Use of PET/CT as a diagnostic tool in various clinical scenarios related to systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a systemic disease mediated by immune complexes of unknown aetiology that generates excessive production of autoantibodies against components of the cell nucleus, generating multisystemic involvement affecting organs or systems such as the central nervous, cardiovascular, haematolymphoid, musculoskeletal, kidney, serous, skin and subcutaneous tissue cells, among others. 2-Fluoro-2-deoxyglucose (FDG) is a glucose analogue that has been shown to be a useful diagnostic tool to establish the initial systemic involvement of this disease and response to the various treatments used.

El lupus eritematoso sistémico (LES) es una enfermedad sistémica mediada por inmunocomplejos de etiología desconocida, la cual genera una producción excesiva de autoanticuerpos contra componentes del núcleo celular. Esto último conlleva un compromiso multisistémico que afecta a órganos o sistemas como el nervioso central, el cardiovascular, el hematolinfoide, el musculoesquelético, el rinón, las serosas, la piel y el tejido celular subcutáneo, entre otros. La 2-fluoro-2-desoxiglucosa (FDG) es un análogo de la glucosa que ha mostrado ser una herramienta diagnostica útil para establecer el compromiso sistémico inicial de esta enfermedad y la respuesta a los diversos tratamientos.

Findings in [99mTc]MAA SPECT/CT in the diagnosis and follow-up of pulmonary embolism after infection by SARS-CoV-2 (COVID-19).

SARS-CoV-2 (COVID-19) infection is a current public health problem that has been shown to cause multiple complications, including pulmonary thromboembolism. The first presented case is a 59-year-old woman with a history of COPD, paroxysmal atrial fibrillation and COVID-19 infection in September 2020, consultation in December 2020 for atypical chest pain with suspected PE, AngioCT of pulmonary vessels was performed negative for emboli, subsequently [99mTc]Tc MAA SPECT/CT was indicated with a report of multiple triangular defects concerning acute pulmonary thromboembolism. A second case is a 70-year-old man with a history of dyslipidaemia, presented COVID-19 infection in September 2020 with a complication of PE with involvement of the left pulmonary artery, followed by [99mTc]Tc MAA SPECT/CT report multiple triangular and not triangles defects concerning pulmonary thromboembolism with signs of reperfusion.

Is there a consensus between clinical practice guidelines for conventional and molecular nuclear medicine studies in parathyroid pathology?

Hyperparathyroidism is a common calcium metabolic disorder, characterized by the presence of high concentrations or inappropriately normal concentrations of parathyroid hormone (PTH) in the context of high calcium. Pharmacological and surgical management is available as treatment. The objective of diagnostic imaging is to determine the location of the causal lesion. For these purposes, non-invasive methods can be divided into anatomical or functional studies, with nuclear medicine studies being in the latter category. The objective of this review, is to establish the similarities and differences that exist in the clinical practice guidelines on conventional and molecular nuclear medicine studies in parathyroid disease.

Accidente cerebro vascular visualizado en gammagrafía conTc-99m MDP, un hallazgo extraóseo inusual / Stroke in scintigraphy with Tc-99m MDP, an unusual extraosseous finding / Acidente vascular cerebral visualizado na cintilografia com Tc-99m MDP, um achado extra-sensorial incomum

Se presenta el caso de un paciente con antecedente de adenocarcinoma de próstata y diagnóstico de ACV isquémico con transformación hemorrágica. La gammagrafía ósea con Tc-99m MDP complementada con SPECT e imágenes de fusión con TC cerebral simple, realizada a los 15 días, muestra hipercaptación en la región temporal izquierda, correspondiente al ACV en etapa subaguda.

We present the case of a patient with a history of prostate adenocarcinoma with a diagnosis of ischemic stroke with hemorrhagic transformation. Bone scintigraphy with Tc-99m MDP supplemented with SPECT and fusion images with simple cerebral CT, performed at 15 days, shows uptake in the left temporal region, corresponding to stroke in subacute stage

Apresentamos o caso de um paciente com história de adenocarcinoma de próstata com diagnóstico de acidente vascular cerebral isquêmico com transformação hemorrágica. A cintilografia óssea com Tc-99m MDP suplementada com SPECT e imagens de fusão com TC cerebral simple, realizadas aos 15 dias, mostra captação na região temporal esquerda, correspondente ao ACV na fase subaguda

Trombosis vascular en injerto renal visualizado en renograma con 99mtc - mag3, un evento infrecuente / Vascular thrombosis in renal graft visualized in 99mtc- mag3 renogram, in unfortunate event / Trombose vascular do enxerto em renal renogram exibido em 99m - mag3, um evento pouco freqüente

El trasplante renal es el tratamiento de elección para la enfermedad renal terminal. Pueden presentarse diversas complicaciones médicas y quirúrgicas posteriores, entre ellas las vasculares (trombosis/estenosis de la vena y/o arteria renal) que son poco frecuentes y resultan en la pérdida del injerto. Presentamos el caso de un paciente masculino que al tercer día posterior al trasplante persisten con anuria y elevación de azoados, realizándose renograma con 99m - Tc MAG3 con hallazgos compatibles de trombosis vascular.

Kidney transplantation is the treatment of choice for end-stage renal disease. Various medical and surgical complications can occur later, among them the vascular ones (thrombosis/stenosis of the vein and/or renal artery) that are infrequent and result in the loss of the graft. We present the case of a male patient who persisted with anuria and azoate elevation on the third day after transplantation, performing a renogram with 99m - Tc MAG3 with compatible findings of vascular thrombosis.

