Browsing by Author "Mota, A"
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- Comparação de dois tipos de colóides tecneciados na detecção de gânglio sentinelaPublication . Dias, L; Geão, A; Mota, A; Santos, A; Quaresma, P; Colarinha, PIntrodução: O gânglio sentinela define-se como o primeiro gânglio detectado numa via de drenagem linfática do tumor primário. O marcador ideal para pesquisa de gânglio sentinela deve apresentar: retenção persistente neste gânglio, reduzida acumulação de radiofármaco nos gânglios satélites e depuração rápida do local de injecção. Há dois tipos de colóides tecneciados que são frequentemente utilizados em linfocintigrafia – colóides de albumina humana e colóides de sulfureto de rénio. Objectivo: Comparar os dois radiofármacos tecneciados - colóides de albumina humana e colóides de sulfureto de rénio – quanto a: 1) tempo de migração e visualização do gânglio sentinela e 2) incidência de gânglios satélites, quando utilizados em linfocintigrafias para pesquisa de gânglio sentinela em doentes com carcinoma da mama. Material e Métodos: Analisaram-se os estudos de pesquisa de gânglio sentinela de 138 pacientes com carcinoma da mama. Em 63 doentes a linfocintigrafia foi realizada com colóides de albumina humana (Nanocoll®) e em 75 doentes o radiofármaco utilizado foi colóides de sulfureto de rénio (Nanocis®). Procedeu-se à aquisição de imagens iniciais após administração do radiofármaco e foram sendo adquiridas imagens seriadas aos 60min, 90min, 120min, 180min, 240min, 300min e 360min até aparecer o gânglio sentinela. Considerou-se como término do estudo o momento de visualização do gânglio sentinela. Em 5 pacientes não se visualizou gânglio sentinela; 3 correspondiam a colóides de albumina humana e 2 correspondiam a colóides de sulfureto de rénio. Estes 5 casos foram excluídos deste estudo. Resultados: Verificou-se que no grupo de doentes a quem foi administrado colóides de albumina humana, o intervalo de tempo para visualização do gânglio sentinela foi de; 130’ (média), 120’(mediana), com um tempo mínimo de 10’ e máximo de 330’. Neste grupo não foram visualizados gânglios satélites. No grupo de doentes a quem foi administrado colóides de sulfureto de rénio o intervalo de tempo para visualização do gânglio sentinela foi de; 145’(média) 150’(mediana), com 10’ de mínimo e 360’ de tempo máximo. Neste grupo de doentes foram observados gânglios satélites em 2 casos. Conclusão: Nesta amostra não foi observada diferença significativa entre os dois radiofármacos utilizados quanto a: taxa de detecção e tempo para visualização do gânglio sentinela, assim como quanto à incidência de visualização de gânglios satélite.
- Comparing two pharmacological stress tests: adenosine vs ATP infusion – patient’s tolerance and image qualityPublication . Santos, A; Geão, A; Mota, A; Pereira, E; Dias, L; Delgado, P; Figueiredo, S; Jerónimo, VAim: Adenosine and Adenosine Triphosphate (ATP) are vasodilator agents that are used for pharmacologic stress testing in Myocardial Perfusion Imaging (MPI). Both pharmaceuticals may cause side-effects that are similarly described in the literature. Although, the half-life of these molecules are slightly different and patient’s tolerance might be different. These molecules have also been associated to an increase in the sub diaphragmatic tracer uptake that may reduce image quality, interfering with image interpretation. The aim of this study was to compare pharmacologic stress tests induced by adenosine infusion and by ATP infusion in terms of side-effects referred by patients and the corresponding image quality. Materials & Methods: Two hundred and forty eight (248) patients that underwent MPI were divided in two groups: Group 1 – Adenosine infusion (n=157); Group 3 – ATP infusion (n=91). Each group was further divided according to the presence or absence of side effects, their number and the need to administer pharmacological therapy to control symptoms: A- No side-effects; B - One side-effect; C – Two side-effects; D – Three or more side-effects and/or pharmacologic therapy needed. Image quality was evaluated according to the requirement of a new stress acquisition due to extra-cardiac activity that interfered with image quality and interpretation. Microsoft ExcelTM and SPSSTM were used in this analysis. We also correlated the two populations (Adenosine and ATP) according to the risk factors for cardiac events and the MPI result (normal or pathologic), in order to ensure that uniformity between both groups. Results: The most common effects were facial flushing, abdominal/throat pressure and discomfort in the arms. (See Table 1). Conclusions: The group with the highest percentage of no side-effects and the smaller percentage of three or more side-effects was group 2. However, in spite of the higher percentage of one side effect for group 2 (group 2=38% vs group 1=34%), the difference between them is not statistically significant (p=0,065), so we can assume that both groups had the same percentage of only one side-effect. Additionally, this group had less acquisition repetition, if compared to group 1 (acquisitions repeated: group 1=19,9%, group 2= 9,9%, p= 0,001). So, the group that had better results in terms of patient’s tolerance and image quality was group 2 – ATP infusion.
- Evaluating Residual Activity in 18F-FDG administrationPublication . Santos, A; Geão, A; Dias, L; Mota, A; Fernandes, MThe Positron Emission Tomography (PET) is an imaging technique, based on functional, biochemical and molecular information. It is also a useful tool in oncological examination. 18F-FluoroDeoxyGlucose (FDG) is a radiopharmaceutical widely used in nuclear medicine departments with PET facilities. FDG’s corrects administration is very important in order to achieve good images and correct Standard Uptake Values (SUV). The aim of this study was to evaluate the residual activity, according to the method used in our department. Materials & Methods: Residual activities of the syringes used to administer FDG to 125 patients were measured and recorded, during one month. The intravenous administration was always performed by the same four nuclear medicine technologists. These technologists are trained in this procedure, according with the developed technique, based on the procedure guidelines for PET imaging. This technique consists in administering FDG in a catheter with a triple channel system (standard system with three-way tap to enable saline flush); the syringe is always filled to its maximum capacity (5cc) and rinsed once, including needle rinsing. Registered time in every procedure was calibrated, in order not to include bias. Results: according to the analysis of the registered data, less than 1% of the activity calculated and measured for each patient remained on the syringe. Conclusions: regarding the search for the best administration procedure, we conclude that the technique used in our department results in a very low residual activity, meaning that it is an accurate technique that leads to reliable SUV values.