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https://hdl.handle.net/20.500.12395/41329

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Does Treatment with Somatostatin Analogs Affect the Radioactivite Uptake of Normal Target Organs and Malignant Lesions on 68GaDOTATATE PET/CT imaging?
(Selçuk Üniversitesi, 2022) Şahin, Özlem; Erol, Çağlagül; Yılmaz, Farise; Önner, Hasan; Gedik, Gonca Kara; Çelik, Ahmet Volkan
Objective: Somatostatin analogs (SSA) are used in treating low-grade neuroendocrine tumors (NET), mainly because of their antiproliferative effect. 68Ga tetraazacyclododecantetraacetic acid-DPhe1-Tyr3-octreotate (DOTATATE) PET/CT as somatostatin receptor imaging has been widely used in recent years. However, there are conflicting publications in the literature, although there are guidelines for discontinuing the use of SSA before imaging. This study aims to investigate the effect of SSAs on Somatostatin receptor imaging. Material and Method: We retrospectively analyzed 253 patients who underwent 68Ga-DOTATATE PET/CT imaging between 2018 and 2022. Among these patients, those with low grades (grade 1 and grade 2) using SSA were included in the study. SUVmax (maximum standard uptake volume) of normal target organs, primary tumors, and metastases with the highest SUVmax in each organ were compared before and after SSA treatment. Results: 28 patients (16 females; 12 males, age [mean±SD], 54.82±14.27, range 18-78) with low-grade NET and 68Ga-DOTATATE PET/CT imaging with SSA therapy were included in the study. Although SUVmax was decreased in the values measured after SSA application in the liver and spleen, it was not statistically significant (p>0.05). There was no significant difference between SUVmax values in primary tumors and metastatic lesions in the liver, bone, lung, or lymph nodes before and after SSA application (P> 0.05). Conclusion: In conclusion, these drugs do not need to be discontinued before 68Ga-DOTATATE PET/CT imaging for treatment follow-up in neuroendocrine tumor patients using SSAs. In addition, these drugs may help report interpretation by increasing the intensity of metastatic lesions in the liver and spleen.
Contribution of SPECT-CT to Planar Imaging in Post-Ablation Imaging in Different Thyroid Cancers, the Clinical Significance of the Differential Diagnosis of Neck and Thorax Uptakes
(Selçuk Üniversitesi, 2022) Yılmaz, Farise; Önner, Hasan; Gedik, Gonca Kara
Background: This study aims to demonstrate the superiority of Single Photon Emission Computed Tomography-Computed Tomography (SPECT-CT) over planar imaging in distinguishing benign from malignant foci and patient management after 131I ablation therapy in patients with differentiated thyroid cancer (DTC). Material and Methods: Planar and SPECT-CT imaging findings were retrospectively analyzed in Eighty patients who received I-131 therapy for thyroid cancer. Possible foci in whole body scanning (WBS), neck, and thorax were compared with SPECT-CT. Anatomical localization of the foci and differential diagnosis of the benign and malignant lesion was made with SPECT-CT. Those without anatomical counterparts were recorded as equivocal foci. According to the 2015 American Thyroid Association (ATA) guidelines, patients were divided into three groups: High, intermediate, and low-risk groups. Interpretation changes between both scannings were recorded as downstage and upstage. Results: A total of 80 patients, 53 female, and 27 male, were included in the study. The patients’ age ranged from 21 to 88 years with a mean age of 47 ±14.2. In 80 patients, 139 foci were detected in planar images and SPECT-CT images (neck: 118, thorax: 21). SPECT-CT revealed that 50% of the lateral neck foci were compatible with pathologies of malignant nature and 50% with pathologies of benign nature. Foci in the middle part of the neck were not only thyroid remnant (56%) but also thyroglossal duct remnant (40%) foci at a significant rate. It was determined that 66% of the foci in the thorax region were lung metastases ,and 34% were bone metastases. It was proved that 33% of the foci in the mediastinal area were lymph nodes. Although only one of the remaining patients had a pathological diagnosis, it was thought that all of them might have thymus pathologies. SPECT-CT images changed the interpretation of 18 patients (22.5%), 5 of whom (6.25%) were upstage and 13 (16.25%) were downstage. Conclusions: SPECT-CT will be very effective in, facilitating patient management and avoiding unnecessary procedures, especially in moderate/high-risk patients with suspicious focal lesions. Knowing the benign iodine uptake foci (thyroglossal duct remnant, etc.) that show iodine uptake other than the thyroid residue in the neck may be influential in deciding whether to ablate in low-risk patients.
