Análisis visual y semicuantitativo del 6-[18F]FDOPA PET/TC en pacientes con tumores cerebrales ante la sospecha de recurrencia tumoral versus radionecrosis / VAnálisis visual y semicuantitativo del 6-[18F]FDOPA PET/TC en pacientes con tumores cerebrales ante la sospecha de recurrencia tumoral versus radionecrosis

Introducción La tomografía por emisión de positrones (PET) con aminoácidos es una herramienta recomendada por las principales sociedades de neuroimagen, en el diagnóstico diferencial entre radionecrosis (RNC) y recurrencia tumoral (RT) en los tumores cerebrales, sin embargo, su uso en nuestro pais aún es limitado. El objetivo de este trabajo es presentar nuestra experiencia con 6-[18F]FDOPA PET/TC (FDOPA) en tumores cerebrales (primarios y M1), comparando estos resultados con otros publicados. Material y métodos Estudio retrospectivo de 62 pacientes con sospecha de RT: 42 metástasis cerebrales (M1) y 20 primarios, a los que se les realizó una FDOPA. Las imágenes fueron analizadas visual y semicuantitativamente, obteniendo el SUVmax y los ratios SUVmaxlesión/SUVmaxestriado (L/E) y SUVmaxlesión/SUVmaxcortex (L/C). Se analizó la validez diagnóstica de la PET y se calcularon los puntos de corte con mayor rendimiento. Los resultados de la PET se compararon con la evolución clínico-radiológica y/o con la histopatología. Resultados Se identificó RT en el 49% de las M1 y en el 76% de los primarios cerebrales. La interpretación de la FDOPA con mejores resultados fue la conjunta; visual y semicuantitativa, con una sensibilidad y especificidad en los primarios del 94 y 80% y en las M1 del 96 y 72%, respectivamente. Los puntos de corte con mejor rendimiento diagnóstico fueron L/C 1,44 en M1 y L/C 1,55 en primarios. Existen resultados discrepantes con otros publicados. Conclusión La FDOPA PET/TC es una herramienta útil en el diagnóstico diferencial entre RT y RNC en tumores cerebrales. Es necesario una estandarización que contribuya a homogeneizar los resultados de la FDOPA a nivel intercentro (AU)

Introduction Amino acid PET is a tool recommended by the main neuroimaging societies in the differential diagnosis between radionecrosis (RNC) and tumour recurrence (TR) in brain tumours, but its use in our country is still limited. The aim of this work is to present our experience with 6-[18F]FDOPA PET/CT (FDOPA) in brain tumours (primary and M1), comparing these results with other published results. Material and methods Retrospective study of 62 patients with suspected tumour recurrence (TR): 42 brain metastases (M1) and 20 primary, who underwent FDOPA. Images were analysed visually and semi-quantitatively, obtaining SUVmax and SUVmaxlesion/SUVmaxstriatum (L/S) and SUVmaxlesion/SUVmaxcortex (L/C) ratios. The diagnostic validity of PET was analysed and the best performing cut-off points were calculated. PET results were compared with clinical-radiological follow-up and/or histopathology. Results TR was identified in 49% of M1 and 76% of brain primaries. The best performing FDOPA interpretation was visual and semi-quantitative, with a sensitivity and specificity in primaries of 94% and 80% and in M1s of 96% and 72% respectively. The cut-off points with the best diagnostic performance were L/C1.44 in M1 and L/C1.55 in primaries. There are discrepant results with other published results. Conclusion FDOPA PET/CT is a useful tool in the differential diagnosis between recurrence and RNC in brain tumours. It is needed a standardization to contribute to homogenise FDOPA results a inter-centre level (AU)

El papel de la PET/TC con 2-[18F]FDG en la enfermedad de Erdheim-Chester / The role of 2-[18F]FDG PET/CT in Erdheim-Chester disease

