Article
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
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GC: ganglios linfáticos centinela; GL: ganglios linfáticos.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. García-Ruiz, I. Martínez-Rodríguez, N. Martínez-Amador, N.V. Carvalho-Duarte, J. Jiménez-Bonilla, R. Quirce" "autores" => array:6 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "García-Ruiz" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Martínez-Rodríguez" ] 2 => array:2 [ "nombre" => "N." "apellidos" => "Martínez-Amador" ] 3 => array:2 [ "nombre" => "N.V." "apellidos" => "Carvalho-Duarte" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Jiménez-Bonilla" ] 5 => array:2 [ "nombre" => "R." "apellidos" => "Quirce" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2253808924000405" "doi" => "10.1016/j.remnie.2024.500024" "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/S2253808924000405?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X24000325?idApp=UINPBA00004N" "url" => "/2253654X/0000004300000004/v3_202408071058/S2253654X24000325/v3_202408071058/es/main.assets" ] ] "itemAnterior" => array:19 [ "pii" => "S2253808924000429" "issn" => "22538089" "doi" => "10.1016/j.remnie.2024.500016" "estado" => "S300" "fechaPublicacion" => "2024-07-01" "aid" => "500016" "copyright" => "Sociedad Española de Medicina Nuclear e Imagen Molecular" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2024;43:" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "Prostatic rhabdomyosarcoma in a 6 years old patient evaluated by [<span class="elsevierStyleSup">18</span>F]FDG PET/CT" "tienePdf" => "en" "tieneTextoCompleto" => "en" "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Rabdomiosarcoma prostático en un paciente de seis años evaluado mediante [<span class="elsevierStyleSup">18</span>F]FDG PET/TC" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1765 "Ancho" => 1327 "Tamanyo" => 239135 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Subsequently, an interim [<span class="elsevierStyleSup">18</span>F]FDG PET/CT study was performed to assess treatment response. In this study, a significant reduction in size, from 63 mm to 16 mm in the main axis, and in metabolic activity of the primary lesion, SULpeak from 5.37 to 2.82, were observed, consistent with partial metabolic response according to PERCIST criteria. Following this, the patient completed the five cycles of the IVA regimen and was referred for brachytherapy to complete the treatment.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Rivas-Navas, T. Rudolphi-Solero, J. Fernández-Fernández, J. Villa-Palacios, C. Ramos-Font" "autores" => array:5 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Rivas-Navas" ] 1 => array:2 [ "nombre" => "T." "apellidos" => "Rudolphi-Solero" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Fernández-Fernández" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Villa-Palacios" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Ramos-Font" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X24000246" "doi" => "10.1016/j.remn.2024.500016" "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/S2253654X24000246?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808924000429?idApp=UINPBA00004N" "url" => "/22538089/0000004300000004/v3_202408070927/S2253808924000429/v3_202408070927/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "Revealing undetected axillary sentinel node in neoadjuvant chemotherapy treated breast cancer" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Aránzazu García-Ruiz, Isabel Martínez-Rodríguez, Néstor Martínez-Amador, Nádia Virgínia Carvalho-Duarte, Julio Jiménez-Bonilla, Remedios Quirce" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Aránzazu" "apellidos" => "García-Ruiz" "email" => array:2 [ 0 => "aranzazu.garcia@scsalud.es" 1 => "garciaruizaranzazu0@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Isabel" "apellidos" => "Martínez-Rodríguez" ] 2 => array:2 [ "nombre" => "Néstor" "apellidos" => "Martínez-Amador" ] 3 => array:2 [ "nombre" => "Nádia Virgínia" "apellidos" => "Carvalho-Duarte" ] 4 => array:2 [ "nombre" => "Julio" "apellidos" => "Jiménez-Bonilla" ] 5 => array:2 [ "nombre" => "Remedios" "apellidos" => "Quirce" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Grupo de Imagen Molecular (IDIVAL), Santander, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondence author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Identificación de ganglio centinela axilar no detectado en cáncer de mama tratado con quimioterapia neoadyuvante" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1552 "Ancho" => 2500 "Tamanyo" => 280382 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Early (A) and late (B) anterior oblique planar images and SPECT/CT lymphoscintigraphic images (C, D, E) showed radiotracer drainage to the SLN detected by MRI at diagnosis and marked with a clip, located at the axillary level I (long arrow), and revealed a second SLN (short arrows) that did not correspond with the second node previously identified by MRI, in this case located at the axillary level II.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present a 39-year-old woman diagnosed with triple negative invasive ductal carcinoma (IDC) at stage T2cN1 (negative ER, PR and HER2, Ki67 35%) in the right breast. At diagnosis two lymph nodes (LNs) in axillary level I were identified through magnetic resonance imaging (MRI), one of them highly suspicious of malignancy, lately confirmed by fine needle aspiration. Localization clips were placed both on the tumour and the pathological LN using ultrasound guidance. The patient received neoadjuvant chemotherapy (NAC). A post-chemotherapy MRI and ultrasound assessment revealed a partial response in the tumour and a complete response in the metastatic LN.