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18F-FDG PET/CT and 68Ga-FAPI-04 PET/CT Findings of Abdominal Leiomyosarcoma
(Lippincott Williams & Wilkins, 2021) Guzel, Yunus; Can, Canan; Sogutcu, Nilgun; Gundes, Ebubekir; Gundogan, Cihan
A 56-year-old woman presented with abdominal pain and vomiting. Her abdominal CT revealed an retroperitoneal mass in the left upper quadrant of the abdomen. F-18-FDG PET/CT performed for metabolic characterization showed low to moderate heterogenous FDG uptake. Ga-68-fibroblast activation protein-specific inhibitor (FAPI)-04 PET/CT performed according to a research carried out in our department showed high heterogenous radiopharmaceutical uptake. The patient was diagnosed with leiomyosarcoma after R0 tumor resection. This case showed that Ga-68-FAPI-04 PET/CT could be a promising radiopharmaceutical in the evaluation of leiomyosarcomas.
18F-FDG PET/CT parameters for prediction of response to neoadjuvant therapy and prognosis in rectal cancer
(Wolters Kluwer Health, 2023) Ebinç, Senar; Güzel, Yunus; Oruç, Zeynep; Kömek, Halil; Kalkan, Ziya; Can, Canan; Taşdemir, Bekir; Urakçı, Zuhat; Kaplan, Muhammet Ali; Küçüköner, Mehmet; Işıkdoğan, Abdurrahman
Objective This study aims to investigate the role of F-18 fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) parameters in the prediction of treatment response and the prognosis in locally advanced rectal cancer. Methods We investigated the relationship of 18F-FDG PET/CT parameters [rectal metabolic tumor volume (MTV), rectal total lesion glycolysis (TLG), rectal standard uptake value (SUV) max, rectal highest peak SUV, lymph node MTV, lymph node TLG, lymph node highest peak SUV] with the pathological response and disease-free survival (DFS) in 60 patients who received neoadjuvant therapy for a diagnosis of locally advanced rectal cancer. Patients with a total score of 0 were assigned to the low-risk group, patients with a score of 1 were assigned to the intermediate-risk group and patients with a score of 2 were assigned to the high-risk group. Results The multivariate analysis revealed that, from baseline PET CT parameters, lymph node highest peak SUV strongly predicted the pathological response at a cutoff value of 2.23. DFS was predicted by the lymph node highest peak SUV at a cutoff value of 3.13 and by the MTV value at a cutoff value of 27 cm3. The risk scoring performed with regard to rectal MTV and lymph node highest peak SUV values determined a median DFS of 19 months in patients with a risk score of 2, whereas the median DFS was not reached in patients with risk scores of 0 and 1 (P < 0.001). Conclusion This study determined that rectal MTV and lymph node highest peak SUV predicted the response to neoadjuvant therapy and DFS.
68GA-FAPI-04 PET/CT Versus 18F-FDG PET/CT in Imaging of Malignant Mixed Germ Cell Testicular Tumor
(Lippincott Williams & Wilkins, 2023) Kaplan, Ihsan; Can, Canan; Guzel, Yunus; Alabalik, Ulas; Komek, Halil
F-18-FDG PET/CT imaging was performed for restaging in in a 16-year-old boy who was operated on for right testicular tumor and was diagnosed with malignant mixed germ cell tumor. Mild FDG uptake was observed in 2 nodules in both lungs and retroperitoneal lymph node in the abdomen. Ga-68-FAPI (fibroblast activation protein inhibitor) 04 PET/CT showed moderate uptake of FAPI in lung nodules and retroperitoneal lymph node. In this case, Ga-68-FAPI-04 PET/CT was shown to be superior to F-18-FDG PET/CT in the evaluation of malignant mixed germ cell testicular tumor metastases.
68Ga-PSMA Versus 18F-FDG PET/CT in the Evaluation of Epithelioid Hemangioendothelioma
(Lippincott Williams & Wilkins, 2024) Senses, Veysi; Kaplan, Ihsan; Kaya, Fulya; Ibiloglu, Ibrahim; Can, Canan
A 32-year-old man with epithelioid hemangioendothelioma was imaged with Ga-68-PSMA PET/CT to evaluate the potential of Lu-177-PSMA radionuclide therapy after progression findings were observed on follow-up F-18-FDG PET/CT imaging. Liver lesions showed low FDG SUVmax. The lesion-to-background ratio (TBR) was calculated as 5.1/2.9 on F-18-FDG PET/CT imaging. However, Ga-68-PSMA PET/CT showed moderate PSMA SUVmax. TBR was calculated as 4.5/1.1. In conclusion, in this case report, we demonstrated that Ga-68-PSMA with moderate TBR in epithelioid hemangioendothelioma may be promising for Lu-177-PSMA radionuclide therapy.
