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Caso clínico evaluado con <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:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2266 "Ancho" => 2497 "Tamanyo" => 531154 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The maximum intensity projection image (A) shows moderate-intense FDG uptake by cervical, mediastinal, hilar and interaortocaval lymph nodes, and by multiple bone lesions. (B) The fused PET/CT coronal image confirms the FDG uptake in these lymph node locations and bone lesions in multiple lytic and blastic lesions in spine, ribs, sternum, right scapula, ilium and proximal third of the left femoral shaft. (C) The transaxial PET/CT fused images reveals mild FDG uptake in pulmonary nodules less than one centimeter in size that does not rule out pulmonary metastases.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L.M. Mena, E. Carmona, F.R. Maza, M.V. Guiote, E. Moreno, J.A. Vallejo" "autores" => array:6 [ 0 => array:2 [ "nombre" => "L.M." "apellidos" => "Mena" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Carmona" ] 2 => array:2 [ "nombre" => "F.R." "apellidos" => "Maza" ] 3 => array:2 [ "nombre" => "M.V." "apellidos" => "Guiote" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Moreno" ] 5 => array:2 [ "nombre" => "J.A." "apellidos" => "Vallejo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808915000890?idApp=UINPBA00004N" "url" => "/22538089/0000003400000005/v1_201508130058/S2253808915000890/v1_201508130058/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2253808915000877" "issn" => "22538089" "doi" => "10.1016/j.remnie.2015.07.013" "estado" => "S300" "fechaPublicacion" => "2015-09-01" "aid" => "678" "copyright" => "Elsevier España, S.L.U. and SEMNIM" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2015;34:333-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 114 "formatos" => array:2 [ "HTML" => 8 "PDF" => 106 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting image</span>" "titulo" => "Bilateral multiple pulmonary <span class="elsevierStyleSup">18</span>F-FDG microembolisms demonstrated on PET/CT" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "333" "paginaFinal" => "334" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Múltiples microembolismos pulmonares bilaterales en <span class="elsevierStyleSup">18</span>F-FDG PET/TAC" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2457 "Ancho" => 3250 "Tamanyo" => 593447 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Maximum intensity projection (A), transaxial slices of CT and fusion PET/CT images of thorax demonstrated bilateral multiple pulmonary focal FDG uptakes in the right upper lobes (B and C), right lower lobe (D) and left upper lobe (E) without any anatomical correlation on CT.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Gungor, M. Mazican, I. Koc, H. Bal, N. Mazican" "autores" => array:5 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Gungor" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Mazican" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "Koc" ] 3 => array:2 [ "nombre" => "H." "apellidos" => "Bal" ] 4 => array:2 [ "nombre" => "N." "apellidos" => "Mazican" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808915000877?idApp=UINPBA00004N" "url" => "/22538089/0000003400000005/v1_201508130058/S2253808915000877/v1_201508130058/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting image</span>" "titulo" => "A vascular lesion mimicking a primitive brain tumour in a patient examined by <span class="elsevierStyleSup">18</span>F-choline PET/CT and MRI" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "335" "paginaFinal" => "336" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "G.L. Cascini, A. Restuccia, T. De Vincenti, F. Manti, F. Calabria" "autores" => array:5 [ 0 => array:3 [ "nombre" => "G.L." "apellidos" => "Cascini" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Restuccia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "T." "apellidos" => "De Vincenti" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "F." "apellidos" => "Manti" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:4 [ "nombre" => "F." "apellidos" => "Calabria" "email" => array:1 [ 0 => "ferdinandocalabria@hotmail.it" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Diagnostic Imaging, Nuclear Medicine Unit, Magna Graecia University, Catanzaro, Italy" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Diagnostic Imaging, Radiology Unit, Magna Graecia University, Catanzaro, Italy" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology – National Research Council (IBFM; CNR), Catanzaro, Italy" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Una lesión vascular imitando un tumor cerebral primitivo en un paciente examinado con PET <span class="elsevierStyleSup">18</span>F-colina/TAC y RM" ] ] "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" => 1656 "Ancho" => 3250 "Tamanyo" => 706081 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Whole skull images. Upper side. Initial PET, CT and PET/CT axial views (a, a′, a″) of a suspected brain lesion with high tracer uptake in the right temporal lobe. Corresponding MR T1-weighted post-contrast and T2-FLAIR axial views (b, c) show vascular lesion with blood–brain-barrier disruption and haemorrhagic transformation in the same side. Bottom side. Post-treatment PET, CT and PET/CT axial views (d, d′, d″) show reduction of the uptake in the right temporal lobe. Corresponding MR T1-weighted post-contrast and T2-FLAIR axial views (e, f) show a lacunar area, confirming the diagnosis of a vascular haemorrhagic lesion.