Objetivo Analizar la distribución corporal de la enfermedad Erdheim-Chester (ECD) y determinar la utilidad de la 2-[18F]FDG-PET/TC frente a otras técnicas de imagen. Asimismo, evaluar la agresividad y la extensión de la enfermedad según la presencia/ausencia de mutación BRAFV600E. Material y métodos Se revisaron las 2-[18F]FDG-PET/TC de todos los pacientes diagnosticados con ECD entre 2008 y 2021: en total, 19 pacientes. Los territorios afectados se clasificaron como detectables por PET/TC o detectables solamente por otras técnicas de imagen (gammagrafía ósea, TC con contraste yodado o RM). Se realizó análisis descriptivo y correlación de la mutación BRAF con los órganos afectados y SUVmáx mediante la prueba t de Student. Resultados De los 19 pacientes (14 hombres; edad media 60,3años), 11 presentaban la mutación BRAFV600E. Se detectaron un total de 127 territorios (64 órgano-sistemas) afectados utilizando las diferentes modalidades de imagen, de los cuales 112 fueron detectados por la PET/TC y 15 territorios adicionales fueron identificados únicamente por la RM cerebral y cardiaca. La presencia de mutación BRAFV600E se asoció con mayor afectación orgánica (p<0,05), sin diferencias en el SUVmáx (p>0,05). Conclusión La 2-[18F]FDG-PET/TC es una prueba de alto rendimiento diagnóstico en pacientes con ECD, detectando la mayoría de los territorios afectados. La RM fue la única prueba de imagen con hallazgos adicionales en territorios con alta captación fisiológica de 2-[18F]FDG (cerebral y cardíaca). La presencia de mutación del BRAFV600E se correlacionó con mayor extensión de la enfermedad (AU)

Objective To analyze the body distribution of Erdheim-Chester disease (ECD) and determine the utility of 2-[18F]FDG PET/CT compared to other imaging techniques. Additionally, to assess the aggressiveness and extent of the disease based on the presence/absence of the BRAFV600E mutation. Materials and methods The 2-[18F]FDG PET/CT scans of all patients diagnosed with ECD between 2008 and 2021 were reviewed, including 19 patients. The affected territories were classified as detectable by PET/CT or detectable only by other imaging techniques (bone scintigraphy, contrast-enhanced CT, or MRI). Descriptive analysis and correlation of the BRAF mutation with the affected organs and maximum SUV were performed using the Student's t-test. Results Out of the 19 patients (14 males; mean age 60.3years), 11 had the BRAFV600E mutation. A total of 127 territories (64 organ-systems) affected were identified using different imaging modalities, of which 112 were detected by PET/CT, and an additional 15 territories were solely identified by cerebral and cardiac MRI. The presence of BRAFV600E mutation was associated with greater organ involvement (P<.05) without differences in SUVmax (P>.05). Conclusion 2-[18F]FDG PET/CT is a highly effective diagnostic tool in patients with ECD, detecting the majority of affected territories. MRI was the only imaging modality with additional findings in territories showing high physiological uptake of 2-[18F]FDG (cerebral and cardiac). The presence of the BRAFV600E mutation correlated with a higher extent of the disease (AU)

The role of 2-[18F]FDG PET/CT in Erdheim-Chester disease.

OBJECTIVE: To analyze the body distribution of Erdheim-Chester disease (ECD) and determine the utility of 2-[18 F]FDG PET/CT compared to other imaging techniques. Additionally, to assess the aggressiveness and extent of the disease based on the presence/absence of the BRAFV600E mutation. MATERIALS AND METHODS: The 2-[18F]FDG-PET/CT scans of all patients diagnosed with ECD between 2008 and 2021 were reviewed, including 19 patients. The affected territories were classified as detectable by PET/CT or detectable only by other imaging techniques (bone scintigraphy, contrast-enhanced CT, or MRI). Descriptive analysis and correlation of the BRAF mutation with the affected organs and maximum SUV were performed using the Student's t-test. RESULTS: Out of the 19 patients (14 males; mean age 60.3 years), 11 had the BRAFV600E mutation. A total of 127 territories (64 organ-systems) affected were identified using different imaging modalities, of which 112 were detected by PET/CT, and an additional 15 territories were solely identified by cerebral and cardiac MRI. The presence of BRAFV600E mutation was associated with greater organ involvement (p < 0.05) without differences in SUVmax (p > 0.05). CONCLUSION: 2-[18F]FDG PET/CT is a highly effective diagnostic tool in patients with ECD, detecting the majority of affected territories. MRI was the only imaging modality with additional findings in territories showing high physiological uptake of 2-[18F]FDG (cerebral and cardiac). The presence of the BRAFV600E mutation correlated with a higher extent of the disease.