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Lymphoscintigraphy was performed injecting the radiotracer subcutaneously and periareolarly the day before surgery and showed two lymphatic drainage channels with also two axillary sentinel lymph nodes (SLN) on the right axilla (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A, early and 1B, late planar images, long and short arrows). The SPECT/CT images showed that one of two SLN corresponded with the previously identified by MRI and marked with radiological clip (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C and D, long arrows), and identified another unexpected SLN in axillary level II (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C and E, short arrows) that did not correspond to the second node visualized in the MRI. A wire-guided tumorectomy and the intraoperative detection of the SLN, assisted by hand-held gamma probe and portable gamma camera were performed, combined with the use of methylene blue dye, administered in the same way, removing the two right axillary SLNs. The SLN identified at diagnosis by MRI and marked with one clip was only detected by radiotracer probe, showing not blue dye uptake and no metastasis detected. The second SLN identified only by scintigraphy was located in axillary level II, and surgically detected both with radiotracer probe and blue dye, and unexpectedly the intraoperative histological analysis revealed the presence of IDC macrometastasis. During the subsequent lymphadenectomy twelve LNs were removed with no signs of malignancy after deferred histological analysis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The anatomopathological analysis yielded a partial tumour response to NAC according with the expected result. Nowadays, the performance of the SLN technique after NAC is recognized by breast cancer management guidelines as a valid alternative to axillary lymphadenectomy in patients who have shown complete axillary response.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> These guidelines advocate for pre-surgical localization and excision of the SLN and the nodes marked with clips through a radioisotopic and colorimetric technique, excising at least various LNs or using different type of markers (magnetic, radiologic, radioactive seeds, radiofrequency) to perform a targeted axillary dissection. In fact, the feasibility of this methodology is well demonstrated in recent articles and clinical case reports, as we have demonstrated in this patient.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">This case highlights the importance of performing a lymphoscintigraphy including a SPECT/CT in NAC patients, especially those with suspected node involvement, or even in previously negative axillary cases. This procedure was helpful not only to localize the affected nodes but also to compare radiological and isotopical findings and to identify previously undetected SLNs, been crucial for guiding personalized treatment, as seen in our patient where lymphoscintigraphy and SPECT/TC allowed the detection of remaining disease in the axilla.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1552 "Ancho" => 2500 "Tamanyo" => 280382 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Early (A) and late (B) anterior oblique planar images and SPECT/CT lymphoscintigraphic images (C, D, E) showed radiotracer drainage to the SLN detected by MRI at diagnosis and marked with a clip, located at the axillary level I (long arrow), and revealed a second SLN (short arrows) that did not correspond with the second node previously identified by MRI, in this case located at the axillary level II.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast cancer, version 3.2022, NCCN Clinical Practice Guidelines in Oncology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.J. Gradishar" 1 => "M.S. Moran" 2 => "J. Abraham" 3 => "R. Aft" 4 => "D. Agnese" 5 => "K.H. Allison" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.6004/jnccn.2022.0030" "Revista" => array:6 [ "tituloSerie" => "J Natl Compr Canc Netw" "fecha" => "2022" "volumen" => "20" "paginaInicial" => "691" "paginaFinal" => "722" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35714673" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "SPECT/CT lymphoscintigraphy accurately localizes clipped and sentinel nodes after neoadjuvant chemotherapy in node-positive breast cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Dilege" 1 => "B. Celik" 2 => "O. Falay" 3 => "M. Boge" 4 => "S. Sucu" 5 => "S. Toprak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RLU.0000000000004669" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2023" "volumen" => "48" "paginaInicial" => "594" "paginaFinal" => "599" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37075247" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radioactive and non-radioactive seeds as surgical localization method of non-palpable breast lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Cebrecos" 1 => "N. Sánchez-Izquierdo" 2 => "S. Ganau" 3 => "E. Mensión" 4 => "A. Perissinotti" 5 => "B. Úbeda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remnie.2022.01.002" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol" "fecha" => "2022" "volumen" => "41" "paginaInicial" => "100" "paginaFinal" => "107" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35193816" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000004300000004/v3_202408070927/S2253808924000405/v3_202408070927/en/main.assets" "Apartado" => array:4 [ "identificador" => "7927" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000004300000004/v3_202408070927/S2253808924000405/v3_202408070927/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808924000405?idApp=UINPBA00004N" ]
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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.
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