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Publicaciones científicas más recientes (desde 2010)

Autores: Rodríguez Fraile, María Macarena (Autor de correspondencia); Cózar-Santiago, M. P.; Sabaté-Llobera, A.; et al.
Revista: REVISTA ESPAÑOLA DE MEDICINA NUCLEAR E IMAGEN MOLECULAR
ISSN 2253-654X  Vol. 39  Nº 1  2020  págs. 57 - 66
Colorectal cancer is the third most frequent cancer worldwide. Although its incidence is increasing, mainly in those aged under50, mortality has decreased by 50% in the more developed countries, principally due to the adoption of new practices in prevention, diagnosis and treatment. In particular, the various diagnostic imaging modalities allow improved therapeutic decision-making, evaluation of the response and early detection of recurrence. The aim of this paper is to review the available scientific evidence on the value of positron emission tomography with 18F-FDG (18F-FDG PET/CT) in the colorectal cancer, with special emphasis on the indications of the guidelines and recommendations of the main international scientific associations regarding this imaging technique.
Autores: de la Torre Aláez, Manuel Antonio (Autor de correspondencia); Jordán Iborra, Carlota; Casadei-Gardini, A.; et al.
Revista: CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY
ISSN 0174-1551  Vol. 43  Nº 8  2020  págs. 1165 - 1172
Purpose In patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib, post-progression survival (PPS) is marked by the pattern of progression. Our aim was to assess the influence of the pattern of progression to selective internal radiotherapy (SIRT) in PPS among patients with HCC. Methods A retrospective analysis of patients treated with SIRT between 2003 and 2015 was conducted, excluding those with a single nodule < 5 cm or with metastases. Four patterns of progression to SIRT were defined: target tumour growth, non-target tumour growth, new intrahepatic disease, and new extrahepatic disease. PPS was calculated from the time of progression based on RECIST 1.1 criteria. Results Out of the 102 patients who met the selection criteria, 76 progressed after a median follow-up of 15 months. Median PPS was 6.5 months (95% CI 3.8-9.3 months). Patients who progressed at pre-existing lesions had a better PPS (median 12.5 months) than those who progressed with new lesions inside or outside the liver (median 4.2 months) (p = 0.02). In a Cox model adjusted by liver function and systemic inflammation, the pattern of progression had a hazard ratio of 1.64 (95% CI 0.92-2.93;p = 0.093). Conclusion In a cohort of HCC patients treated with SIRT, the pattern of progression associated with worst survival was the development of new intrahepatic lesions or extrahepatic metastases.
Autores: González Gutiérrez, Jessica; Rivera Ortega, Pilar; Rodríguez Fraile, María Macarena; et al.
Revista: THE INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (PRINT)
ISSN 1176-9106  Vol. 15  2020  págs. 1823 - 1829
Rationale: Emphysema and osteoporosis are tobacco-related diseases. Many studies have shown that emphysema is a strong and independent predictor of low bone mineral density (BMD) in smokers; however, none of them explored its association with different emphysema subtypes. Objective: To explore the association between the different emphysema subtypes and the presence of low bone mineral density in a population of active or former smokers with and without chronic obstructive pulmonary disease (COPD). Methods: One hundred and fifty-three active and former smokers from a pulmonary clinic completed clinical questionnaires, pulmonary function tests, a low-dose chest computed tomography (LDCT) and a dual-energy absorptiometry (DXA) scans. Subjects were classified as having normal BMD or low BMD (osteopenia or osteoporosis). Emphysema was classified visually for its subtype and severity. Logistic regression analysis explored the relationship between the different emphysema subtypes and the presence of low BMD adjusting for other important factors. Results: Seventy-five percent of the patients had low BMD (78 had osteopenia and 37 had osteoporosis). Emphysema was more frequent (66.1 vs 26.3%, p=<0.001) and severe in those with low BMD. Multivariable analysis adjusting for other significant cofactors (age, sex, FEV1, and severity of emphysema) showed that BMI (OR=0.91, 95% CI: 0.76-0.92) and centrilobular emphysema (OR=26.19, 95% CI: 1.71 to 399.44) were associated with low BMD. Conclusion: Low BMD is highly prevalent in current and former smokers. BMI and centrilobular emphysema are strong and independent predictors of its presence, which suggests that they should be considered when evaluating smokers at risk for low BMD.
Autores: Morales Lozano, María Isabel; Erhard García, Álvaro; Lozano Escario, María Dolores; et al.
Revista: REVISTA ESPAÑOLA DE MEDICINA NUCLEAR E IMAGEN MOLECULAR
ISSN 2253-654X  Vol. 39  Nº 2  2020  págs. 102 - 103
Autores: Ezponda Casajús, Ana (Autor de correspondencia); Rodríguez Fraile, María Macarena; Morales Lozano, María Isabel; et al.
