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Our aim was to analyse the performance of [Three hundred and twenty-nine [Two hundred and nineteen (66.6%) out of the 329 PET/CT examinations were positive. The percentage of positive examinations was significantly higher in patients with other initial treatment than RP compared to patients with RP (85.6% vs. 43.6%, respectively). One hundred and thirty PET/CT (59.4%) showed local recurrence, 48 (21.9%) distant recurrence, and 41 (18.7%) local plus distant recurrence. Initial therapeutic approach was changed in 139 cases (63.5%). In the subgroup of 81 [[

Objective Carbon-11-(11C)-choline PET/computed tomography (CT) has shown good results in re-staging of prostate cancer (PCa) with raised serum levels of prostate-specific antigen. Our aim was to evaluate the effect of positive 11C-choline PET/CT results in the therapeutic management of patients with PCa with biochemical relapse (BR) after curative intention treatment. Patients and methods A total of 112 patients with PCa BR and positive 11C-choline PET/CT were retrospectively evaluated. PET/CT was acquired 20 min after intravenous administration of 555–740 MBq of 11C-choline. The therapeutic management after 11C-choline PET/CT was obtained from the clinical records. The minimum follow-up time was 18 months. Results In 80 (71.4%) of 112 patients, 11C-choline PET/CT showed local recurrence of PCa; in 17 (15.2%) patients, distant recurrence; and in 15 (13.4%) patients, local plus distant recurrence. A second malignancy was detected in five (4.5%) patients. The planned therapeutic management was changed as per positive 11C-choline PET/CT result in 74 (66.1%) patients and were treated as follows: 31 (27.7%) patients with HT, combined with other treatments in eight (7.1%), 17 (15.2%) with BT, 13 (11.6%) with external beam radiotherapy, one (0.9%) with RP, and four (3.6%) with chemotherapy. Treatment approach was not modified in 37 (33%) patients. No data was available from one (0.9%) patient. Conclusion Positive 11C-choline PET/CT result had an important effect in the therapeutic management of patients with PCa and BR, leading to a change in the planned approach in two (66.1%) out of three patients. In addition, in 4.5% of the patients, the 11C-choline PET/CT allowed the detection of a second malignancy.

The aim of this study was to evaluate the cerebral amyloid distribution in patients with mild cognitive impairment (MCI), assessed by carbon-11-Pittsburgh compound B (C-PIB) PET/CT, after 5 years of follow-up.Ten amnestic MCI (A-MCI) and four nonamnestic (NA-MCI) patients were studied by C-PIB PET/CT and re-evaluated 5 years later by a new C-PIB PET/CT. PET/CT scans were acquired 60-90 min after the administration of 555 MBq C-PIB and analyzed visually, to obtain a score of the cerebral cortical C-PIB retention in the frontal, basal ganglia (BG), temporoparietal (TP), occipital, posterior cingulate, and cerebellum areas. Initial and 5-year follow-up C-PIB retentions were compared.Initially, 9/10 A-MCI patients were C-PIB positive and one was C-PIB negative. All four NA-MCI patients were C-PIB negative. Of the C-PIB-positive A-MCI patients, seven progressed to Alzheimer's disease dementia (AD-D), one to mixed dementia and one remained as A-MCI. The C-PIB-negative A-MCI patient remained as A-MCI. Of the four C-PIB-negative NA-MCI, one progressed to semantic dementia. All changes in C-PIB retention were of low intensity. The A-MCI patients who progressed to AD-D (n=7) showed an increase in C-PIB retention in the frontal (5/7), BG (3/7), TP (3/7), occipital (1/7), and posterior cingulate (1/7) regions. The A-MCI patient who progressed to mix dementia showed an increase in C-PIB retention in the frontal region. The C-PIB-positive A-MCI patient who remained as A-MCI showed an increase in C-PIB retention in the frontal, BG, and TP areas. The amyloid deposition in the anterior part of the brain (frontal, TP, and BG) increased more than that in the posterior part (occipital and precuneus) (7/9 vs. 2/9; P0.05).PIB retention increased predominantly in the frontal, BG, and TP areas. C-PIB-positive A-MCI patients mostly progressed to AD-D, showing similar topographic changes in their cerebral C-PIB pattern than the patient who remained as A-MCI.