The Appearances of Brain Metastases of Small Cell Lung Cancer on 18F-FDG PET/CT
(Selçuk Üniversitesi, 2022) Önner, Hasan; Yilmaz, Farise; Özer, Halil; Batur, Abdüssamet; Gedik, Gonca Kara
Purpose: We evaluate the appearances of the brain metastases (BMs) detected by brain magnetic resonance imaging (MRI) of small cell lung cancer (SCLC) on 18Fluor-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). Patients and methods: SCLC patients who had an 18F-FDG PET/CT scan and a brain MRI within 30 days for initial staging were included. MRI was used to detect BMs. The imaging results of BMs on 18F-FDG PET/CT were assessed. On the 18F-FDG PET/CT study, the BMs were classified as undetectable, hypometabolic, hypermetabolic, or mixed patterns (lesions with both hypermetabolic and hypometabolic parts). Results: A total of 51 patients [48 (94.1%) of whom were male and 3 (5.9%) female, with an average age of 62.57 ± 9.64] were included in this study. Fifteen patients (29.4%) were in the limited stage, whereas 36 patients (69.6%) were in the extensive stage. In 11 individuals, MRI indicated 28 BMs. On 18F-FDG PET/CT, 13 of the 28 metastases were visible. The following were the BMs appearances on 18F-FDG PET/CT: hypometabolic (n: 4), hypermetabolic (n: 6), and mixed (n: 3). While the mean diameter of BMs detected in 18F-FDG PET/CT was 16mm; the mean diameter of undetected ones was 4.3 mm. Conclusion: On 18F-FDG PET/CT, BMs can have a variety of appearances, including hypometabolic, hypermetabolic, and mixed patterns. On the other hand, failure to detect millimetric size BMs in 18F-FDG PET/CT prevents proper staging.
Bone mineral density in emphysema and chronic bronchitis phenotypes in hospitalized male chronic obstructive pulmonary disease patients
(WILEY, 2020) Yormaz, Burcu; Cebeci, Hakan; Yılmaz, Farise; Süerdem, Mecit
Introduction Risk of osteoporosis known to increase in chronic obstructive pulmonary disease (COPD), but is usually overlooked, especially in male patients. Objectives The present study compares the bone mineral density (BMD) measurements of male COPD patients with emphysema and the chronic bronchitis phenotype, and evaluates the association between density of emphysema and osteoporosis. Methods Ninety-four patients with COPD, and with emphysema and the chronic bronchitis phenotype, were included in the prospective study. A high-resolution computed tomography (HRCT) was used for the diagnosis of emphysema, and a dual X-ray absorptiometry was used to measure the BMD of the lumbar vertebrae and neck of the femur. Results Emphysema phenotype 45.75% and chronic bronchitis phenotype 54.25%, based on their clinical findings and a quantitative volumetric analysis by HRCT. Osteoporosis was found 60.47% and 17.65% of patients with emphysema and bronchitis, while osteopenia was detected 27.91% and 41.18% of patients with emphysema and bronchitis, respectively. A negative correlation was found between HRCT emphysema density and the bone densitometer t-score in patients with osteoporosis. Among the patients with osteoporosis, a positive correlation was found between Body Mass Index (BMI) and the bone densitometer t-score. Only BMI and emphysema score were found to be independent risk factors for a low BMD. One unit drop in BMI increased the risk of osteoporosis by 28% (OR = 1.28, 95% CI 1.14-1.45) (P < 0.001). One unit increase in emphysema score increased the risk of osteoporosis by 6% (OR = 1.06, 95% CI 1.03-1.09) (P < 0.001). Conclusion Especially male patients with emphysema, high dyspnea score, low BMI and frequent exacerbations should be evaluated for osteoporosis.
Is there any improvement in clinical staging with 18F-FDG PET/CT compared to surgical staging in cases of lung cancer
(ELSEVIER ESPANA SLU, 2019) Kara Gedik, Gonca.; Yilmaz, Farise.