Revista: CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY
ISSN 0174-1551  Vol. 43  Nº 7  2020  págs. 987 - 995
Purpose To assess the feasibility of performing same-day vascular flow redistribution and Yttrium-90 radioembolization (90Y-RE) for hepatic malignancies. Materials and Methods From November 2015 to February 2019, patients undergoing same-day hepatic flow redistribution during work-up angiography,(99m)Technetium-labeled macroaggregated albumin (Tc-99m-MAA) SPECT/CT and 90Y microsphere-RE, were recruited. Within 18 h following the delivery of 90Y resin microspheres, an 90Y-PET/CT study was performed. According to patients' vascular anatomy, flow redistribution was performed by microcoil embolization of extrahepatic branches (group A), intrahepatic non-tumoral vessels (group B) and intrahepatic tumoral arteries (group C). The accumulation of(99m)Tc-MAA particles and microspheres in the redistributed areas was qualitatively evaluated using a 5-point visual scale (grade 1 = < 25% accumulation; grade 5 = 100% accumulation). Differences in the distribution of microspheres among groups were assessed with Mann-WhitneyUtest. Results Twenty-two patients were treated for primary (n = 17) and secondary (n = 5) hepatic malignancies. The MAA-SPECT/CT showed uptake in all the redistributed areas. Regarding the accumulation of microspheres within the redistributed segments in all the groups, perfusion patterns were classified as 2 in 1 case, 4 in 6 cases and 5 in 15 cases. No statistically significant differences were observed between groups A and B-C (Uvalue = 34,p = 0.32) and between groups B and C (Uvalue = 26,p = 0.7). Mean predicted absorbed doses by the tumoral and normal hepatic tissues were 163.5 +/- 131.2 Gy and 60.4 +/- 69.3 Gy, respectively. Mean total procedure time (from work-up angiography to 90Y delivery) was 401 +/- 0.055 min. Conclusion Performing same-day redistribution of the arterial hepatic flow to the target and 90Y-microsphere delivery is feasible in the treatment of liver tumors. Clinical Trials RegistryNCT03380130.
Autores: Morán Velasco, Verónica; Prieto Azcárate, Elena; Sancho Rodriguez, Lidia; et al.
Revista: EJNMMI RESEARCH
ISSN 2191-219X  Vol. 7  Nº 1  2020  págs. 72
Background: Prior radioembolization, a simulation using 99mTc-macroaggregated albumin as 90Y-microspheres surrogate is performed. Gamma scintigraphy images (planar, SPECT, or SPECT-CT) are acquired to evaluate intrahepatic 90Y-microspheres distribution and detect possible extrahepatic and lung shunting. These images may be used for pre-treatment dosimetry evaluation to calculate the 90Y activity that would get an optimal tumor response while sparing healthy tissues. Several dosimetry methods are available, but there is still no consensus on the best methodology to calculate absorbed doses. The goal of this study was to retrospectively evaluate the impact of using different dosimetry approaches on the resulting 90Y-radioembolization pre-treatment absorbed dose evaluation based on 99mTc-MAA images. Methods: Absorbed doses within volumes of interest resulting from partition model (PM) and 3D voxel dosimetry methods (3D-VDM) (dose-point kernel convolution and local deposition method) were evaluated. Additionally, a new "Multi-tumor Partition Model" (MTPM) was developed. The differences among dosimetry approaches were evaluated in terms of mean absorbed dose and dose volume histograms within the volumes of interest. Results: Differences in mean absorbed dose among dosimetry methods are higher in tumor volumes than in non-tumoral ones. The differences between MTPM and both 3D-VDM were substantially lower than those observed between PM and any 3D-VDM. A poor correlation and concordance were found between PM and the other studied dosimetry approaches. DVH obtained from either 3D-VDM are pretty similar in both healthy liver and individual tumors. Although no relevant global differences, in terms of absorbed dose in Gy, between both 3D-VDM were found, important voxel-by-voxel differences have been observed. Conclusions: Significant differences among the studied dosimetry approaches for 90Y-radioembolization treatments exist. Differences do not yield a substantial impact in treatment planning for healthy tissue but they do for tumoral liver. An individual segmentation and evaluation of the tumors is essential. In patients with multiple tumors, the application of PM is not optimal and the 3D-VDM or the new MTPM are suggested instead. If a 3D-VDM method is not available, MTPM is the best option. Furthermore, both 3D-VDM approaches may be indistinctly used.
Autores: González Gutiérrez, Jessica; Rodríguez Fraile, María Macarena; Rivera Ortega, Pilar; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 14  Nº 2  2019  págs. e0209777
BACKGROUND: Smoking is a recognized risk factor for osteoporosis. Trabecular bone score (TBS) is a novel texture parameter to evaluate bone microarchitecture. TBS and their main determinants are unknown in active and former smokers. OBJECTIVE: To assess TBS in a population of active or former smokers with and without Chronic Obstructive Pulmonary Disease (COPD) and to determine its predictive factors. METHODS: Active and former smokers from a pulmonary clinic were invited to participate. Clinical features were recorded and bone turnover markers (BTMs) measured. Lung function, low dose chest Computed Tomography scans (LDCT), dual energy absorptiometry (DXA) scans were performed and TBS measured. Logistic regression analysis explored the relationship between measured parameters and TBS. RESULTS: One hundred and forty five patients were included in the analysis, 97 (67.8%) with COPD. TBS was lower in COPD patients (median 1.323; IQR: 0.13 vs 1.48; IQR: 0.16, p = 0.003). Regression analysis showed that a higher body mass index (BMI), younger age, less number of exacerbations and a higher forced expiratory volume-one second (FEV1%) was associated with better TBS (ß = 0.005, 95% CI:0.000-0.011, p = 0.032; ß = -0.003, 95% CI:-0.007(-)-0.000, p = 0.008; ß = -0.019, 95% CI:-0.034(-)-0.004, p = 0.015; ß = 0.001, 95% CI:0.000-0.002, p = 0.012 respectively). The same factors with similar results were found in COPD patients.
