Article
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
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Rubí, V. Camacho" "autores" => array:2 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Rubí" ] 1 => array:2 [ "nombre" => "V." "apellidos" => "Camacho" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2253808919300941" "doi" => "10.1016/j.remnie.2019.07.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808919300941?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X19302070?idApp=UINPBA00004N" "url" => "/2253654X/0000003800000005/v1_201909070732/S2253654X19302070/v1_201909070732/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2253808919300680" "issn" => "22538089" "doi" => "10.1016/j.remnie.2019.04.005" "estado" => "S300" "fechaPublicacion" => "2019-09-01" "aid" => "1073" "copyright" => "Sociedad Española de Medicina Nuclear e Imagen Molecular" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Med Nucl Imagen Mol. 2019;38:275-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Improved diagnostic accuracy for myocardial perfusion imaging using artificial neural networks on different input variables including clinical and quantification data" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "275" "paginaFinal" => "279" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Precisión diagnóstica mejorada para la imagen de perfusión miocárdica usando redes neuronales artificiales en diferentes variables de entrada incluyendo datos clínicos y de cuantificación" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3079 "Ancho" => 3168 "Tamanyo" => 433905 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The curve for the diagnostic performance of a two-layer feed-forward network to predict angiography result (normal vs. abnormal), obstructive CAD (absent vs. present), and Gensini scores (above vs. below 10). (a) The input was the result of MPI; (b) quantification of 40 segments of stress and rest polar plots; and (c) quantification of 40 segments in addition to the number of clinical risk factors. In addition to the false and true positive rates, accuracies are also provided. The performance of the network using the MPI was inferior to those of networks using quantification of 40 segments with or without risk factor data.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Reza Rahmani, Parisa Niazi, Maryam Naseri, Mohamadreza Neishabouri, Saeed Farzanefar, Mohammad Eftekhari, Farhang Derakhshan, Reza Mollazadeh, Alipasha Meysami, Mehrshad Abbasi" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Reza" "apellidos" => "Rahmani" ] 1 => array:2 [ "nombre" => "Parisa" "apellidos" => "Niazi" ] 2 => array:2 [ "nombre" => "Maryam" "apellidos" => "Naseri" ] 3 => array:2 [ "nombre" => "Mohamadreza" "apellidos" => "Neishabouri" ] 4 => array:2 [ "nombre" => "Saeed" "apellidos" => "Farzanefar" ] 5 => array:2 [ "nombre" => "Mohammad" "apellidos" => "Eftekhari" ] 6 => array:2 [ "nombre" => "Farhang" "apellidos" => "Derakhshan" ] 7 => array:2 [ "nombre" => "Reza" "apellidos" => "Mollazadeh" ] 8 => array:2 [ "nombre" => "Alipasha" "apellidos" => "Meysami" ] 9 => array:2 [ "nombre" => "Mehrshad" "apellidos" => "Abbasi" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X18300465" "doi" => "10.1016/j.remn.2019.04.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X18300465?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808919300680?idApp=UINPBA00004N" "url" => "/22538089/0000003800000005/v1_201909030619/S2253808919300680/v1_201909030619/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Nuclear medicine in epilepsy: New challenges in SPECT and PET analysis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "273" "paginaFinal" => "274" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. Rubí, V. Camacho" "autores" => array:2 [ 0 => array:3 [ "nombre" => "S." "apellidos" => "Rubí" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "V." "apellidos" => "Camacho" "email" => array:1 [ 0 => "mcamachom@santpau.cat" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Nuclear, Hospital Universitari Son Espases, Institut d’Investigacio Sanitària Illes Balears (IdISBa), Palma, Islas Baleares, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Medicina Nuclear en la epilepsia: avances en el análisis de los estudios SPECT y PET" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Together with dementias, movement disorders and brain tumors, epilepsy has been and continues to be one of the principal clinical settings for the application of functional nuclear neuroimaging.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a> However, there are comparatively few departments in our setting with experience and personnel dedicated to nuclear neuroimaging in epilepsy. The main reason for this is probably that brain positron emission tomography (PET) and single photon emission computed tomography (SPECT) are fundamentally applied to patients with pharmacoresistant epilepsies, which are evaluated for possible surgical treatment in multidisciplinary hospital units for epilepsy only found in specific reference centers. At present, nuclear medicine is not used in epilepsy except by these multidisciplinary units. The basic pillars of presurgical localization of the epileptogenic zone (EZ) carried out in these units are prolonged video-electroencephalography (video-EEF) of the patient and structural neuroimaging by magnetic resonance (MR) using specific protocols. However, in a relevant proportion of the cases, and especially when the MR is negative for the localization of an epileptogenic lesions, nuclear neuroimaging becomes essential.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">2,3</span></a> The methodology needed to optimize the application of PET and SPECT in the detection of the EZ is complex and is a challenge for a nuclear medicine physician who is invited to be a member of an Epilepsy Unit. This specialist is expected to establish dedicated brain SPECT and PET protocols which go beyond the simple injection of the radiopharmaceutical, posterior acquisition of images and their final interpretation by visual inspection. In the case of brain perfusion SPECT, ictal studies must be obtained with the radiopharmaceutical being injected as early as possible after the onset of an epileptic seizure during hospital admission of the patient in the Epilepsy Unit. Traditionally, optimization of this injection was performed by a skilled nursing professional trained in the setting of epileptology and who was familiarized with the manipulation of non encapsulated radioactive sources. Today, however, commercial self-injection devices are available which automatize the injection process, thereby reducing the intervention of healthcare personnel whose mission in this case is reduced to pressing a button to detect the electroclinical onset of the seizure in the video-EEG monitoring room, shortening the injection time and reducing exposure to radiation.