Article
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
array:22 [ "pii" => "S2253808921000471" "issn" => "22538089" "doi" => "10.1016/j.remnie.2021.03.006" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "1250" "copyrightAnyo" => "2021" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2021;40:383-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S225380892100135X" "issn" => "22538089" "doi" => "10.1016/j.remnie.2021.09.001" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "1327" "copyright" => "Sociedad Española de Medicina Nuclear e Imagen Molecular" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Med Nucl Imagen Mol. 2021;40:385-96" "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">Continuing Education</span>" "titulo" => "Determination of the segmental hepatic clearance rate of <span class="elsevierStyleSup">99m</span>Tc-mebrofenin and its application in the functional assessment of future liver remnant after liver resection" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "385" "paginaFinal" => "396" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Determinación de la tasa de aclaramiento hepático segmentario de <span class="elsevierStyleSup">99m</span>Tcmebrofenina y su aplicación en la evaluación funcional del remanente hepático futuro tras resección hepática" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0060" "etiqueta" => "Image 12" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "pl12.jpeg" "Alto" => 3222 "Ancho" => 3000 "Tamanyo" => 1121899 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0060" "detalle" => "Image 1" "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Reconstructed SPECT-CT image with the delimitation of segments and total volume. The sphere used to know the mean hepatic activity is also visualized with the aim of substituting the activity of the biliary tree.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jon Andoni Uña-Gorospe" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Jon Andoni" "apellidos" => "Uña-Gorospe" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X21001608" "doi" => "10.1016/j.remn.2021.09.001" "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/S2253654X21001608?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225380892100135X?idApp=UINPBA00004N" "url" => "/22538089/0000004000000006/v1_202110290541/S225380892100135X/v1_202110290541/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "S2253808921000434" "issn" => "22538089" "doi" => "10.1016/j.remnie.2021.03.003" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "1238" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2021;40:380-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "Intravascular large cell lymphoma. <span class="elsevierStyleSup">18</span>F-FDG PET/CT and necropsy findings" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "380" "paginaFinal" => "382" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Linfoma de célula grande intravascular. Hallazgos en la <span class="elsevierStyleSup">18</span>F-FDG PET/TC y necropsia" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 828 "Ancho" => 1750 "Tamanyo" => 173818 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG PET/CT showed diffuse hypermetabolism in the adrenal glands (arrows), with an SUVmax of 6.9 for the right and 7.9 for the left gland, values ​​in the high range of the cases previously described (ranging between 2.3 and 8.8). Higher uptake intensity has been associated with a worse prognosis in these patients. In the CT component of the examination, both glands were enlarged (arrows). The study also revealed diffuse hypermetabolism of the bone marrow and spleen, which has been described as the most common presentation pattern for these organs.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. Martínez-Rodríguez, A. Azueta Etxebarria, A. Insunza, F.J. Gómez-de la Fuente, J. García-Reyero, I. Banzo" "autores" => array:6 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Martínez-Rodríguez" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Azueta Etxebarria" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Insunza" ] 3 => array:2 [ "nombre" => "F.J." "apellidos" => "Gómez-de la Fuente" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "García-Reyero" ] 5 => array:2 [ "nombre" => "I." "apellidos" => "Banzo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808921000434?idApp=UINPBA00004N" "url" => "/22538089/0000004000000006/v1_202110290541/S2253808921000434/v1_202110290541/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "Bilateral adrenal hypermetabolism with <span class="elsevierStyleSup">18</span>F-FDG PET/CT as an incidental finding in suspected recurrence of adrenocortical carcinoma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "383" "paginaFinal" => "384" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Márquez Fernández, L.M. Mena Bares, E. Carmona Asenjo, F.R. Maza Muret, E. Moreno Ortega, J.A. Vallejo Casas" "autores" => array:6 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Márquez Fernández" "email" => array:1 [ 0 => "marquezfernandezjuan@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "L.M." "apellidos" => "Mena Bares" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Carmona Asenjo" ] 3 => array:2 [ "nombre" => "F.R." "apellidos" => "Maza Muret" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Moreno Ortega" ] 5 => array:2 [ "nombre" => "J.A." "apellidos" => "Vallejo Casas" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Gestión Clínica de Medicina Nuclear, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hipermetabolismo adrenal bilateral con <span class="elsevierStyleSup">18</span>F-FDG PET/TC como hallazgo casual en la sospecha de recurrencia de carcinoma adrenocortical" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1104 "Ancho" => 1500 "Tamanyo" => 141109 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">F-18 FDG-PET/CT study from the skull base to proximal thigh was performed 53 min after i.v. administration of FDG (155 MBq) after 5 months with mitotane adjuvant treatment. Axial fusion image of the thorax lung window (A). We observed a hypermetabolic ground glass image (SUVmax 6.7) in the RLL, corresponding to the area treated by SBRT. Axial and Coronal fusion images of abdomen soft tissue window (B) (C). Significant glycidic metabolism increase is observed in bilateral adrenal tissue (right adrenal remnant with SUVmax 12.4 and left adrenal gland with SUVmax 13.9) without morphological changes in the glandular structure.