Objective: F-18-Fluorine fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FOG PET/CT) imaging is considered the standard imaging modality for patients with non-small cell lung carcinoma. The aim of this study was to compare clinical staging (cTNM) performed with F-18-FDG PET/CT and surgical staging (sTNM) in patients with non-small cell carcinoma treated with surgery. Material and methods: We performed a retrospective analysis of 99 surgical patients with non-small cell carcinoma who underwent F-18-FDG PET/CT examination. Semiquantitative measures were calculated from the primary lesions and mediastinal lymph nodes. Findings of cTNM were compared with final surgical-pathological evaluation. Subjects were divided into two groups as postsurgical cTNM changed and cTNM unchanged. Patients in the cTNM changed group were further classified as postsurgical upstaged (US) and downstaged (DS). Results of the US patients were compared with the results of the remaining patients consisting of cTNM unchanged and DS to evaluate the predictable roles of semiquantitative parameters for postsurgical upstaging. To determine mediastinal tumoral involvement, cut-off values were obtained from calculated semiquantitative results of FDG uptakes in lymph nodes. A p value <0.05 was considered statistically significant. Results: Subjects were aged 40-82 years with a mean age of 64.78 +/- 8.70 years. Classification agreement was observed in 43 patients (43%) and in 57%, postsurgical stage migration was seen. Concurrence of cTNM and sTNM was more pronounced in the T1 and N0 subsets which were 84% and 74%, respectively. The lowest concurrence was observed in N1 classification followed by T4 and N2 (1%, 50% and 58%, respectively). Change in T staging occurred in 20 of 56 (36%), in N staging 22 of 56 (39%) and change in T and N in 14 patients (25%). Distribution of US and DS patients in the cTNM changed group was 43% (24 of 56) and 57% (32 of 56), respectively. Results of semiquantitative measures were significantly higher in US patients than the results of the group consisting of DS patients and cTNM unchanged patients, for all parameters. Cut-off value calculated from mediastinal uptakes was most specific for metastases in MTV (metabolic tumor volume) with an acceptable sensitivity (90% and 67%, respectively). Conclusions: The concordance between cTNM and sTNM was better in staging T category compared to N stations. Semiquantitative measures of primary tumor may play a role in predicting postsurgical upstaging. Taking MTV into consideration in the mediastinal region may be more valuable than other parameters in the assessment of nodal involvement. (C) 2019 Published by Elsevier Espalia, S.L.U. on behalf of Sociedad Espanola de Medicina Nuclear e Imagen Molecular.
Evaluation of bone mineral density (BMD) and indicators of bone turnover in patients with hemophilia
(ASSOC BASIC MEDICAL SCI FEDERATION BOSNIA & HERZEGOVINA SARAJEVO, 2018) Dağlı, Mehmet; Kutlucan, Ali; Abuşoğlu, Sedat; Baştürk, Abdulkadir; Sözen, Mehmet; Kutlucan, Leyla; Ünlü, Ali; Yılmaz, Farise
A decrease in bone mass is observed in hemophilic patients. The aim of this study was to evaluate bone mineral density (BMD), parathyroid hormone (PTH), 25-hydroxy vitamin D (vitamin D), and a bone formation and resorption marker, procollagen type I N-terminal propeptide (PINP) and urinary N-terminal telopeptide (uNTX) respectively, in hemophilic patients and healthy controls. Laboratory parameters related to the pathogenesis of bone loss such as neutrophil- lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were also evaluated. Thirty-five men over 18 years of age, with severe hemophilia (A and B) and receiving secondary prophylaxis, were included in the study. The same number of age-, sex-, and ethnicity-matched healthy controls were evaluated. Anthropometric, biochemical, and hormonal parameters were determined in both groups. No significant difference in anthropometric parameters was found between the two groups. The BMD was low in 34% of hemophilic patients. Vitamin D, calcium, and free testosterone levels were significantly lower (p < 0.001, p = 0.011, p < 0.001, respectively), while PTH, PINP, and activated partial thromboplastin time (aPTT) levels were significantly higher (p < 0.014, p = 0.043, p < 0.001, respectively), in hemophilic patients compared to controls. There was no significant difference between the two groups in NLR, PLR, phosphorus, thyroid-stimulating hormone, and uNTX level. The reduction of bone mass in hemophilic patients may be evaluated using the markers of bone formation and resorption, enabling early detection and timely treatment.