Background:Tocilizumab (TCZ) has shown efficacy in large vessel vasculitis (LVV)-Giant Cell Arteritis (LVV-GCA) (1-2). 18F-fluodeoxyglucose positron emission tomography (18F-FDG PET/CT) is useful to assess LVV disease activity (3-5). It is unknown if early treatment with TCZ may have an influence on clinical, laboratory and imaging outcomes.Objectives:To assess clinical, laboratory and PET/CT activity improvement in LVV-GCA patients treated with TCZ according to the time from disease diagnosis to TCZ onset.Methods:Comparative single-center study of 30 LVV-GCA patients treated with TCZ who were divided into 2 groups depending on the time of onset of TCZ: a) early onset (≤ 6 months; n=15) and b) late onset (> 6 months; n=15). All patients had a baseline and a follow-up PET/CT scan. Complete clinical improvement and normalization of laboratory markers (CRP ≤0.5mg/dL and/or ESR ≤ 20 mm/1st hour) was assessed. For imaging evaluation, normalization of total visual score (TVS) was considered when TVS = 0 and normalization of semiquantitative activity if the target to background ratio (TBR) at the thoracic aorta was Results:30 patients were included (24 women/6 men); mean age 65.7± 9.8 years. Patients in the TCZ early-onset group were receiving higher doses of prednisone (10.0[5.9-15.0] vs 5.0 [5.0-7.5] mg/day; p< 0.01) and had higher TVS scores (7.0 [4.0-9.0] vs 3.0 [2.0-5.0]; p< 0.01) at baseline (Table 1). Following TCZ initiation, after a mean of 10.8±3.7 months, most patients achieved complete clinical improvement and normalization of ESR and CRP in both groups. Uncoupling with imaging outcomes was observed in both groups. Although non-significant statistical differences were observed, complete TBR normalization (TBR Table 1.Early-onset TCZ therapy(n= 15)Late-onset TCZ therapy(n=15)pGeneral featuresAge (years), mean ± SD65.8 ± 9.965.5 ± 10.10.94Sex (female), n (%)11 (73.3)13 (86.7)0.65GCA evolution before TCZ onset, median [IQR]2.0 [1.0-5.0]18.0 [9.0-34.0]< 0.01LaboratoryESR (mm/1st hour), mean ± SD34.7 ± 26.330.8 ± 28.70.70CRP (mg/dL), median [IQR]1.1 [0.6-2.3]0.8 [1.8 -2.5]0.28Prednisone dose (mg/day), mean ± SD10.0 [5.9-15.0]5.0 [5.0-7.5]0.01TCZ therapyIntravenous, n (%)10 (66.7)11(73.3)0.99Combined with MTX, n(%)6 (40)8 (53.3)0.46PET /CT activityTBR at thoracic aorta1.86 ± 0.691.54 ± 0.180.09TVS7.0 [4.0-9.0]3.0 [2.0-5.0]< 0.01Complete clinical improvement, n (%)13 (86.7)12 (80)0.99Normalization of ESR and CRP, n (%)15 (100)15 (100)0.99PET/CT improvementComplete TBR normalization6 (40)3 (20)0.23Complete TVS normalization2 (13.3)1 (6.7)0.54CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; TBR: target-to-background ratio. * Normalization of TBR was considered when TBR < 1.34. ** Normalization of TVS was considered when TVS=0.Conclusion:TCZ was effective in patients with LVV-GCA regardless the time from disease diagnosis to TCZ onset. However, complete normalization of vascular activity in PET/CT scans tended to occur more likely in patients who receive early-onset TCZ therapy within the first 6 months of the disease.References:[1]Calderón-Goercke M et al. Semin Arthritis Rheum. 2019; 49:126-135. PMID: 30655091[2]Prieto Peña D et al. Clin Exp Rheumatol. 2020. PMID: 33253103[3]González-Gay MA et al. Expert Rev Clin Immunol. 2018; 14:593-605. PMID: 29877748[4]Martínez-Rodríguez et al. Semin Arthritis Rheum.2018; 47(4): 530-537. PMID: 28967430[5]Prieto-Peña D et al. Semin Arthritis Rheum. 2019; 48:720-727. PMID: 28967430Disclosure of Interests:Diana Prieto-Peña Grant/research support from: UCB Pharma, Roche, Sanofi, Pfizer, AbbVie and Lilly, Isabel Martínez-Rodríguez: None declared, Belén Atienza-Mateo: None declared, Oriana Cuenca-Vera: None declared, Francisco Javier Gomez de la Fuente: None declared, Aida Sanchez-Salmón: None declared, Miguel A González-Gay Grant/research support from: Abbvie, MSD, Jansen and Roche and had consultation fees/participation in company sponsored speaker´s bureau from Abbvie, Pfizer, Roche, Sanofi, Lilly, Celgene and MSD, Ricardo Blanco Grant/research support from: Abbvie, MSD and Roche, and had consultation fees/participation in company sponsored speaker´s bureau from Abbvie, Lilly, Pfizer, Roche, Bristol-Myers, Janssen, UCB Pharma and MSD