Autores: Gutierrez Buey, Gala; Restituto Aranguibel, Patricia; Botella Martínez, María Sonsoles; et al.
Revista: CLINICAL ENDOCRINOLOGY
ISSN 0300-0664  Vol. 91  Nº 3  2019  págs. 391 - 399
Context Bone loss is accelerated in the late perimenopause and early menopause. The date of the final menstrual period cannot be stated until 1 year after it has ended, and at that time, most of the rapid bone loss phase will have elapsed. Therefore, early detection of bone loss is crucial. Objectives To evaluate the utility of bone turnover markers (BTM) to identify the women who are more likely to lose more bone mass during the transition to menopause and quantify the loss of bone quality measured by trabecular bone score (TBS). Design, patients and setting Sixty-four healthy premenopausal women, mean age between 44 and 57 years old, were enrolled and followed up for 5 years. Clinical features, lifestyle, bone densitometry, TBS and BTM (CTX, P1NP and osteocalcin) were measured at baseline and follow-up. Results All women had densitometrically normal bone at the time of enrolment. After 5 years, 48.4% had normal bone mineral density, 45.8% low bone mass and 6.3% osteoporosis. Women with osteopenia/osteoporosis at follow-up had higher CTX and P1NP at enrolment compared with women with densitometrically normal bone. The areas under the curve for the prediction of low bone mass or osteoporosis were 0.69 (P = 0.011) for P1NP, 0.69 for CTX (P = 0.013) and 0.77 (P 0.001) for OC. A significant correlation was found between P1NP increase after 5 years and the decrease in lumbar bone density (r = -0.383, P = 0.002). At baseline, 7 (10.9%) women had deteriorated microarchitecture (TBS < 1.3). Three of these women developed osteoporosis and four osteopenia at follow-up. Conclusions Women with higher P1NP and CTX and lower TBS at baseline had lower BMD in the transition to menopause suggesting these novel tools could have potential use in identifying women at high risk of rapidly decreasing bone mass.
Autores: Cappelli, A.; Sangro del Alcazar, Paloma; Mosconi, C.; et al.
Revista: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
ISSN 1619-7070  Vol. 46  Nº 3  2019  págs. 661 - 668
PURPOSE: Patients with hepatocellular carcinoma (HCC) of intermediate stage (BCLC-B according to the Barcelona Clinic Liver Cancer classification) are a heterogeneous group with different degrees of liver function impairment and tumour burden. The recommended treatment is transarterial chemoembolization (TACE). However, patients in this group may be judged as poor candidates for TACE because the risk-benefit ratio is low. Such patients may receive transarterial radioembolization (TARE) only by entering a clinical trial. Experts have proposed that the stage could be further divided into four substages based on available evidence of treatment benefit. We report here, for the first time, the outcome in patients with BCLC-B2 substage HCC treated with TARE. METHODS: A retrospective analysis of the survival of 126 patients with BCLC-B2 substage HCC treated with TARE in three European hospitals was performed. RESULTS: Overall median survival in patients with BCLC-B2 substage was not significantly different in relation to tumour characteristics; 19.35 months (95% CI 8.27-30.42 months) in patients with a single large (>7 cm) HCC, and 18.43 months (95% CI 15.08-21.77 months) in patients with multinodular HCC (p¿=¿0.27). However, there was a higher proportion of long-term survivors at 36 months among those with a single large tumour (29%) than among those with multiple tumours (16.8%). CONCLUSION: Given the poor efficacy of TACE in treating patients with BCLC-B2 substage HCC, TARE
Autores: Rodríguez Fraile, María Macarena; Morales, M. ; Ezponda Casajús, Ana; et al.
Revista: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
ISSN 1619-7070  Vol. 46  Nº SUPPL 1  2019  págs. S481 - S482
Autores: Orduz, L. S.; Morales Lozano, María Isabel; Aradas-Cabado, B.; et al.
Revista: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
ISSN 1619-7070  Vol. 46  Nº SUPPL 1  2019  págs. S534 - S534
Autores: García Velloso, María José (Autor de correspondencia); Rodríguez Fraile, María Macarena
Revista: REVISTA ESPAÑOLA DE MEDICINA NUCLEAR E IMAGEN MOLECULAR
ISSN 2253-654X  Vol. 37  Nº 2  2018  págs. 71 - 72
Autores: Prieto Azcárate, Elena; García Velloso, María José; Rodríguez Fraile, María Macarena; et al.
Revista: PHYSICA MEDICA
ISSN 1120-1797  Vol. 46  2018  págs. 134-139
A significant radiation dose reduction of 28.7% was reached. Despite a slight reduction in image quality, the new regime was successfully implemented with readers reporting unchanged clinical confidence
Autores: Bilbao Jaureguizar, José Ignacio; Sancho Rodriguez, Lidia; Páramo Alfaro, María; et al.
Revista: JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
ISSN 1051-0443  Vol. 29  Nº 9  2018  págs. 1305 - 1306
Autores: Rivera Ortega, Pilar; González Gutiérrez, Jessica; Restituto Aranguibel, Patricia; et al.
