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Also, somatostatin receptor (SSTR) expressing metastatic disease was found in left cervical lymph nodes (e, f; white arrows, g; bold white arrow) and multiple skeletal sites (g; white arrows)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Mukherjee, V. Singh Dhull, S. Arora, C. Bal, R. Kumar" "autores" => array:5 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Mukherjee" ] 1 => array:2 [ "nombre" => "V." "apellidos" => "Singh Dhull" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Arora" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Bal" ] 4 => array:2 [ "nombre" => "R." 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"apellidos" => "García" "email" => array:1 [ 0 => "jrgarcia@cetir.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "F.J." "apellidos" => "Alvarez Moro" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Bassa" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Soler" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Llinares" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Riera" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "CETIR-ERESA, Esplugues de Llobregat, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Detección de tumores pardos por hiperparatiroidismo secundario mediante PET/TC con 11C-colina" ] ] "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" => 1857 "Ancho" => 2502 "Tamanyo" => 230834 ] ] "descripcion" => array:1 [ "en" => "11C-Choline PET/CT. Focal tracer uptake is seen in parathyroid inferior nodules (right: SUVmax 5.4; left: SUVmax 3.6) due to parathyroid hyperplasia secondary to chronic kidney disease, which was confirmed surgically. (A, B) Irregular 11C-Choline uptake in both prostate lobules, with moderate intensity,(right: SUV 2.4; left: SUV 2.9), which reflected primary tumor burden diagnosed in this patient. Low 11C-Choline uptake, less than the bony lesions in left bone collar (C) and tibia (D), which corresponded with a lytic lesion on CT on distal end of left bone collar, with thickening and ill-defined cortical margins (curvilineal reconstruction – C), as well as another lytic lesion with outer cortical thickening and sclerosis in lateral aspect of proximal epiphysis of tibia (reconstructed coronal slice – D)." ] ] ] "textoCompleto" => "A 76-year-old patient with a long term gouty nephropathy is reported. Patient presented with prostatic syndrome and prostate carcinoma was diagnosed (Gleason score 3+4; PSA 11ng/ml; T1c stage). For staging purpose, abdominal CT and bone scan were performed. CT was uneventful and bone scan showed a metabolic systemic pattern with a focal uptake in distal end of left collar bone and proximal end of left tibia (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Given these non-specific lesions in bone scan, a PET/CT with 11C-Choline was performed, which showed increase uptake in both prostate lobes related to primary disease, and no hypermetabolic foci were detected in lymphatic territories. Bone lesions previously described showed a less phospholypidic than phosphonate uptake, and the CT scan depicted lytic component. Bilateral focal 11C-Choline uptake was shown in lower parathyroid gland (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>In light of these findings, patient underwent biochemical study, and an inhibited PTH was revealed, with normal calcium levels. Parathyroid adenoma and hyperplasia are the main cause of primary hyperparathyroidism, represented by increase in PTH and hypercalcemia. Secondary hyperparathyroidism represents a PTH oversecretion due to hypocalcemia secondary to increased renal excretion of calcium in patients with chronic renal failure. In very late stages, these patients may show hypercalcemia, known as tertiary hyperparathyroidism.<a class="elsevierStyleCrossRefs" href="#bib0020">1,2</a>Taking into account the patient history, 11C-Choline PET/CT and biochemical findings, a subtotal parathyroidectomy was performed, which showed inferior bilateral parathyroid hyperplasia.Therefore, it is suggested that this patient is bearing a prostate carcinoma stage T1cN0M0 along with bone lesions in left collar bone and tibia, most likely related to brown tumors.Renal osteodystrophy accounts for bone metabolic changes related to chronic kidney disease, and its scintigraphy pattern is variable. Most common finding is a general increased tracer uptake in bone, secondary to high bone turnover, due to secondary hyperparathyroidism (blood phosphate increase and loss of Vitamin D, which induces hypocalcemia and increase in PTH production). There may be also findings related to osteomalacia and an increase in subperiosteal osseous formation-process in long bones. In advanced cases, a generalized decrease in bone uptake may appear, secondary to bone loss.<a class="elsevierStyleCrossRefs" href="#bib0020">1–3</a>Focal lesions may also appear, besides diffuse bone changes, which are known as brown tumors or osteitis fibrosa cystica, thus representing a cellular reparative process rather than a malignant disease. Hypocalcemia in patients with chronic kidney disease results in skeletal calcium recruitment, thus increasing bone osteoclastic turnover. In these sites where bone loss is especially dramatic, normal medullar content may be replaced by granulomatous reparative tissue, with hemorrhagic patches and proliferative fibrous tissue, which all result in brown tumors. These lesions are lytic on CT imaging and show avid tracer uptake in bone scan.