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Bilateral adrenal hypermetabolism with F-18 FDG PET/CT as an incidental finding in suspected recurrence of adrenocortical carcinoma. We report the case of a 60-year-old man with right adrenocortical carcinoma (Stage I, Ki67 5–10%), who underwent incomplete laparoscopic adrenalectomy. Three months after surgery, a F-18 FDG PET/CT study was performed without adrenal involvement evidence (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), although a slightly hypermetabolic pulmonary nodule was observed in the right lower lobe (RLL). The mentioned nodule, was treated with SBRT (5 fractions/12 Gy on five consecutive days). In addition, adjuvant treatment with mitotane was established. Five months later, mitotane treatment was suspended due to poor tolerance and it was decided to perform a new F-18 FDG PET/CT study. The study showed a notable increased glycidic metabolism in the left adrenal as well as in the right adrenal remnant, with lack of anatomical alteration. This could be justified by mitotane treatment and less probably related with neoplastic disease (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Inflammatory changes in the right lung parenchyma were related to recent radiotherapy treatment. In the follow-up, a new F-18 FDG PET/CT study was performed 10 months after the previous one, and this time, no adrenal hypermetabolism was observed, confirming the suspected relationship with mitotane treatment (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Mitotane is a chemotherapy treatment adjuvant to surgery used in adrenocortical carcinoma, that improves patient survival. It has a cytotoxic and inhibitory effect on the adrenal cortex, because its accumulation in the fascicular and reticular layers causes mitochondrial damage, and therefore, it produces necrosis. Nevertheless, the mechanism is not fully known. The response rate to mitotane in some series reaches up to 36%. This treatment is more frequently used in secretory tumors, incomplete resections and in tumors with a Ki67 proliferation index > 10%. Its use requires a first dose followed by adequate control of serum levels because the adverse effects are dose-dependent, most of them related to gastrointestinal disorders.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Patients treated with mitotane are also treated with high-dose corticosteroids to minimize early-onset adrenal insufficiency. The goal of treatment is to achieve therapeutic mitotane levels and ACTH levels in the normal range. Patients persist with a state of relative hypocortisolism despite high replacement therapy, generally due to relative high ACTH levels. Although cortisol secretion is inhibited, the adrenal cortical cell has a high avidity for F-18 FDG, his is probably related to ACTH stimulation.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In some series, this increase in glycidic metabolism in the contralateral adrenal tissue has been reported in up to 29% of cases with metabolic normalization within subsequent 24 months. This shows a link to an effect of concurrent mitotane treatment and a possible functional endocrine compensation.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> This case is an example of the importance of considering the physiopathological processes in the differential diagnosis between neoplastic recurrence and possible reactive hypermetabolism due to adjuvant treatment.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Márquez Fernández J, Mena Bares LM, Carmona Asenjo E, Maza Muret FR, Moreno Ortega E, Vallejo Casas JA. Hipermetabolismo adrenal bilateral con <span class="elsevierStyleSup">18</span>F-FDG PET/TC como hallazgo casual en la sospecha de recurrencia de carcinoma adrenocortical. Rev Esp Med Nucl Imagen Mol. 2021;40:383–384.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1089 "Ancho" => 1500 "Tamanyo" => 151633 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">F-18 PET/CT study from the skull base to proximal thigh was performed 60 min after intravenous (i.v.) administration of FDG (160 MBq). Axial fusion image of the thorax lung window (A). We observed the subcentimetric pulmonary nodule in the RLL (SUVmax 1.9). Axial and Coronal fusion images of abdomen soft tissue window (B)(C). Three months after surgery, the postsurgical changes in the right adrenal remnant was observed, without significant increase in glycidic metabolism.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1104 "Ancho" => 1500 "Tamanyo" => 141109 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">F-18 FDG-PET/CT study from the skull base to proximal thigh was performed 53 min after i.v. administration of FDG (155 MBq) after 5 months with mitotane adjuvant treatment. Axial fusion image of the thorax lung window (A). We observed a hypermetabolic ground glass image (SUVmax 6.7) in the RLL, corresponding to the area treated by SBRT. Axial and Coronal fusion images of abdomen soft tissue window (B) (C). Significant glycidic metabolism increase is observed in bilateral adrenal tissue (right adrenal remnant with SUVmax 12.4 and left adrenal gland with SUVmax 13.9) without morphological changes in the glandular structure.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 643 "Ancho" => 1500 "Tamanyo" => 104865 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">F-18 FDG-PET/CT follow-up study, after 10 months suspension of mitotane treatment. Acquisition from the skull base to the proximal thigh was performed 63 min after i.v. administration of FDG (173 Mbq). Axial and Coronal fusion images of abdomen soft tissue window (A)(B). A glycidic metabolism normalization is observed in the adrenal tissue (right adrenal remnant with SUVmax 1.8 and left adrenal gland with SUVmax 1.6).</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" => "Molecular imaging in the management of adrenocortical cancer: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "K.K. Wong" 1 => "B.S. Miller" 2 => "B.L. Viglianti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RLU.0000000000001112" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2016" "volumen" => "41" "paginaInicial" => "e368" "paginaFinal" => "82" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26825212" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High (18)F-FDG uptake by the remaining adrenal gland four months after surgery and initiation of mitotane treatment in two patients with adrenocortical carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "I. Mpanaka" 1 => "V.D. Lyra" 2 => "G. Kaltsas" 3 => "S.N. Chatziioannou" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Hell J Nucl Med" "fecha" => "2011" "volumen" => "14" "paginaInicial" => "168" "paginaFinal" => "172" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21761022" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fluorodesoxyglucose uptake in the remaining adrenal glands during the follow-up of patients with adrenocortical carcinoma: do not consider it as malignancy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Leboulleux" 1 => "D. Deandreis" 2 => "C. Escourrou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1530/EJE-10-0666" "Revista" => array:6 [ "tituloSerie" => "Eur J Endocrinol" "fecha" => "2011" "volumen" => "164" "paginaInicial" => "89" "paginaFinal" => "94" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20921280" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000004000000006/v1_202110290541/S2253808921000471/v1_202110290541/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/22538089/0000004000000006/v1_202110290541/S2253808921000471/v1_202110290541/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808921000471?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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