Undescended Testis in Inguinal Canal Detected Incidentally on Fluorodeoxyglucose PET/CT Imaging
(ELSEVIER SCIENCE INC, 2012) Özcan Kara, Pelin; Kaya, Buğra; Kara Gedik, Gonca; Sarı, Oktay; Varoğlu, Erhan
The differential diagnosis at the inguinal region is very important for hypermetabolic foci because of the possibility of metastasis at this level in cancer patients ongoing PET imaging for detection of metastases. It is important to distinguish this activity from other possible malignant and benign conditions such as lymph node activity, testicular cancer, metastatic disease activity, inflammation and urine skin contamination artefact (1). A 66-year-old male patient with operated colon cancer and liver metastasis was referred for PET/CT examination for re-staging because of suspicious metastases. Findings of PET/CT imaging with undescended testis detected incidentally was presented.
The Value of FDG-PET/CT in the Post-Treatment Evaluation of Endometrial Carcinoma: A Comparison of PET/CT Findings with Conventional Imaging and CA 125 as a Tumour Marker
(ELSEVIER DOYMA SL, 2012) Özcan Kara, P.; Kara, T.; Kaya, B.; Kara Gedik, G.; Sarı, O.
Objectives: This retrospective study was designed to assess the value of positron emission tomography/computed tomography imaging (PET/CT) in the post-treatment evaluation of the patients with endometrial carcinoma and to compare PET/CT scan with conventional imaging (Cl) including computed tomography (CT), ultrasonography (US) and magnetic resonance imaging (MRI) and CA 125 with both 20 U/ml and 35 U/ml cut-off values. Materials and methods: A total of 31 patients who were treated for histopathologically proven endometrial adenocarcinoma, underwent PET/CT examination for restaging and suspected recurrence. Thirty five PET/CT studies were performed in 31 patients. Lesion status was determined on the basis of clinical follow-up including radiological imaging (follow-up CT scan) at least 6 months and response to therapy. Results: Of the 35 PET/CT studies, 13 (37%) studies were positive, whereas 22 (63%) of them were negative. On study-based analysis the overall sensitivity, specificity, accuracy for PET/CT imaging were 100%, 96% and 97%, respectively. The corresponding information for Cl were 46%, 87% and 74%, for CA 125 (cut off= 20 U/ml) measurement were 45%, 88% and 74%, and for CA 125 (cut off = 35 U/ml) measurement were 27%, 100% and 78%, respectively. On lesion-based analysis, PET/CT revealed only one false positive case. In none of 21 patients with negative 22 PET/CT studies, no subsequent clinical or radiological recurrences were observed with a follow-up of at least 6 months. Conclusion: FDG-PET/CT is found more useful modality than CI and CA 125 in the evaluation of post-treatment endometrial carcinoma patients, for suspected recurrence.
The Role of FDG-PET/CT in Ovarian Cancer Patients with High Tumor Markers or Suspicious Lesion on Contrast-Enhanced Ct in Evaluation of Recurrence and/or in Determination of Intraabdominal Metastases
(ELSEVIER SCIENCE INC, 2012) Sarı, O.; Kaya, B.; Özcan Kara, P.; Kara Gedik, G.; Çelik, C.; Özbek, O.; Serdengeçti, M.
Objectives: This retrospective study was designed to investigate the role of fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in determination of recurrence and/or intraabdominal metastasis in patients with ovarian cancer having increased tumor markers or suspicious lesion detected by a contrast-enhanced abdominal CT (ceCT). Materials and methods: A total of 34 female patients who were treated for histopathologically proven ovarian cancer, underwent PET/CT examination for restaging and suspected recurrence. Patients with pathology report, tumor marker levels, ceCT and PET/CT performed within one month were included in the study. Results: A total of 34 patients were included in the study. 25 of 34 patients had high tumor marker (CA 125) level. The remaining 9 patients had suspected recurrence on ceCT imaging with normal tumor marker levels. Recurrence was confirmed by re-operation and biopsy (n = 4), clinical and imaging follow-up (n = 21) in 25 patients with elevated tumor markers. Recurrent disease was not shown in 5 of 25 patients on ceCT imaging and 1 of 25 patients on PET/CT imaging with high CA125 values. Both ceCT and PET/CT revealed recurrent disease in 19 of 25 patients. PET/CT showed more lesions in 11 of 19 patients. Sensitivity, specificity and accuracy of the PET/CT were 96.1%, 100% and 97%, respectively. Conclusion: PET/CT is found as a beneficial method for detection of the recurrence, in patients with increased serum CA 125 level and negative CT findings or with normal CA 125 level and recurrence detected by CT which was performed due to clinical symptoms.