Hiperplasia de las 4 glándulas paratiroides en hiperparatiroidismo terciario, una imagen infrecuente visualizada en la gammagrafía con Tc-99m MIBI

RESUMEN El hiperparatiroidismo terciario es una complicación presentada en pacientes con enfermedad renal crónica llevados a trasplante renal cuyo manejo quirúrgico requiere de la ubicación mediante imágenes diagnosticas para garantizar el éxito de esta intervención. Se presenta caso de mujer en hemodiálisis crónica que presentó hiperparatiroidismo terciario por hiperplasia paratiroidea confirmada con Tc-99m MIBI SPECT.

ABSTRACT Tertiary hyperparathyroidism is a complication presented in patients with chronic kidney disease subjected to renal transplantation whose surgical management requires location through diagnostic images to guarantee the success of this intervention. We present the case of a woman on chronic hemodialysis who presented tertiary hyperparathyroidism due to parathyroid hyperplasia confirmed by Tc-99m MIBI SPECT.

Hallazgos en gammagrafía con análogos de la somatostatina (Tc-99m HYNIC-TOC) en metástasis sobre cuero cabelludo como debut en un tumor neuroendocrino de origen incierto / Findings insomatostatin analogue scintigraphy (99mtc-HYNIC-TOC) in scalp metastasis as debut in a neuroendocrine tumor of uncertain origin / Achados em cintilografia com análogos de somatostatina (Tc-99m HYNIC-TOC) em metástases no couro cabeludo como estréia em um tumor neuroendócrino de origem incerta

Los estudios de medicina nuclear permiten en tumor neuroendocrino (TNE) de origen desconocido la búsqueda del tumor primario y estadificación de la enfermedad

Nuclear medicine studies allow neuroendocrine tumor (NET) of unknown origin to search for the primary tumor and staging the disease

Estudos de medicina nuclear permitem o tumor neuroendócrino (NET) de origem desconhecida para a pesquisa do tumor primário e o estadiamento da doença

Carcinoma de uraco, una neoplasia maligna poco frecuente / Urachal carcinoma, a rare malignant neoplasm / Carcinoma de úraco, uma neoplasia maligna pouco frequente

El carcinoma de uraco es una neoplasia maligna poco frecuente de predominio masculino entre la quinta a sexta década de la vida. Se localizan típicamente en la cúpula de la vejiga, con patrón histopatológico predominante de adenocarcinoma en el 90% de los casos. Tiene un curso indolente con manifestaciones clínicas en etapas tardías caracterizadas por hematuria, dolor abdominal, disuria, mucosuria, entre otros. El diagnóstico se basa en el hallazgo de la lesión por métodos endoscópicos e imagenológicos. Dado lo infrecuente de esta patología, se describe el caso de una paciente en su cuarta década de vida con infección de vías urinarias recurrente, en quien se documentó por medio de urografía por tomografía computarizada multicorte (UROTAC) de pólipo vesical resecado por resección transuretral (RTU) con reporte histológico de adenocarcinoma de tipo entérico.

Urachal carcinoma is a rare malignant neoplasm of male predominance between the fifth to sixth decade of life. It is typically located in the dome of the bladder, with a predominant histopathological pattern of adenocarcinoma in 90% of cases. It has an indolent course with clinical manifestations in late stages characterized by hematuria, abdominal pain, dysuria, mucosuria, among others. Diagnosis is based on the finding of the lesion by endoscopic and imaging techniques. Given the infrequent nature of this pathology, we describe the case of a female patient in her fourth decade of life with recurrent urinary tract infection, who was documented by MSCTU of bladder polyp resected by TURP with a histological report of enteric-type adenocarcinoma.

O carcinoma de úraco, é uma neoplasia maligna pouco frequente, predominantemente masculina que se manifesta entre a quinta e a sexta década de vida. Sua localização típica é a cúpula vesical e em 90% dos casos sua histologia corresponde a adenocarcinomas. Apresenta evolução indolente com manifestações clínicas nas etapas tardias caracterizadas por hematúria, dor abdominal, disúria, mucosúria, entre outros. O diagnóstico está baseado no achado da lesão por métodos endoscópicos e de imagens. Considerando a baixa frequência desta patologia, descreve-se o caso de uma paciente de sexo feminino em sua quarta década de vida com infecção recorrente das vias urinarias, na qual foi registrado, através de UROTAC, um pólipo vesical ressecado por RTU com laudo histológico de adenocarcinoma de tipo entérico.

Condrosarcoma en columna torácica: reporte de caso y revisión de la literatura / Thoracic spine chondrosarcoma: case report and literature review

El condrosarcoma espinal es un tumor maligno primario de la columna vertebral poco prevalente, ubicándose en mayor frecuencia a nivel torácico y lumbosacro. La dorsalgia de predominio nocturno es el principal síntoma y los signos de mielopatía por compresión los menos frecuentes. El diagnóstico requiere de estudios imagenológicos como la tomografía computarizada (TC) y resonancia magnética (RM). El tratamiento es quirúrgico y según su histopatología definirá la terapia coadyuvante. Presentamos un paciente con dorsalgia crónica y hemiparesia izquierda; donde la RM evidenció una lesión tumoral a nivel de T1-T3, realizándose resección quirúrgica con posterior reporte histopatológico de condrosarcoma grado II.(AU)

Spinal chondrosarcoma is a primary malignant tumor of the spine that is not very prevalent, being located more frequently at the thoracic and lumbosacral levels. Dorsalgia of nocturnal predominance is the main symptom and the signs of compression myelopathy are the least frequent. Diagnosis requires imaging studies such as computed tomography (CT) and magnetic resonance imaging (MRI). The treatment is surgical and according to histopathology will define adjuvant therapy. We present a patient with chronic dorsalgia and left hemiparesis; where MRI showed a T1-T3 tumor lesion, and surgical resection with a histopathological report of chondrosarcoma grade II was performed.(AU)