Revista: EUROPEAN RESPIRATORY JOURNAL
ISSN 0903-1936  Vol. 52  Nº Supl. 62  2018 
Autores: Sangro Gómez-Acebo, Bruno Carlos; Rodríguez Fraile, María Macarena
Revista: LIVER INTERNATIONAL
ISSN 1478-3223  Vol. 37  Nº 1  2017  págs. 32 - 34
Autores: Marti Climent, Josep María; Prieto Azcárate, Elena; Morán Velasco, Verónica; et al.
Revista: EJNMMI RESEARCH
ISSN 2191-219X  Vol. 7  Nº 1  2017  págs. 37
The mean ED for body and brain PET/CT protocols with different radiopharmaceuticals ranged between 4.6 and 20.0 mSv. The major contributor to total ED for body protocols is CT, whereas for brain studies, it is the PET radiopharmaceutical.
Autores: Sangro Gómez-Acebo, Bruno Carlos; Rodríguez Fraile, María Macarena
Revista: LIVER INTERNATIONAL
ISSN 1478-3223  Vol. 37  Nº 1  2017  págs. 32-34
Autores: Sancho Rodriguez, Lidia; Rodríguez Fraile, María Macarena; Bilbao Jaureguizar, José Ignacio; et al.
Revista: JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
ISSN 1051-0443  Vol. 28  Nº 11  2017  págs. 1536 - 1542
Purpose:To determine if baseline patient, tumor, and pretreatment evaluation characteristics could help identify patients who require technetium-99m (Tc-99m) macroaggregated albumin Tc-(99m MAA) imaging before selective internal radiation therapy (SIRT). Materials and Methods: In this retrospective analysis, 532 consecutive patients with primary (n = 248) or metastatic (n = 284) liver tumors were evaluated between 2006 and 2015. Variables were compared between patients in whom Tc-99m MAA imaging results contraindicated/modified SIRT administration with yttrium-90 (Y-90) resin microspheres and those who were treated as initially planned. The Tc-99m MAA findings that contraindicated/modified SIRT were a lung shunt fraction (LSF) > 20%, gastrointestinal Tc-99m MAA uptake, or a mismatch between Tc-99m MAA uptake and intrahepatic tumor distribution. Results: LSF > 20% and gastrointestinal MAA uptake were observed in 7.5% and 3.9% of patients, respectively, and 11% presented a mismatch. Presence of a single lesion (odds ratio [OR] = 2.4) and vascular invasion (OR = 5.5) predicted LSF > 20%, and GI MAA uptake was predicted by the presence of liver metastases (OR = 3.7) and Tc-99m MAA injection through the common/proper hepatic artery (OR = 4.7). Vascular invasion (OR = 4.1) was the only predictor of LSF > 20% and/or GI MAA uptake (sensitivity = 49.2%, specificity = 80.3%, negative predictive value = 92.4%). Previous antiangiogenic treatment (OR = 2.4) and presence of a single lesion (OR = 2.6) predicted mismatch. Conclusions: Imaging with Tc-99m MAA is essential in SIRT workup because baseline characteristics may not adequately predict Tc-99m MAA results. Nevertheless, the absence of vascular invasion potentially identifies a group of patients at low risk of SIRT contraindication/modification in whom performing SIRT in a single session (ie, pretreatment evaluation and SIRT on the same day) should be explored.
Autores: García Velloso, María José; Ribelles Segura, María Jesús; Rodríguez Fraile, María Macarena; et al.
Revista: EUROPEAN RADIOLOGY
ISSN 0938-7994  Vol. 27  Nº 8  2017  págs. 3190-3198
Our aim was to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in primary tumour staging of patients with breast cancer. METHODS: This retrospective study evaluated 45 women with 49 pathologically proven breast carcinomas. MRI and prone PET-CT scans with time-of-flight and point-spread-function reconstruction were performed with the same dedicated breast coil. The studies were assessed by a radiologist and a nuclear medicine physician, and evaluation of fused images was made by consensus. The final diagnosis was based on pathology (90 lesions) or follow-up¿¿¿24 months (17 lesions). RESULTS: The study assessed 72 malignant and 35 benign lesions with a median size of 1.8 cm (range 0.3-8.4 cm): 31 focal, nine multifocal and nine multicentric cases. In lesion-by-lesion analysis, sensitivity, specificity, positive and negative predictive values were 97%, 80%, 91% and 93% for MRI, 96%, 71%, 87%, and 89% for prone PET, and 97%. 94%, 97% and 94% for MRI fused with PET. Areas under the curve (AUC) were 0.953, 0.850, and 0.983, respectively (p¿<¿0.01). CONCLUSIONS: MRI fused with FDG-PET is more accurate than FDG-PET in primary tumour staging of breast cancer patients and increases the specificity of MRI.
Autores: Guillen Valderrama, Edgar Fernando; Díaz Perdigón, M.; García García, Berta; et al.
Revista: REVISTA ESPAÑOLA DE MEDICINA NUCLEAR E IMAGEN MOLECULAR
ISSN 2253-654X  Vol. 36  Nº Supl 1  2017  págs. 16
Autores: Hernández Argüello, Miguel David; Quiceno Arias, Hernán Dario; Pascual Piedrola, Juan Ignacio; et al.
