Editorial
Role of SPECT/CT in bone disease: is this technique still a valid option?
Papel de la SPECT/TC en la patología ósea: ¿Sigue siendo una opción válida realizar esta técnica?
a Servicio de Medicina Nuclear del Hospital General Universitario de Ciudad Real. Presidente del Grupo de Trabajo de Patología Músculo-Esquelética de la SEMNIM. EANM‘s Inflammation & Infection Committee Member, Spain
b Jefe del Servicio de Servicio de Traumatología y Cirugía Ortopédica del Hospital General Universitario de Ciudad Real, Spain
Read
8
Timeswas read the article
5
Total PDF
3
Total HTML
Share statistics
array:22 [ "pii" => "S2253808919300825" "issn" => "22538089" "doi" => "10.1016/j.remnie.2019.04.007" "estado" => "S300" "fechaPublicacion" => "2019-07-01" "aid" => "1074" "copyrightAnyo" => "2019" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Rev Esp Med Nucl Imagen Mol. 2019;38:205-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3 "formatos" => array:2 [ "HTML" => 1 "PDF" => 2 ] ] "Traduccion" => array:1 [ "es" => array:18 [ "pii" => "S2253654X19300897" "issn" => "2253654X" "doi" => "10.1016/j.remn.2019.04.003" "estado" => "S300" "fechaPublicacion" => "2019-07-01" "aid" => "1074" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Rev Esp Med Nucl Imagen Mol. 2019;38:205-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 227 "formatos" => array:2 [ "HTML" => 143 "PDF" => 84 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Papel de la SPECT/TC en la patología ósea: ¿Sigue siendo una opción válida realizar esta técnica?" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "205" "paginaFinal" => "206" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Role of SPECT/CT in bone pathology: Is this technique still a valid option?" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Noriega-Álvarez, P. Zorrilla Ribot" "autores" => array:2 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Noriega-Álvarez" ] 1 => array:2 [ "nombre" => "P. Zorrilla" "apellidos" => "Ribot" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2253808919300825" "doi" => "10.1016/j.remnie.2019.04.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808919300825?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X19300897?idApp=UINPBA00004N" "url" => "/2253654X/0000003800000004/v1_201906280916/S2253654X19300897/v1_201906280916/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2253808919300564" "issn" => "22538089" "doi" => "10.1016/j.remnie.2019.05.001" "estado" => "S300" "fechaPublicacion" => "2019-07-01" "aid" => "1068" "copyright" => "Sociedad Española de Medicina Nuclear e Imagen Molecular" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Med Nucl Imagen Mol. 2019;38:207-11" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1 "HTML" => 1 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Hepatobiliary scintigraphy in the study of complications in adult patients after liver transplant. Description of the experience" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "207" "paginaFinal" => "211" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Gammagrafía hepatobiliar en el estudio de las complicaciones del trasplante hepático en adultos. Descripción de la experiencia" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "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" => 680 "Ancho" => 1250 "Tamanyo" => 67312 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">(A) Static hepatobiliary scintigraphy image in anterior projection at 120<span class="elsevierStyleHsp" style=""></span>min after radiotracer injection in an adult liver transplant patient with leakage of bile-like material in the subcutaneous drain. Persistence of radioactivity is observed in the liver (dysfunction, black arrow) with scarce transit of the radiotracer to the intestine (red arrow) and great transit to the right percutaneous drain (blue arrow) compatible with the presence of a high output fistula. (B) Hepatobiliary scintigraphy performed in the same patient following corrective surgery and closure of the fistula. This image was also obtained at 120<span class="elsevierStyleHsp" style=""></span>min after radiotracer injection; comparatively, less hepatic radioactivity is observed (adequate function, black arrow), and there is adequate transit of the radiotracer to the intestine without obstructions (red arrow) and the absence of bile by external drains, indicating resolution of the fistula following surgery.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Vélez-Gutierrez, C. Gutierrez-Villamil, S. Arevalo-Leal, G. Mejía-Hernandez, V. Marín-Oyaga" "autores" => array:5 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Vélez-Gutierrez" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Gutierrez-Villamil" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Arevalo-Leal" ] 3 => array:2 [ "nombre" => "G." "apellidos" => "Mejía-Hernandez" ] 4 => array:2 [ "nombre" => "V." "apellidos" => "Marín-Oyaga" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X18302981" "doi" => "10.1016/j.remn.2019.02.006" "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/S2253654X18302981?