Article
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
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Pudis, J.J. Martín-Marcuartu, A. Feu-Llauradó, J.G. Reyes-Junca, C. Soldevila-Lozano, M. Cortés-Romera" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Pudis" ] 1 => array:2 [ "nombre" => "J.J." "apellidos" => "Martín-Marcuartu" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Feu-Llauradó" ] 3 => array:2 [ "nombre" => "J.G." "apellidos" => "Reyes-Junca" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Soldevila-Lozano" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Cortés-Romera" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808921000537?idApp=UINPBA00004N" "url" => "/22538089/0000004100000003/v1_202205140730/S2253808921000537/v1_202205140730/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "S2253808921000550" "issn" => "22538089" "doi" => "10.1016/j.remnie.2021.03.013" "estado" => "S300" "fechaPublicacion" => "2022-05-01" "aid" => "1262" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2022;41:188-9" "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" => "[<span class="elsevierStyleSup">18</span>F]FDG PET/CT in an azygos vein spindle-cell sarcoma in a patient with thoracic pain" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "188" "paginaFinal" => "189" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "[<span class="elsevierStyleSup">18</span>F]FDG PET/TC en un sarcoma fusocelular de la vena ácigos en un paciente con dolor torácico" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1594 "Ancho" => 3008 "Tamanyo" => 562426 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">An angio-CT showed an unspecific mediastinal round mass partially surrounding the thoracic aorta with no significant stenosis (a–c, black arrow) as well as a filling intravascular defect in azygos vein (b, red arrow). [<span class="elsevierStyleSup">18</span>F]FDG PET/CT (d, axial; e, coronal; f, sagittal views; g, MIP) revealed a round paraortic mass in relation to the morphological findings of the CT scan with intense peripheral radiotracer uptake (SUVmax: 11,9) and large ametabolic central area compatible with necrosis. A 8 cm linear lesion filling the azygos vein lumen (SUVmax: 13,4) suggestive of a tumor thrombus (e,f, white arrowhead). Hypermetabolic lesion in the right adrenal gland with SUVmax of 13 (e,g, white arrow). Fine-needle-biopsy containing malignant spindle-shaped cells (h, hematoxylin-eosin-stainning ×300, i,Papanicolau-staining ×600) and strong staining for Vimentin (j) compatible with a SCS of the azygos vein.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. León-Asuero-Moreno, P. Fernández-Rodríguez, J.M. Masero Carretero, Y. Herrera Martínez, J.M. Jiménez-Hoyuela García, I. Acevedo Báñez" "autores" => array:6 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "León-Asuero-Moreno" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Fernández-Rodríguez" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Masero Carretero" ] 3 => array:2 [ "nombre" => "Y." "apellidos" => "Herrera Martínez" ] 4 => array:2 [ "nombre" => "J.M." "apellidos" => "Jiménez-Hoyuela García" ] 5 => array:2 [ "nombre" => "I." "apellidos" => "Acevedo Báñez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808921000550?idApp=UINPBA00004N" "url" => "/22538089/0000004100000003/v1_202205140730/S2253808921000550/v1_202205140730/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "Early diagnosis of cardiac sarcoidosis in inflammatory stage on cardiac [<span class="elsevierStyleSup">18</span>F]FDG PET/MRI. A case report" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "190" "paginaFinal" => "191" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. Olivero, J.R. Garcia, P. Bassa, P. Garcia, E. Riera, A. Maceira" "autores" => array:6 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Olivero" ] 1 => array:4 [ "nombre" => "J.R." "apellidos" => "Garcia" "email" => array:1 [ 0 => "jrgarcia@cetir.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Bassa" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Garcia" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Riera" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Maceira" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad PET/RM Viladomat, CETIR, ASCIRES Grupo Biomédico, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Diagnóstico precoz de sarcoidosis cardiaca en fase inflamatoria mediante cardio PET/RM con [<span class="elsevierStyleSup">18</span>F]FDG. A propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 437 "Ancho" => 1500 "Tamanyo" => 55566 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Patient preparation: 72 h previous to the procedure patient was placed on a high-fat diet with carbohydrates restriction, and fasted for 12 h. Fifty units/Kg of SC heparin were injected 15 min prior to the [<span class="elsevierStyleSup">18</span>F]FDG injection.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Synchronous PET/CMR acquisition:</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>• PET: 1 beds/10 min. Cardiac/breath gating.</p> <p id="spar0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>• CMR: anatomical sequences; cine; phase contrast; STIR; gadolinium administration (first-pass perfusion, late gadolinium enhancement).