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Cruz-Cortes Á, Avendaño-Estrada A, Alcauter S, Núñez-Enríquez JC, Rivera-Bravo B, Olarte-Casas MÁ, Ávila-Rodríguez MÁ. Semiquantitative analysis of cerebral [ 18F]FDG-PET uptake in pediatric patients. Pediatr Radiol 2023; 53:2574-2585. [PMID: 37910188 PMCID: PMC10698097 DOI: 10.1007/s00247-023-05794-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Glycolytic metabolism in the brain of pediatric patients, imaged with [18F] fluorodeoxyglucose-positron emission tomography (FDG-PET) is incompletely characterized. OBJECTIVE The purpose of the current study was to characterize [18F]FDG-PET brain uptake in a large sample of pediatric patients with non-central nervous system diseases as an alternative to healthy subjects to evaluate changes at different pediatric ages. MATERIALS AND METHODS Seven hundred ninety-five [18F]FDG-PET examinations from children < 18 years of age without central nervous system diseases were included. Each brain image was spatially normalized, and the standardized uptake value (SUV) was obtained. The SUV and the SUV relative to different pseudo-references were explored as a function of age. RESULTS At all evaluated ages, the occipital lobe showed the highest [18F]FDG uptake (0.27 ± 0.04 SUV/year), while the parietal lobe and brainstem had the lowest uptake (0.17 ± 0.02 SUV/year, for both regions). An increase [18F]FDG uptake was found for all brain regions until 12 years old, while no significant uptake differences were found between ages 13 (SUV = 5.39) to 17 years old (SUV = 5.52) (P < 0.0001 for the whole brain). A sex dependence was found in the SUVmean for the whole brain during adolescence (SUV 5.04-5.25 for males, 5.68-5.74 for females, P = 0.0264). Asymmetries in [18F]FDG uptake were found in the temporal and central regions during infancy. CONCLUSIONS Brain glycolytic metabolism of [18F]FDG, measured through the SUVmean, increased with age until early adolescence (< 13 years old), showing differences across brain regions. Age, sex, and brain region influence [18F]FDG uptake, with significant hemispheric asymmetries for temporal and central regions.
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Affiliation(s)
- Álvaro Cruz-Cortes
- Unidad de Radiofarmacia-Ciclotrón, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
| | - Arturo Avendaño-Estrada
- Unidad de Radiofarmacia-Ciclotrón, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico.
| | - Sarael Alcauter
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro City, Mexico
| | - Juan Carlos Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiología Clínica, UMAE Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico
| | - Belen Rivera-Bravo
- División de Investigación Facultad de Medicina Universidad Nacional Autónoma de México, Unidad PET/CT, Ciudad de Mexico, Mexico
| | - Miguel Ángel Olarte-Casas
- División de Investigación Facultad de Medicina Universidad Nacional Autónoma de México, Unidad PET/CT, Ciudad de Mexico, Mexico
| | - Miguel Ángel Ávila-Rodríguez
- Unidad de Radiofarmacia-Ciclotrón, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
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Plata-Corona JC, Carvajal-Juarez I, Espinola-Zavaleta N, Damas-De Los Santos F, Rivera-Bravo B, Alexanderson-Rosas E. 13N-Ammonia myocardial blood flow quantitation in patient with aneurismal coronary artery disease. J Nucl Cardiol 2022; 29:1826-1831. [PMID: 33959843 DOI: 10.1007/s12350-021-02642-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
Aneurysmal coronary artery disease includes coronary artery aneurysms and ectasia; this condition has been associated with poor long-term outcomes. Few studies have explored myocardial blood flow 13N-ammonia PET/CT MPI added value. We present a 45-year-old man who came to the emergency department with chest pain. After a physical examination and laboratory studies, he was diagnosed with very high-risk unstable angina and referred to the catheterization laboratory. Coronary angiography showed the culprit lesion in the LCx and was treated by angioplasty and stent. LAD was found with coronary artery ectasia (TIMI 2 flow grade) and the RCA with aneurysmal disease in the proximal and middle segments (TIMI 3 flow grade). Medical treatment was decided for these findings and the patient was discharged. Two weeks later, we performed a 13N-ammonia PET/CT MPI founding apical, inferior, and inferoseptal severe ischemia, and reduced hyperemic coronary blood flow and coronary flow reserve in the RCA territory. Flow was normal in the LAD territory. Although coronary angiography remains the gold standard for evaluating these coronary abnormalities, it does not show the physiological compromise. Therefore 13N-ammonia PET/CT MPI should be performed as a complementary noninvasive imaging approach.