Visual and semi-quantitative analysis of 6-[18F]FDOPA PET/CT in patients with brain tumors and suspected tumor recurrence versus radionecrosis.

INTRODUCTION: Amino acid PET is a tool recommended by the main neuroimaging societies in the differential diagnosis between radionecrosis (RNC) and umour recurrence (TR) in brain tumours, but its use in our country is still limited. The aim of this work is to present our experience with 6-[18F]FDOPA PET/CT (FDOPA) in brain tumours (primary and M1), comparing these results with other published results. MATERIAL AND METHODS: Retrospective study of 62 patients with suspected tumour recurrence (TR): 42 brain metastases (M1) and 20 primary, who underwent FDOPA. Images were analysed visually and semi-quantitatively, obtaining SUVmax and SUVmaxlesion/SUVmaxstriatum (L/S) and SUVmaxlesion/SUVmaxcortex (L/C) ratios. The diagnostic validity of PET was analysed and the best performing cut-off points were calculated. PET results were compared with clinical-radiological follow-up and/or histopathology. RESULTS: TR was identified in 49% of M1 and 76% of brain primaries. The best performing FDOPA interpretation was visual and semi-quantitative, with a sensitivity and specificity in primaries of 94% and 80% and in M1s of 96% and 72% respectively. The cut-off points with the best diagnostic performance were L/C1.44 in M1 and L/C1.55 in primaries. There are discrepant results with other published results. CONCLUSION: FDOPA PET/CT is a useful tool in the differential diagnosis between recurrence and RNC in brain tumours. It is needed a standardization to contribute to homogenise FDOPA results a inter-centre level.

Musicogenic reflex seizures in epilepsy with glutamic acid decarbocylase antibodies.

BACKGROUND: Musicogenic reflex seizures (MRS) are a rare form of seizures described in patients with temporal lobe epilepsy (TLE), mainly of unknown etiology. Epilepsy with antibodies against glutamic acid decarboxylase (GAD-ab) is a form of autoimmune epilepsy for which no specific semiology has been described. AIM OF THE STUDY: To retrospectively review the incidence of MRS in the general epileptic population and in the series of patients with epilepsy and GAD-ab and to describe its clinical and paraclinical characteristics. METHODS: Patients recorded between January 2010 and January 2016 in the Database of Bellvitge Hospital Epilepsy Unit were reviewed. RESULTS: From a group of 1510 epileptic patients, three reported MRS (0.0019%) (two patients with epilepsy and GAD-ab and one patient with cryptogenic TLE). The incidence of MRS in patients with epilepsy and GAD-ab was 2 of 22 (9%). Both patients had a normal magnetic resonance Imaging (MRI), but FDG-PET showed medial temporal lobe hypometabolism (unilateral or bilateral) in both and also in the insula in one of them. MRS (recorded via video-EEG[electroencephalography] in one patient) arose from the right temporal lobe. CONCLUSIONS: MRS may be a distinctive seizure type in patients with epilepsy and antiGADab. Determination of GAD-ab should be carried out in all cases of MRS, even those with normal structural MRI.

Diagnosing neuroleukemiosis: is there a role for 18F-FDG-PET/CT? / Diagnosticando la neuroleucemiosis: ¿existe un papel para la PET/TC con 18F-FDG?

An imaging case is presented on a patient referred to our department for an 18F-FDG-PET/CT, as a paraneoplastic syndrome was suspected due to his clinical situation. He had a history of acute myeloid leukemia (AML) treated two years earlier, with sustained complete remission to date. 18F-FDG-PET/CT findings revealed hypermetabolism in almost all nerve roots, suggesting meningeal spread, consistent with the subsequent MRI findings. Cerebrospinal fluid (CSF) findings confirmed a leptomeningeal reactivation of AML. Although not many studies have evaluated the role of 18F-FDG-PET/CT in leukemia, it is a noninvasive tool for detecting extramedullary sites of disease and a good imaging alternative for those patients on whom an MRI cannot be performed (AU)