Splenic and Multiple Abdominal Metastases of Endometrial Carcinoma Detected with FDG-PET/CT
(ELSEVIER SCIENCE INC, 2012) Kara, T.; Kara, P. O.; Gedik, G. K.; Sarı, O.
A 58 year old female was referred for FDG-PET/CT for restaging of endometrial adenocarcinoma. For evaluation of treatment, no metastases were detected on FDG-PET/CT which was performed 18 months later after the surgery. During follow-up, FDG-PET/CT was performed 6 months later than the previous FDG-PET/CT for restaging. A lesion with increased metabolic activity (SUV max: 10.21) was detected at spleen which was not seen on previous FDG-PET/CT scan. The lesion was consistent with metastasis of endometrial carcinoma. Splenic metastasis of endometrial carcinoma is extremely rare. There are only 13 cases of splenic metastasis from endometrial carcinoma that reported in the literature before. There is only one splenic metastasis of endometrial carcinoma case reported in the literature which is imaged with FDG-PET. To best of our knowledge this is the first report of solitary splenic metastasis of endometrial carcinoma that is imaged with FDG-PET/CT.
Mercaptoacetyltriglycine Renal Scan for the Differential Diagnosis of Acute Tubular Necrosis and İnterstitial Nephritis Associated to Vancomycin
(ELSEVIER DOYMA SL, 2012) Gedik, G. K.; Yılmaz, F.; Kaya, B.; Kara, P. O.; Sarı, O.
The differential diagnosis of vancomycin associated renal toxicity includes acute tubular necrosis and interstitial nephritis. We report a case of vancomycin induced renal toxicity shown by Tc-99m mercaptoacetyltriglycine renal scan. Nephrotoxicity was evolved secondary to vancomycin used for treating a patient with meningitis. Tc-99m mercaptoacetyltriglycine renal scan may play a role in differentiation between acute tubular necrosis and tubulointerstitial nephritis of vancomycin associated renal toxicity and can facilitate the clinical decision making. (C) 2011 Elsevier Espana, S.L. and SEMNIM. All rights reserved.
Intramedullary Metastasis Detected With F-18 FDG-PET/CT
(Elsevıer Doyma Sl, 2012) Sarı, O.; Kaya, B.; Kara Gedik, G.; Özcan Kara, P.; Varoğlu, E.
We report F-18 FDG-PET/CT images of MRI-correlated spine metastasis from non-small cell lung cancer (NSCLC). A 50-yearold woman was admitted to hospital with shortness of breath, chest pain, back pain and hemoptysis. She had a diagnosis of nonsmall cell lung cancer by lung biopsy. F-18 FDG-PET/CT study was carried out for staging. PET/CT imaging showed a gross mass in the upper lobe of the right lung, mediastinal, right cervical and supraclavicular metastatic lymph nodes, liver metastasis and multiple bone and muscle metastasis. Also, there was an increased FDG uptake in the spine in the level of 11th thoracic vertebrae (SUVmax: 6.9). This focal lesion was an intramedullary metastasis. Correlation with MRI showed that intramedullary mass Fig. 1. A 50-year-old woman with a history of shortness of breath, chest pain, back pain and hemoptysis diagnosed as lung cancer. The patient was done PET/CT for initial imaging. PET/CT showed an increased FDG uptake in the spine at the level of 11th thoracic vertebrae (SUVmax: 6.9). This focal lesion was an intramedullary metastasis. ∗ Corresponding author. E-mail address: oktaysari@gmail.com (O. Sari). showed an heterogeneous contrast enhancement. This image was suggestive of malignant lesion (Figs. 1 and 2).
