Multitracer PET/CT with [¹⁸F]Fluorodeoxiglucose and [¹⁸F]Fluorocholine in the Initial Staging of Multiple Myeloma Patients Applying the IMPeTus Criteria: A Pilot Study

Initial staging of patients diagnosed with multiple myeloma (MM) can lead to negative results using conventional diagnostic imaging workup, including [18F]Fluorodesoxiglucose ([18F]FDG) PET/CT. The aim of this prospective pilot study was to evaluate the diagnostic efficacy of [18F]Fluorocholine ([18F]FCH) PET/CT in the initial staging of MM patients who were candidates for autologous bone marrow transplant. Materials and Methods: The inclusion criteria of our study were: (a) patients diagnosed with MM; (b) candidates for autologous bone marrow transplant (AT); and (c) studied with [18F]FCH PET/CT and [18F]FDG PET/CT for initial staging less than 4 weeks apart. Imaging analysis included the presence of: bone marrow infiltration, focal bone lesions, and para-medullary or extra-medullary disease, according to the proposed IMPeTus criteria. The analysis was performed per lesion, per patient, and per location. Results: The study population included ten patients. Globally, [18F]FCH PET/CT showed bone marrow uptake in all the patients and visualised 16 more focal lesions than [18F]FDG PET/CT. One patient presented a plasmacytoma, detected by both tracers. Extra-medullary and para-medullary disease was identified with different degrees of uptake by both tracers. In summary, [18F]FCH PET seemed to be superior to [18F]FDG PET/CT in detecting focal bone lesions. SUVmax values were slightly higher in [18F]FCH PET/CT than in [18F]FDG PET/CT. Conclusions: Taking into account the small study population, according to our results, [18F]FCH PET/CT could be a useful tool for staging MM patients

Sentinel Node Biopsy Imaging in Breast Cancer: Scatter Reduction Using 3-Dimensionally Printed Lead Shields.

Point of injection scatter (SPI) confounds breast cancer sentinel lymph node detection. Round flat lead shields (FLSs) incompletely reduce SPI, requiring repositioning. We designed lead shields that reduce SPI and acquisition time. Two concave lead shields, a semioval lead shield (OLS) and a semispherical lead alloy shield (SLS), were created with a SICNOVA JCR 1000 3D printer to cover the point of injection (patent no. ES1219895U). Twenty breast cancer patients had anterior and anterior oblique imaging, 5 minutes and 2 hours after a single 111 MBq nanocolloid in 0.2 mL intratumoral or periareolar injection. Each acquisition was 2 minutes. Absolute and normalized background corrected scatter counts (CSCs) and scatter reduction percentage (%SR) related to the FLS were calculated. Repositionings were recorded. Differences between means of %SR (t test) and between means of CSC (analysis of variance) with Holm multiple comparison tests were determined. Mean %SR was 91.8% with OLS and 92% using SLS in early images (P = 0.91) and 87.2%SR in OLS and 88.5% in late images (P = 0.66). There were significant differences between CSC using FLS and OLS (P We designed 2 concave lead shields that significantly reduce the SPI and repositioning with sentinel lymph node lymphoscintigraphy

Medicina nuclear en tiempos de pandemia COVID-19

The type 2 virus that causes severe acute respiratory syndrome, belonging to the coronavirus family (SARS-Cov-2) was discovered at the end of 2019 in the city of Wuhan, China and has been the cause of the last global pandemic of the that we havent gotten rid of yet. The first cases that were declared corresponded to people with severe respiratory distress caused by the infection of a new infectious agent of the coronavirus family, which was called SARSCov-2. Later, it was found that, although the respiratory manifestations were the initial and sometimes the most serious, the virus could also colonize other body structures and cause their dysfunction. This work collects the findings found in the Nuclear Medicine examinations, caused by SARS-Cov-2 in patients treated in our San Pedro / CIBIR Hospital Service, as well as those published in scientific journals within our specialty.El virus tipo 2 causante del síndrome respiratorio agudo severo, perteneciente a la familia de los coronavirus (SARS-Cov-2) fue descubierto a finales de 2019 en la ciudad de Wuhan, China y ha sido el causante de la última Pandemia global de la que todavía no nos hemos librado. Los primeros casos que se declararon correspondía a personas con un distrés respiratorio severo producido por la infección de un nuevo agente infeccioso de la familia de los coronavirus, que fue denominado SARS-Cov-2. Posteriormente, se comprobó que, aunque las manifestaciones respiratorias fueron las iniciales y a veces las más graves, el virus también podía colonizar otras estructuras corporales y provocar su disfunción. En este trabajo se recogen los hallazgos encontrados en las exploraciones de Medicina Nuclear, provocados por el SARS-Cov-2 en pacientes atendidos en nuestro Servicio del Hospital San Pedro/CIBIR, así como las publicadas en revistas de difusión científica dentro de nuestra especialidad