ECTS credits, participating in the training of 1219 students each academic year. This incorporation in the new degrees has tripled the number of subjects in which undergraduate teaching is taught, and doubled both the number of ECTS credits and the number of undergraduate students to whom it directs its training work. Thus, given the possible creation of new university degrees in the near future (Diagnostic Imaging and Radiotherapy Technicians), it would be necessary to involve a greater number of accredited professionals, from different specialties, and to optimize teaching resources (bibliography, material teacher, clinical cases, etc.,) for its usefulness in the different subjects that share similar contents.
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Protección Radiológica , Radiología , Humanos , Universidades , RadiografíaAsunto(s)
Radioisótopos de Flúor , Fluorodesoxiglucosa F18 , Linfadenitis Necrotizante Histiocítica/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Radiofármacos , Adulto , Diagnóstico Diferencial , Femenino , Radioisótopos de Flúor/farmacocinética , Fluorodesoxiglucosa F18/farmacocinética , Estudios de Seguimiento , Humanos , Biopsia Guiada por Imagen , Ganglios Linfáticos/irrigación sanguínea , Ganglios Linfáticos/metabolismo , Ganglios Linfáticos/patología , Linfadenopatía/diagnóstico , Radiofármacos/farmacocinética , Ultrasonografía DopplerRESUMEN
PURPOSE: Neoadjuvant radiochemotherapy (RCT) is an accepted treatment for locally advanced rectal cancer (LARC) that improves surgical outcomes. If a pathological complete response is achieved, conservative surgery can be considered. The objective of our study was to assess the reliability of (18)F-FDG PET/CT for evaluating the response to neoadjuvant RCT in LARC. METHODS: We prospectively studied 41 patients diagnosed with LARC and candidates for neoadjuvant RCT. PET/CT was performed before RCT and again 7 weeks later. A visual and semiquantitative analysis was carried out. The pathological response was classified according to the Mandard tumour regression grade (TRG). We analysed: (a) the relationship between TRG and the result of the posttreatment PET/CT scan, and (b) the correlation between the percentage of pathological response and the percentage decrease in SUVmax according to the response index (RI). RESULTS: The mean SUVmax of the rectal lesions at diagnosis was 13.6 and after RCT 3.96. The mean RI was 65.32 %. Sensitivity was 88.88 %, specificity 92.86 %, positive predictive value 96 %, negative predictive value 81 %. Of the 41 patients, 8 had TRG I (all negative PET/CT); 6 had TRG II (5 negative, 1 positive PET/CT); 16 had TRG III (13 positive, 3 negative PET/CT); 9 had TRG IV (all positive PET/CT); 2 had TRG V (all positive PET/CT). Of the 14 patients classified as responders (TRG I, II), 13 (92.86 %) had negative PET/CT. Of the 27 patients classified as nonresponders (TRG III-V), 24 (88.88 %) had positive PET/CT. Differences were statistically significant (p < 0.0001). The RI in responders was 79.9 % and in nonresponders was 60.3 %. Differences were statistically significant (p < 0.037). CONCLUSION: PET/CT is a reliable technique for assessing response to neoadjuvant RCT in LARC, with a view to considering more conservative surgical treatment. The combination of the visual and semiquantitative analysis increases the diagnostic validity of PET/CT.
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Adenocarcinoma/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Imagen Multimodal , Terapia Neoadyuvante , Tomografía de Emisión de Positrones , Radiofármacos , Neoplasias del Recto/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adenocarcinoma/terapia , Adulto , Anciano , Anciano de 80 o más Años , Quimioradioterapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias del Recto/terapia , Reproducibilidad de los Resultados , Resultado del TratamientoAsunto(s)
Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Neoplasias de los Bronquios/diagnóstico por imagen , Tumor Carcinoide/diagnóstico por imagen , Tumor Carcinoide/secundario , Radioisótopos de Indio , Octreótido/análogos & derivados , Osteoartritis/diagnóstico por imagen , Radiofármacos , Anciano de 80 o más Años , Biomarcadores de Tumor/análisis , Diagnóstico Diferencial , Humanos , Masculino , Osteoartritis/diagnóstico , CintigrafíaRESUMEN
INTRODUCTION: The cytokinesis-blocked (CB) micronucleus test (MN) on irradiated human lymphocytes is normally used to evaluate chromosomal and genotoxic damage produced by various physical and chemical agents. OBJECTIVE: Determine any possible genotoxic effect induced by the different types of ionizing radiation employed in medical diagnostic radiology and nuclear medicine. MATERIAL AND METHODS: The frequency of the MN appearance was determined in CB lymphocyte cultures of a total of 4 different groups of patients: (1) in 35 supposedly healthy volunteers to establish the MN spontaneous frequency in the medium; (2) in 9 volunteers to measure the in vitro dose-response curves in order to calculate the MN frequency following X-ray irradiation and gamma radiation; (3) in 25 patients in whom a specific diagnostic and/or therapeutic procedure employing diagnostic radiology techniques involving X-ray exposure was applied, and (4) in 26 patients in whom the diagnostic procedure in question involved nuclear medicine techniques (scintiscan). RESULTS: A lineal relationship was observed between the MN frequency and the dose of ionizing radiation administered in vitro, both in X-rays and gamma radiation. A significant increase in the MN is observed after radiation is given to patients during medical diagnostic radiology examinations when compared with the control values obtained from the same patients prior to being subjected to the radiological procedure (p < 0.01). No significant MN increase is observed following exposure to radiation involved in diagnostic examinations in patients studied in Nuclear Medicine. CONCLUSION: Ionizing radiation employed in complex medical diagnostic radiology examinations produces a significant increase in the MN appearance frequency and as such indicates both radiation induced chromosomal and genotoxic damage. However, the ionizing radiation used in diagnostic nuclear medicine examinations does not induce any significant increase in MN appearance frequency.
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Cromosomas/efectos de la radiación , Daño del ADN , Dosis de Radiación , Traumatismos por Radiación/etiología , Adulto , Anciano , Anciano de 80 o más Años , Relación Dosis-Respuesta en la Radiación , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: The experience in detection of sentinel lymph node in melanoma using preoperative scintigraphy and intraoperative gamma probe is referred. PATIENTS AND METHODS: We studied 60 patients with stage I-II melanoma who underwent sentinel lymph node biopsy performed using 99m-Tc-labelled sulphur colloid as radioactive tracer. A preoperative scintigraphy was performed and intraoperative gamma probe was used to localize the sentinel node in all cases. Scintigraphy results, effectiveness of intraoperative detection (technical efficacy), pathological results, and follow-up have been studied. RESULTS: Preoperative detection was 98.3% and the mean basin detected was 1.17. There were multiple basins especially when melanomas were on the trunk. Technical efficacy was 98.4% and intraoperative detection was more difficult in parotid gland region. HMB-45 immunohistochemical staining was essential in pathological studies, in whom 10% were positives. Lymphadenectomy could be avoided in 90% of the patients. Recurrences were not detected during follow-up and metastases were found only in non biopsied cases. Sentinel node biopsy morbidity was significative lesser than that of lymphadenectomy. CONCLUSIONS: Preoperative scintigraphy and intraoperative gamma probe use to localize sentinel node in melanoma have a high efficacy. They can reveal multiple basins and they allow a more selective surgical approach and a minimal dissection.