Presentamos el caso de un paciente remitido a nuestro servicio para la realización de una PET/TC con 18F-FDG por sospecha clínica de un síndrome paraneoplásico Entre sus antecedentes destacaba el de una leucemia mieloide aguda tratada 2 años antes y en remisión completa en los controles sucesivos. La PET/TC con 18F-FDG mostró hipermetabolismo en prácticamente todas las raíces nerviosas, apuntando a enfermedad meníngea diseminada, en concordancia con los hallazgos de la RM realizada posteriormente. El análisis del líquido cefalorraquídeo confirmó una reactivación leptomeníngea de la leucemia mieloide aguda. A pesar de los pocos estudios existentes sobre el papel de la PET/TC con 18F-FDG en la leucemia, es una herramienta no invasiva para localizar recidivas extramedulares de la enfermedad y una buena técnica de imagen alternativa para aquellos pacientes a los que no se les puede realizar una RM (AU)

Diagnosing neuroleukemiosis: Is there a role for 18F-FDG-PET/CT?

An imaging case is presented on a patient referred to our department for an 18F-FDG-PET/CT, as a paraneoplastic syndrome was suspected due to his clinical situation. He had a history of acute myeloid leukemia (AML) treated two years earlier, with sustained complete remission to date. 18F-FDG-PET/CT findings revealed hypermetabolism in almost all nerve roots, suggesting meningeal spread, consistent with the subsequent MRI findings. Cerebrospinal fluid (CSF) findings confirmed a leptomeningeal reactivation of AML. Although not many studies have evaluated the role of 18F-FDG-PET/CT in leukemia, it is a noninvasive tool for detecting extramedullary sites of disease and a good imaging alternative for those patients on whom an MRI cannot be performed.

[Positron emission tomography-computed tomography in tumors of the locomotor apparatus]. / La tomografía por emisión de positrones asociada con la tomografía computarizada en tumores del aparato locomotor.

Positron emission tomography/computed tomography (PET/CT) is a hybrid imaging technique that combines the anatomic information from CT with the metabolic information acquired from PET after the administration of specific radiotracers, the most commonly used of which is F18-fluorodeoxyglucose (FDG). In oncology, this technique is based on the increased uptake of FDG by malignant lesions. In the locomotor apparatus, some uptake by bones and soft tissues is physiological or benign and this uptake must be differentiated from uptake by malignancies, whether primary or secondary. The most important limitations are active inflammatory or infectious processes, which are positive on PET images, and malignant lesions that are smaller than 1cm, cystic, necrotic, or low-grade, which are negative on PET images. PET/CT in the locomotor apparatus is especially useful for the detection of metastases from the most common tumors. It is also used for staging and monitoring the response to treatment of some hematological tumors like lymphoma, where it is fundamental to determine whether the bone marrow has been infiltrated, or myeloma. Lastly, although it is not yet an established indication, PET/CT is being increasingly used to study sarcomas, because it can provide additional information that can be useful for the characterization and grading of tumors, for guiding biopsies, for staging and re-staging, and for evaluating the response to neoadjuvant therapy as well as for evaluating new drugs in clinical trials.

La tomografía por emisión de positrones asociada con la tomografía computarizada en tumores del aparato locomotor / Positron emission tomography-computed tomography in tumors of the locomotor apparatus

La tomografía por emisión de positrones asociada con la tomografía computarizada (PET/TC) es una técnica de imagen híbrida que combina la información anatómica de la TC con la metabólica tras la administración de radiofármacos específicos, de los cuales el más usado es la 18F-fluordesoxiglucosa (FDG). La mayor captación de FDG de las lesiones malignas es la base para la aplicación de la técnica en oncología. En el aparato locomotor hay captaciones óseas y en partes blandas que son fisiológicas o benignas y que se deben diferenciar de las malignas, secundarias o primarias. Las limitaciones más importantes son los procesos inflamatorios o infecciosos activos (positivos en PET) y las lesiones de tamaño inferior a un centímetro, quísticas, necróticas o de bajo grado (negativos en PET). La PET/TC en el aparato locomotor permite especialmente la detección de metástasis de los tumores más frecuentes. También se utiliza en la estadificación y monitorización de la respuesta al tratamiento de algunos tumores hematológicos como el linfoma (donde la determinación de la infiltración de la médula ósea es fundamental) o el mieloma. Por último, aunque no de forma generalizada, es creciente el uso en sarcomas ya que puede aportar información adicional para la caracterización y gradación tumoral, la guía de biopsia, la estadificación y reestadificación, y la evaluación de la respuesta al tratamiento neoadyuvante y de nuevos fármacos en ensayos clínicos (AU)