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Affiliation(s)
- Juan Carlos Plata-Corona
- Clinical Cardiology Department, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Isabel Carvajal-Juarez
- Nuclear Cardiology Department, National Institute of Cardiology Ignacio Chavez, Juan Badiano Nº 1, Colonia Seccion XVI, Tlalpan, P.C 14080, Mexico City, Mexico
- Nuclear Medicine Department, UMAE, Cardiology Hospital, CMNSXXI, Mexico City, Mexico
| | - Nilda Espinola-Zavaleta
- Nuclear Cardiology Department, National Institute of Cardiology Ignacio Chavez, Juan Badiano Nº 1, Colonia Seccion XVI, Tlalpan, P.C 14080, Mexico City, Mexico
- Echocardiography Department, ABC Medical Center, Mexico City, Mexico
| | | | - Belen Rivera-Bravo
- PET/CT Unit, Faculty of Medicine, Autonomous National University of Mexico (UNAM), Mexico City, Mexico
| | - Erick Alexanderson-Rosas
- Nuclear Cardiology Department, National Institute of Cardiology Ignacio Chavez, Juan Badiano Nº 1, Colonia Seccion XVI, Tlalpan, P.C 14080, Mexico City, Mexico.
- PET/CT Unit, Faculty of Medicine, Autonomous National University of Mexico (UNAM), Mexico City, Mexico.
- Department of Physiology, Faculty of Medicine, Autonomous National University of Mexico (UNAM), Mexico City, Mexico.
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Gurrola-Luna H, Rojas-Sernaque JK, Barajas Paulin AJ, Carvajal-Juarez I, Bermudez-Gonzalez JL, Rivera-Bravo B, Soto-Lopez ME, Garcia-Arroyo AJ, Cuellar-Vargas JK, Arce-Sandoval CR, Zavala-Romero L, Romero-Montiel RE, Gomez-Salgado M, Alexanderson Rosas E. Comorbidities associated with reduced myocardial flow reserve in non-obstructive disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Microvascular Dysfunction defined as a Myocardial Flow Reserve (MFR) <2 or <2.5 depending on the center, may present in the absence of significant obstruction (1,2); it is included as a diagnosis criteria of Microvascular Angina (MVA) (3,4) and is an independent risk factor associated with poor prognosis (5–7). Traditional Coronary Artery Disease (CAD)risk factors have also been associated with MVA (8–10), however, there is reduced data in latin populations with high prevalence of comorbidities. The aim of this study was to identify the comorbidities that alter MFR with 13N-ammonia Positron Emission Tomography/Cardiac Tomography (PET/CT) and Cardiac Computed Tomography Angiography (CCTA) in a cardiovascular imaging referral center.
Methods
Retrospective cross-sectional study of patients with suspected CAD in which both PET/CT and CCTA were performed. Inclusion:CCTA with obstruction <50%. Exclusion: incomplete study, previous infarction or intervention. Clinical data was assessed. Mean (±DE) or median (interquartile range) to present continuous variables according to their distribution; T student or U Man Whitney to compare them. For each variable two groups were conformed depending on its presence or absence in order to compare MFR between them. Statistical analysis was performed with Statistical Package for Social Science (SPSs Inc, Chicago, IL; version 23.0) and GraphPad Prism version 9.0. p<0.05 was considered as significant.
