BNCT research activities at the Granada group and the project NeMeSis: Neutrons for medicine and sciences, towards an accelerator-based facility for new BNCT therapies, medical isotope production and other scientific neutron applications.

The Granada group in BNCT research is currently performing studies on: nuclear and radiobiological data for BNCT, new boron compounds and a new design for a neutron source for BNCT and other applications, including the production of medical radioisotopes. All these activities are described in this report.

[Staging of non-small cell lung cancer. Diagnosis efficacy of structural (CT) and functional (FDG-PET) imaging methods]. / Estadificación del cáncer de pulmón de células no pequeñas. Utilidad de la imagen estructural (TAC) y funcional (FDG-PET).

PURPOSE: To evaluate diagnostic accuracy of FDG-PET in the definition of non-small cell lung cancer (NSCLC) and analyze diagnostic validity of CT scan and FDG-PET in its staging. METHODS: Patients with clinical suspicion of potentially resectable NSCLC (n = 108) were studied by standard procedures in our setting, including fibrobronchoscopy, transthoracic fine-needle aspiration, thoracoabdominal CT scan and FDG-PET. Gold standard was histopathological study in patients who underwent surgery and by specific imaging methods and biopsy, when available, in patients who did not. RESULTS: In 13% of patients, the FDG-PET findings were negative and no tumor was observed in the histological study of the piece. In 22% of patients, FDG-PET detected metastatic disease (M0 by CT scan). For mediastinal involvement, global diagnostic accuracy was 0.90 with FDG-PET and 0.59 with CT scan. False positive FDG-PET findings were produced by inflammatory conditions and false negative findings by the small size or proximity of lymph nodes to primary tumor. Mediastinal staging by CT scan and FDG-PET was correct in 56% and 87% of patients, respectively. CONCLUSIONS: Although complementary, the functional method (FDG-PET) is significantly superior to the structural method (CT) for detection of mediastinal tumor disease.

[Positron emission tomography with 18F-fluorodeoxyglucose in patients with uterine sarcoma]. / Tomografía por emisión de positrones con 18F-fluordesoxiglucosa en pacientes con sarcoma uterino.

OBJECTIVE: Describe our experience with 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), in patients with uterine sarcomas, under suspicion of recurrence and in tumour staging after hysterectomy as an incidental pathology finding. MATERIAL AND METHODS: A retrospective review, between april 2002 and january 2006, of FDG-PET performed in 10 patients with clinical diagnosis of uterine sarcoma was made (7 patients under recurrence suspicion and three under initial staging). Mean age was 52.2 yrs. Evolution time after initial diagnosis vary from one month to 15 yrs (median time: 14 months). Lesions were classified as 8 leiomyosarcomas and 2 carcinosarcomas. FIGO staging were establish resulting 5 patients stage I, 1 patient stage III, and 4 patients stage IV. RESULTS: 4 of 7 patients under suspicion of recurrence showed discrepancies between positron emission tomography (PET) and conventional imaging techniques (CIT) information. FDG-PET was negative in three cases of non-conclusive CT. PET was negative in one case with pulmonary metastases. The 3 staging studies were concordant both FDG-PET and CIT images. Pathological information was obtained in 5 cases, and a mean time of 14 months of clinical follow up was made. CONCLUSIONS: FDG-PET can be useful in the follow up of uterine sarcoma patients, and also when it is an incidental finding in other causes hysterectomy.

[Utility of diuretic renography in the detection of an enteroureteral fistula]. / Utilidad del renograma diurético en la detección de una fístula enteroureteral.

After a 2-year-old male with left impairment underwent surgery for a left vesicoureteral stenosis, his renal function was followed up by means of dynamic renal scintigraphy with 99mTc-DTPA. Incidental radiotracer accumulation was observed in left hemiabdomen tracing the descending and sigmoid colon. A vesico-colonic fistula was suspected. However, ultrasonography and cystography studies showed no presence of a vesico-enteric fistula. Because the patient persisted without symptoms, an expectant approach was adopted. One year later, he began to suffer watery diarrhoea episodes. 99mTc-DTPA renography was again performed to re-evaluated renal function and explore presence of urinary-enteric fistula. Diuretic renography demonstrated the presence of a vesical leak to sigmoid gut, which was confirmed by recovery of fecal matter from the patient. Both isotopic renograms evidenced the presence of uretero-sigmoid fistula, an uncommon postsurgical that was not detected by cystography, ultrasonography or RMN. The patient subsequently underwent surgery for fistula repair.

[Positron emission tomography with fluordesoxyglucose-F18 in follow-up of endometrial cancer]. / Tomografía de emisión de positrones con fluordesoxiglucosa-F18 en el seguimiento del cáncer de endometrio.