<a class="elsevierStyleCrossRefs" href="#bib0020">1–3</a>In our case, patient was treated with radiotherapy and hormonotherapy (6 months) for his prostate cancer and remains free of disease 1 year afterwards, with PSA levels within normal range.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: García JR, Alvarez Moro FJ, Bassa P, Soler M, Llinares E, Riera E. Detección de tumores pardos por hiperparatiroidismo secundario mediante PET/TC con 11C-colina. Rev Esp Med Nucl Imagen Mol. 2016;35:209–210." ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1668 "Ancho" => 1013 "Tamanyo" => 53563 ] ] "descripcion" => array:1 [ "en" => "Bone scan. A metabolic pattern is shown, characterized by diffuse increase of tracer in axial skeleton and faint renal uptake (“superscan” pattern suggested by a hyperparathyroidism of renal origin). Moreover, unexpected tracer uptake is seen in myocardial region. There are also focal active spots in distal end of left bone collar and proximal epiphysis of left tibia, which could be attributed to bone malignancy in uncommon sites. Scintigraphic appearance of bilateral hip is suggestive of proximal femur osteonecrosis with predominant ischemia in right femur, and more advanced stage in left femur. To be correlated with MRI findings. Osteoarthritic changes are seen in thoracic and lumbar spine, in left ankle and tarsus, left trapezoid-metacarpal osteoarthritis, joint overload in right knee and ankle." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1857 "Ancho" => 2502 "Tamanyo" => 230834 ] ] "descripcion" => array:1 [ "en" => "11C-Choline PET/CT. Focal tracer uptake is seen in parathyroid inferior nodules (right: SUVmax 5.4; left: SUVmax 3.6) due to parathyroid hyperplasia secondary to chronic kidney disease, which was confirmed surgically. (A, B) Irregular 11C-Choline uptake in both prostate lobules, with moderate intensity,(right: SUV 2.4; left: SUV 2.9), which reflected primary tumor burden diagnosed in this patient. Low 11C-Choline uptake, less than the bony lesions in left bone collar (C) and tibia (D), which corresponded with a lytic lesion on CT on distal end of left bone collar, with thickening and ill-defined cortical margins (curvilineal reconstruction – C), as well as another lytic lesion with outer cortical thickening and sclerosis in lateral aspect of proximal epiphysis of tibia (reconstructed coronal slice – D)." ] ] ] "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" => "Differential diagnosis between secondary and tertiary hyperparathyroidism in a case of a giant-cell and brown tumor containing mass. Findings by 99mTc-MDP, 18F-FDG PET/CT and 99mTc-MIBI scans" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.K. Gedik" 1 => "O. Ata" 2 => "P. Karabagli" 3 => "O. Sari" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1967/s002449910147" "Revista" => array:6 [ "tituloSerie" => "Hell J Nucl Med" "fecha" => "2014" "volumen" => "17" "paginaInicial" => "214" "paginaFinal" => "217" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25397627" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Localization of parathyroid adenoma by 11C-choline PET/CT: preliminary results" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Orevi" 1 => "N. Freedman" 2 => "E. Mishani" 3 => "M. Bocher" 4 => "O. Jacobson" 5 => "Y. Krausz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RLU.0000000000000607" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2014" "volumen" => "39" "paginaInicial" => "1033" "paginaFinal" => "1038" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25290292" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteitis fibrosa cystica mistaken for malignant disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.H. Lee" 1 => "S.M. Chung" 2 => "H.S. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3342/ceo.2013.6.2.110" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Otorhinolaryngol" "fecha" => "2013" "volumen" => "6" "paginaInicial" => "110" "paginaFinal" => "113" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23799171" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003500000003/v2_201703300105/S2253808916000276/v2_201703300105/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/22538089/0000003500000003/v2_201703300105/S2253808916000276/v2_201703300105/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808916000276?idApp=UINPBA00004N"]

ISSN: 2253-8089

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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Impact factor

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Impact factor 2023

1.6

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1.1

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0.208

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SNIP 2023

0.273

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