FDG-PET/CT Imaging in a Patient With Lymphangiosarcoma
(Lippincott Williams & Wilkins, 2010) Kara, Pelin Özcan; Kara Gedik, Gonca; Sarı, Oktay; Kara, Taylan; Yılmaz, Farise
Lymphangiosarcoma is a well-recognized complication of chronic lymphedema. We present a rare case of lymphangiosarcoma in a 34-year-old woman who presented with a mass on her left lymphedematous leg. Her leg had become persistently swollen in the weeks during pregnancy and a clinical diagnosis of lymphedema was made, initially. During the third trimester, she developed an ulcerated mass lesion. MRI and FDG-PET/CT scans were performed after delivery. MRI demonstrated a 6 8 9.5 cm mass in the left thigh. Biopsy of the lesion was consistent with lymphangiosarcoma. FDG-PET/CT demonstrated the primary lesion and its distant metastases.
Evaluation of Osteoblastic Activity Around Dental Implants Using Bone Scintigraphy
(Wiley, 2010) Kalaycı, Abdullah; Durmuş, Ercan; Taştekin, Güngör; Işık, Kubilay; İnan, Özgür
Objectives: The aim of this study was to evaluate the osteoblastic activity around delayloaded intraosseous dental implants using nuclear medicine imaging techniques. Material and methods: Seven totally edentulous patients (two females and five males, between 48 and 57 years of age) were included in the study. Two implants were inserted into mandibular canine regions and removable prostheses were produced after 3 months. Whole-body bone scintigraphies with 20 mCi technetium 99m labelled methylene diphosphonate were taken from the patients before implant insertion, 3 months after implant placement just before the prostheses were made and 1 year after implant placement. Standardized count/pixel (SC/P) rates were calculated for each patient. Preimplantation SC/P values were compared with the 3- and 12-month values. Three-month values were compared with the 12-month values as well. Results: SC/P rates in the third month were significantly higher (Po0.05) than preoperative values and the SC/P rates of the 12th month were significantly lower (Po0.05) than 3-month values. The SC/P rates of the 12th month were relatively higher than first scintigraphies but the difference was insignificant (P40.05). Conclusions: Within the limitations of this study, in which delayed loading was applied, we showed that osteoblastic activity persisted more in delay loaded implants than immediate and early loading. After 1 year, there was no cellular activity around two implants and this implied that two implants were sufficient for a total prosthesis.
Evaluation of FDG Uptake in Pulmonary Hila with FDG PET/CT and Contrast-Enhanced CT in Patients with Thoracic and Non-Thoracic Tumors
(Springer, 2010) Kara Gedik, Gonca; Özcan Kara, Pelin; Kara, Taylan; Sarı, Oktay; Kara, Fatih
Objective Fluorine-18 fluorodeoxyglucose (FDG) uptake is frequently observed in lung hilus. This finding causes difficulties during the interpretation. Our objective was to evaluate the features of FDG uptake in lung hilus associated with benign or malignant etiology in patients with thoracic and non-thoracic tumors. Methods We retrospectively evaluated the files of 1172 patients who had undergone FDG positron emission tomography (PET)/computed tomography (CT) examination between January 2008 and June 2009. Forty-eight patients (21 males, 27 females, age range 12-80 years, mean 60.9 +/- 15.82 years) with either unilateral or bilateral hilar FDG uptake and who had thorax contrast-enhanced computed tomography (CECT) performed within 1 month of the FDG PET/CT scan were enrolled in the study. Characteristics of FDG uptake were classified according to the pathology and CECT or PET/CT follow-up over 12 months. Results The characteristics of 71 hilar regions with FDG uptake could be classified. In 30 of 71 (42.3%) hilar regions, FDG uptake was considered to be physiological because no lymph node was observed on CECT. In 19 of 71 (26.8%), FDG uptake was secondary to benign lymph nodes and in 22 (30.9%) to malignant lymph nodes. Significant differences were observed between benign and malignant lymph nodes for SUVhilus and SUVhilus/SUVliver ratio. Using 4.49 as the cut-off value for SUVhilus, a sensitivity of 85.7% and a specificity of 86.4% were achieved (area under curve, AUC: 0.956). For SUVhilus/SUVliver ratio, sensitivity and specificity to detect malignant lymph nodes were 77.6 and 77.3% (AUC: 0.885), respectively, at a cut-off value of 1.75. Conclusion SUVhilus and SUVhilus/SUVliver ratio were found to be significant parameters for determining malignancy in lung hilus. Combined interpretation with CECT is warranted during the evaluation of lung hilus with FDG PET/CT.
