Parkinsonian syndromes are considered clinicopathological conditions that are challenging to diagnose. Molecular imaging with [18F]-FDOPA and [18F]-FDG contributes to a more accurate clinical diagnosis by evaluating presynaptic dopaminergic pathways and glucose metabolism, respectively. The aim of this study was to correlate diagnoses made from dual PET/CT with the initial clinical diagnoses, as well as during follow-ups in patients with Parkinsonian syndromes. A secondary objective was to describe the imaging findings. Methods: A total of 150 patients with a clinical diagnosis of neurodegenerative Parkinsonism were evaluated using dual PET/CT. Clinically, 82% were diagnosed with PD, while the remaining 18% had an atypical Parkinsonism. Results: Using dual PET/CT, the most frequent diagnosis was PD in 67% of the patients, with the rest being diagnosed with an atypical Parkinsonism. In an agreement analysis between the initial clinical diagnosis and the imaging diagnosis by dual PET/CT, a concordance of 94.1% (n = 95) was observed for PD. In the remaining patients, the clinical diagnosis differed from that suggested by dual PET/CT, with atypical Parkinsonian syndromes being diagnosed as DLB in 40% (n = 4), PSP in 46.7% (n = 7), MSA-C in 75% (n = 6), MSA-P in 70% (n = 7), and CBD in 66.7% (n = 4). A total of 38.66% (n = 58) of patients were followed up (median follow-up of 27 months), with a Kappa coefficient of 0.591 (p < 0.001), suggesting substantial agreement. Conclusions: Dual FDOPA–FDG PET/CT demonstrated moderate agreement with the initial clinical diagnosis of Parkinsonism and moderate to substantial agreement during follow-up. This dual technique, therefore, stands out in differentiating between types of Parkinsonisms.

Gliomas, including glioblastomas (GB) and high-grade astrocytomas (HGA), are the most common brain tumors in adults, with poor survival rates around 15 months. Hormonal factors, particularly progesterone receptor (PR) activation, promote tumor growth. Current treatment involves surgery, radiotherapy and chemotherapy (temozolomide), but survival rates remain low. Repurposing mifepristone (MF), a contraceptive drug, shows promise for GB treatment, warranting further study. PR expression in U87, U251 and C6 cell lines were assessed using immunofluorescence and Western Blot. PR isoforms were quantified by densitometry. Progesterone (P4) and 5α-dihydroprogesterone (5α-DHP) synthesis were evaluated using LC/MS. MF's effect on cell viability was determined by IC₅₀ and IC₂₀ values. Its impact on non-tumoral cells and 3D glioma sphere formation was also analyzed. The effects of in situ administration of MF were assessed in vivo using a rat model with C6 glioma implants. Clinical outcomes were evaluated in GB patients receiving MF alongside standard treatment. PR was predominantly nuclear in all cell lines, with U87 showing the highest PR-B isoform levels. Only U251 synthesized 5α-DHP significantly. MF reduced viability in U251, U87 and C6 cells without affecting non-tumoral cells. Sphere formation efficiency decreased with MF treatment. In rats, MF reduced tumor volume dose-dependently. Clinically, MF improved patient survival from 165 to 588days and enhanced quality of life without severe adverse effects. MF effectively reduces GB cell viability, sphere formation efficacy and tumor volume. These findings support further investigation of MF as a therapeutic strategy in GB treatment. Our research highlights the critical role PR in GB progression using in vitro and in vivo models. MF, a PR modulator, effectively reduced cell viability and sphere formation in cellular assays and significantly decreased tumor volume in an in vivo study. The pilot trial demonstrated the pharmacological safety of using MF as an adjuvant in GB treatment. Patients treated with MF showed a significant increase in survival, with an 80% survival rate at 1 year compared to 0% in those who were treated with the standard treatment.

Introducción: Los gliomas de bajo grado (GBG) son tumores poco frecuentes del sistema nervioso central cuya carga trasciende los desenlaces oncológicos tradicionales y afecta la cognición, la salud mental, la autonomía, la funcionalidad y la participación social. En Colombia, la limitada información específica y las posibles brechas asistenciales evidencian la necesidad de evaluar integralmente su impacto. Métodos: Entre mayo y julio de 2026 se realizaron cuatro mesas técnicas multidisciplinarias en Colombia con expertos en neurología, neurooncología, neurocirugía, pediatría, medicina interna, psiquiatría, epidemiología y gestión del riesgo. Las presentaciones y discusiones fueron documentadas y analizadas mediante una síntesis temática descriptiva para identificar desafíos recurrentes y oportunidades de mejora. Resultados: Se identificaron cuatro dominios principales: oportunidad diagnóstica y rutas de atención; equidad en el acceso al diagnóstico molecular y la innovación terapéutica; atención centrada en la persona, incluyendo salud mental, funcionalidad y rehabilitación; y fortalecimiento de los sistemas de información. Se destacaron la fragmentación asistencial, el acceso limitado a la caracterización molecular y a alternativas terapéuticas, y la insuficiente evaluación de desenlaces cognitivos, emocionales, funcionales y sociales. Se identificó como prioritario el desarrollo de rutas multidisciplinarias integradas y de un registro nacional de tumores del SNC que incorpore desenlaces clínicos, quirúrgicos, radiológicos, moleculares y reportados por los pacientes. Conclusiones: Mejorar la atención de los GBG en Colombia requiere rutas multidisciplinarias coordinadas, mayor acceso al diagnóstico molecular y terapéutico, sistemas de información robustos y la incorporación sistemática de desenlaces centrados en el paciente. El éxito terapéutico debe considerar tanto la supervivencia como la preservación de la cognición, autonomía, salud mental, funcionalidad y participación social.