</p> <p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">CMR: Left ventricle is mildly dilated, with slight concentric hypertrophy; basal inferolateral segmental akinesia and diffuse hypokinesia; systolic function is moderately depressed (LVEF 40%).</p> <p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Integrated [<span class="elsevierStyleSup">18</span>F]FDG PET/CMR axial images obtained with a GE Signa 3T equipment:</p> <p id="spar0035" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>• [<span class="elsevierStyleSup">18</span>F]FDG PET: Adequate myocardial suppression with segmental radiotracer uptake seen on basal inferolateral territory.</p> <p id="spar0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>• Post-gadolinium MRI: Late myocardial enhancement with gadolinium, especially in inframyocardial area, which suggested fibrosis on basal inferolateral segment, spreading to basal anterolateral segment, with minimum subendocardial involvement.</p> <p id="spar0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>• Hybrid PET/CMR imaging: Image matching is seen between segmental [<span class="elsevierStyleSup">18</span>F]FDG uptake and late gadolinium enhancement on basal inferolateral territory, which corresponded to an active sarcoidosis pattern.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The case of a 62-year-old man, former smoker and with high blood pressure (BP) as factors for cardiovascular risk, with history of mediastinal and lung sarcoidosis diagnosed by a lymph node biopsy in 2006 is presented. Patient was referred to the Cardiology Clinic for dyspnea symptoms with mild left heart failure signs (crackles in base of lungs). The ECG tracing revealed sinus rhythm, a first-degree atrioventricular block and right bundle branch block. Echocardiography showed a slightly enlarged left ventricle with moderately depressed systolic function. Considering these findings, a coronary angiography was requested, which showed non-significant coronary artery disease.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Since cardiac sarcoidosis was suspected, and considering this technique availability in our setting, patient was referred for an integrated [<span class="elsevierStyleSup">18</span>F]FDG positron emission tomography (PET)/cardiac magnetic resonance (CMR) (GE Signa 3T), after suppression of glucose uptake in the myocardium by means of dietary preparation and heparin administration.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Whole-body [<span class="elsevierStyleSup">18</span>F]FDG PET/MRI did not show metabolically active lymph node involvement. Cardiac PET/MRI showed adequate myocardial glucose uptake suppression, and [<span class="elsevierStyleSup">18</span>F]FDG segmental uptake on basal inferolateral territory, matching late gadolinium enhancement (LGE) feature (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Sarcoidosis is a multisystem granulomatous disease of unknown origin, probably immunological, that mainly involves lungs and lymph nodes (90% of cases). Most frequently is seen in women, between 26 and 60 years. Cardiac involvement is seen in 5% of cases, although subclinical prevalence seems considerably higher, considering a 25% of cardiac infiltration at least, revealed in post-mortem examination in patients with sarcoidosis.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Main clinical features of the disease include rhythm disturbances, ventricular arrhythmia (sudden death syndrome may become the clinical presentation), and cardiac failure; with the latter being a poor prognostic factor, especially due to left ventricular dysfunction.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Early detection of cardiac sarcoidosis allows for targeting immunosuppressive treatment and thus reducing patient morbimortality. Three consensuses for diagnostic criteria have been drawn, with the latest being the “World Association for Sarcoidosis and Other Granulomatous Disorders Criteria”. [<span class="elsevierStyleSup">18</span>F]FDG PET and CMR are techniques included in all these consensuses, with the aim of reducing the need for endomyocardial biopsy, given the risk of myocardial perforation involved.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">[<span class="elsevierStyleSup">18</span>F]FDG segmental uptake is the main PET feature, related to the disease inflammatory activity and with values of sensitivity and specificity 89% and 78%, respectively.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">LGE is the main CMR feature, related to myocardial edema/fibrosis/necrosis and with values of sensitivity and specificity 100% and 75% respectively. Cardiac volumes and LV ejection fraction may also be studied.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Deck et al. described four patterns for cardiac sarcoidosis<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1</span><p id="par0050" class="elsevierStylePara elsevierViewall">Positive [<span class="elsevierStyleSup">18</span>F]FDG + positive LGE: active sarcoidosis.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2</span><p id="par0055" class="elsevierStylePara elsevierViewall">Negative [<span class="elsevierStyleSup">18</span>F]FDG + positive LGE: old sarcoidosis scar.