OBJECTIVE: To assess the utility of FDG-PET in the follow-up of patients treated for endometrial cancer and with suspicion of recurrence according to conventional imaging methods (CT, MRI) and/or elevation of serum tumour markers. MATERIALS AND METHODS: Between April 2002 and December 2005, eleven patients underwent 17 FDG-PET studies (six with 2 studies); mean age was 63.4 yrs (range, 52-69 yrs) and time since diagnosis ranged from 11 months to 12 yrs (mean of 56 months). Initially, seven patients were in stage I, three in stage III and one in stage IV (FIGO classification). Histologically, they corresponded to 8 endometrioid carcinomas and 3 non endometrioid carcinomas. RESULTS: FDG-PET showed infradiaphragmatic uptake in 3 patients and disseminated disease in 7 cases. FDG-PET showed no uptake in one patient. CT (n = 7) or MRI (n = 7) detected infradiaphragmatic lesions in 5 patients and visceral lesions in 2. In 11 patients, tumour markers were elevated (CA125, n = 9; CA19.9, n = 2; CA15.3, n = 2). In 7 patients, FDG-PET modified the information yielded by conventional imaging techniques and in 4 patients, the FDG-PET contributed no additional information. In 2 patients, histologic confirmation of the lesions was obtained and in 9 patients, there were clinical follow-up (from 3 to 20 months, mean of 8.7 months) and imaging studies. CONCLUSIONS: FDG-PET is superior to CT and MRI for detecting recurrences in the follow-up of patients with endometrial cancer.

[Value of thallium 201-SPECT in typing brain space-occupying lesions]. / Valor de la SPECT con Talio-201 en la tipificación de lesiones ocupantes de espacio intracerebrales.

OBJECTIVE: This study was designed to assess the diagnostic accuracy of single photon emission computed tomography with Tl-201 (SPECT Tl-201) to establish the tumoral or non-tumoral nature of brain space occupying lesions in comparison with usual diagnostic techniques. MATERIAL AND METHODS: The study population consisted of 37 patients, 24 men (64.9 %) and 13 women (35.1 %), mean age 48 +/- 16 years. After establishing the clinical and radiological diagnosis of brain lesion, all patients underwent SPECT Tl-201, evaluating it only by subjective analysis and blinded to neuroestructural techniques. After surgical resection all patients were evaluated anatomopathologically to establish the histologic nature. RESULTS: The sensitivity of SPECT Tl-201 (0.87) was higher than standard neuroimaging techniques (0.78). Specificity (0.43), positive (0.87) and negative (0.43) predictive values of SPECT were similar to neuroestructural procedures (MRI and CT scan) with 0.43, 0.82 and 0.38 values. Tumoral disease prevalence was 0.81. Neuroestructural procedures were non-conclusive in 18.9 % of the studies. No non-conclusive results were obtained with SPECT Tl-201. CONCLUSIONS: SPECT Tl-201 is a diagnostic procedure of high sensitivity to establish the tumoral nature of brain lesions, with poor specificity, similar to structural X-ray techniques.

[Attitudes, beliefs, and motivations in blood donors and non-donors]. / Actitudes, creencias y motivaciones en donantes y no donantes de sangre.

OBJECTIVE: To know and compare the beliefs, attitudes and motivations of donors and non-donors in relation with blood donation. MATERIAL AND METHODS: Transversal study by questionnaires administered to 197 blood donors and 303 non-donors. The questionnaires gathered: sociodemographic data, beliefs and attitudes (using a Likert scale), and motivations and demotivations (using upon questions). The responses were analysed using different descriptive analyses and bivariant tests, and factorial analysis and discriminant analysis were performed as multivariant analyses. RESULTS: The donor group had a mean age of 37.8 years, were 58.4 female and 41.6% male, and had made 6.02 donations. The non-donor group had a mean age of 39.8 years and were 53.8% female and 46.2 male. Regarding attitudes and beliefs, the donor group showed more confidence in the good conditions in which donations are performed, had less fears about the possibility that donation can affect health, their attitudes were generally less egotistical, and they had less fears about possible commercialisation of the blood. Both groups believed that blood banks and society itself give inadequate compensation to donors, but this belief was significantly greater among non-donors. Regarding the motivations of donors, the highest proportion were related with a sense of solidarity or duty (26.4%), followed by issues related with information or pressure (23.4%), and the possible personal or family benefits that donation might bring (21.8%). The initial motivations of most donors (75.9%) had not varied with the passage of time, and the factors found to be most demotivating for donation had to do with problems of access and comfort (74.6%). We would highlight that most non-donors denied any worries about blood donation (70.9%) and did not agree that those who need blood should be those who pay for it (92.8%). For non-donors, lack of information (43.6%) and different fears (32.3%) were the principal factors discouraging them from donating. Finally, discriminant analysis selected 11 of the items as providing 75.6% of correct discrimination between the one population and the other. CONCLUSIONS: Donors and non-donors reveal very different beliefs, attitudes and motivations towards blood donation, and the questionnaire employed in this study permits a high degree of discrimination between the two groups. The attitudes of non-donors towards donation are generally less favourable, but allow us to think that a high percentage of these could be changed with the right conditions.