Introduccion. La radioterapia es un tratamiento de gran utilidad en las neoplasias del sistema nervioso central. El rango temporal de sus complicaciones es muy amplio, ya que aparecen incluso muchos anos mas tarde de haberla finalizado. Estas complicaciones tardias se comportan clinica y radiologicamente de forma similar a una recidiva; un estudio funcional diagnostico con isotopos radiactivos puede ayudar a tomar una decision terapeutica. Caso clinico. Varon que presento de forma brusca sintomatologia neurologica deficitaria en la misma localizacion donde 25 anos antes habia recibido radioterapia por un astrocitoma pilocitico. La resonancia magnetica sugeria un ictus lacunar, pero un hallazgo en la secuencia de perfusion obligaba a ser mas preciso en el diagnostico. Una tomografia por emision de positrones-tomografia computarizada (PET-TC) con C11-metionina mostro un aumento de captacion compatible con neoplasia. La evolucion espontanea regresiva de los sintomas inclino a tomar una actitud conservadora. Una resonancia magnetica realizada tres meses mas tarde confirmo el ictus lacunar. Conclusiones. La reaparicion de sintomas neurologicos anos mas tarde de la radioterapia de una neoplasia cerebral supone un dilema diagnostico. Las tecnicas diagnosticas actuales son muy precisas, pero presentan falsos positivos. Las distintas tecnicas de medicina nuclear, en concreto la PET-TC con C11-metionina, suponen una ayuda diagnostica. Con este caso se pretende llamar la atencion sobre una de las complicaciones tardias de la radioterapia y los distintos diagnosticos diferenciales. Los avances diagnosticos y terapeuticos han aumentado la esperanza de vida de los pacientes oncologicos, con lo que estas complicaciones tardias se preven mas frecuentes.

