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1.
Phys Med Biol ; 68(2)2023 01 11.
Artículo en Inglés | MEDLINE | ID: mdl-36595320

RESUMEN

Objective: Time-of-flight positron emission tomography (PET) is the next frontier in improving the effective sensitivity. To achieve superior timing for time-of-flight PET, combined with high detection efficiency and cost-effectiveness, we have studied the applicability of BaF2 in metascintillators driven by the timing of cross-luminescence photon production.Approach: Based on previous simulation studies of energy sharing and analytic multi-exponential scintillation pulse, as well as sensitivity characteristics, we have experimentally tested a pixel of 3 × 3 × 15 mm3 based on 300µm BGO and 300µm BaF2 layers. To harness the deep ultraviolet cross-luminescent light component, which carries improved timing, we use the FBK VUV SiPM. Metascintillator energy sharing is addressed through a double integration approach.Main results: We reach an energy resolution of 22%, comparable to an 18% resolution of simple BGO pixels using the same readout, through the optimized use of the integrals of the metascintillator pulse in energy sharing calculation. We measure the energy sharing extent of each pulse with a resolution of 25% and demonstrate that experimental and simulation results agree well. Based on the energy sharing, a timewalk correction is applied, exhibiting significant improvements for both the coincidence time resolution (CTR) and the shape of the timing histogram. We reach 242 ps CTR for the entire photopeak, while for a subset of 13% of the most shared events, the CTR value improves to 108 ps, comparable to the 3 × 3 × 5 mm3 LYSO:Ce:Ca reference crystal.Significance: While we are considering different ways to improve further these results, this proof-of-concept demonstrates the applicability of cross-luminescence for metascintillator designs through the application of VUV compatible SiPM coupling, and easily implementable digital algorithms. This is the first test of BaF2-based metascintillators of sufficient stoppng power to be included in a PET scanner, demonstrating the industrial applicability of such cross-luminescent metascintillators.


Asunto(s)
Luminiscencia , Fotones , Tomografía de Emisión de Positrones/métodos , Rayos Ultravioleta , Algoritmos , Conteo por Cintilación/métodos
2.
Phys Med Biol ; 67(24)2022 12 09.
Artículo en Inglés | MEDLINE | ID: mdl-36384047

RESUMEN

Objective. The goal of this work is to experimentally compare the 3D spatial and energy resolution of a semi-monolithic detector suitable for total-body positron emission tomography (TB-PET) scanners using different surface crystal treatments and silicon photomultiplier (SiPM) models.Approach. An array of 1 × 8 lutetium yttrium oxyorthosilicate (LYSO) slabs of 25.8 × 3.1 × 20 mm3separated with Enhanced Specular Reflector (ESR) was coupled to an array of 8 × 8 SiPMs. Three different treatments for the crystal were evaluated: ESR + RR + B,with lateral faces black (B) painted and a retroreflector (RR) layer added to the top face; ESR +RR, with lateral faces covered with ESR and a RR layer on the top face and; All ESR, with lateral and top sides with ESR. Additionally, two SiPM array models from Hamamatsu Photonics belonging to the series S13361-3050AE-08 (S13) and S14161-3050AS-08 (S14) have been compared. Coincidence data was experimentally acquired using a22Na point source, a pinhole collimator, a reference detector and moving the detector under study in 1 mm steps in thex- andDOI- directions. The spatial performance was evaluated by implementing a neural network (NN) technique for the impact position estimation in thex- (monolithic) andDOIdirections.Results. Energy resolution values of 16 ± 1%, 11 ± 1%, 16 ± 1%, 15 ± 1%, and 13 ± 1% were obtained for theS13-ESR + B + RR,S13-AllESR,S14-ESR + B + RR,S14-ESR + RR,andS14-AllESR, respectively. Regarding positioning accuracy, mean average error of 1.1 ± 0.5, 1.3 ± 0.5 and 1.3 ± 0.5 were estimated for thex- direction and 1.7 ± 0.8, 2.0 ± 0.9 and 2.2 ± 1.0 for theDOI- direction, for the ESR + B + RR, ESR + RR and All ESR cases, respectively, regardless of the SiPM model.Significance. Overall, the obtained results show that the proposed semi-monolithic detectors are good candidates for building TB-PET scanners.


