ABSTRACT
Objetivo: Evaluar la utilidad de la PET/RM con 18F-colina simultánea en la sospecha de recurrencia del carcinoma de próstata y relacionar su tasa de detección de enfermedad con variables analíticas y anatomopatológicas. Material y métodos: Estudio retrospectivo de 27 pacientes con carcinoma de próstata que recibieron terapia local como tratamiento primario, a quienes se les realizó una PET/RM con 18F-colina por sospecha de recurrencia (elevación mantenida de los niveles de PSA). Los hallazgos patológicos de la PET/RM con 18F-colina fueron validados mediante el análisis anatomopatológico, otras pruebas de imagen o por la respuesta bioquímica al tratamiento oncológico. Resultados: La PET/RM con 18F-colina detectó enfermedad en 15 de los 27 pacientes (tasa de detección del 55,56%); 4 (15%) presentaron recurrencia exclusivamente local, 5 (18%) metástasis ganglionares y 7 (26%) metástasis óseas. El PSA medio (PSAmed) a la realización del estudio fue de 2,94ng/mL (rango 0,18-10ng/mL). Los pacientes con PET/RM positiva presentaron un PSAmed de 3,70ng/mL (rango 0,24-10ng/mL), mayor que los pacientes con PET/RM negativa, PSAmed de 1,97ng/mL (rango 0,18-4,38ng/mL), aunque sin diferencias estadísticamente significativas. La puntuación Gleason al diagnóstico de los pacientes con estudio positivo fue de 7,33 (rango 6-9), y la de los pacientes con estudio negativo fue de 7 (rango 6-9), sin diferencias estadísticamente significativas. Conclusión: La tasa de detección de la PET/RM con 18F-colina fue considerable pese a los valores relativamente bajos de PSA en nuestra muestra. La influencia de la puntuación Gleason y del nivel de PSA en la tasa de detección de la PET/RM con 18F-colina no fue estadísticamente significativa
Objective: To evaluate the usefulness of simultaneous 18F-choline PET/MRI in the suspicion of prostate cancer recurrence and to relate 18F-choline PET/MRI detection rate with analytical and pathological variables. Material and methods: 27 patients with prostate cancer who received local therapy as primary treatment underwent a 18F-choline PET/MRI due to suspicion of recurrence (persistently rising serum PSA level). 18F-choline PET/MRI findings were validated by anatomopathological analysis, other imaging tests or by biochemical response to oncological treatment. Results: 18F-choline PET/MRI detected disease in 15 of 27 patients (detection rate 55.56%). 4 (15%) presented exclusively local recurrence, 5 (18%) lymph node metastases and 7 (26%) bone metastases. Mean PSA (PSAmed) at study time was 2.94ng/mL (range 0.18-10ng/mL). PSAmed in patients with positive PET/MRI was 3.70ng/mL (range 0.24-10ng/mL), higher than in patients with negative PET/MRI, PSAmed 1.97ng/mL (range 0.18-4.38ng/mL), although without statistically significant differences. Gleason score at diagnosis in patients with a positive study was 7.33 (range 6-9) and in patients with a negative study was 7 (range 6-9), without statistically significant differences. Conclusion: 18F-choline PET/MRI detection rate was considerable despite the relatively low PSA values in our sample. The influence of Gleason score and PSA level on 18F-choline PET/MRI detection rate was not statistically significant
Subject(s)
Humans , Male , Middle Aged , Aged , Aged, 80 and over , Positron-Emission Tomography/methods , Magnetic Resonance Spectroscopy/methods , Radiopharmaceuticals , Prostatic Neoplasms/diagnostic imaging , Neoplasm Recurrence, Local/diagnostic imaging , Carcinoma/diagnostic imaging , Choline , Prostate-Specific Antigen/analysis , Retrospective Studies , Neoplasm Metastasis/diagnostic imagingABSTRACT
OBJECTIVE: To evaluate the usefulness of simultaneous 18F-choline PET/MRI in the suspicion of prostate cancer recurrence and to relate 18F-choline PET/MRI detection rate with analytical and pathological variables. MATERIAL AND METHODS: 27 patients with prostate cancer who received local therapy as primary treatment underwent a 18F-choline PET/MRI due to suspicion of recurrence (persistently rising serum PSA level). 18F-choline PET/MRI findings were validated by anatomopathological analysis, other imaging tests or by biochemical response to oncological treatment. RESULTS: 18F-choline PET/MRI detected disease in 15 of 27 patients (detection rate 55.56%). 4 (15%) presented exclusively local recurrence, 5 (18%) lymph node metastases and 7 (26%) bone metastases. Mean PSA (PSAmed) at study time was 2.94ng/mL (range 0.18-10ng/mL). PSAmed in patients with positive PET/MRI was 3.70ng/mL (range 0.24-10ng/mL), higher than in patients with negative PET/MRI, PSAmed 1.97ng/mL (range 0.18-4.38ng/mL), although without statistically significant differences. Gleason score at diagnosis in patients with a positive study was 7.33 (range 6-9) and in patients with a negative study was 7 (range 6-9), without statistically significant differences. CONCLUSION: 18F-choline PET/MRI detection rate was considerable despite the relatively low PSA values in our sample. The influence of Gleason score and PSA level on 18F-choline PET/MRI detection rate was not statistically significant.