Revista: PROSTATE
ISSN 0270-4137  Vol. 76  Nº 1  2016  págs. 3 - 12
BACKGROUND: Index lesion characterization is important in the evaluation of primary prostate carcinoma (PPC). The aim of this study was to analyze the contribution of (11) C-Choline PET/CT and the Apparent Diffusion Coefficient maps (ADC) in detecting the Index Lesion and clinically significant tumors in PPC. METHODS: Twenty-one untreated patients with biopsy-proven PPC and candidates for radical prostatectomy (RP) were prospectively evaluated by means of Ultra-High Definition PET/CT and 3T MRI, which included T2-weighted imaging (T2WI) and ADC maps obtained from diffusion weighted imaging (DWI). Independent experts analyzed all the images separately and were unaware of the pathological data. In each case, the Index lesion was defined as the largest tumor measured on histopathology (Index H). In addition, the largest lesion observed on MRI (Index MRI) and the highest avid (11) C-Choline uptake lesion (Index PET) were obtained. The Gleason scores (GS) of the tumors were determined. PET/CT and ADC map quantitative parameters were also calculated. Measures of correlation among imaging parameters as well as the sensitivity (S), specificity (Sp), negative and positive predictive values (NPV and PPV) for tumor detection were analyzed. All data was validated with the pathological study. RESULTS: In the morphological study, 139 foci of carcinoma were identified, 47 of which corresponded to clinically significant tumors (>0.5¿cm(3) ). The remaining foci presented a maximum diameter (dmax ) of 0.1¿cm¿±¿SD 0.75 and were not classified as clinically significant. Thirty-two tumors presented a GS (3¿+¿3), nine GS (3¿+¿4), and six GS (4¿+¿3). A total of 21 Index H (dmax ¿=¿1.37¿cm SD¿±¿0.61) were identified. The S, Sp, NPV, and PPV for tumor detection with PET were 100%, 70%, 83%, 100%, and for MRI were 46%, 100%, 100%, 54%, respectively. Both Index PET and Index MRI were complementary and identified 95% of the Index H when quantitative criteria were used. CONCLUSION: In spite of the fact that PET imaging has higher tumor sensitivity than MRI, (11) C-Choline PET and ADC maps have complementary roles in the evaluation of Index Lesion in PPC. Index PET and Index MRI could be complementary targets in the therapeutic planning of PPC.
Autores: Prieto de Frías, César; Conchillo Armendáriz, María de los Ángeles; Payeras Mas, Marina Laura; et al.
Revista: EUROPEAN JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
ISSN 0954-691X  Vol. 28  Nº 2  2016  págs. 139 - 145
Objective Hypermetabolism in cirrhosis is associated with a high risk of complications and mortality. However, studies about underlying mechanisms are usually focussed on isolated potential determinants and specific etiologies, with contradictory results. We aimed at investigating differences in nutrition, metabolic hormones, and hepatic function between hypermetabolic and nonhypermetabolic men with cirrhosis of the liver. Patients and methods We prospectively enrolled 48 male cirrhotic inpatients. We evaluated their resting energy expenditure (REE) and substrate utilization by indirect calorimetry, body composition by dual-energy X-ray absorptiometry, liver function, and levels of major hormones involved in energy metabolism by serum sample tests. Patients with ascites, specific metabolic disturbances, and hepatocellular carcinoma were excluded. Results REE and REE adjusted per fat-free mass (FFM) were significantly increased in cirrhotic patients. Overall, 58.3% of cirrhotic patients were classified as hypermetabolic. Groups did not differ significantly in age, etiology of cirrhosis, liver function, presence of ascites, use of diuretics, â-blockers, or presence of transjugular intrahepatic portosystemic shunts. Hypermetabolic cirrhotic patients had lower weight, BMI (P< 0.05), nonprotein respiratory quotient (P< 0.01), leptin (P<0.05), and leptin adjusted per fat mass (FM) (P<0.05), but higher FFM% (P< 0.05) and insulin resistance [homeostatic model assessment-insulin resistance (HOMA-IR)] (P<0.05). Only HOMA-IR, leptin/FM, and FFM% were independently related to the presence of hypermetabolism. Conclusion Hypermetabolic cirrhotic men are characterized by lower weight, higher FFM%, insulin resistance, and lower leptin/FM when compared with nonhypermetabolic men. HOMA-IR, FFM%, and leptin/FM were independently associated with hypermetabolism, and may serve as easily detectable markers of this condition in daily clinical practice.
Autores: Sancho Rodriguez, Lidia; Rodríguez Fraile, María Macarena; Prieto Azcárate, Elena; et al.
Revista: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
ISSN 1619-7070  Vol. 43  Nº Suppl. 1  2016  págs. S12 - S12
Autores: Rodríguez Fraile, María Macarena; Sancho Rodriguez, Lidia; Guillén Grima, Francisco; et al.
Revista: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
ISSN 1619-7070  Vol. 43  2016  págs. S329 - S329
Autores: Prieto Azcárate, Elena; Morán Velasco, Verónica; García García, Berta; et al.
Revista: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
ISSN 1619-7070  Vol. 43  Nº Supl.1  2016  págs. S528 - S528
Autores: Morán Velasco, Verónica; Prieto Azcárate, Elena; Zubiria, A.; et al.