Asunto(s)
Redes Neurales de la Computación , Tomografía de Emisión de Positrones
3.
Ultrasonics ; 111: 106317, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33310407

RESUMEN

Beamforming enhances the performance of array-based photoacoustic microscopy (PAM) systems for large-area scan. In this study, we quantify the imaging performance of a large field-of-view optical-resolution photoacoustic-microscopy system using an phased-array detector. The system combines a low-cost pulsed-laser diode with a 128-element linear ultrasound probe. Signal-to-noise ratio (SNR) and generalized contrast-to-noise ratio (gCNR) are quantified using the phased-array detector and applying three beamforming strategies: a no-beamforming method equivalent to a single-element flat transducer, a fixed focus beamforming method that mimics a single-element focused transducer, and a dynamic focus beamforming using a delay-and-sum (DAS) algorithm. The imaging capabilities of the system are demonstrated generating high-resolution images of tissue-mimicking phantoms containing sub-millimetre ink tubes and an ex vivo rabbit's ear. The results show that dynamic focus DAS beamforming increases and homogenizes SNR along 1-cm2 images, reaching values up to 15 dB compared to an unfocused detector and up to 30 dB compared to out-of-focus regions of the fixed focus configuration. Moreover, the obtained values of gCNR using the DAS beamformer indicate an excellent target visibility, both on phantoms and ex vivo. This strategy makes it possible to scan larger surfaces compared to standard configurations using single-element detectors, paving the way for advanced array-based PAM systems.

4.
Phys Med ; 76: 72-76, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32599377

RESUMEN

The transparent polymer polyallyl-diglycol-carbonate (PADC), also known as CR-39, is widely used as detector for heavy charged particles at low fluence. It allows for detection of single protons and ions via formation of microscopic tracks after etching in NaOH or KOH solutions. PADC combines a high sensitivity and high specificity with inertness towards electromagnetic noise. Present fields of application include laser-ion acceleration, inertial confinement fusion, radiobiological studies with cell cultures, and dosimetry of nuclear fragments in particle therapy. These require precise knowledge of the energy-dependent response of PADC to different ion species. We present calibration data for a new type of detector material, Radosys RS39, to protons (0.2-3 MeV) and carbon ions (0.6-12 MeV). RS39 is less sensitive to protons than other types of PADC. Its response to carbon ions, however, is similar to other materials. Our data indicate that RS39 allows for measuring carbon ion energies up to 10 MeV only from the track diameters. In addition, it can be used for discrimination between protons and carbon ions in a single etching process.


Asunto(s)
Polímeros , Radiometría , Aceleración , Iones , Rayos Láser , Análisis Espectral
5.
Sensors (Basel) ; 20(5)2020 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-32121227

RESUMEN

The development of dedicated positron emission tomography scanners is an active area of research, especially aiming at the improvement of lesion detection and in support of cancer treatment and management. Recently, dedicated Positron Emission Tomography (PET) systems with different configurations for specific organs have been developed for improving detection effectiveness. Open geometries are always subject to distortion and artifacts in the reconstructed images. Therefore, the aim of this work is to determine the optimal geometry for a novel cardiac PET system that will be developed by our team, and determine the time resolution needed to achieve reasonable image quality for the chosen geometry. The proposed geometries consist of 36 modules. These modules are arranged in two sets of two plates, each one with different configurations. We performed Monte Carlo simulations with different TOF resolutions, in order to test the image quality improvement in each case. Our results show, as expected, that increasing TOF resolution reduces distortion and artifact effects. We can conclude that a TOF resolution of the order of 200 ps is needed to reduce the artifacts, to acceptable levels, generated in the simulated cardiac-PET open geometries.