Subject(s)
Choline/analogs & derivatives , Magnetic Resonance Imaging , Neoplasm Recurrence, Local/diagnostic imaging , Positron-Emission Tomography , Prostatic Neoplasms/diagnostic imaging , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Prostatic Neoplasms/pathology , Retrospective StudiesABSTRACT
Objetivo. El objetivo de esta revisión fue evaluar la capacidad diagnóstica de la PET/RM simultánea en oncología, comparándola con la de la PET/TC, basándonos en la evidencia disponible. Material y métodos. Se realizó una búsqueda sistemática en las bases de datos Medline y Embase hasta el 21 de enero de 2016, para identificar artículos clínicos originales que realizasen un análisis comparativo entre PET/RM simultánea y PET/TC en pacientes oncológicos. Resultados. Se obtuvo un total de 57 artículos, distribuidos por enfermedades del siguiente modo: carcinoma de cabeza y cuello (5), pulmón y nódulos pulmonares (13), carcinoma colorrectal (1), lesiones hepáticas (2), incidentalomas abdominales (1), tumores neuroendocrinos (2), carcinoma de tiroides (2), carcinoma de mama (3), tumores ginecológicos (2), carcinoma de próstata (4), linfoma (2), mieloma múltiple (1), metástasis óseas (3), tumores intracraneales (2), oncología pediátrica (1) y neoplasias diversas (13). En la mayoría de las enfermedades oncológicas, el rendimiento diagnóstico de la PET/RM simultánea fue similar o incluso superior al de la PET/TC. Sin embargo, la PET/TC fue superior en la detección de pequeños nódulos pulmonares. Conclusión. La PET/RM simultánea en oncología es factible, obteniendo resultados al menos equiparables a los de la PET/TC, con menor exposición a radiaciones ionizantes. No obstante, la evidencia disponible aún es limitada, y son necesarios estudios que incluyan a un mayor número de pacientes y neoplasias para establecer las indicaciones de la PET/RM e identificar los protocolos adecuados a cada enfermedad (AU)
Objective. The aim of this review was to evaluate the diagnostic performance of simultaneous PET/MRI in oncology compared with that of PET/CT, based upon the available evidence. Material and methods. A systematic search was performed in the Medline and Embase databases to identify original clinical articles published up to 21 January 2016, in order to compare simultaneous PET/MRI and PET/CT in oncology patients. Results. A total of 57 articles were obtained that included various diseases: head and neck cancer (5), lung cancer and lung nodules (13), colorectal cancer (1), liver lesions (2), abdominal incidentalomas (1), neuroendocrine tumours (2), thyroid carcinoma (2), breast cancer (3), gynaecological cancer (2), prostate cancer (4), lymphoma (2), multiple myeloma (1), bone metastases (3), intracranial tumours (2), paediatric oncology (1) and various tumours (13). Diagnostic performance of simultaneous PET/MRI was similar or even better to that of PET/CT in most oncological diseases. However, PET/CT was superior for small lung nodule detection. Conclusion. Simultaneous PET/MRI in oncology is feasible, performing at least equally as well as PET/CT, with lower radiation exposure. However, available evidence is still limited. Studies including more patients and tumours are needed to establish PET/MRI indications and to identify appropriate protocols for each disease (AU)
Subject(s)
Humans , Male , Female , Positron-Emission Tomography/instrumentation , Positron-Emission Tomography/methods , Neoplasms/complications , Neoplasms , Carcinoma/complications , Carcinoma , Head and Neck Neoplasms , Thyroid Neoplasms , Breast Neoplasms , Prostatic Neoplasms , Lung Neoplasms , Multiple Pulmonary Nodules/complications , Multiple Pulmonary Nodules/epidemiology , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms , Neuroendocrine Tumors/epidemiology , Neuroendocrine TumorsABSTRACT