Revista: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
ISSN 1619-7070  Vol. 43  Nº Supl 1  2016  págs. S410
Autores: Rodríguez Fraile, María Macarena (Autor de correspondencia); Iñarrairaegui Bastarrica, Mercedes
Revista: REVISTA ESPAÑOLA DE MEDICINA NUCLEAR E IMAGEN MOLECULAR
ISSN 2253-654X  Vol. 34  Nº 4  2015  págs. 244 - 257
Autores: Kolligs , Frank T; Bilbao Jaureguizar, José Ignacio; Jakobs, Tobías; et al.
Revista: LIVER INTERNATIONAL
ISSN 1478-3223  Vol. 35  Nº 6  2015  págs. 1715-21
Single-session SIRT appeared to be as safe and had a similar impact on HRQoL as multiple sessions of TACE, suggesting that SIRT might be an alternative option for patients eligible for TACE.
Autores: Sancho Rodriguez, Lidia; Guillen Valderrama, Edgar Fernando; García Velloso, María José; et al.
Revista: JOURNAL OF NUCLEAR MEDICINE
ISSN 0161-5505  Vol. 56  Nº Supl.3  2015  págs. 1273
Autores: Sancho Rodriguez, Lidia; Guillen Valderrama, Edgar Fernando; Pérez Pevida, Belén; et al.
Revista: REVISTA ESPAÑOLA DE MEDICINA NUCLEAR E IMAGEN MOLECULAR
ISSN 2253-8070  Vol. 34  Nº Supl.1  2015  págs. 79
Conclusiones: La interrupción de M 48h fue mejor que 24h para la reducción de la CI de 18F-FDG en pacientes con DM2 y mejoró significativamente la calidad de los estudios 18F-FDG-PET/CT. Aunque la glucemia aumentó tras la interrupción de M, permaneció en rangos aceptables.
Autores: Fernández Ros, Nerea; Silva, N.; Bilbao Jaureguizar, José Ignacio; et al.
Revista: HPB
ISSN 1365-182X  Vol. 16  Nº 3  2014  págs. 243-49
The present results warrant further studies to better elucidate the mechanism underlying this phenomenon of spared hemiliver hypertrophy and to investigate its role as an alternative to portal vein embolization in the management of patients with potentially resectable liver tumours.
Autores: Marti Climent, Josep María; Prieto Azcárate, Elena; Elosúa, césar; et al.
Revista: MEDICAL PHYSICS
ISSN 0094-2405  Vol. 41  Nº 9  2014  págs. 092503
Qualitative and quantitative 90Y PET imaging improved with the introduction of TOF in a PET/CT scanner, thereby allowing the visualization of microsphere deposition in lesions not visible in non-TOF images. This technique accurately quantifies the total activity delivered to the liver during radioembolization with (90)Y-microspheres and allows dose estimation.
Autores: Gil Alzugaray, Belén; Chopitea Ortega, Ana; Iñarrairaegui Bastarrica, Mercedes; et al.
Revista: Hepatology
ISSN 0270-9139  Vol. 57  Nº 3  2013  págs. 1078 - 1087
Radioembolization (RE)-induced liver disease (REILD) has been defined as jaundice and ascites appearing 1 to 2 months after RE in the absence of tumor progression or bile duct occlusion. Our aims were to study the incidence of REILD in a large cohort of patients and the impact of a series of changes introduced in the processes of treatment design, activity calculation, and the routine use of ursodeoxycholic acid and low-dose steroids (modified protocol). Between 2003 and 2011, 260 patients with liver tumors treated by RE were studied (standard protocol: 75, modified protocol: 185). REILD appeared only in patients with cirrhosis or in noncirrhosis patients exposed to systemic chemotherapy prior to RE. Globally, the incidence of REILD was reduced in the modified protocol group from 22.7% to 5.4% and the incidence of severe REILD from 13.3% to 2.2% (P < 0.0001). Treatment efficacy was not jeopardized since 3-month disease control rates were virtually identical in both groups (66.7% and 67.2%, P = 0.93). Exposure to chemotherapy in the 2-month period following RE and being treated by the standard protocol were independent predictors of REILD among noncirrhosis patients. In cirrhosis, the presence of a small liver (total volume <1.5 L), an abnormal bilirubin (>1.2 mg/dL), and treatment in a selective fashion were independently associated with REILD. Conclusion: REILD is an uncommon but relevant complication that appears when liver tissue primed by cirrhosis or prior and subsequent chemotherapy is exposed to the radiation delivered by radioactive microspheres. We designed a comprehensive treatment protocol that reduces the frequency and the severity of REILD. (HEPATOLOGY 2013)
Autores: Golfieri, Rita; Bilbao Jaureguizar, José Ignacio; Carpanese, Livio; et al.
Revista: JOURNAL OF HEPATOLOGY
ISSN 0168-8278  Vol. 59  Nº 4  2013  págs. 753-61
Radioembolization appears to be as well-tolerated and effective for the elderly as it is for younger patients with unresectable HCC. Age alone should not be a discriminating factor for the management of HCC patients.
Autores: Rodríguez Lago, Iago Israel; Carretero Ribón, Cristina; Herráiz Bayod, Maite; et al.