We have studied the possible relationship between the immunohistochemical expression of p16 INK4a and the maximum standardized uptake value (SUV max) of F-18 fluorodeoxyglucose-positron emission tomography (F-18 FDG- PET) in 49 patients with non-small cell lung cancer (NSCLC). Immunohistochemical negativity of p16 INK4a was verified in 71.4 % of the patients, higher in squamous cell carcinomas than in adenocarcinomas (p: 0.033). The SUV max corre- lates with negativity for p16 INK4a (p: 0.042) and was higher (p: 0.024) in cases with p16 INK4a -negative (17.3 ± 8.3) than in cases with p16 INK4a -positive (12.7 ± 5.2). We can conclude that inactivation of the p16 INK4a gene is very frequent in NSCLC, with higher values in squamous cell carcinomas. SUV max correlated positively and statistically with negativity for p16 INK4a , which could explain why higher estimates of SUV max are found in squamous cell carcinomas when com- pared to adenocarcinomas. Only the clinical stage was found to be an independent prognostic value after multivariate analysis.

Objective: To study the expression of COX-2 and its possible relationship with the maximum standardized uptake value (SUV) in FDG-PET, and EGFR, p16 and MIB1 expression in patients with NSCLC. Material and method: 45 patients (12 adenocarcinomas and 33 squamous cell carcinomas) were included in this study; the immunohistochemical expression of COX-2, MIB-1, p16 and EGFR was determined using tissue-array. Each PET was performed 60 minutes after the i.v. administration of 350-518 MBq of FDG on an Advance system (GE) in 2D acquisition mode. Results: COX-2 expression was detected in 35 out of 45 cases, and was very significant (> ++) in 12 of them. SUV values were lower in the COX-2 > ++ cases that in the remaining cases (13.4 ± 1.2 vs. 12.9 vs. 17.1 ± 1.5; p = 0.059). COX-2 > ++ expression and maxSUV values were not correlated with the clinical stage. The expression of COX-2 > ++ was correlated positively with p16 (r = 0.36; p = 0.014) and negatively with MIB1 (r = -0.32; p = 0.041) expression, whereas the SUV was correlated positively with EGFR (r = 0.44; p = 0.004) and negatively with p16 (r = -0.29; p = 0.041) expression. Conclusions: Our results suggest that: a) the expression of COX-2 > ++ is often found in this kind of lung cancer and is not associated with the clinical stage; b) the maxSUVs were not related to the stage and were lower in COX-2 > ++ tumours than in the other cases; and c) the different behaviour of both parameters can be explained by their correlation with cell proliferation (MIB1), EGFR and p16 expression.

In order to evaluate the influence of hormone dependence on the features of infiltrating ductal carcinoma of the breast we have assayed the cytosolic levels of estrogen receptor (ER), progesterone receptor (PR), pS2 and cathepsin D in 53 women aged over 70 years and in 95 women aged between 55 and 70 years. Tumor size, axillary involvement, distant metastasis, histological grade, ploidy and S-phase were taken into account. Carcinomas of women aged over 70 did not show higher concentrations or higher positive results for ER and PR than those of women in the 55–70-year age group. In older patients, negativity for ER was associated only with higher S-phase fraction, while negativity for PR was not associated with any of the parameters analyzed. In the younger subgroup, negativity for ER was associated with larger tumor size, higher S-phase fraction, lymph node involvement, histological grade 3 and lower pS2 values. Negativity for PR was associated with the same parameters, as well as with a higher frequency of recurrence. Our results suggest a reduced influence of hormone dependence on the clinicopathological features of breast carcinomas in patients older than 70 years compared with women aged between 55 and 70 years.

Resumen Objetivo Estudiar la posible correlacion entre las concentraciones sericas preoperatorios de CA15.3 y la proliferacion celular medida por la fase de sintesis (FS) en carcinomas ductales infiltrantes de mama (CDI). Material y metodos El grupo estudio incluyo 79 pacientes de edades comprendidas entre los 39 y 86 anos (64,8 ± 11,8). La ploidia y FS fueron determinadas por citometria de flujo en muestras en fresco (Fascam. Beckton Dikinson. EE.UU.). Resultados Tomando como dintel de positividad para la FS el valor de 7 %, que representa la mediana obtenida previamente en un grupo de 321 CDI (i: 0,8-51,2; 9,3 ± 7,9; percentiles 25 y 75; 4,3 y 11,8 %), observamos que las concentraciones del marcador fueron mayores (p: 0,015) en los casos con menor proliferacion celular. Esto mismo se constato al valorar cualitativamente ( > 30 U/ml) el marcador. Asimismo, las concentraciones de CA15.3 aumentaron significativamente (p = 0,007) al pasar la FS de 11,8 %. Este mismo comportamiento lo observamos en los tumores sin afectacion axilar. Conclusiones a) La liberacion del CA15.3 ocurre cuando la FS se incrementa hasta alcanzar el valor del 7,1 %, para luego ir disminuyendo aunque aquella aumente, y b) este mismo comportamiento del marcador con la fase S se constato cuantitativamente en los tumores aneuploides y sin afectacion axilar.