Positron emission tomography/computed tomography (PET/CT) is a hybrid imaging technique that combines the anatomic information from CT with the metabolic information acquired from PET after the administration of specific radiotracers, the most commonly used of which is F18-fluorodeoxyglucose (FDG). In oncology, this technique is based on the increased uptake of FDG by malignant lesions. In the locomotor apparatus, some uptake by bones and soft tissues is physiological or benign and this uptake must be differentiated from uptake by malignancies, whether primary or secondary. The most important limitations are active inflammatory or infectious processes, which are positive on PET images, and malignant lesions that are smaller than 1cm, cystic, necrotic, or low-grade, which are negative on PET images. PET/CT in the locomotor apparatus is especially useful for the detection of metastases from the most common tumors. It is also used for staging and monitoring the response to treatment of some hematological tumors like lymphoma, where it is fundamental to determine whether the bone marrow has been infiltrated, or myeloma. Lastly, although it is not yet an established indication, PET/CT is being increasingly used to study sarcomas, because it can provide additional information that can be useful for the characterization and grading of tumors, for guiding biopsies, for staging and re-staging, and for evaluating the response to neoadjuvant therapy as well as for evaluating new drugs in clinical trials (AU)

Utilidad de la PET-TC en la valoración de la respuesta precoz al tratamiento en el linfoma B difuso de celula grande. Resultados preliminares / Utility of the PET-CT in the evaluation of early response to treatment in the diffuse large B-cell lymphoma. Preliminary results

Objetivo. Valorar la utilidad de la PET-TC con FDG tras los primeros ciclos de quimioterapia en la predicción de la respuesta al tratamiento en pacientes con linfoma B difuso de célula grande. Metodologia. Se incluyeron 20 pacientes (edad media: 48), 16 en la estadificación inicial y 4 por recidiva. La PET-TC se realizó en tres tiempos: 1) Basal, 2) Tras el primer-tercer ciclo (valoración de respuesta precoz), y 3) Al finalizar el tratamiento (valoración de respuesta final). Los hallazgos de la valoración precoz fueron correlacionados con la valoración final y el seguimiento. La valoración de la respuesta se estableció según la disminución de la captación de las lesiones (SUVmax). En la valoración precoz el indicador de buena respuesta (IBR) fue la reducción del SUVmax > 50% o la desaparición. Al final del tratamiento se determinó la respuesta metabólica completa (RMC) en ausencia de focos. El seguimiento fue superior a los 19 meses, estableciendo progresión/recidiva o sin evidencia de enfermedad (SEE). Resultados. La valoración precoz fue IBR en 16/16 pacientes de estadificación inicial (100%) y en 2/4 de recidiva (50%). Al final del tratamiento, en el primer grupo 14/16 pacientes con IBR consiguieron RMC y 1/16 RMP; 14 continuaron SEE y uno recidivó. En el segundo grupo 2/2 pacientes con IBR consiguieron RMC; uno continuó SEE y otro recidivó. Conclusion. La PET-TC tras los primeros ciclos de quimioterapia es útil para monitorizar el tratamiento debido a su elevado valor predictivo negativo (87,5%), modificando la terapia precozmente en los no respondedores(AU)