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808919300564?idApp=UINPBA00004N" "url" => "/22538089/0000003800000004/v1_201907020628/S2253808919300564/v1_201907020628/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Role of SPECT/CT in bone disease: is this technique still a valid option?" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "205" "paginaFinal" => "206" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "E. Noriega-Álvarez, P. Zorrilla Ribot" "autores" => array:2 [ 0 => array:4 [ "nombre" => "E." "apellidos" => "Noriega-Álvarez" "email" => array:1 [ 0 => "edelnoriega@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "P. Zorrilla" "apellidos" => "Ribot" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Nuclear del Hospital General Universitario de Ciudad Real. Presidente del Grupo de Trabajo de Patología Músculo-Esquelética de la SEMNIM. EANM‘s Inflammation & Infection Committee Member, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Jefe del Servicio de Servicio de Traumatología y Cirugía Ortopédica del Hospital General Universitario de Ciudad Real, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Papel de la SPECT/TC en la patología ósea: ¿Sigue siendo una opción válida realizar esta técnica?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">At a time in which positron emission tomography/computerized tomography (PET/CT) seems to be the most advanced imaging technique in nuclear medicine (NM), we need to consider whether this technique is able to unseat single photon emission computerized tomography combined with CT (SPECT/CT).</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">View of a nuclear medicine physician</span><p id="par0010" class="elsevierStylePara elsevierViewall">Conventional NM and not PET constituted by scintigraphic studies is a fundamental tool in many diagnostic processes. The use of SPECT/CT can significantly increase the diagnostic sensitivity and specificity of scintigraphic studies (whether they are bone scintigraphies with labeled leucocytes or with any other SPECT radiotracer) translating into greater general accuracy of the NM diagnostic procedures. This hybrid technique favors the diagnosis and clinical management of multiple diseases, mainly bone diseases as well as malignant and benign tumoral diseases. In addition, it is gaining increasingly more applications in articular disease (inflammatory and degenerative arthropathies), metabolic bone disease, musculoskeletal trauma disease, sports lesions, evaluation of articular prostheses and bone grafts as well as in vascular bone disease (avascular bone necrosis, algodystrophy) .<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In malignant bone disease, SPECT/CT not only improves the anatomical localization of doubtful lesions in planar images but is also useful in the follow-up of different types of tumors and their metastasis.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> Although most bone metastases and benign (such as enchondroma) or malignant tumors appear as points of increased uptake (“hot”) in bone scintigraphy, purely lytic lesions can be seen as cold lesions similar to some benign lesions such as hemangioma, possibly making differential diagnosis difficult. However, co-registry of CT in bone SPECT/CT enables the differentiation of benign and malignant lesions. In addition, fusion images can be used to guide biopsies in bone lesions.</p><p id="par0020" class="elsevierStylePara elsevierViewall">SPECT/CT is the least frequently requested imaging study in other benign musculoskeletal diseases. However, it has shown to be better than other anatomical imaging techniques and is useful to detect physiological processes and metabolic alterations which often precede morphological changes by days or even weeks. Therefore, while first line imaging modalities cannot identify the underlying cause of a disease, SPECT/CT can better characterize benign skeletal abnormalities such as fractures,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> temporomandibular hyperplasia,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> post-traumatic pseudoarthrosis, patients with limp,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> among others.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Osteoarticular infection continues to be an important cause of morbidity and mortality and accurate localization of infectious foci can be challenging.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Hybrid images (in both bone scintigraphy and with labeled leucocytes) play a fundamental role, especially in delimiting possible bone involvement, providing anatomical and metabolic information in, for example, in infection of diabetic foot, a task which is very complicated because of the small size of the bones.