Objective To study the possible correlations between the preoperative CA15.3 serum levels and the cellular proliferation, measured by S-phase (SP), in patients having infiltrating ductal carcinomas (IDC) of the breast Material and methods The study group included 79 patients with an age ranged between 39 and 86 yrs (64.8 ± 11.8). Ploidy and S-phase were measured by cytometry (Fascam. Beckton Dikinson. USA) in fresh simples Results Using as cut-off for SP the value of 7 %, which represents the median obtained previously in 321 patients with IDC (r: 0.8-51.2; 9.3 ± 7.9; percentiles 25 y 75; 4.3 y 11.8 %), we can observed that the antigenic levels were higher (p: 0.015) in the tumors with low SP. These same behavior was noted when 30U/ml was used as cut-off for CA15.3. Likewise, the levels of the tumor marker increased significantly (p: 0.007) when the SP moved from Conclusion a) Release of CA15.3 happens when SP increases to rise the 7.1 % value, to decrease later although that goes on increasing, and b) The same behaviour of this marker with the S-phase was observed in tumors without axillary involvement, as well as in aneuploid carcinomas.

Resumen La tomografia por emision de positrones (PET) se ha convertido, en los ultimos anos, en una tecnica muy util para el control de los pacientes afectos de enfermedad de Hodgkin (EH). Ante la sospecha de persistencia de enfermedad tras el tratamiento, esta tecnica permite valorar la actividad de las lesiones residuales que se observan en la tomografia axial computarizada y, gracias al estudio de cuerpo completo, detectar nuevas localizaciones tumorales, lo que cambia, en numerosas ocasiones, la intencion terapeutica. Hay que tener en cuenta, sin embargo, que la 18F-FDG es un marcador muy sensible pero poco especifico, pues ciertos procesos inflamatorios o infecciosos pueden asociarse a captaciones importantes del radiofarmaco. Por ello, es fundamental la integracion de la informacion aportada por la PET con el resto de las pruebas de imagen, la clinica y la evolucion del paciente para tratar de mejorar la especificidad diagnostica. Presentamos el caso de una paciente con EH, en cuyo control tras el tratamiento se incluyo la PET, presentandose ambos procesos (tumoral e infeccioso) en diferentes momentos de la evolucion, y en la que la integracion de toda la informacion, radiologica, clinica, analitica y metabolica, permitio un mejor y correcto conocimiento de la enfermedad.

New oncologic procedures are currently more focused on the biological features of tumors. The ideal objective is the administration of personalized effective treatments for each patient that affects not just the location and spread of disease but also special metabolic characteristics of tumoral cells. Radiologic diagnostic methods are extremely important in the management of the patient for staging, restaging, and evaluation of treatment response, and clinicians are avid for some additional functional and metabolic information. Further, they need more dynamic methods for follow-up. Nuclear Medicine and positron emission tomography (PET) in many cases can meet this requirement, although it is not perfect, at least at the present time. Currently 2-((18)F)fluoro-2-desoxi-D: -glucose positron emission tomography is being widely used for oncologic purposes. Its information can be very useful in abdominal diseases and must be taken into account with the results of radiologic imaging. Thus, many changes in the choice of treatment are seen. However, it is very important to know that sometimes there is a lack of specificity that has to be considered.