Revista: WORLD JOURNAL OF GASTROENTEROLOGY
ISSN 1007-9327  Vol. 19  Nº 19  2013  págs. 2935 - 2940
IM: To evaluate the long-term natural history of the gastroduodenal lesions secondary to extrahepatic embolization with Ytrium 90(Y-90) spheres. METHODS: From September 2003 to January 2012, 379 procedures of liver radioembolization(RE) using resin microspheres loaded with Y-90 were performed in our center. We have retrospectively compiled the data from 379 RE procedures performed in our center. We report a comprehensive clinical, analytical, endoscopic and histologic long-term follow-up of a series of patients who developed gastroduodenal lesions after the treatment. RESULTS: Six patients(1.5%) developed gastrointestinal symptoms and had gastrointestinal lesions as shown by upper endoscopy in the next 12 wk after RE. The mean time between RE and the appearance of symptoms was 5 wk. Only one patient required endoscopic and surgical treatment. The incidence of gastrointestinal ulcerations was 3.75%(3/80) when only planar images were used for the pre-treatment evaluation. It was reduced to 1%(3/299) when single-photon emission computed tomography(SPECT) images were also performed. The symptoms that lasted for a longer time were nausea and vomiting, until 25 mo after the treatment. CONCLUSION: All patients were free from severe symptoms at the end of follow-up. The routine use of SPECT has decreased the incidence of gastrointestinal lesions due to unintended deployment of Y-90 particles.
Autores: Marti Climent, Josep María; Prieto Azcárate, Elena; Domínguez Prado, Inés; et al.
Revista: REVISTA ESPAÑOLA DE MEDICINA NUCLEAR
ISSN 0212-6982  Vol. 32  Nº 1  2013  págs. 13 - 21
Objective: To characterize the performance of the Biograph mCT PET/CT TrueV scanner with time of flight (TOF) and point spread function (PSF) modeling. Material and methods: The PET/CT scanner combines a 64-slice CT and PET scanner that incorporates in the reconstruction the TOF and PSF information. PET operating characteristics were evaluated according to the standard NEMA NU 2-2007, expanding some tests. In addition, different reconstruction algorithms were included, and the intrinsic radiation and tomographic uniformity were also evaluated. Results: The spatial resolution (FWHM) at 1 and 10 cm was 4.4 and 5.3 mm, improving to 2.6 and 2.5 mm when PSF is introduced. Sensitivity was 10.9 and 10.2 Kcps/MBq at 0 and 10 cm from the axis. Scatter fraction was less than 34% at low concentrations and the noise equivalent count rate (NECR) was maximal at 27.8 kBq/mL with 182 Kcps, the intrinsic radiation produced a rate of 4.42 true coincidences per second. Coefficient of variation of the volume and system uniformity were 4.7 and 0.8% respectively. The image quality test showed better results when PSF and TOF were included together. PSF improved the hot spheres contrast and background variability, while TOF improved the cold spheres contrast. Conclusions: The Biograph mCT TrueV scanner has good performance characteristics. The image quality improves when the information from the PSF and the TOF is incorporated in the reconstruction.
Autores: Peñuelas Sánchez, Iván; Domínguez Prado, Inés; García Velloso, María José; et al.
Revista: JOURNAL OF ONCOLOGY
ISSN 1687-8450  Vol. 12  Nº 7  2012  págs. 710561
Molecular imaging of breast cancer has undoubtedly permitted a substantial development of the overall diagnostic accuracy of this malignancy in the last years. Accurate tumour staging, design of individually suited therapies, response evaluation, early detection of recurrence and distant lesions have also evolved in parallel with the development of novel molecular imaging approaches. In this context, positron emission tomography (PET) can be probably seen as the most interesting molecular imaging technology with straightforward clinical application for such purposes. Dozens of radiotracers for PET imaging of breast cancer have been tested in laboratory animals. However, in this review we shall focus mainly in the smaller group of PET radiopharmaceuticals that have lead through into the clinical setting. PET imaging can be used to target general metabolic phenomena related to tumoural transformation, including glucose metabolism and cell proliferation, but can also be directed to specific hormone receptors that are characteristic of the breast cancer cell. Many other receptors and transport molecules present in the tumour cells could also be of interest for imaging. Furthermore, molecules related with the tumour microenvironment, tumour induced angiogenesis or even hypoxia could also be used as molecular biomarkers for breast cancer imaging.
Autores: Iñarrairaegui Bastarrica, Mercedes; Pardo Sánchez, Fernando; Bilbao Jaureguizar, José Ignacio; et al.
Revista: European Journal of surgical Oncology
ISSN 0748-7983  Vol. 38  Nº 7  2012  págs. 594 - 601
Autores: Rincón Mayans, Aníbal Pablo; Zudaire Díaz-Tejeiro, Beatriz; Rioja Zuazu, Jorge Pedro; et al.
Revista: ARCHIVOS ESPANOLES DE UROLOGIA
ISSN 0004-0614  Vol. 64  Nº 8  2011  págs. 746 - 764
Autores: Domínguez Prado, Inés; Rodríguez Fraile, María Macarena; Alcalde Navarrete, Juan Manuel; et al.
Revista: REVISTA ESPAÑOLA DE MEDICINA NUCLEAR
ISSN 0212-6982  Vol. 30  Nº 5  2011  págs. 325-326
Autores: Quincoces Fernández, Gemma; López Sánchez, Luisa María; Sánchez Martínez, María; et al.