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> On the other hand, this hybrid imaging method increases scintigraphic specificity by recognizing the physiological activity of the bone marrow. SPECT/CT can also be used to indicate an adequate biopsy site and obtain histological confirmation on suspicion of infection.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the last two decades the number of articular prosthesis implants has considerably increased, leading to an increase in the incidence of post-surgical complications and the need for reintervention.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Adequate diagnosis of each complication is essential for therapeutic decision making, being of vital importance to differentiate bone infection of the soft tissue, and this is possible thanks to SPECT/CT.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The recurrence of pain following surgery of the lumbar spine is frequent and is due to multiple causes. It is a challenge to identify the source of pain in the images, and not all structual and functional changes can be translated into clinical or pathological symptoms. In this disease, bone SPECT/CT is useful to diagnose pseudoarthrosis, vertebral compression, loosening/misalignment of osteosynthesis material or post-operative infection and should be routinely used in symptomatic patients with erroneous results with other imaging techniques.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Unfortunately, in many clinical specialties NM techniques, and especially hybrid methods such as SPECT/CT, are not frequently used, sometimes due to unawareness of their utility. Fortunately, however, this situation is changing thanks to multiple collaborations as well as the formation of multidisciplinary work groups which are increasingly more common in clinical practice and are currently very necessary.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">View of a traumatology physician</span><p id="par0045" class="elsevierStylePara elsevierViewall">In a Department of Traumatology and Orthopedic Surgery in our setting, there is a diagnostic arsenal which remains underused. Adequate exploitation of the resources emerging from NM offers the possibility of achieving greater effectiveness and efficiency in both the detection and the control of diseases which are, in addition, great consumers of these resources precisely due to the difficulty in their diagnosis and, on occasions, they are also diseases which cannot allow a delay in diagnosis.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Nuclear medicine plays a key role following anamnesis and clinical examination, which continue to be the cornerstone of clinical diagnosis in bone and joint disease, but the introduction of the hybrid SPECT/CT technique may change this situation in some patients.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">This is the case of the presence of material or metallic artifacts close to the study region, which contraindicates the use of magnetic resonance (MR) in cases such as, for example, suspicion of avascular necrosis of the head of the femur in patients with a previous osteosynthesized subcapital or pertrochanteric hip fracture and also necrosis in the femoral chondyle in patients with osteosynthesis around the knee.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Likewise, hip and knee arthroscopy can leave metallic artifacts which come from the motor terminal used for grinding or regularization and are not distinguishable in simple radiology, but can lead to metal-induced artifacts in MR images. In all these circumstances, SPECT/CT is a valuable tool. In hip, knee and shoulder arthroplasty it is not only a diagnostic technique of great value for aseptic and septic loosening by detecting radiolucent zones, but it can also correctly assess misalignment of the components of a painful prothesis, identifying areas of osteolysis and others of overload with bone reinforcement.</p><p id="par0060" class="elsevierStylePara elsevierViewall">We cannot forget the great value of the still unexploited SPECT/CT in the diagnosis of pain which is manifested at sites of the skeletal system far from its origin within the same system or of visceral origin. An example of this is hip pain the origin of which is the lumbar rachis or the sacroiliac articulations, or knee pain which can also originate in these points or in the hip.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Neither can we forget the diagnostic help which SPECT/CT will provide in algodystrophy in the future, especially when it is of post-surgical onset and which originates so many headaches in legal claims in the specialty of Traumatology.