Objective. To assess the role of FDG-PET/CT performed after the first cycles of chemotherapy in the prediction of response to treatment in patients with diffuse large B-cell lymphoma. Methods. Twenty patients (mean age: 48 years) were included, 16 initial staging and 4 relapse. All patients underwent PET/CT at 3 times: 1) Baseline, 2) After 1-3 cycles of chemotherapy (early response assessment), and 3) End of treatment (evaluation of final response). Early PET/CT findings were correlated to the end-treatment PET/CT and follow-up. The evaluation of the response was established according to the decrease in uptake of the lesions (SUVmax). In the early assessment, a good response indicator (GRI) was obtained when the lesion disappeared or had more than 50% reduction in SUVmax. At the end of the treatment, a complete metabolic response (CMR) was determined in negative PET scans. Follow-up was superior to 19 months and final outcome was established as progression/relapse or no evidence of disease (NED). Results. At the early treatment evaluation, 16/16 patients of initial staging (100%) and 2/4 of relapse (50%) achieved GRI. At the end of treatment evaluation, 14/16 patients of initial staging with GRI achieved CMR and 1/16 PMR: 14 were alive with NED in the follow-up while 1 relapsed. In the second group, 2/2 patients with GRI achieved CMR (100%): 1 continued with NED in the follow-up and another relapsed. Conclusion. FDG-PET/CT after the first cycles of chemotherapy is useful to monitor treatment due to its high negative predictive value (87.5%), using it to modify treatment early in the non-responders(AU)

Utility of the PET-CT in the evaluation of early response to treatment in the diffuse large B-cell lymphoma. Preliminary results.

OBJECTIVE: To assess the role of FDG-PET/CT performed after the first cycles of chemotherapy in the prediction of response to treatment in patients with diffuse large B-cell lymphoma. METHODS: Twenty patients (mean age: 48 years) were included, 16 initial staging and 4 relapse. All patients underwent PET/CT at 3 times: 1) Baseline, 2) After 1-3 cycles of chemotherapy (early response assessment), and 3) End of treatment (evaluation of final response). Early PET/CT findings were correlated to the end-treatment PET/CT and follow-up. The evaluation of the response was established according to the decrease in uptake of the lesions (SUVmax). In the early assessment, a good response indicator (GRI) was obtained when the lesion disappeared or had more than 50% reduction in SUVmax. At the end of the treatment, a complete metabolic response (CMR) was determined in negative PET scans. Follow-up was superior to 19 months and final outcome was established as progression/relapse or no evidence of disease (NED). RESULTS: At the early treatment evaluation, 16/16 patients of initial staging (100%) and 2/4 of relapse (50%) achieved GRI. At the end of treatment evaluation, 14/16 patients of initial staging with GRI achieved CMR and 1/16 PMR: 14 were alive with NED in the follow-up while 1 relapsed. In the second group, 2/2 patients with GRI achieved CMR (100%): 1 continued with NED in the follow-up and another relapsed. CONCLUSION: FDG-PET/CT after the first cycles of chemotherapy is useful to monitor treatment due to its high negative predictive value (87.5%), using it to modify treatment early in the non-responders.

Valoración del estado de ansiedad de los pacientes que reciben un tratamiento con radioyodo o son sometidos a una exploración de ganglio centinela en el servicio de Medicina Nuclear / Evaluation of the anxiety state in patients receiving radioiodine treatment or who undergo a sentinel lymph node examination in the Nuclear Medicine Department

ObjetivoAnalizar la presencia de ansiedad en pacientes derivados a un servicio de Medicina Nuclear (SMN).Material y métodoSe incluyeron 148 pacientes; 67 derivados para tratamiento con radioyodo, 48 con hipertiroidismo (HT), 19 con carcinoma diferenciado de tiroides (CDT) y 81 para detección y biopsia del ganglio centinela (GC) en carcinoma de mama (CM).Material y métodoSe rellenaron los siguientes documentos: datos de filiación, escala de ansiedad estado-rasgo, escala de factores predisponentes ansiógenos y cuestionario de información.Material y métodoSe estudiaron los factores predisponentes ansiógenos y la influencia de la información en el padecimiento de ansiedad.ResultadosUn 47% de los pacientes con HT tenían ansiedad en el momento de la visita, que no se relacionó con el nivel de información recibido. El factor que más les preocupaba era la administración de radioyodo. El hecho de ser la primera visita a un SMN se relacionó estadísticamente (p<0,05) con la aparición de ansiedad.ResultadosEl 42% de los pacientes con CDT tenían ansiedad en el momento de la visita, que no se relacionó con el nivel de información recibido. El factor que más les preocupaba era la propia enfermedad. Ningún factor fue relacionado estadísticamente con la aparición de ansiedad.ResultadosEl 53% de los pacientes con CM tenían ansiedad en el momento de la visita, que no se relacionó con el nivel de información recibido. El factor que más les preocupaba eran los resultados. El antecedente ansioso-depresivo se relacionó estadísticamente (p<0,05) con la aparición de ansiedad.ConclusiónLa cantidad de información proporcionada antes de un procedimiento en un SMN no influye en el padecimiento de ansiedad. No obstante, es nuestro deber dar la mejor información posible(AU)