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">4</span></a> Although the cost of this equipment is elevated, its acquisition is very recommendable, especially in reference centers with a large volume of patients and which plan complex surgical procedures (non lesional epilepsies, extratemporal localizations, among others), the result of which strongly depends on the most accurate localization of the zone of ictal onset. In contrast to ictal SPECT, PET studies in epilepsy are fundamentally performed in an interictal situation, which must be guaranteed by the nuclear physician before injection of the radiopharmaceutical. This is achieved by a previous correct anamnesis to rule out recent epileptic seizures, and in cases of patients in whom anamnesis is difficult, or who have an elevated frequency of seizures or subclinical seizures, EEG monitoring should be done during the period of radiopharmaceutical incorporation after injection to rule out the presence of epileptiform discharges. These aspects related to peri-injection of the radiopharmaceutical in ictal and interictal studies have considerably increased the methodological complexity of PET and SPECT compared to neurological indications other than epilepsy, and their relevance was demonstrated by different experts who participated in the session “Update on Molecular Neuroimaging in Epilepsy” organized by the Neuroimaging Working Group of Neuroimaging in the recent symposium by the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM) in Córdoba, Spain (7–8 June). The speakers also coincided in highlighting the importance of another aspect contributing to the increased complexity of nuclear imaging in epilepsy: that is, the image analysis technique to help in the diagnosis. While in other settings of nuclear neurology the use of software to help achieve the diagnosis is very recommendable, albeit not essential, it is agreed that in epilepsy the methods of analysis are fundamental because of the profound therapeutic implications which the PET or SPECT brain imaging results may have. For example, to date, surgery or depth electrode placement is not considered based on findings in an ictal SPECT without this having been presented and analyzed by substraction of ictal SPECT co-registered to MR (SISCOM) of the patient. Likewise, omission of the application of methods of interictal PET imaging analysis may lead to a loss of opportunity to detect a mild focus of hypometabolism which is practically invisible by visual inspection or to demonstrate a more widely affected neuronal network,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> increasing the risk of surgical failure with conventional resection techniques which may occur in the so-called termporal-plus epilepsies or in cases of dual disease, among others. The Clinical Note published in this issue of REMNIM by the group of the Hospital Clínic of Barcelona<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a> shows up to what point it may be decisive to use adequate tools of analysis and the importance of promoting continuing improvement. In the case presented, it was retrospectively observed how with the use of the PISCOM analysis (substraction of ictal SPECT over interictal FDG-PET) and PET analysis software, the so-called principle of concordance among the different diagnostic techniques in presurgical evaluation would have been satisfied. The surgical decision and its possibilities of success depend on adequate topographic concordance among the techniques. The authors, together with other collaborators, developed and duly validated these programs in the absence of commercial software for routine clinical use of PET and SPECT analysis. One part of the processing algorithms developed by this group of authors now constitutes the basis of the commercial software Neurocloud<span class="elsevierStyleSup">®</span>.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> It would be desirable for these initiatives to awaken general interest on behalf of the suppliers of commercial nuclear medicine equipment to translate this into greater availability to all centers of specific tools for epilepsy analysis such as SISCOM and its variants as well as comparative methods of FDG-PET with bases of healthy controls which have been validated within the setting of epilepsy.</p><p id="par0010" class="elsevierStylePara elsevierViewall">It is of note that in contrast to other settings such as dementias or brain tumors in which recent advances have been produced with the development of new radiopharmaceuticals, the progress in the diagnostic performance of PET and SPECT in epilepsy has, overall, been linked to perfecting the techniques of image analysis as illustrated in the Clinical Note in this issue. While it is true that PET radiopharmaceuticals other than <span class="elsevierStyleSup">18</span>F-FDG have been applied in the presurgical evaluation of epilepsy (i.e.: <span class="elsevierStyleSup">11</span>C-flumazenyl in temporal epilepsy or <span class="elsevierStyleSup">11</span>C-alpha-methyl-tryptophan in tuberous sclerosis or multiple focal cortical dysplasias),<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a> these have not been widely diffused for technical (<span class="elsevierStyleSup">11</span>C) and/or clinical reasons. It is, therefore, likely that technetium radiopharmaceuticals of brain perfusion and <span class="elsevierStyleSup">18</span>F-FDG will continue to play a predominating role in functional neuroimaging in epilepsy for a long time. Likewise, the incorporation of these techniques in algorithms in nuclear medicine or decision making guidelines in the presurgical evaluation of epilepsy is important<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> to promote their use in the most rational and homogeneous way possible among the different centers.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Correctly protocolized and interpreted neuroimaging techniques applied in the presurgical evaluation of pharmacoresistant epilepsy may be decisive in the cure or clinical improvement of patients with this incapacitating disease.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Rubí S, Camacho V. Medicina Nuclear en la epilepsia: avances en el análisis de los estudios SPECT y PET. Rev Esp Med Nucl Imagen Mol. 2019;38:273–274.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nuevos tiempos para la neuroimagen de Medicina Nuclear en España: ¿de dónde partimos?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.A. Balsa" 1 => "V. Camacho" 2 => "P. Garrastachu" 3 => "D. García-Solís" 4 => "M. Gómez-Río" 5 => "S. 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The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles. The works may be submitted in Spanish or English and are subjected to a peer review process. In 2009, it became the leading Spanish journal in the field of Medical Imaging on having an Impact Factor , awarded by the Journal Citation Reports.
Science Citation Index Expander, Medline, IME, Bibliomed, EMBASE/Excerpta Medica, Healthstar, Cancerlit, Toxine, Inside Conferences, Scopus
See moreThe Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.
© Clarivate Analytics, Journal Citation Reports 2022
SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.
See moreSNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.
See moreRevista Española de Medicina Nuclear e Imagen Molecular (English Edition)
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