Tip 2 Diabetes Mellituslu Hastalarda Tc-99m-Sestamibi ile Perfüzyon Rezervi Hesaplanarak Alt Ekstremitede Vasküler Patolojilerin Araştırılması
(2010) Öztürk, İhsan Sabri; Sarı, Oktay; Yazıcı, Mehmet; Kaya, Buğra; Gönen, Mustafa Sabit
Amaç: Çalışmamızda diyabeti olan ve olmayan hastalarda Tc-99m-sestamibi ile alt ekstremitede perfüzyon rezervi (PR)’ni hesaplayarak, PR’nin diyabetes mellitus (DM) süresi, HbA1c ve bazı kan değerleri ile ilişkisini ve diyabetik olmayan hastaların PR’leri ile karşılaştırarak diyabetik hastalarda periferik vasküler hastalığın varlığını araştırdık. Gereç ve Yöntemler: Çalışmaya, kliniğimize herhangi bir nedenle myokard perfüzyon sintigrafisi istemi ile gelen 32 tip 2 DM’lu hasta, hasta grubunu, yaş ve cinsiyetleri ile uyumlu 28 diyabetik olmayan hasta ise kontrol grubunu oluşturacak şekilde toplam 60 hasta alındı. Tc-99m-sestamibi enjeksiyonundan önce, oturur pozisyonda hastaların sağ ayaklarına dorsal ve plantar fleksiyon yaptırıldı. 300 MBq Tc-99m-sestamibi antekubital venden enjekte edildi. Enjeksiyon sonrası fleksiyona devam edildi ve her iki baldırdan gama kamerada statik görüntü alındı. İlgi alanları çizilerek perfüzyon rezervi hesaplandı. Bulgular: PR, Tip 2 DM grubunda ortalama % 31.411.6, kontrol grubunda % 53.218.35 idi. İki grubun arasında PR ortalamaları karşılaştırıldığında, DM grubunda istatistiksel olarak anlamlı düşüklük vardı. Sonuç: Diyabetik hastalardaki alt ekstremite PR’leri diyabetik olmayan kontrol grubuna göre daha düşüktür. Tc-99m-sestamibi sintigrafisi diyabetik hastalarda mikro ve makroanjiopati patofizyolojisinin araştırılmasında faydalı bir yöntemdir.
Miyokard Perfüzyon Sintigrafsi, Eforlu EKG ve Koroner Anjiograf Sonuçlarının Karşılaştırılması
(2010) Dostbil, Zeki; Çil, Habib; Arıtürk Atılgan, Zuhal; Tekbaş, Ebru; Kaya, Buğra; Kaya, Savaş
Amaç: Koroner arter hastalığı tüm dünyada en sık görülen mortalite ve morbidite sebeplerinden birisidir. Koroner arterlerdeki aterosklerotik darlığın kesin tanısında koroner anjiograf kullanılmaktadır. Bu çalışmada koroner arter hastalığı tanısında kullanılan eforlu EKG ve miyokard perfüzyon sintigraf ve koroner anjiograf bulguları karşılaşrtırıldı. Gereç ve Yöntem: 101 hasta (47 erkek, 54 kadın; yaş ortalaması: 55 10.95 yıl) çalışmaya alındı. Bu hastalara treadmill cihazıyla efor yaptırılarak 99m Tc-MIBI miyokard perfüzyon sintigrafsi çekildi. Bir ay içerisinde koroner anjiograf yapılan hastalar çalışmaya dahil edildi. Bulgular: Efor testi pozitif olan hastaların %55’i, şüpheli olanların %82’si ve negatif olanların ise %29’unda koroner anjiografde darlık tespit edilirken miyokard perfüzyon sintigrafsinde iskemi gözlenen hastaların %66’sında ve normal değerlendirilen hastaların %12’sinde darlık görüldü. Sonuç: Koroner arter darlığının tanı ve takibinde efor testi ve miyokard perfüzyon sintigrafsi gibi noninvaziv testler kullanılmaktadır. Bu testlerin sonuçları birlikte değerlendirildiğinde koroner arter darlığını göstermedeki doğrulukları artmaktadır.
