ABSTRACT
Isolated limb perfusion (ILP) is a method for treating unresectable lesions of limbs in patients with melanoma or sarcoma by using high doses of tumor necrosis factor alpha and melphalan. These high doses can result in high systemic toxicity if there is a drug leak from the isolated circulation of the limb to the systemic. This makes it imperative to monitor the leakage rate (F[%]) during the infusion, currently performed with radiotracers. The objective of this work was to develop a leakage monitoring protocol as accurate as possible to ensure safe ILP. MATERIAL AND METHOD: We built a phantom with 3compartments (body, limb and precordial area) and a high sensitivity collimator fitted to a portable gammacamera. We simulate ILP with scheduled leaks every 10minutes from 1% to 9% (theorical F[%]). We mesured F(%) using 2equation: one is the proposed in the literature and another corrected by decay of the radioisotope. We test the optimal radiopharmaceutical doses to minimize the detector dead time error and compare F(%) mesured by both equations regarding the theoretical F(%). The leakage monitoring protocol was used in 17 ILP of 16 patients and an analysis of the recorded data was performed. RESULTS: We found significant differences between F(%) mesured using the first equation and theoretical F(%), obtaining results very adjusted to the theorical after applying the decay correction. CONCLUSIONS: The decay correction of the radioisotope is a simple manner to carry out the procedure more safely, reducing the error in the calculation of F(%).
ABSTRACT
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Subject(s)
Humans , Female , Aged , Adenoma, Oxyphilic/secondary , Skin Neoplasms/secondary , Thyroid Neoplasms/secondary , Adenoma, Oxyphilic/diagnostic imaging , Thyroid Neoplasms/diagnostic imagingABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Thyroid Neoplasms/pathology , Thyroid Cancer, Papillary/pathology , Single Photon Emission Computed Tomography Computed Tomography/methods , False Positive Reactions , Thyroidectomy , Postoperative Complications/diagnostic imaging , Cysts/diagnostic imagingABSTRACT
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Subject(s)
Humans , Male , Aged, 80 and over , Cystocele/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Fluorodeoxyglucose F18 , Incidental Findings , Lung Neoplasms/diagnostic imagingABSTRACT
The Erdheim-Chester disease (ECD) is an extremely rare form of non-Langerhans cell histiocytosis. The main difficulty for its diagnosis lies in the wide variety of non-specific symptoms and signs that can occur in the disease process, leading, therefore, to there being no clear-cut algorithm as a guide for an optimal biopsy to confirm the diagnosis. An 81-year-old male with history of diabetes insipidus was admitted due to non-specific respiratory signs. Imaging techniques revealed osteoblastic lesions in the lumbar spine. Whole-body bone-scintigraphy (BS) was performed, in which lesions involving the axial and appendicular skeleton, with different rates of osteoblastic activity, were observed. This highlighted a symmetrical severely intense uptake in the knees, leading to an accurate biopsy specimen that enabled making the definitive diagnosis. BS is a widely available, safe, and inexpensive technique that shows a characteristic pattern of uptake for ECD, thus its use is highly recommended for screening and guiding biopsy if clinical suspicion exists. Furthermore, when the scintigraphy pattern is incidentally observed, biopsy of increased uptake areas (tibia preferably) is mandatory in order to rule out the disease (AU)
La enfermedad de Erdheim-Chester es una histiocitosis no-Larngerhans extremadamente rara. La dificultad en su diagnóstico se debe a los signos y síntomas inespecíficos que presenta, que conlleva la ausencia de un claro algoritmo diagnóstico. Reportamos el caso de un varón de 81 años con diabetes insipidus en estudio por síntomas respiratorios inespecíficos. Lesiones osteoblásticas en la columna fueron referidas en técnicas radiológicas. Mediante gammagrafía ósea (GO) se observaron lesiones osteoblásticas con diferente actividad metabólica en esqueleto axial y apendicular, destacando una actividad muy elevada y simétrica en rodillas, cuya biopsia permitió el diagnóstico definitivo. La GO es una técnica disponible, segura y barata que muestra un patrón característico, por lo que recomendamos su realización como screening y guía para toma de biopsia. Ante el hallazgo incidental de dicho patrón debería realizarse biopsia (AU)
Subject(s)
Humans , Male , Aged, 80 and over , Radionuclide Imaging/instrumentation , Radionuclide Imaging/methods , Erdheim-Chester Disease/complications , Erdheim-Chester Disease , Histiocytosis, Non-Langerhans-Cell/pathology , Histiocytosis, Non-Langerhans-Cell , Algorithms , Tomography, Emission-Computed/instrumentation , Tomography, Emission-Computed/methods , Tomography, Emission-Computed , Tomography, Emission-Computed/trendsABSTRACT
The Erdheim-Chester disease (ECD) is an extremely rare form of non-Langerhans cell histiocytosis. The main difficulty for its diagnosis lies in the wide variety of non-specific symptoms and signs that can occur in the disease process, leading, therefore, to there being no clear-cut algorithm as a guide for an optimal biopsy to confirm the diagnosis. An 81-year-old male with history of diabetes insipidus was admitted due to non-specific respiratory signs. Imaging techniques revealed osteoblastic lesions in the lumbar spine. Whole-body bone-scintigraphy (BS) was performed, in which lesions involving the axial and appendicular skeleton, with different rates of osteoblastic activity, were observed. This highlighted a symmetrical severely intense uptake in the knees, leading to an accurate biopsy specimen that enabled making the definitive diagnosis. BS is a widely available, safe, and inexpensive technique that shows a characteristic pattern of uptake for ECD, thus its use is highly recommended for screening and guiding biopsy if clinical suspicion exists. Furthermore, when the scintigraphy pattern is incidentally observed, biopsy of increased uptake areas (tibia preferably) is mandatory in order to rule out the disease.