ObjectiveTo analyze the presence of anxiety in patients referred to a Nuclear Medicine Department (NMD).Material and methodsA total of 148 patients were included: 67 were referred for radioiodine therapy, 48 with hyperthyroidism (HT), 19 with differentiated thyroid carcinoma (DTC), and 81 were referred for detection and biopsy of the sentinel node in breast cancer (BC).Material and methodsThe following documents were filled out: personal data, a state-trait anxiety inventory, a scale of pre-disposing factors causing anxiety and an information questionnaire.Material and methodsAnxiety-predisposing factors and the influence of the information on the presence of anxiety were studied.ResultsHT patients: 47% had anxiety in the moment of the visit that was not related to the level of information received. The factor that worried them the most was the radioiodine administration. Being the first visit to a NMD significantly influenced (p<0.05) on the presence of anxiety.ResultsDTC patients: 42% had anxiety in the moment of the visit not related to the level of information received. The factor that worried them the most was the illness itself. No factor had a significant influence on the presence of anxiety.ResultsBC patients: 53% had anxiety in the moment of the visit that was not related to the level of information received. What worried them the most were the results. Having anxiety and/or depression significantly influenced (p<0.05) the presence of anxiety.ConclusionThe quantity of information given before a procedure in a NMD does not influence on the presence of anxiety. Nevertheless, it is our duty to give the best possible information(AU)

[Evaluation of the anxiety state in patients receiving radioiodine treatment or who undergo a sentinel lymph node examination in the Nuclear Medicine Department]. / Valoración del estado de ansiedad de los pacientes que reciben un tratamiento con radioyodo o son sometidos a una exploración de ganglio centinela en el servicio de Medicina Nuclear.

OBJECTIVE: To analyze the presence of anxiety in patients referred to a Nuclear Medicine Department (NMD). MATERIAL AND METHODS: A total of 148 patients were included: 67 were referred for radioiodine therapy, 48 with hyperthyroidism (HT), 19 with differentiated thyroid carcinoma (DTC), and 81 were referred for detection and biopsy of the sentinel node in breast cancer (BC). The following documents were filled out: personal data, a state-trait anxiety inventory, a scale of pre-disposing factors causing anxiety and an information questionnaire. Anxiety-predisposing factors and the influence of the information on the presence of anxiety were studied. RESULTS: HT patients: 47% had anxiety in the moment of the visit that was not related to the level of information received. The factor that worried them the most was the radioiodine administration. Being the first visit to a NMD significantly influenced (p<0.05) on the presence of anxiety. DTC patients: 42% had anxiety in the moment of the visit not related to the level of information received. The factor that worried them the most was the illness itself. No factor had a significant influence on the presence of anxiety. BC patients: 53% had anxiety in the moment of the visit that was not related to the level of information received. What worried them the most were the results. Having anxiety and/or depression significantly influenced (p<0.05) the presence of anxiety. CONCLUSION: The quantity of information given before a procedure in a NMD does not influence on the presence of anxiety. Nevertheless, it is our duty to give the best possible information.

Evaluación mediante mapas estadísticos paramétricos de los cambios de la perfusión cerebral en pacientes con estenosis de la arteria carótida sometidos a endarterectomía / Evaluation by “statistical parametric mapping” of the cerebral perfusion changes in patients with carotid artery stenosis after endarterectomy