European Journal of General Medicine
(2009) Sarı, O.
[Abstract not Available]
Correlation of Magnetic Resonance Imaging Findings with Hexamethylpropyleneamine Oxime Brain Single Photon Emission Computed Tomography in Ischemic Stroke Patients in the Subacute Stage
(Sage Publications Ltd, 2006) Kireşi, Demet; Taştekin, G.; Cengiz, Ş. L.; Üstün, M. E.; Yürüten, B.
Purpose: To evaluate the correlation between magnetic resonance imaging (MRI) findings and Tc-99m-hexamethylpropyleneamine oxime (HMPAO) brain single photon emission computed tomography (SPECT) during the subacute stage in ischemic stroke patients. Material and Methods: The T1 and T2- weighted images and brain SPECT findings of 84 patients (mean age 60.69 +/- 12.47 years) with subacute cerebral ischemia during the period 1998-2004 were reviewed. All HMPAO SPECT and MRI studies were performed between 3 and 7 days (mean time delay 4.76 +/- 1.29 days) after the onset of stroke symptoms. Results: An ischemic lesion was seen both in T1 and T2- weighted images with perfusion defects above 60% (severe defect) according to count/pixel data of the lesion in HMPAO SPECT studies in 30 (90.9%) of 33 patients. Otherwise, the ischemic lesion was seen only on T2- weighted images with perfusion defects between 30% and 60% (moderate defect) in HMPAO SPECT studies in 25 (89.3%) of 28 patients. In 20 (87%) of 23 patients who had perfusion defects below 30% (mild defect) on HMPAO SPECT, only non-specific findings such as cerebral atrophy and/or periventricular ischemic-gliotic lesions could be seen in MRI. The difference between these ratios was statistically significant (P < 0.01). Conclusion: Brain Tc-99m-HMPAO SPECT findings indicate good correlation with MRI findings. When the ischemic lesions could be seen in both T1 and T2- weighted images, the patients frequently had severe perfusion defects. When only seen in T2- weighted images, the perfusion defect was moderate. When only non-specific findings were revealed by MRI, only mild perfusion defects were found by SPECT.
Omental Transposition Decreases Ischemic Brain Damage Examined in a New Ischemia Model
(Karger, 2003) Vatansev, Celalettin; Üstün, M. E.; Öğün, C. O.; Taştekin, G.; Karabacakoğlu, A.; Yılmaz, H.
Purpose:The aim of this study was to determine whether omental transposition at the time of focal cerebral ischemia can decrease ischemic brain damage produced in dogs, in a new ischemia model, which had been described by us. Methods: In group 1 (n = 5), the left internal carotid artery and arterial circle of the brain (posterior communicating artery in humans) were occluded permanently. In group 2 (n = 5), additionally to this ischemia model, omental transposition was performed simultaneously. In the postoperative early period (first 24 h), single photon emission computed tomography (SPECT) and in the late period (72-96 h) SPECT and magnetic resonance imaging (MRI) of the brain were performed. Mann-Whitney U, paired t and Wilcoxon signed rank tests were used for statistical analyses, and p < 0.05 was considered significant. Results: The dogs had a neurological score (NS) of 3.6 +/- 0.5 and 3.4 +/- 0.5 in groups 1 and 2, respectively, in the early period (p > 0.05). In the late period, the dogs had an NS of 4.4 +/- 0.5 and 5.6 +/- 0.5 in groups 1 and 2, respectively (p < 0.05). The NS of each group differed significantly between the early and late period (p < 0.05). Early SPECT imaging showed 50 7.0% and 52 +/- 8.4% hypoperfusion corresponding to the left middle cerebral artery territory in groups 1 and 2, respectively (p > 0.05). In the late period, the degree of hypoperfusion decreased to 34 +/- 5.5% and 12 +/- 4.8% in groups 1 and 2, respectively (p < 0.05). The degree of hypoperfusion in both groups changed significantly between the early and late period (p < 0.05). In T-1- and T-2-weighted MRI images, the volume of the lesion in group 1 was significantly greater than in group 2 (p < 0.001). Conclusion: In our new ischemia model, simultaneous omental transposition is helpful in reversing the neurologic deficit and cerebral ischemic damage.

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