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Subsequent post-therapeutic monitoring images (B & D) of improved lung cancer, resolved bone metastasis and resolved muscle uptake." ] ] ] "textoCompleto" => "A 62-year old woman, with lung cancer, was staged with 18F FDG PET/CT. This initial exam showed, in addition to a hypermetabolic right upper lung lesion and scattered tracer-avid bone metastasis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A & C), asymmetrically diffuse muscular uptake features of the right neck, shoulder girdle and upper extremity (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A & C). The patient’s clinical history was remarkable for an early infancy cerebro-vascular accident with spastic cerebral palsy. Her right upper extremity spasticity was treated periodically with botulinum toxin A (BTA). The initial PET/CT was acquired after the weaning of BTA effects. Subsequent post-treatment PET/CT surveillance showed improvement of the right upper lung lesion and resolution of bone metastasis. This second PET/CT was acquired one month after repeat BTA injections (200 IU) of the right upper limb with resolved tracer uptake of the relaxed muscles (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B & D).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Muscle uptake of 18F FDG on PET/CT may be from physiologic, artifactual and pathologic causes<a class="elsevierStyleCrossRef" href="#bib0005">1</a>. Physiologic voluntary activities encompass simple tasks such as talking or chewing to more strenuous exercises with the more vigorous the muscle use and the closer the activities to the PET/CT imaging the more intense the tracer uptake. Physiologic involuntary activities may be from labored breathing, coughing, muscle spasm, spastic cerebral palsy, and epilepsy. Artifactual causes of muscle uptake are related to improper fasting prior to PET/CT imaging acquisition or medically induced effects of insulin or corticosteroids. Pathologic causes are inflammatory, infectious, traumatic, and malignant. Our patient showed diffuse muscle uptake features of the right neck and right upper extremity secondary to the known history of post-stroke cerebral palsy (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Her spasticity has been treated with intermittent BTA injections. The depiction of tracer-avid muscles on the initial PET/CT was coincidental to the cessation of BTA effects. The subsequent PET/CT resolution of spastic muscle uptake was secondary to the full relaxation impact of this re-administered drug. PET/CT has been reported in the imaging of cervical dystonia/spasmodic torticollis and documentation of improvement of this syndrome under BTA therapy<a class="elsevierStyleCrossRef" href="#bib0010">2</a>. This treatment has also shown reduction of upper limb spasticity in cerebral palsy patients<a class="elsevierStyleCrossRef" href="#bib0015">3</a>. As the most potent neurotoxin of Clostridium botulinum, BTA irreversibly binds to cholinergic presynaptic membranes at the neuromuscular junctions and inhibits acetylcholine release with dual effect of chemodenervation and reduction of spasticity. Due to its short duration of 3–4 months, repeat BTA injections are necessary to maintain the spasticity reduction.<elsevierMultimedia ident="fig0010"></elsevierMultimedia>Conflict of interestThe authors have no conflicts of interest to declare." "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:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2321 "Ancho" => 2508 "Tamanyo" => 343657 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Anterior PET maximum intensity projection (MIP) and axial fused PET/CT images of the initial staging (A & C) showing hypermetabolic lung cancer with bone metastasis (arrowheads), and diffuse muscle uptake features of the right neck and right upper extremity involving mostly the right sternocleidomastoid muscle, right scalenus anterior muscle, right pectoralis muscles, right subscapularis muscle, right infraspinatus muscle, right biceps muscle, part of the triceps muscle and extensor muscle group of the right forearm (arrows). Subsequent post-therapeutic monitoring images (B & D) of improved lung cancer, resolved bone metastasis and resolved muscle uptake." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1415 "Ancho" => 2508 "Tamanyo" => 210843 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "(A) Axial T2 TSE and (B) Axial contrast enhanced T1 MR images of the encephalomalacia of the left middle cerebral artery territory (arrows) responsible for the right upper extremity spasticity." ] ] ] "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" => "FDG-PET/CT in skeletal muscle: pitfalls and pathologies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.K. Parida" 1 => "S.G. Roy" 2 => "R. Kumar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.semnuclmed.2017.02.003" "Revista" => array:7 [ "tituloSerie" => "Semin Nucl Med" "fecha" => "2017" "volumen" => "47" "paginaInicial" => "362" "paginaFinal" => "372" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28583276" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673606685784" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Localization of dystonic muscles with 18F-FDG PET/CT in idiopathic cervical dystonia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.H. Sung" 1 => "J.Y. Choi" 2 => "D.H. Kim" 3 => "E.S. Kim" 4 => "Y.I. Son" 5 => "Y.S. Cho" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Nucl Med" "fecha" => "2007" "volumen" => "48" "paginaInicial" => "1790" "paginaFinal" => "1795" "itemHostRev" => array:3 [ "pii" => "S1474442209700195" "estado" => "S300" "issn" => "14744422" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of Botulinum Toxin Type A on cerebral palsy with upper limb spasticity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T.F. Yang" 1 => "C.P. Fu" 2 => "N.T. Kao" 3 => "R.C. Chan" 4 => "S.J. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.PHM.0000056989.67763.07" "Revista" => array:7 [ "tituloSerie" => "Am J Phys Med Rehabil" "fecha" => "2003" "volumen" => "82" "paginaInicial" => "284" "paginaFinal" => "289" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12649654" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1474442204009305" "estado" => "S300" "issn" => "14744422" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000004200000002/v2_202311010503/S2253808922000933/v2_202311010503/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/22538089/0000004200000002/v2_202311010503/S2253808922000933/v2_202311010503/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808922000933?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

The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

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Impact factor 2023

1.6

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Citescore 2023

1.1

SJR

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SJR 2023

0.208

SNIP

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SNIP 2023

0.273

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