Asunto(s)
Corazón/fisiología , Tomografía de Emisión de Positrones/métodos , Algoritmos , Artefactos , Simulación por Computador , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Método de Montecarlo , Fantasmas de Imagen
6.
Rev Sci Instrum ; 89(2): 023302, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29495831

RESUMEN

CR-39 nuclear track material is frequently used for the detection of protons accelerated in laser-plasma interactions. The measurement of track densities allows for determination of particle angular distributions, and information on the kinetic energy can be obtained by the use of passive absorbers. We present a precise method of measuring spectral distributions of laser-accelerated protons in a single etching and analysis process. We make use of a one-to-one relation between proton energy and track size and present a precise calibration based on monoenergetic particle beams. While this relation is limited to proton energies below 1 MeV, we show that the range of spectral measurements can be significantly extended by simultaneous use of absorbers of suitable thicknesses. Examples from laser-plasma interactions are presented, and quantitative results on proton energies and particle numbers are compared to those obtained from a time-of-flight detector. The spectrum end points of continuous energy distributions have been determined with both detector types and coincide within 50-100 keV.

7.
Med Phys ; 40(5): 051906, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23635276

RESUMEN

PURPOSE: The authors have developed a trimodal PET∕SPECT∕CT scanner for small animal imaging. The gamma ray subsystems are based on monolithic crystals coupled to multianode photomultiplier tubes (MA-PMTs), while computed tomography (CT) comprises a commercially available microfocus x-ray tube and a CsI scintillator 2D pixelated flat panel x-ray detector. In this study the authors will report on the design and performance evaluation of the multimodal system. METHODS: X-ray transmission measurements are performed based on cone-beam geometry. Individual projections were acquired by rotating the x-ray tube and the 2D flat panel detector, thus making possible a transaxial field of view (FOV) of roughly 80 mm in diameter and an axial FOV of 65 mm for the CT system. The single photon emission computed tomography (SPECT) component has a dual head detector geometry mounted on a rotating gantry. The distance between the SPECT module detectors can be varied in order to optimize specific user requirements, including variable FOV. The positron emission tomography (PET) system is made up of eight compact modules forming an octagon with an axial FOV of 40 mm and a transaxial FOV of 80 mm in diameter. The main CT image quality parameters (spatial resolution and uniformity) have been determined. In the case of the SPECT, the tomographic spatial resolution and system sensitivity have been evaluated with a (99m)Tc solution using single-pinhole and multi-pinhole collimators. PET and SPECT images were reconstructed using three-dimensional (3D) maximum likelihood and ordered subset expectation maximization (MLEM and OSEM) algorithms developed by the authors, whereas the CT images were obtained using a 3D based FBP algorithm. RESULTS: CT spatial resolution was 85 µm while a uniformity of 2.7% was obtained for a water filled phantom at 45 kV. The SPECT spatial resolution was better than 0.8 mm measured with a Derenzo-like phantom for a FOV of 20 mm using a 1-mm pinhole aperture collimator. The full width at half-maximum PET radial spatial resolution at the center of the field of view was 1.55 mm. The SPECT system sensitivity for a FOV of 20 mm and 15% energy window was 700 cps∕MBq (7.8 × 10(-2)%) using a multi-pinhole equipped with five apertures 1 mm in diameter, whereas the PET absolute sensitivity was 2% for a 350-650 keV energy window and a 5 ns timing window. Several animal images are also presented. CONCLUSIONS: The new small animal PET∕SPECT∕CT proposed here exhibits high performance, producing high-quality images suitable for studies with small animals. Monolithic design for PET and SPECT scintillator crystals reduces cost and complexity without significant performance degradation.


Asunto(s)
Imagen Multimodal/instrumentación , Tomografía de Emisión de Positrones/instrumentación , Tomografía Computarizada de Emisión de Fotón Único/instrumentación , Tomografía Computarizada por Rayos X/instrumentación , Animales , Calibración , Diseño de Equipo , Procesamiento de Imagen Asistido por Computador , Ratones , Ratas
8.
Comput Biol Med ; 43(8): 1053-61, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23706690

RESUMEN

We suggest a symmetric-polar pixellation scheme which makes possible a reduction of the computational cost for expectation maximization (EM) iterative algorithms. The proposed symmetric-polar pixellation allows us to deal with 3D images as a whole problem without dividing the 3D problem into 2D slices approach. Performance evaluation of each approach in terms of stability and image quality is presented. Exhaustive comparisons between all approaches were conducted in a 2D based image reconstruction model. From these 2D approaches, that showing the best performances were finally implemented and evaluated in a 3D based image reconstruction model. Comparison to 3D images reconstructed with FBP is also presented. Although the algorithm is presented in the context of computed tomography (CT) image reconstruction, it can be applied to any other tomographic technique as well, due to the fact that the only requirement is a scanning geometry involving measurements of an object under different projection angles. Real data have been acquired with a small animal (CT) scanner to verify the proposed mathematical description of the CT system.


