Expert recommendations about the use of gadoxetic acid in patients with liver metastases in Spain.

BACKGROUND AND AIMS: Magnetic resonance imaging (MRI) with gadoxetic acid is widely used in clinical practice in Spain for the diagnosis, treatment, and follow-up of patients with liver metastases, although its use varies. This paper aims to provide recommendations for the use of MRI with gadoxetic acid in the detection and diagnosis of liver metastases in clinical practice in Spain. MATERIAL AND METHODS: This project was undertaken by a group of nine experts who analyzed a series of recommendations about the use of gadoxetic acid extracted from international consensus documents. From this analysis, the experts decided to reject, adopt, contextualize, or adapt each of the recommendations. Once established, the final recommendations were voted on by the same group of experts. RESULTS: The experts reached a consensus about five recommendations related to the use of this imaging technique in the management of liver metastases in three clinical situations: (i) in the detection, (ii) in the diagnosis and preoperative characterization, and (iii) in the detection after a chemotherapy treatment. CONCLUSION: The results support a clinical benefit for MRI with gadoxetic acid in the detection of liver metastases, favoring preoperative planning, especially in metastases measuring less than 1 cm, thus facilitating early diagnosis of metastatic spread.

Microangiopatía trombótica tumoral pulmonar, una forma infrecuente de presentación de cáncer de mama / No disponible

No disponible

11C-colina PET/TAC y RM multiparamétrica en la recidiva bioquímica del cáncer de próstata / 11C-choline PET/CT and multiparametric MRI in patients with biochemical relapse of prostate cancer

Problema clínico con casuística: Comparar la utilidad diagnóstica de la PET/TC con 11C-colina y la RM multiparamétrica en la detección de la recidiva del cáncer de próstata a nivel pélvico. Hemos estudiado retrospectivamente 21 pacientes con antecedente de cáncer de próstata, tratados inicialmente con cirugía (n = 12) o radioterapia (n = 9), que presentaban elevación del PSA (poscirugía 0,3-3,6 ng/ml; posradioterapia 2,4-8,8 ng/ml). A todos ellos, en un periodo de tiempo inferior a 15 días, se les realizó: estudio PET/TC «doble fase» de cuerpo completo, inmediatamente tras la administración de11C-colina (296 ± 29 MBq) y RM prostática multiparamétrica, empleando secuencias anatómicas, estudio de difusión y estudio dinámico tras la administración de contraste intravenoso paramagnético. A partir de nuestros resultados, a todos ellos se les realizó estudio diagnóstico dirigido y/o seguimiento clínico, analítico y de imagen. En 15 pacientes (71,4%) ambas exploraciones fueron concordantes, 4 negativas y 11 positivas: 7 recidivas locales, 3 adenopatías pélvicas únicas (2 infracentimétricas), una recidiva local y una M1 ósea única. En 6 pacientes (28,6%) ambas exploraciones fueron discordantes: 3 recidivas locales identificadas en la RM y sin significación en la PET, una recidiva local identificada en la PET sin significación en la RM y 2 M1 óseas identificadas en la PET fuera del campo de RM. Comentario: La PET/TC con 11C-colina y la RM multiparamétrica tienen un papel complementario para la detección de recidiva local del cáncer de próstata, con sensibilidad similar para la detección de inflitración ganglionar. La PET/TC con 11C-colina, como técnica de cuerpo completo, permite la estadificación ósea