Resumen Objetivo La proteina pS2 (TFF1/pS2) es una molecula inducida por los estrogenos en los carcinomas mamarios. Nosotros hemos querido estudiar su expresion en carcinomas ductales infiltrantes de mama RE + y RP +, correlacionarla con otros parametros clinico-biologicos y conocer su impacto en la evolucion. Material y metodos La pS2 citosolica fue determinada utilizando un IRMA (CIS. BioInternational. Francia). Hemos analizado, ademas, las concentraciones citosolicas de catepsina D y activador del plasminogeno tipo tisular (t-AP), asi como las del receptor del factor de crecimiento epidermico (EGFR), oncoproteina erbB2, CD44v5 y CD44v6 en las membranas celulares. El tamano tumoral, grado histologico (GH), afectacion axilar, metastasis a distancia, ploidia, indice de DNA y fase de sintesis celular (FS) fueron tambien considerados. Resultados Los tumores pS2-positivos (> 5ng/mg prot.) mostraron mayores concentraciones de catepsina D (p:0,0043) y t-AP (p:0,0089) y fueron, asimismo, menos frecuentemente GH3 (p:0,0231), FS > 7% (p:0,0005) y FS > 14 % (p:0,0014). Durante el periodo de seguimiento (i: 1-147; 50,1+/−31,7; mediana 37 meses) los tumores pS2 positivos mostraron menor numero de recidivas (5/101 vs 6/69; p:0,059), pero no de muertes por el tumor (1/101 vs 2/6); ns). Conclusiones Nuestros resultados apoyan la relacion inversa de la pS2 con la proliferacion celular en los tumores RE+ y RP+, lo cual puede sugerir una nueva funcion biologica distinta a la de indicadora de la hormonodependencia. Sin embargo, necesitamos tener mayor tiempo de seguimiento para poder precisar si ello incide directamente en la evolucion ulterior del tumor.

Resumen Introduccion El CA125 serico es util marcador de los carcinomas no mucinosos de ovario, pero puede incrementarse en otros tumores, entre los cuales estan los no microciticos de pulmon. Nosotros hemos querido estudiar, en adenocarcinomas pulmonares, su concentracion citosolicas y correlacionarlas con la pS2, CD44s, CD44v5 y CD44v6, todas ellas con interes fisiopatologico en aquellos tumores. Pacientes y motodos El grupo estudio incluyo 55 pacientes (33 varones) afectos de adenocarcinomas pulmonares. El CA125 y la pS2 citosolicos fueron determinados mediante sendos IRMAS (CIS. Biointernational.Francia), mientras que las concentraciones de CD44s, CD44v5 y CD44v6 en las membranas celulares fueron dosificadas mediante EIAS (Bender Diagnostics. Austria). Otros parametros considerados fueron el estadio clinico, ploidia y la fase de sintesis celular. Resultados Las concentraciones citosolicas de CA125 oscilaron entre 1 y 225 U/mg prot. (mediana 80.5) y fueron superiores (p: 0,002) a las observadas en 16 muestras de tejido pulmonar normal de los mismos pacientes (i:1-32,5; mediana 6,7 U/mg prot.). Cuando los adenocarcinomas fueron clasificados en funcion de la concentracion de CA125, tomando como dinteles los percentiles 25 (7,2 U/mg prot.) y 75 (320 U/mg prot.), pudimos observar que los tumores con altos valores antigenicos mostraron mayor positividad para el CD44v6 (p: 0,002) y menor para el CD44s (p: 0,053); asimismo, tuvieron tendencia a ser mas frecuentemente pS2 + (p: 0,09). Conclusiones Los resultados anteriores nos inducen a las siguientes consideraciones: 1) en los adenocarcinomas pulmonares las concentraciones citosolicas de CA125 son superiores a las constatadas en el tejido pulmonar normal de los mismos pacientes; 2) los adenocarcinomas pulmonares con altas concentraciones de CA125 presentan una mayor positividad para el CD44v6 y menor para el CD44s, mostrando, ademas, una tendencia a ser mas frecuentemente pS2 +. Todo ello apoya su interes como indicador de un peor pronostico en este subtipo histologico pulmonar.