Asunto(s)
Algoritmos , Procesamiento de Imagen Asistido por Computador/métodos , Tomografía Computarizada por Rayos X/métodos , Fantasmas de Imagen , Tomografía Computarizada por Rayos X/instrumentación
9.
Med Phys ; 39(9): 5393-404, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22957607

RESUMEN

PURPOSE: A breast dedicated positron emission tomography (PET) scanner has been developed based on monolithic LYSO crystals coupled to position sensitive photomultiplier tubes (PSPMTs). In this study, we describe the design of the PET system and report on its performance evaluation. METHODS: MAMMI is a breast PET scanner based on monolithic LYSO crystals. It consists of 12 compact modules with a transaxial field of view (FOV) of 170 mm in diameter and 40 mm axial FOV that translates to cover up to 170 mm. The patient lies down in a prone position that facilitates maximum breast elongation. Quantitative performance analysis of the calculated method for the attenuation correction specifically developed for MAMMI, and based on PET image segmentation, has also been conducted in this evaluation. In order to fully determine the MAMMI prototype's performance, we have adapted the measurements suggested for National Electrical Manufacturers Association (NEMA) NU 2-2007 and NU 4-2008 protocol tests, as they are defined for whole-body and small animal PET scanners, respectively. RESULTS: Spatial resolutions of 1.6, 1.8, and 1.9 mm were measured in the axial, radial, and tangential directions, respectively. A scatter fraction of 20.8% was obtained and the maximum NEC was determined to be 25 kcps at 44 MBq. The average sensitivity of the system was observed to be 1% for an energy window of (250 keV-750 keV) and a maximum absolute sensitivity of 1.8% was measured at the FOV center. CONCLUSIONS: The overall performance of the MAMMI reported on this evaluation quantifies its ability to produce high quality PET images. Spatial resolution values below 3 mm were measured in most of the FOV. Only the radial component of spatial resolution exceeds the 3 mm at radial positions larger than 60 mm. This study emphasizes the need for standardized testing methodologies for dedicated breast PET systems similar to NEMA standards for whole-body and small animal PET scanners.


Asunto(s)
Mama/diagnóstico por imagen , Tomografía de Emisión de Positrones/instrumentación , Diseño de Equipo , Humanos , Procesamiento de Imagen Asistido por Computador
10.
Med Phys ; 39(2): 643-53, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22320773

RESUMEN

PURPOSE: The authors have developed a small animal Positron emission tomography (PET) scanner based on monolithic LYSO crystals coupled to multi-anode photomultiplier tubes (MA-PMTs). In this study, the authors report on the design, calibration procedure, and performance evaluation of a PET system that the authors have developed using this innovative nonpixelated detector design. METHODS: The scanner is made up of eight compact modules forming an octagon with an axial field of view (FOV) of 40 mm and a transaxial FOV of 80 mm diameter. In order to fully determine its performance, a recently issued National Electrical Manufacturers Association (NEMA) NU-4 protocol, specifically developed for small animal PET scanners, has been followed. By measuring the width of light distribution collected in the MA-PMT the authors are able to determine depth of interaction (DOI), thus making the proper identification of lines of response (LORs) with large incidence angles possible. PET performances are compared with those obtained with currently commercially available small animal PET scanners. RESULTS: At axial center when the point-like source is located at 5 mm from the radial center, the spatial resolution measured was 1.65, 1.80, and 1.86 mm full width at half maximum (FWHM) for radial, tangential, and axial image profiles, respectively. A system scatter fraction of 7.5% (mouse-like phantom) and 13% (rat-like phantom) was obtained, while the maximum noise equivalent count rate (NECR) was 16.9 kcps at 12.7 MBq (0.37 MBq/ml) for mouse-like phantom and 12.8 kcps at 12.4 MBq (0.042 MBq/ml) for rat-like phantom The peak absolute sensitivity in the center of the FOV is 2% for a 30% peak energy window. Several animal images are also presented. CONCLUSIONS: The overall performance of our small animal PET is comparable to that obtained with much more complex crystal pixelated PET systems. Moreover, the new proposed PET produces high-quality images suitable for studies with small animals.