Subject(s)
Bone and Bones/diagnostic imaging , Erdheim-Chester Disease/diagnostic imaging , Aged, 80 and over , Biopsy , Bone and Bones/pathology , Erdheim-Chester Disease/pathology , Histiocytosis, Non-Langerhans-Cell , Humans , Male , Tibia/diagnostic imagingABSTRACT
Multiple endocrine neoplasia syndrome, type 2B (MEN 2B), is a rare entity characterized by the presence of medullary thyroid cancer in 100% of the cases. The phenotype of this syndrome consists in the presence of marfanoid features and mucocutaneous neuromas. We describe the case of a male patient with MEN 2B syndrome who was diagnosed with medullary thyroid cancer after lung metastases was found. We analyze the role of DMSA-V and the new hybrid SPECT-CT scan systems in the extension study and monitoring of medullary thyroid cancer.
Subject(s)
Carcinoma, Medullary/secondary , Lumbar Vertebrae/diagnostic imaging , Multimodal Imaging , Multiple Endocrine Neoplasia Type 2b/diagnostic imaging , Positron-Emission Tomography , Radiopharmaceuticals , Spinal Neoplasms/secondary , Technetium Tc 99m Dimercaptosuccinic Acid , Thoracic Vertebrae/diagnostic imaging , Thyroid Neoplasms/pathology , Tomography, X-Ray Computed , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Benzenesulfonates/administration & dosage , Carcinoma, Medullary/diagnostic imaging , Carcinoma, Medullary/drug therapy , Humans , Liver Neoplasms/secondary , Lung Neoplasms/secondary , Male , Multiple Endocrine Neoplasia Type 2b/genetics , Neck Dissection , Niacinamide/analogs & derivatives , Octreotide/administration & dosage , Phenylurea Compounds , Proto-Oncogene Proteins c-ret/genetics , Pyridines/administration & dosage , Sorafenib , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/drug therapy , Thyroid Neoplasms/surgery , Thyroidectomy , Young AdultSubject(s)
Hepatitis C, Chronic/complications , Polyneuropathies/etiology , Sarcoidosis/etiology , Female , Humans , Middle AgedABSTRACT
No disponible
Subject(s)
Female , Middle Aged , Humans , Sarcoidosis/complications , Hepatitis C/complications , Radiography, Thoracic , Electromyography , Tomography, Emission-Computed , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Female , Aged , Humans , 3-Iodobenzylguanidine , Tomography, Emission-Computed, Single-Photon/methods , Thyroid Neoplasms , Adenocarcinoma, Follicular , GallbladderABSTRACT
We present the case of a 78 year old man admitted to the hospital with progressive memory disorder. Neuropsychological examination showed inability to recognize familiar faces (prosopagnosia). MRI documented cortical atrophy, which did not explain the neurological deficit. CT did not show abnormalities. Most patients with prosopagnosia present brain atrophy, as they are more than 65 years old. Scanning by SPECT revealed hypoperfusion in the right parietotemporal region, which was worse in a later examination.
Subject(s)
Cerebral Cortex/diagnostic imaging , Prosopagnosia/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Aged , Disease Progression , Humans , MaleABSTRACT
Se presenta el caso de un varón de 78 años que acudió al hospital por deterioro progresivo de la memoria. El estudio neuropsicológico informó que el paciente presentaba incapacidad para reconocer caras familiares (prosopagnosia). La prueba de RMN mostró atrofia cortical generalizada, que no explicaba la sintomatología. La TAC no evidenció anormalidades. La mayoría de los pacientes con prosopagnosia primaria presentan atrofia senil, debido a que son mayores de 65 años. La SPECT cerebral mostró áreas de hipoperfusión en región parietotemporal derecha, que empeoran en un control posterior (AU)