Pleomorphic xanthoastrocytoma (PXA) is a brain neoplasm included in the astrocytic group, exceptionally manifesting with meningeal dissemination. We described a 27-year-old patient presented with acute bilateral visual loss and papilledema with normal brain computed tomography scan, initially mimicking idiopathic intracranial hypertension (IIH). Brain and spinal cord magnetic resonance imaging (MRI) study revealed a subtle area of hyperintensity of the gyri surrounding the left central sulcus, and contrast enhancement of the thoracic leptomeninges. Brain biopsy of the parietal lesion revealed nonanaplastic PXA. Treatment with temozolomide was given. Yearly control MRI demonstrated new brain lesions and marked progression of leptomeningeal spinal enhancement. In spite of this, the patient has remained stable with no new symptoms. Nonanaplastic PXA may present with widespread meningeal dissemination with acute visual loss and papilledema mimicking IIH, and no clinical progression at 3 years.

Objective To establish an automated procedure for the preparation of sodium fluoride 18 F injection using the resources available in our laboratory for the preparation of 18 FDG and to analyze the repercussion of the conditioning column of the fluoride ion entrapment on the characteristics of the final product. Material and method The sequence of an 18 FDG synthesis module prepared so that it traps the fluoride ion from the cyclotron in ion-exchange resin diluted with 0.9% sodium chloride. The final solution was dosified and sterilized in a final vial in an automatized dispensing module. Three different column conditioning protocols within the process were tested. Quality controls were run according to USP 32 and EurPh 6, adding control of ethanol levels of residual solvent and quality controls of the solution at 8 h post-preparation. Results Activation of the resin cartridges with ethanol and water was the chosen procedure, with fluoride ion trapping >95% and pH around 7. Ethanol levels were Conclusion This is an easy, low-cost, reliable automated method for sodium fluoride preparation in PET facilities with existing equipment for 18 FDG synthesis and quality control.

Resumen Objetivos Establecer un procedimiento automatizado para la preparacion de la disolucion inyectable de [ 18 F] NaF utilizando los recursos disponibles en nuestro laboratorio para la preparacion de 18 FDG, analizando la repercusion del acondicionamiento de la columna de atrapamiento del ion fluoruro sobre las caracteristicas del producto final. Material y metodo Se modifico la secuencia de un modulo de sintesis de 18 FDG automatizado de manera que el ion fluoruro procedente del ciclotron se atrapa en resina de intercambio anionico y se eluye con cloruro sodico 0,9%. La disolucion final se dosifica y autoclava en envase final en equipo automatizado. Dentro del proceso, se estudiaron tres protocolos diferentes de acondicionamiento de columna. Se realizaron los controles de calidad descritos en USP 32 y PhEur 6, anadiendo el control de etanol como disolvente residual y los controles de calidad de la disolucion a las 8 h de la preparacion. Resultados La activacion de los cartuchos de resina con etanol y agua presenta una atrapamiento del ion fluoruro > 95% y pH en torno a 7, por lo que es el procedimiento de acondicionamiento de eleccion. La concentracion de etanol se mantuvo Conclusiones Se describe un metodo automatizado sencillo, economico y reproducible, de preparacion de una disolucion inyectable de 18 F-fluoruro sodico al alcance de cualquier centro con equipamiento convencional para sintesis y control de calidad de 18 FDG.