La eficacia de la endarterectomía carotídea (EC) en los accidentes cerebrovasculares producidos por estenosis carotídea puede ser evaluada mediante la tomografía computarizada de emisión de fotón único de perfusión cerebral, utilizando SPM (statistical parametric mapping ‘mapas estadísticos paramétricos’).Material y métodosSe incluyeron en el estudio 12 pacientes con estenosis significativa de la arteria carótida que fueron sometidos a endarterectomía. A todos se les realizó un estudio de perfusión cerebral con 99mTc-etilen cisteinato dietilester (ECD) basal tras la endarterectomía. Mediante los SPM se comparó de forma independiente el estudio basal/poscirugía con el grupo control formado por 20 pacientes y se obtuvieron los correspondientes SPM. Se valoraron los cambios tanto en extensión (o número de vóxeles) como en intensidad (cambio en el valor de T) de las zonas significativamente hipoperfundidas y el sentido de estos cambios.ResultadosEn el grupo de 12 pacientes se observó una mejoría de la perfusión cerebral posquirúrgica, en 5 pacientes con disminución en la extensión de las zonas hipoperfundidas del 50,56% y de intensidad del 30,9% de media. Cuatro pacientes mostraron un aumento en la extensión de la hipoperfusión cerebral del 85,53% y de la intensidad del 34,21% de media. En tres pacientes no se apreciaron cambios significativos entre ambos estudios.ConclusionesEl SPM ha demostrado ser una herramienta útil que permite objetivar los cambios de flujo sanguíneo cerebral que se producen tras la intervención quirúrgica, valorando los cambios en extensión e intensidad de las zonas significativamente hipoperfundidas(AU)

The efficacy of carotid endartectomy (CE) in cerebrovascular accidents produced by carotid stenosis can be evaluated with the cerebral perfusion with single photon emission tomography, using statistical parametric mapping (SPM).Material and methodsTwelve patients with significant carotid stenosis who underwent endartectomy were included in the study. All underwent a cerebral perfusion study with 99mTc-etilen cisteinato dietilester (ECD) at baseline and after the endartectomy. Using SPM, the baseline/post-surgery study was compared independently with the control group made up of 20 patients and the corresponding parametric statistical mappings were obtained. Changes in extension (kE or voxel number) and intensity (change in the T value) of the significantly hypoperfused zones and direction of these changes were evaluated.ResultsIn the group of 12 patients, improvement of the post-surgical cerebral perfusion was observed in 5 patients with an average 50.56% decrease in the extension of the hypoperfused zones and average 30.9% decrease of intensity. Four patients showed an average 85.53% increase in the extension of cerebral hypoperfusion and of 34.21% in intensity. No significant changes between both studies were found in three patients.ConclusionsSPM has been shown to be a useful tool that makes it possible to objectify the cerebral brain flow changes produced after the surgical intervention, evaluating the changes in extension and intensity of the significantly hypoperfused zones(AU)

[Evaluation by "statistical parametric mapping" of the cerebral perfusion changes in patients with carotid artery stenosis after endarterectomy]. / Evaluación mediante mapas estadísticos paramétricos de los cambios de la perfusión cerebral en pacientes con estenosis de la arteria carótida sometidos a endarterectomía.

UNLABELLED: The efficacy of carotid endartectomy (CE) in cerebrovascular accidents produced by carotid stenosis can be evaluated with the cerebral perfusion with single photon emission tomography, using statistical parametric mapping (SPM). MATERIAL AND METHODS: Twelve patients with significant carotid stenosis who underwent endartectomy were included in the study. All underwent a cerebral perfusion study with 99mTc-etilen cisteinato dietilester (ECD) at baseline and after the endartectomy. Using SPM, the baseline/post-surgery study was compared independently with the control group made up of 20 patients and the corresponding parametric statistical mappings were obtained. Changes in extension (k(E) or voxel number) and intensity (change in the T value) of the significantly hypoperfused zones and direction of these changes were evaluated. RESULTS: In the group of 12 patients, improvement of the post-surgical cerebral perfusion was observed in 5 patients with an average 50.56% decrease in the extension of the hypoperfused zones and average 30.9% decrease of intensity. Four patients showed an average 85.53% increase in the extension of cerebral hypoperfusion and of 34.21% in intensity. No significant changes between both studies were found in three patients. CONCLUSIONS: SPM has been shown to be a useful tool that makes it possible to objectify the cerebral brain flow changes produced after the surgical intervention, evaluating the changes in extension and intensity of the significantly hypoperfused zones.