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3</span><p id="par0060" class="elsevierStylePara elsevierViewall">Negative [<span class="elsevierStyleSup">18</span>F]FDG FDG + negative LGE: no cardiac sarcoidosis involvement.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4</span><p id="par0065" class="elsevierStylePara elsevierViewall">Positive [<span class="elsevierStyleSup">18</span>F]FDG + negative LGE: false positive case probably due to inadequate myocardial metabolism suppression.</p></li></ul></p><p id="par0070" class="elsevierStylePara elsevierViewall">In our case, the integrated [<span class="elsevierStyleSup">18</span>F]FDG PET/CMR allowed for early detection of active cardiac sarcoidosis by means of one-step procedure, therefore shortening the disease diagnostic time and reducing patient dosimetry, and with treatment decision for immunosuppressive agents in our patient.</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: Olivero R, Garcia JR, Bassa P, Garcia P, Riera E, Maceira A. Diagnóstico precoz de sarcoidosis cardiaca en fase inflamatoria mediante cardio PET/RM con <span class="elsevierStyleSup">18</span>F-FDG. A propósito de un caso. Rev Esp Med Nucl Imagen Mol. 2022;41:190–191.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 437 "Ancho" => 1500 "Tamanyo" => 55566 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Patient preparation: 72 h previous to the procedure patient was placed on a high-fat diet with carbohydrates restriction, and fasted for 12 h. Fifty units/Kg of SC heparin were injected 15 min prior to the [<span class="elsevierStyleSup">18</span>F]FDG injection.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Synchronous PET/CMR acquisition:</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>• PET: 1 beds/10 min. Cardiac/breath gating.</p> <p id="spar0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>• CMR: anatomical sequences; cine; phase contrast; STIR; gadolinium administration (first-pass perfusion, late gadolinium enhancement).</p> <p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">CMR: Left ventricle is mildly dilated, with slight concentric hypertrophy; basal inferolateral segmental akinesia and diffuse hypokinesia; systolic function is moderately depressed (LVEF 40%).</p> <p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Integrated [<span class="elsevierStyleSup">18</span>F]FDG PET/CMR axial images obtained with a GE Signa 3T equipment:</p> <p id="spar0035" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>• [<span class="elsevierStyleSup">18</span>F]FDG PET: Adequate myocardial suppression with segmental radiotracer uptake seen on basal inferolateral territory.</p> <p id="spar0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>• Post-gadolinium MRI: Late myocardial enhancement with gadolinium, especially in inframyocardial area, which suggested fibrosis on basal inferolateral segment, spreading to basal anterolateral segment, with minimum subendocardial involvement.</p> <p id="spar0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>• Hybrid PET/CMR imaging: Image matching is seen between segmental [<span class="elsevierStyleSup">18</span>F]FDG uptake and late gadolinium enhancement on basal inferolateral territory, which corresponded to an active sarcoidosis pattern.</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" => "The role of positron emission tomography in the assessment of cardiac sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Genovesi" 1 => "M. Bauckneht" 2 => "C. Altini" 3 => "C.E. Popescu" 4 => "P. Ferro" 5 => "L. Monaco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/bjr.20190247" "Revista" => array:3 [ "tituloSerie" => "Br J Radiol" "fecha" => "2019" "volumen" => "92" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiac magnetic resonance imaging for diagnosis of cardiac sarcoidosis: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Zhang" 1 => "Y. Li" 2 => "Q. Xu" 3 => "B. Xu" 4 => "H. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2018/7457369" "Revista" => array:3 [ "tituloSerie" => "Can Respir J" "fecha" => "2018" "volumen" => "2018" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hybrid magnetic resonance imaging and positron emission tomography with fluorodeoxyglucose to diagnose active cardiac sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.R. Dweck" 1 => "R. Abgral" 2 => "M.G. Trivieri" 3 => "P.M. Robson" 4 => "N. Karakatsanis" 5 => "V. Mani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcmg.2017.02.021" "Revista" => array:6 [ "tituloSerie" => "JACC Cardiovasc Imaging" "fecha" => "2018" "volumen" => "11" "paginaInicial" => "94" "paginaFinal" => "107" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28624396" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000004100000003/v1_202205140730/S2253808921000549/v1_202205140730/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/22538089/0000004100000003/v1_202205140730/S2253808921000549/v1_202205140730/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808921000549?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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