Asunto(s)
Corazón/diagnóstico por imagen , Aumento de la Imagen/instrumentación , Tomografía de Emisión de Positrones/instrumentación , Tomografía de Emisión de Positrones/veterinaria , Animales , Diseño de Equipo , Análisis de Falla de Equipo , Ratones , Fantasmas de Imagen , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
11.
Rev. esp. med. nucl. (Ed. impr.) ; 30(5): 286-291, sept.-oct. 2011.
Artículo en Español | IBECS | ID: ibc-90612

RESUMEN

Objetivo. Desarrollar un sistema SPECT de animal pequeño utilizando una cámara portátil de bajo coste equipada con colimador de tipo pinhole (con agujero de alfiler), un cristal de centelleo continuo y un tubo fotomultiplicador sensible a la posición. Material y métodos. Se incorporó la gammacámara a un sistema de radio variable que nos permitió optimizar la resolución y la sensibilidad ajustando el radio de rotación al tamaño del objeto. A fin de investigar la capacidad del sistema SPECT para obtener imágenes de animal pequeño se estudió la dependencia de la resolución y los parámetros de calibración con el radio, y se realizaron adquisiciones de maniquí de tamaño pequeño y de ratones. Resultados. Se obtuvieron valores de resolución de 1mm para un radio de 21,4mm hasta 1,4mm para un radio de 37,2mm, justificando el interés en un sistema SPECT de radio variable. Conclusiones. Los resultados de calidad de imagen de los maniquís y animales fueron satisfactorios, confirmando la utilidad del sistema SPECT para realizar estudios de animal pequeño(AU)


Objective. To develop a small-animal SPECT system using a low cost commercial portable gamma camera equipped with a pinhole collimator, a continuous scintillation crystal and a position-sensitive photomultiplier tube. Material and methods. The gamma camera was attached to a variable radius system, which enabled us to optimize sensitivity and resolution by adjusting the radius of rotation to the size of the object. To investigate the capability of the SPECT system for small animal imaging, the dependence of resolution and calibration parameters on radius was assessed and acquisitions of small phantoms and mice were carried out. Results. Resolution values, ranging from 1.0mm for a radius of 21.4mm and 1.4mm for a radius of 37.2mm were obtained, thereby justifying the interest of a variable radius SPECT system. Conclusions. The image quality of phantoms and animals were satisfactory, thus confirming the usefulness of the system for small animal SPECT imaging(AU)


Asunto(s)
Animales , Masculino , Femenino , Ratones , Tomografía Computarizada de Emisión de Fotón Único/instrumentación , Tomografía Computarizada de Emisión de Fotón Único , Asignación de Costos/economía , Control de Costos/economía , Costos y Análisis de Costo/economía , Elementos Radiactivos , Tomografía Computarizada de Emisión de Fotón Único/tendencias , Medicina Nuclear/métodos
12.
Rev Esp Med Nucl ; 30(5): 286-91, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21640439

RESUMEN

OBJECTIVE: To develop a small-animal SPECT system using a low cost commercial portable gamma camera equipped with a pinhole collimator, a continuous scintillation crystal and a position-sensitive photomultiplier tube. MATERIAL AND METHODS: The gamma camera was attached to a variable radius system, which enabled us to optimize sensitivity and resolution by adjusting the radius of rotation to the size of the object. To investigate the capability of the SPECT system for small animal imaging, the dependence of resolution and calibration parameters on radius was assessed and acquisitions of small phantoms and mice were carried out. RESULTS: Resolution values, ranging from 1.0mm for a radius of 21.4mm and 1.4mm for a radius of 37.2mm were obtained, thereby justifying the interest of a variable radius SPECT system. CONCLUSIONS: The image quality of phantoms and animals were satisfactory, thus confirming the usefulness of the system for small animal SPECT imaging.