Resumen Objetivo Estudiar la posible correlacion entre la expresion de ciclina B1, proliferacion celular y la SUV maxima-18F-FDG-PET en pacientes con carcinomas no microciticos pulmonares. Material y metodo Se incluyo a 49 pacientes (15 adenocarcinomas, 27 carcinomas escamosos y 7 carcinomas broncoalveolares) y se realizo la expresion inmunohistoquimica de ciclina B1 mediante tissue-arrays. Asimismo, analizamos la proliferacion celular (MIB-1). El PET se realizo 60 min despues de la administracion intravenosa (i.v.) de 350-518 MBq de 18F-FDG en un PET (Advance, GE) y adquision en 2D. Resultados La expresion inmunohistoquimica de ciclina B1 se detecto en 40 (81,6%) casos y no se relaciono con el estadio clinico (I-II: 17/21 frente a III-IV: 23/28). Los valores de SUV fueron mayores (p = 0,04) en los casos positivos (16,4 ± 8,1) que en los negativos (10,9 ± 6,2) y no difirieron en funcion del estadio clinico. La expresion de ciclina B1 se correlaciono (p Conclusiones Nuestros resultados muestran una relacion directa entre la expresion de ciclina B1 y los valores max SUV en el PET de pacientes afectos de carcinomas no microciticos de pulmon, lo cual, unido a la asociacion de aquella con la positividad del MIB1, apoya el papel de la proliferacion celular en la captacion del radiofarmaco por el tumor.

Aim: To study the expression of cyclin B1 and its possible relationship with the maximum SUV in FDG-PET and MIB1 expression in patients with NSCLC. Materials and methods: 49 patients (15 adenocarcinomas, 27 squamous cell carcinomas and 7 bronchoalveolar carcinomas) were included in this study; the immunohistochemical expression of cyclin B1 was determined using the tissue-array technique. Each PET was performed 60 minutes after the i.v. administration of 350-518 MBq of FDG on an Advance system (GE) in 2D acquisition mode. Results: Cyclin B1 expression was detected in 40 out of 45 cases. The SUV values were higher (p = 0.04) in the cyclin B1+ cases than in the negative cases (16.4 ± 8.1 vs 10.9 ± 6.2). Cyclin B1 expression and SUV values were not correlated with the clinical stage. The expression of cyclin B1+ correlated positively (p < 0.0001) with that of MIB1. After univariate analysis, only the cellular proliferation was a prognostic factor (p = 0.037). Conclusions: Our results suggest that there is a direct correlation between cyclin B1 expression and max-SUV values in the PET of NSCLC patients. When the association of cyclin B1 with positive MIB1 is also considered, our results support the role of cell proliferation in FDG uptake by the tumour. © 2009 Elsevier Espana, S.L y Sociedad Espanola de Medicina Nuclear (SEMN).

Resumen El manejo de los tumores del estroma gastrointestinal, definidos como neoplasias mesenquimales c-Kit positivas, ha cambiado rapidamente en los ultimos cinco anos. El mesilato de imatinib (Glivec ® ) es el tratamiento estandar de los tumores del estroma gastrointestinal irresecables o metastaticos. El imatinib debe administrarse hasta el desarrollo de intolerancia o la progresion de la enfermedad. No es infrecuente que los tumores del estroma gastrointestinal aumenten de tamano durante los primeros meses de tratamiento, de ahi el valor limitado de los criterios convencionales de evaluacion de respuesta de los tumores solidos para determinar la eficacia del imatinib durante este periodo. La tomografia de emision de positrones empleando 18 F-fluorodesoxiglucosa ha demostrado tener una alta sensibilidad en la evaluacion precoz de la respuesta tumoral al imatinib. Presentamos el caso de una mujer de 53 anos diagnosticada de recidiva de tumor del estroma gastrointestinal 18 meses despues de finalizar tratamiento adyuvante con imatinib. Tras 72 horas de tratamiento con imatinib el tumor mostraba en la tomografia de emision de positrones una disminucion en la captacion de 18 F-fluorode-soxiglucosa.