Clinic problem and case series: To assess the diagnostic usefulness of 11C-choline PET/CT vs. multi-parametric MRI in the prostate cancer relapse. A retrospective study of 21 patients with prostate cancer treated initially with surgery (n = 12), radiotherapy (n = 9). PSA levels were increased (post-surgery: .3-3.6 ng/ml; post-radiotherapy: 2.4-8.8 ng/ml). In an interval of time of 15 days all patients were underwent to: whole-body-dual-modality PET-CT carried out early after 11C-choline (296 ± 29 MBq) injection, and multiparametric prostate MRI with paramagnetic intravenous contrast (using anatomical imaging sequences, diffusion-weighted imaging and dynamic contrast-enhanced imaging). On the basis of our results, all patients were underwent to directed diagnosis and/or clinical, analytic and imaging follow-up. In 15 patients (71.4%) both procedures showed concordant results: 4 negative and 11 positive cases [7 local recurrences, 3 isolated pelvic lymph nodes (2 infracentimetric), 1 local relapse and only one M1 bone metastases]. The results were discordant in 6 patients (28.6%): 3 local relapses in MRI with no PET significance, 1 local relapse in PET with no MRI significance. 2 bone metastases were identified with PET (out of the field-of-view of MRI). Coment 11C-choline PET/CT and multi-parametric MRI play a complementary role in the detection of local relapse in prostate cancer patients, with similar sensitivity for the detection of lymph involvement. Whole-body 11C-choline PET/CT technique is also useful for bone staging

(11)C-choline PET/CT and multiparametric MRI in patients with biochemical relapse of prostate cancer.

CLINIC PROBLEM AND CASE SERIES: To assess the diagnostic usefulness of (11)C-choline PET/CT vs. multi-parametric MRI in the prostate cancer relapse. A retrospective study of 21 patients with prostate cancer treated initially with surgery (n=12), radiotherapy (n=9). PSA levels were increased (post-surgery: .3-3.6 ng/ml; post-radiotherapy: 2.4-8.8 ng/ml). In an interval of time of 15 days all patients were underwent to: whole-body-dual-modality PET-CT carried out early after (11)C-choline (296 ± 29 MBq) injection, and multiparametric prostate MRI with paramagnetic intravenous contrast (using anatomical imaging sequences, diffusion-weighted imaging and dynamic contrast-enhanced imaging). On the basis of our results, all patients were underwent to directed diagnosis and/or clinical, analytic and imaging follow-up. In 15 patients (71.4%) both procedures showed concordant results: 4 negative and 11 positive cases [7 local recurrences, 3 isolated pelvic lymph nodes (2 infracentimetric), 1 local relapse and only one M1 bone metastases]. The results were discordant in 6 patients (28.6%): 3 local relapses in MRI with no PET significance, 1 local relapse in PET with no MRI significance. 2 bone metastases were identified with PET (out of the field-of-view of MRI). COMMENT: (11)C-choline PET/CT and multi-parametric MRI play a complementary role in the detection of local relapse in prostate cancer patients, with similar sensitivity for the detection of lymph involvement. Whole-body 11C-choline PET/CT technique is also useful for bone staging.

Bajo rendimiento diagnóstico de la PET/TC con 11C-colina en la detección de metástasis hepáticas de origen prostático / Low diagnostic yield of the 11C-choline PET/CT in the detection of liver metastasis from prostate cancer

No disponible

Calcitonin gene-related peptide II, substance P and vasoactive intestinal peptide in plasma and synovial fluid from patients with inflammatory joint disease.

Immunoreactive plasma and synovial fluid concentrations of calcitonin gene-related peptide II (CGRP II), substance P and vasoactive intestinal peptide (VIP) were measured in patients with osteoarthritis, gout and rheumatoid arthritis. Significantly higher levels of CGRP II and substance P-like immunoreactivity levels in synovial fluid were found in gout as well as CGRP II, substance P and VIP-like immunoreactivities in rheumatoid arthritis when compared to those in osteoarthritis. Plasma CGRP II, substance P and VIP-like immunoreactivity levels showed no significant differences among patients in the three different groups of arthritis. Our results suggest that these neuropeptides released from peripheral nerve endings into the synovial cavity probably play a pathogenic role in human joint inflammation.

McArdle's disease and gout.

We report the first case of McArdle's disease (muscle phosphorylase deficiency) and tophaceous gout. To examine the contribution of adenine nucleotide degradation to the disturbance of uric acid metabolism, we labeled the adenine nucleotide pool with [8-14C]adenine, and measured plasma and urine purines following vigorous exercise tests. Plasma and urinary hypoxanthine and xanthine concentrations and the specific radioactivity of urinary purines increased markedly, but plasma urate levels and uric acid excretion were not substantially modified. We suggest that, in this patient, the association of McArcle's disease with gout is coincidental.