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Inicio Actas Urológicas Españolas La tomografía por emisión de positrones (pet) y pet-tac en riñón, vías urin...
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Vol. 33. Issue 1.
Pages 11-23 (January 2009)
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Vol. 33. Issue 1.
Pages 11-23 (January 2009)
La tomografía por emisión de positrones (pet) y pet-tac en riñón, vías urinarias y próstata: actualización
Positron emission tomography (pet) and pet-ct in renal, bladder and prostate cancer: update
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Roberto C. Delgado bolton
,**,1
Corresponding author
rbolton@telefonica.net

Correspondencia autor: Dr. Roberto C. Delgado Bolton Servicio de Medicina Nuclear. Hospital Clínico Univ. San Carlos Profesor Martín Lagos, s/n - 28040 Madrid. Tel. 913 303 415
, Jorge Mucientes rasilla*, Mª Jesús pérez castejón**, José L. Carreras delgado*
* Servicio de Medicina Nuclear, Hospital Clínico San Carlos. Madrid
** Instituto PET Focuscan. Madrid
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Resumen

La PET ha demostrado su utilidad en la toma de decisiones diagnóstico-terapéuticas en diversos tipos de tumores. En los tumores del tracto urinario y del cáncer de próstata su rendimiento diagnóstico ha sido menor debido a la eliminación urinaria del radiotrazador que puede enmascarar la presencia de lesiones. No obstante, deben aplicarse protocolos específicos que mejoran el rendimiento diagnóstico de la PET con 18F-FDG en la valoración de lesiones pélvicas. Además, el cáncer de próstata es un tumor de bajo grado con escasa avidez por la 18F-FDG. A pesar de estas limitaciones, con la PET se han planteado nuevas e interesantes posibilidades diagnósticas. La disponibilidad de equipos PET-TAC ha mejorado su rendimiento diagnóstico. Por otra parte, el desarrollo de nuevos radiotrazadores que permiten marcar otros procesos moleculares y que son metabolizados por vías diferentes de la urinaria, supone una ventaja importante respecto a la 18F-FDG y han proporcionado resultados interesantes.

Palabras clave:
FDG- colina
Acetato
PET
PET-TAC
Vejiga
Próstata
Renal
Cancer urológico
Abstract

PET has demonstrated its utility in management decisions in several types of tumors. In urologic tract tumors and prostate cancer its diagnostic performance has been lower due to the urinary excretion of the radiotracer, which can mask the presence of lesions. However, specific protocols must be applied that improve the diagnostic performance of PET with 18FFDG in the evaluation of pelvic lesions. Furthermore, prostate cancer is a low-grade tumor with low avidity for 18F-FDG. In spite of these limitations, with PET new and interesting possibilities have been presented. The availability of PET-CT systems has improved its diagnostic performance. On the other hand, the development of new radiotracers that allow targeting other molecular processes and that are metabolized by pathways different to the urinary tract signifies an important advantage compared to 18F-FDG and has evidenced interesting results.

Key words:
FDG
Choline
Acetate
PET
PET-CT
Bladder
Prostate
Renal
Urologic cancer

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