Asunto(s)
Cámaras gamma , Tomografía Computarizada de Emisión de Fotón Único/instrumentación , Animales , Encéfalo/diagnóstico por imagen , Calibración , Diseño de Equipo , Procesamiento de Imagen Asistido por Computador , Pulmón/diagnóstico por imagen , Ratones , Fantasmas de Imagen , Radiofármacos , Agregado de Albúmina Marcado con Tecnecio Tc 99m , Exametazima de Tecnecio Tc 99m , Tomografía Computarizada de Emisión de Fotón Único/veterinaria
13.
Med Phys ; 33(11): 4210-20, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17153400

RESUMEN

We have developed two prototypes of portable gamma cameras for medical applications based on a previous prototype designed and tested by our group. These cameras use a CsI(Na) continuous scintillation crystal coupled to the new flat-panel-type multianode position-sensitive photomultiplier tube, H8500 from Hamamatsu Photonics. One of the prototypes, mainly intended for intrasurgical use, has a field of view of 44 x 44 mm2, and weighs 1.2 kg. Its intrinsic resolution is better than 1.5 mm and its energy resolution is about 13% at 140 keV. The second prototype, mainly intended for osteological, renal, mammary, and endocrine (thyroid, parathyroid, and suprarenal) scintigraphies, weighs a total of 2 kg. Its average spatial resolution is 2 mm; it has a field of view of 95 x 95 mm2, with an energy resolution of about 15% at 140 keV. The main advantages of these gamma camera prototypes with respect to those previously reported in the literature are high portability and low weight, with no significant loss of sensitivity and spatial resolution. All the electronic components are packed inside the mini gamma cameras, and no external electronic devices are required. The cameras are only connected through the universal serial bus port to a portable PC. In this paper, we present the design of the cameras and describe the procedures that have led us to choose their configuration together with the most important performance features of the cameras. For one of the prototypes, clinical tests on melanoma patients are presented and images are compared with those obtained with a conventional camera.


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Cámaras gamma , Aumento de la Imagen/instrumentación , Ganglios Linfáticos/diagnóstico por imagen , Melanoma/diagnóstico por imagen , Cintigrafía/instrumentación , Diseño de Equipo , Análisis de Falla de Equipo , Humanos , Aumento de la Imagen/métodos , Metástasis Linfática , Miniaturización , Fantasmas de Imagen , Cintigrafía/métodos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
14.
Med Phys ; 31(6): 1384-97, 2004 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15259642

RESUMEN

Design optimization, manufacturing, and tests, both laboratory and clinical, of a portable gamma camera for medical applications are presented. This camera, based on a continuous scintillation crystal and a position-sensitive photomultiplier tube, has an intrinsic spatial resolution of approximately 2 mm, an energy resolution of 13% at 140 keV, and linearities of 0.28 mm (absolute) and 0.15 mm (differential), with a useful field of view of 4.6 cm diameter. Our camera can image small organs with high efficiency and so it can address the demand for devices of specific clinical applications like thyroid and sentinel node scintigraphy as well as scintimammography and radio-guided surgery. The main advantages of the gamma camera with respect to those previously reported in the literature are high portability, low cost, and weight (2 kg), with no significant loss of sensitivity and spatial resolution. All the electronic components are packed inside the minigamma camera, and no external electronic devices are required. The camera is only connected through the universal serial bus port to a portable personal computer (PC), where a specific software allows to control both the camera parameters and the measuring process, by displaying on the PC the acquired image on "real time." In this article, we present the camera and describe the procedures that have led us to choose its configuration. Laboratory and clinical tests are presented together with diagnostic capabilities of the gamma camera.


Asunto(s)
Cámaras gamma , Fenómenos Biofísicos , Biofisica , Electrónica Médica , Diseño de Equipo , Humanos , Hipertiroidismo/diagnóstico por imagen , Cintigrafía , Nódulo Tiroideo/diagnóstico por imagen
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