Results
335 patients included. MFR difference for each variable: female sex, hypertension (HT), Type 2 diabetes (T2D) and smoking – Appendix 1. Significant MFR difference for HT (p=0.024) and T2D (p=0.046). Severe ischemia had significant MFR reduction (p=0.006); patients with both HT and mild ischemia (p=0.018) – Appendix 2.
Discussion
Individuals with HT and T2D had a significantly lower MFR, consistent with previous studies (8,9). Absence of correlation with other risk factors, such as smoking (10) and female sex (11); latter may be caused by a significant lower number of women (108 vs 227). Further analysis in this subgroup ought to be done. When comparing MFR between level-of-ischemia groups, microvascular function was not reduced until severe ischemia. Remarkably, if we analyze the coexistence of HT with ischemia, MFR is reduced even in patients with mild ischemia. This finding highlights the importance of HT which alters function in early stages even in the absence of significant obstruction. This is one of the first studies correlating MFR with comorbidities in our population. Limitations the retrospective nature of the study.
Conclusions
MFR non-invasive assessment by PET/CT allows identifying very early stages of MVD, even in asymptomatic patients and when there's no evidence of ischemia or CAD. Therefore, timely recognition of this problem is mandatory to implement action strategies to stop the triggered events' cascade.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Gurrola-Luna
- National Autonomous University of Mexico, Mexico City, Mexico
| | | | | | - I Carvajal-Juarez
- Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, Mexico
| | | | - B Rivera-Bravo
- National Autonomous University of Mexico, PET/CT Unit, Faculty of Medicine., Mexico City, Mexico
| | - M E Soto-Lopez
- Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, Mexico
| | | | | | | | - L Zavala-Romero
- National Autonomous University of Mexico, Mexico City, Mexico
| | | | - M Gomez-Salgado
- National Autonomous University of Mexico, Mexico City, Mexico
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Avendaño-Estrada A, Velasco F, Velasco AL, Cuellar-Herrera M, Saucedo-Alvarado PE, Marquez-Franco R, Rivera-Bravo B, Ávila-Rodríguez MA. Quantitative Analysis of [18F]FFMZ and [18F]FDG PET Studies in the Localization of Seizure Onset Zone in Drug-Resistant Temporal Lobe Epilepsy. Stereotact Funct Neurosurg 2019; 97:232-240. [PMID: 31722358 DOI: 10.1159/000503692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 09/25/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Positron emission tomography (PET) imaging in epilepsy is an in vivo technique that allows the localization of a possible seizure onset zone (SOZ) during the interictal period. Stereo-electro-encephalography (SEEG) is the gold standard to define the SOZ. The objective of this research was to evaluate the accuracy of PET imaging in localizing the site of SOZ compared with SEEG. METHODS Seven patients with refractory temporal lobe epilepsy (Ep) and 2 healthy controls (HC) underwent 2 PET scans, one with 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) and another with 2'-[18F]fluoroflumazenil (FFMZ), acquired 1 day apart. FDG was acquired for 10 min (static scan) 1 h after administration. An FFMZ scan was acquired for 60 min from radiopharmaceutical administration in a dynamic mode. Each brain PET image was segmented using a standard template implemented in PMOD 3.8. The pons was used as the reference region for modeling of the nondisplaceable binding potential (BPND)for FFMZ, and to obtain uptake ratios for FDG. SEEG studies of patients were performed as a part of their surgical evaluation to define the SOZ. RESULTS Well-defined differences between HC and Ep were found with both radiopharmaceuticals, showing the utility to identify abnormal brain regions using quantitative PET imaging. Lateralization of the SOZ findings by PET (lower uptake/binding in a specific brain hemisphere) matched in 86% for FFMZ and 71% for FDG with SEEG data. CONCLUSION Quantitative PET imaging is an excellent complementary tool that matches reasonably well with SEEG to define SOZ in presurgical evaluation.