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Of course, the utility of SPECT/CT will be demonstrated in many other diseasess such as tendinopathies and plantar fasciitis, tarsal coalition and bone accessories, benign tumors an paratumoral lesions, ankylosis spondylitis, acetabular femoral impingement, and stress fractures,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> among many others.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">CONCLUSIONS</span><p id="par0070" class="elsevierStylePara elsevierViewall">Co-registered SPECT/CT images have gained an increasingly more relevant position in the study of osteoarticular diseases, providing valuable advantages, among which the following are of note: a) considerable improvement in both the sensitivity and specificity of scintigraphic studies; b) SPECT/CT can accurately describe the localization of the disease and the possible participation of adjacent tissues; and lasty, c) it provides accurate correction of attenutation and anatomical-functional fusion images. The incorporation of new technological advances and novel radiopharmaceuticals lend SPECT/CT an ever more relevant weight in clinical practice.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Perhaps, the next step to increase the use of this technique may be knowledge of the technique itself and its utility, and its efficient indications do not lie only within the setting of NM but can also be part of the diagnostic armamentarium of other clinical specialties such as Traumatology and Orthopedic Surgery which would undoubedly require rotations in NM to be incorporated in the educational training programs.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Although there are many new innovative applications in PET which will compete with SPECT in the short term, the newest and most accurate SPECT procedures continue to evolve. In summary, far from suggesting that SPECT/CT is becoming obsolete and will be replaced by PET/CT, the current trend indicates that the future of NM will be represented by hybrid images in general.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "View of a nuclear medicine physician" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "View of a traumatology physician" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "CONCLUSIONS" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Noriega-Álvarez E, Ribot PZ. Papel de la SPECT/TC en la patología ósea: ¿Sigue siendo una opción válida realizar esta técnica?. Rev Esp Med Nucl Imagen Mol. 2019;38:205–206.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The EANM practice guidelines for bone scintigraphy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Van den Wyngaert" 1 => "K. Strobel" 2 => "W.U. Kampen" 3 => "T. Kuwert" 4 => "van der BruggenW" 5 => "H.K. Mohan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00259-016-3415-4" "Revista" => array:6 [ "tituloSerie" => "Eur J Nucl Med Mol Imaging." "fecha" => "2016" "volumen" => "43" "paginaInicial" => "1723" "paginaFinal" => "1738" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27262701" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "F-18 NaF PET for detection of bone metastases in lung cancer: accuracy, cost-effectiveness, and impact on patient management" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Hetzel" 1 => "C. Arslandemir" 2 => "H.H. Konig" 3 => "A.K. Buck" 4 => "K. Nussle" 5 => "G. Glatting" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1359/jbmr.2003.18.12.2206" "Revista" => array:6 [ "tituloSerie" => "J. Bone Miner Res." "fecha" => "2003" "volumen" => "18" "paginaInicial" => "2206" "paginaFinal" => "2214" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14672356" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prospective evaluation of the clinical value of planar bone scans SPECT, and (18)F-labeled NaF PET in newly diagnosed lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Schirrmeister" 1 => "G. Glatting" 2 => "J. Hetzel" 3 => "K. Nussle" 4 => "C. Arslandemir" 5 => "A.K. Buck" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Nucl Med." "fecha" => "2001" "volumen" => "42" "paginaInicial" => "1800" "paginaFinal" => "1804" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11752076" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "BuckAK" 1 => "NekollaS" 2 => "ZieglerS" 3 => "BeerA" 4 => "KrauseBJ" 5 => "K. Herrmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2967/jnumed.107.050195" "Revista" => array:5 [ "tituloSerie" => "SPECT/CT*. J Nucl Med" "fecha" => "2008" "volumen" => "49" "paginaInicial" => "11A" "paginaFinal" => "12A" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of four methods for quantitative assessment of 99mTc-MDP SPECT in patients with suspected condylar hyperplasia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. López Buitrago" 1 => "J. Muñoz Acosta" 2 => "R. Cárdenas-Perilla" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s41824-018-0026-2" "Revista" => array:5 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol (English Edition)." "fecha" => "2019" "volumen" => "38" "paginaInicial" => "72" "paginaFinal" => "79" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of