Revista: Applied Radiation and Isotopes
ISSN 0969-8043  Vol. 68  Nº 12  2010  págs. 2298 - 301
Autores: Iñarrairaegui Bastarrica, Mercedes; Bilbao Jaureguizar, José Ignacio; Rodríguez Fraile, María Macarena; et al.
Revista: HOSPITAL PRACTICE
ISSN 2154-8331  Vol. 38  Nº 3  2010  págs. 103 - 109
Autores: Richter Echevarria, José Ángel; Rodríguez Fraile, María Macarena; Rioja Zuazu, Jorge Pedro; et al.
Revista: Molecular Imaging and Biology
ISSN 1536-1632  Vol. 12  Nº 2  2010  págs. 210 - 217
Autores: Iñarrairaegui Bastarrica, Mercedes; Martínez de la Cuesta, Antonio; Rodríguez Fraile, María Macarena; et al.
Revista: International Journal of Radiation Oncology, Biology, Physics
ISSN 0360-3016  Vol. 77  Nº 5  2010  págs. 1441 - 1448
Autores: Rioja Zuazu, Jorge Pedro; Rodríguez Fraile, María Macarena; Lima-Favaretto, R.; et al.
Revista: BJU INTERNATIONAL
ISSN 1464-4096  Vol. 106  Nº 11  2010  págs. 1578 - 1593
center dot A critical, non-structured review of the literature of the role of PET and PET/CT in urological oncology was conducted. center dot PET and PET/CT can play a role in the management of urological malignancies. For prostate cancer, the advances in radiotracers seems promising, with novel radiotracers yielding better diagnostic and staging results than 18F-fluorodeoxyglucose (18F-FDG). In kidney cancer, PET and PET/CT allow a proper diagnosis before the pathological examination of the surgical specimen. For testis cancer, PET and PET/CT have been shown to be useful in the management of seminoma tumours. In bladder cancer, these scans allow a better initial diagnosis for invasive cancer, while detecting occult metastases. center dot PET and its combined modality PET/CT have shown their potential in the diagnosis of urological malignancies. However, further studies are needed to establish the role of PET in the management of these diseases. Future applications of PET may involve fusion techniques such as magnetic resonance imaging with PET.
Autores: Bilbao Jaureguizar, José Ignacio; Garrastachu Zumarán, María del Puy; Herráiz Bayod, María José; et al.
Revista: Cardiovascular and Interventional Radiology
ISSN 0174-1551  Vol. 33  Nº 3  2010  págs. 523 - 531
Autores: Iñarrairaegui Bastarrica, Mercedes; Thurston Kenneth, G; Bilbao Jaureguizar, José Ignacio; et al.
Revista: Journal of vascular and interventional radiology (Print)
ISSN 1051-0443  Vol. 21  Nº 8  2010  págs. 1205 - 1212
Autores: Domínguez Prado, Inés; García Velloso, María José; Vigil Díaz, Carmen; et al.
Revista: JOURNAL OF NUCLEAR MEDICINE
ISSN 0161-5505  Vol. 51  Nº Supl. 2  2010  págs. 1197
Objectives Sentinel node biopsy (SNB) has become a standard treatment in staging axillary lymph nodes in early breast cancer. However, SNB is an invasive procedure. Breast cancer is frequently characterised by increased 18FDG uptake and many studies have shown encouraging results in detecting axillary lymph node metastases. The aim of this study was to compare SNB and positron emission tomography/computed tomography (PET/CT) imaging, to assess their values in detecting occult axillary metastases. Methods Forty-nine women (mean age 55-year old) with 50 breast cancer (mean primary tumor size 1.97 cm) and clinically negative axilla were enrolled in the study. 18FDG PET was carried out before surgery, using a PET/CT scanner. In all patients, SNB was carried out after identification through lymphoscintigraphy. Patients underwent axillary lymph nodes dissection (ALND) in cases of positive SNB. The results of PET scan were compared with histopathology of SNB and ALND. Results In all, 23 out of the 49 patients (47%) had metastases in axillary nodes. The standardized uptake value (SUV) was related to the histological grading (2.6±1.1 in well differentiated vs 3.7±3.1 in poorly differentiated). Sensitivity of FDG-PET scan for detection of axillary lymph node metastases in this series was very low (13%) due to 7 false negative in micrometastases and 6 false negative in immunohistochemistry metastases. Positive predictive value was 75% due to a false positive diagnosis. However, specificity was acceptable (96%). Conclusions The high specificity of PET/CT imaging indicates that patients who have a PET-positive axilla should have an ALND rather than an SNB for axillary staging. In contrast, FDG-PET showed poor sensitivity in the detection of axillary metastases, confirming the need for SNB in cases where PET is negative in the axilla
Autores: Arbizu Lostao, Javier; Bilbao Jaureguizar, José Ignacio; Garrastachu Zumarán, María del Puy; et al.
Libro:  Therapeutic Nuclear Medicine
2014  págs. 361-377
Autores: Arbizu Lostao, Javier; Rodríguez Fraile, María Macarena; Marti Climent, Josep María; et al.
Libro:  Liver radioembolization with 90Y microspheres
2014  págs. 63-75
Autores: García Velloso, María José; Coma Canella, María Isabel; Peñuelas Sánchez, Iván; et al.
Libro:  Medicina Nuclear en la práctica clínica
2012  págs. 295-305

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