OBJECTIVE: The aim of this review was to evaluate the diagnostic performance of simultaneous PET/MRI in oncology compared with that of PET/CT, based upon the available evidence. MATERIAL AND METHODS: A systematic search was performed in the Medline and Embase databases to identify original clinical articles published up to 21 January 2016, in order to compare simultaneous PET/MRI and PET/CT in oncology patients. RESULTS: A total of 57 articles were obtained that included various diseases: head and neck cancer (5), lung cancer and lung nodules (13), colorectal cancer (1), liver lesions (2), abdominal incidentalomas (1), neuroendocrine tumours (2), thyroid carcinoma (2), breast cancer (3), gynaecological cancer (2), prostate cancer (4), lymphoma (2), multiple myeloma (1), bone metastases (3), intracranial tumours (2), paediatric oncology (1) and various tumours (13). Diagnostic performance of simultaneous PET/MRI was similar or even better to that of PET/CT in most oncological diseases. However, PET/CT was superior for small lung nodule detection. CONCLUSION: Simultaneous PET/MRI in oncology is feasible, performing at least equally as well as PET/CT, with lower radiation exposure. However, available evidence is still limited. Studies including more patients and tumours are needed to establish PET/MRI indications and to identify appropriate protocols for each disease.
Subject(s)
Magnetic Resonance Imaging , Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Humans , Multimodal ImagingABSTRACT
Neuropsychiatric manifestations in 25% to 70% of patients with systemic lupus erythematosus (SLE), generally in young people. The variability in its clinical expression and lack of diagnostic methods have hindered the diagnosis of Central Nervous System Lupus. When the literature was reviewed on this subject, an important variability was found between the Single Photon Emission Computed Tomography (SPECT) findings and the patient's clinical symptoms and disease course. The case we are presenting shows the usefulness of brain perfusion SPECT because it shows alterations in the central nervous system that are not detected with other imaging modalities.
Subject(s)
Apraxias/diagnostic imaging , Cerebrovascular Circulation , Lupus Erythematosus, Systemic/diagnostic imaging , Memory Disorders/diagnostic imaging , Mood Disorders/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Adolescent , Apraxias/etiology , Apraxias/physiopathology , Female , Humans , Lupus Erythematosus, Systemic/complications , Memory Disorders/etiology , Memory Disorders/physiopathology , Mood Disorders/etiology , Mood Disorders/physiopathology , RadiographyABSTRACT
La clínica neuropsiquiátrica aparece entre un 25 y un 70% de los pacientes con lupus eritematoso sistémico (LES), fundamentalmente en jóvenes. La variedad en la expresión clínica y la falta de métodos diagnósticos ha dificultado el diagnóstico de la afectación neurológica del lupus. Revisada la literatura al respecto, se observa una importante variabilidad entre los hallazgos de la tomografía computarizada por emisión de fotón único (SPECT) con los síntomas clínicos de los pacientes y la evolución de la enfermedad. El caso que presentamos muestra la utilidad de la SPECT de perfusión cerebral, porque evidencia alteraciones en el sistema nervioso central que no se observan con otras técnicas de imagen(AU)
Neuropsychiatric manifestations in 25% to 70% of patients with systemic lupus erythematosus (SLE), generally in young people. The variability in its clinical expression and lack of diagnostic methods have hindered the diagnosis of Central Nervous System Lupus. When the literature was reviewed on this subject, an important variability was found between the Single Photon Emission Computed Tomography (SPECT) findings and the patient's clinical symptoms and disease course. The case we are presenting shows the usefulness of brain perfusion SPECT because it shows alterations in the central nervous system that are not detected with other imaging modalities(AU)