hybrid bone SPECT/CT imaging in the work-up of the limping patient: a symptom-based and joint-oriented review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.K. Mohan" 1 => "K. Strobel" 2 => "W. van der Bruggen" 3 => "G. Gnanasegaran" 4 => "W.U. Kampen" 5 => "T. Kuwert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00259-017-3765-6" "Revista" => array:4 [ "tituloSerie" => "EuropeanJournal of HybridImaging." "fecha" => "2018" "volumen" => "2" "paginaInicial" => "8" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Protocolo de un día vs protocolo de dos días de adquisición mediante gammagrafía con leucocitos marcados in vitro para el diagnóstico de infección osteoarticular" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Noriega-Álvarez" 1 => "M.T. Bajén" 2 => "J. Rodríguez-Rubio" 3 => "A.M. Benítez" 4 => "A. Rodríguez-Gasén" 5 => "J. Suils" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2018.02.006" "Revista" => array:5 [ "tituloSerie" => "RevEspMedNucl Imagen Mol." "fecha" => "2018" "volumen" => "37" "paginaInicial" => "277" "paginaFinal" => "284" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hybrid imaging in foot and ankle disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "García JiménezR" 1 => "García-GómezFJ" 2 => "Noriega-ÁlvarezE" 3 => "Martín-MarcuartuJ.J. Calvo MorónC" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2017.10.003" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol." "fecha" => "2018" "volumen" => "37" "paginaInicial" => "191" "paginaFinal" => "202" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29221678" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complications of shoulder arthroplasty: added value of SPECT/CT imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. Suárez" 1 => "M.L. Domínguez" 2 => "N. Zeidán" 3 => "M.E. García" 4 => "D. Lisei" 5 => "N. Martín" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2018.12.004" "Revista" => array:2 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol (English Edition), Available online" "fecha" => "30 January 2019" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aportación clínica de SPECT/TC en la gammagrafía con leucocitos marcados con 99mTc-HMPAO en infección de prótesis de cadera y rodilla" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Sengoz" 1 => "O. Yaylali" 2 => "D. Yuksel" 3 => "F. Demirkan" 4 => "O. Uluyol" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2019.01.005" "Revista" => array:2 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol." "fecha" => "2018" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Al-RiyamiK" 1 => "G. Gnanasegaran" 2 => "T. Van den Wyngaert" 3 => "J. Bomanji" 4 => "J. Eur" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00259-017-3765-6" "Revista" => array:4 [ "tituloSerie" => "Nucl Med Mol Imaging." "fecha" => "2017" "volumen" => "44" "paginaInicial" => "2094" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation and management of hip pain: an algorithmic approach" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Margo" 1 => "J. Drezner" 2 => "D. Motzkin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Fam Pract." "fecha" => "2003" "volumen" => "52" "paginaInicial" => "607" "paginaFinal" => "617" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12899815" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MRI after arthroplasty: comparison of MAVRIC and conventional fast spin-echo technique" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.L. Hayter" 1 => "M.F. Koff" 2 => "P. Shah" 3 => "T.T. Miller" 4 => "H.G. Potter" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/AJR.11.6659" "Revista" => array:5 [ "tituloSerie" => "AJR Am J Roentgenol." "fecha" => "2011" "volumen" => "197" "paginaInicial" => "W41" "paginaFinal" => "W405" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low back pain: prediction of short-term outcome of facet joint injection with bone scintigraphy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.G. Pneumaticos" 1 => "S.N. Chatziioannou" 2 => "J.A. Hipp" 3 => "W.H. Moore" 4 => "S.I. Esses" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiol.2382041930" "Revista" => array:6 [ "tituloSerie" => "Radiology." "fecha" => "2006" "volumen" => "238" "paginaInicial" => "693" "paginaFinal" => "698" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16436824" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003800000004/v1_201907020628/S2253808919300825/v1_201907020628/en/main.assets" "Apartado" => array:4 [ "identificador" => "7983" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorial" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003800000004/v1_201907020628/S2253808919300825/v1_201907020628/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808919300825?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 1 | 1 | 2 |
| 2020 May | 1 | 2 | 3 |
| 2019 July | 1 | 2 | 3 |