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Affiliation(s)
- Arturo Avendaño-Estrada
- Unidad Radiofarmacia-Ciclotrón, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Francisco Velasco
- Unit for Stereotactic and Functional Neurosurgery, Hospital General de México, Mexico City, Mexico
| | - Ana Luisa Velasco
- Unit for Stereotactic and Functional Neurosurgery, Hospital General de México, Mexico City, Mexico
| | - Manola Cuellar-Herrera
- Unit for Stereotactic and Functional Neurosurgery, Hospital General de México, Mexico City, Mexico
| | - Pablo E Saucedo-Alvarado
- Unit for Stereotactic and Functional Neurosurgery, Hospital General de México, Mexico City, Mexico
| | - Rene Marquez-Franco
- Unit for Stereotactic and Functional Neurosurgery, Hospital General de México, Mexico City, Mexico
| | - Belen Rivera-Bravo
- Unidad PET/CT, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Miguel A Ávila-Rodríguez
- Unidad Radiofarmacia-Ciclotrón, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico,
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Gayosso-Gómez LV, Zárraga-Granados G, Paredes-Garcia P, Falfán-Valencia R, Vazquez-Manríquez ME, Martinez-Barrera LM, Castillo-Gonzalez P, Rumbo-Nava U, Guevara-Gutierrez R, Rivera-Bravo B, Ramirez-Venegas A, Sansores R, Negrete-Garcia MC, Ortiz-Quintero B. Identification of circulating miRNAs profiles that distinguish malignant pleural mesothelioma from lung adenocarcinoma. EXCLI J 2014; 13:740-50. [PMID: 26417297 PMCID: PMC4464514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 05/27/2014] [Indexed: 11/30/2022]
Abstract
Accurate diagnosis of malignant pleura mesothelioma (MPM) is challenging. Differential diagnosis of MPM versus lung adenocarcinoma (AD) is particularly difficult, yet clinically important since the two neoplasias call for different treatment approaches. Circulating miRNA-profiling to identify miRNAs that can be used to distinguish MPM from AD has not been reported. We conducted a wide screening study of miRNA profiles in serum pools of MPM patients (N = 11), AD patients (N = 36), and healthy subjects (N = 45) to identify non-invasive biomarkers for differential diagnosis of MPM and AD, using deep sequencing. Sequencing detected up to 300 known miRNAs and up to 25 novel miRNAs species in the serum samples. Among known miRNAs, 7 were upregulated in MPM and 12 were upregulated in AD compared to healthy controls. Of these, eight were distinctive for AD and three were unique for MPM. Direct comparison of the miRNA profiles for MPM and AD revealed differences in miRNA levels that could be useful for differential diagnosis. No differentially expressed novel miRNAs were found. Further bioinformatics analysis indicated that three upregulated miRNAs in MPM are associated with the p38 pathway. There are unique alterations in serum miRNAs in MPM and AD compared to healthy controls, as well as differences between MPM and AD profiles. Differing miRNA levels between MPM and AD may be useful for differential diagnosis. A potential association to p38 pathway of three upregulated miRNAs in MPM was revealed.
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Affiliation(s)
- LV Gayosso-Gómez
- Research Unit, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - G Zárraga-Granados
- Research Unit, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - P Paredes-Garcia
- Research Unit, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - R Falfán-Valencia
- Department of HLA, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - ME Vazquez-Manríquez
- Department of Pathology, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - LM Martinez-Barrera
- Pneumology-Oncology Service, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - P Castillo-Gonzalez
- Pneumology-Oncology Service, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - U Rumbo-Nava
- Pneumology-Oncology Service, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - R Guevara-Gutierrez
- Department of Clinical Analysis, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - B Rivera-Bravo
- Department of Nuclear Medicine, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - A Ramirez-Venegas
- COPD and Smoking Cessation Clinics, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - R Sansores
- COPD and Smoking Cessation Clinics, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - MC Negrete-Garcia
- Research Unit, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Blanca Ortiz-Quintero
- Research Unit, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico,*To whom correspondence should be addressed: Blanca Ortiz-Quintero, Unidad de Investigación, Departamento de Bioquímica. Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas". Calzada de Tlalpan 4502, Colonia Sección XVI, 14080. México city, México. Fax (52)(55) 56654623, Tel (52)(55) 54871705, E-mail:
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