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 67-year-old man with headache and dizziness was submitted to a contrast-enhanced CT of the brain that showed an area of non-homogeneous contrast enhancement in the right temporal lobe. Initially, the MRI was not performed, due to a metallic sliver in the skull. A PET/CT with <span class="elsevierStyleSup">18</span>F-choline, carried out to obtain a metabolic characterization of the brain, showed an area of focal uptake in the right temporal lobe (SUVmax:11) with surrounding area of oedema, as evident in axial PET (a), CT (a′) and PET/CT views (a″). Considering both the anatomic and functional findings, a neoplastic brain lesion was suspected (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Subsequently, the preoperative anti-oedema premedication allowed a significant clinical improvement; a further CT showed unexpected reduction of the size of the lesion. Therefore, in accordance with the clinicians, we supposed a vascular disease. After the surgical extraction of the sliver in the skull, the MRI was performed and the results were suggestive for a vascular lesion with blood–brain-barrier disruption and haemorrhagic transformation, in T1-weighted post-contrast (b) and T2-FLAIR axial views (c).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Three months after, additional PET/CT with <span class="elsevierStyleSup">18</span>F-choline and MRI showed meaningful reduction of the uptake (SUVmax:3.1) and the oedema (d, d′, d″) and a lacunar area on T1-weighted (e) and T2-FLAIR axial views (f). Therefore, the diagnosis of a post-haemorrhagic vascular lesion was confirmed.</p><p id="par0020" class="elsevierStylePara elsevierViewall">It is well known that <span class="elsevierStyleSup">18</span>F-choline is a marker of lipogenesis and a surrogate of rapid synthesis of cell membrane in the neoplasms; nevertheless, the <span class="elsevierStyleSup">18</span>F-choline is a non-specific tumour tracer.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">As known in literature, caution is mandatory when we diagnose neoplastic lesions <span class="elsevierStyleSup">18</span>F-choline avid, because of a large amount of false positive cases and pitfalls with high tracer uptake, as well described for inflammation<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> and benign tumours, especially in the brain.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In our report, the uptake of the tracer was associated to a vascular lesion, mimicking the metabolic activity of a tumour, consequent to the damage of the blood–brain-barrier and the activation of some cellular types such as macrophages and fibroblasts (with an high rate of lipogenesis). Moreover, similar false positive findings are already known for other radiopharmaceuticals.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In conclusion, <span class="elsevierStyleSup">18</span>F-choline PET/CT seems not suitable for characterization of suspected brain lesions. The necessary correlation with MRI is of the utmost importance.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they did not receive funding for this work by any of the following organizations: National Institutes of Health (NIH), Wellcome Trust, Howard Hughes Medical Institute (HHMI), or others.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] 2 => array:2 [ "identificador" => "xack183048" "titulo" => "Acknowledgements" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1656 "Ancho" => 3250 "Tamanyo" => 706081 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Whole skull images. Upper side. Initial PET, CT and PET/CT axial views (a, a′, a″) of a suspected brain lesion with high tracer uptake in the right temporal lobe. Corresponding MR T1-weighted post-contrast and T2-FLAIR axial views (b, c) show vascular lesion with blood–brain-barrier disruption and haemorrhagic transformation in the same side. Bottom side. Post-treatment PET, CT and PET/CT axial views (d, d′, d″) show reduction of the uptake in the right temporal lobe. Corresponding MR T1-weighted post-contrast and T2-FLAIR axial views (e, f) show a lacunar area, confirming the diagnosis of a vascular haemorrhagic lesion.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleSup">18</span>F-choline PET/CT pitfalls in image interpretation: an update on 300 examined patients with prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Calabria" 1 => "A. Chiaravalloti" 2 => "O. Schillaci" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RLU.0000000000000303" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2014" "volumen" => "39" "paginaInicial" => "122" "paginaFinal" => "130" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24368525" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of intracranial meningioma detected by (18)F-choline PET/CT and examined by PET/MRI fusion imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F. Calabria" 1 => "E. Calabria" 2 => "A. Chiaravalloti" 3 => "M. Barbarisi" 4 => "O. Schillaci" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2013.06.006" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol." 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Bianco" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Curr Pharm Biotechnol" "fecha" => "2014" "volumen" => "14" "paginaInicial" => "1099" "paginaFinal" => "1104" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24725130" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack183048" "titulo" => "Acknowledgements" "texto" => "<p id="par0050" class="elsevierStylePara elsevierViewall">The authors thank Stefania Barbiere and Valentina K. Setzu for the assistance in editing the manuscript.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003400000005/v1_201508130058/S2253808915000889/v1_201508130058/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/22538089/0000003400000005/v1_201508130058/S2253808915000889/v1_201508130058/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808915000889?idApp=UINPBA00004N" ]
Journal Information
Interesting image
A vascular lesion mimicking a primitive brain tumour in a patient examined by 18F-choline PET/CT and MRI
Una lesión vascular imitando un tumor cerebral primitivo en un paciente examinado con PET 18F-colina/TAC y RM
a Department of Diagnostic Imaging, Nuclear Medicine Unit, Magna Graecia University, Catanzaro, Italy
b Department of Diagnostic Imaging, Radiology Unit, Magna Graecia University, Catanzaro, Italy
c Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology – National Research Council (IBFM; CNR), Catanzaro, Italy