Clinical, Laboratory and Radiologic Course and Prognosis of COVID-19 in Cancer Patients and Comparison with General Population: A Single-Center Experience
(Akad Doktorlar Yayinevi, 2021) Erdur, Erkan; Yildirim, Ozgen Ahmet; Poyraz, Kerem; Can, Canan; Komek, Halil
In this study, we aimed to investigate the clinical findings and follow-up data of patients with COVID-19 and had a history of cancer, and compare these data with other COVID-19 patients. We included 2349 COVID-19 inpatients between March 2020 and July 2020. 82 of these patients were found to have a cancer diagnosis (Group 1). Patients undergoing chemotherapy were assigned to group 1A, patients receiving non-chemotherapy treatment were assigned to group 1B, cancer patients without any treatment to group 1C and non-cancer patients to group 2. These groups were compared in terms of basic demographic characteristics, symptoms, comorbidities, laboratory and imaging findings, intensive care unit (ICU) admission rate and death. The median age of the patients in group 1 was statistically higher than group 2 (61 and 52, p< 0.001). The most common cancer diagnosis was breast cancer (n= 16, 19.5%). Inflammatory parameters such as CRP and D-dimer were found to be higher in patients in group 1 than group 2 (p= 0.005 and p= 0.003, respectively). The mortality rate of the patients in group 1 was 15.8%, while the mortality rate in group 2 was 5.1% and this was statistically significantly higher (p< 0.001). Being in group 1 and group 1A were determined as the predictive parameters for death (r= 0.087, p< 0.001 and r: 0.254, p= 0.021 respectively). Our data suggests that history of cancer and active chemotherapy treatment are independent prognostic factors for severe disease and mortality in COVID-19.
Comparison of (18F)FDG PET/CT and (68Ga)DOTATATE PET/CT imaging methods in terms of detection of histological subtype and related SUVmax values in patients with pulmonary carcinoid tumors
(Lippincott Williams & Wilkins, 2019) Komek, Halil; Can, Canan; Urakci, Zuhat; Kepenek, Ferat
Objective This study was designed to compare the 18-Fluorodeoxyglucose positron emission tomography/computed tomography [(F-18)FDG PET/CT] and 1,4,7,10-tetraazacyclododecane-NI,NII,NIII,NIIII-tetraacetic acid (D)-Phe1-thy3-octreotate [(Ga-68)DOTATATE PET/CT) findings in patients with pulmonary carcinoid (PC) tumors. Materials and methods A total of 20 patients [mean (SD) age: 52.2 (12.9) years, 60% women] with PC tumors and available records on digital images of (F-18)FDG PET/CT and (Ga-68)DOTATATE PET/CT and histopathological analysis were included in this retrospective single-center study. Patient characteristics, structural and functional imaging, and final histopathology were recorded in all patients. Typical and atypical PC tumors were compared in terms of patient age, tumor site, tumor size, and SUV max values obtained by (F-18)FDG PET/CT and (Ga-68)DOTATATE PET/CT imaging. Results Overall, median (minimum-maximum) SUVmax values were 3.2 (1.2-11.2) in (F-18)FDG PET/CT and 17.2 (2.5-89.0) in (Ga-68)DOTATATE PET/CT. Atypical PC tumor was associated with significantly higher mean +/- SD age (64.6 +/- 5.4 vs. 45.5 +/- 10.5 years, P=0.036) and median (minimum-maximum) (F-18)FDG PET/CT SUVmax values [7.3 (4.8-11.2) vs. 2.4 (1.2-3.9), P=0.003], but with significantly lower median (minimum-maximum) (Ga-68)DOTATATE PET/CT SUVmax values [6.4 (2.5-10.6) vs. 23.7 (14.2-89), P<0.001], compared with typical PC tumor. (F-18)FDG PET/CT and (Ga-68)DOTATATE PET/CT SUVmax values were negatively correlated (r=-0.429, P=0.011). Conclusion Our findings in patients with histologically proven PC tumors showed higher SUV max values for (F-18)FDG PET/CT in atypical PC tumors and for (Ga-68)DOTATATE PET/CT in typical PC tumors. Our findings indicate the likelihood of higher detection rates particularly for typical PC tumors by (Ga-68)DOTATATE PET/CT imaging and the potential utility of the SUVmax ratio in predicting the histological subtype of PC tumors.
Comparison of 18F-FDG PET/CT and 68Ga-FAPI-04 PET/CT in patients with non-small cell lung cancer
(Lippincott Williams & Wilkins, 2022) Can, Canan; Kepenek, Ferat; Komek, Halil; Gundogan, Cihan; Kaplan, Ihsan; Tasdemir, Bekir; Guzel, Yunus
Aim In this study, we aimed to compare the diagnostic accuracy of F-18-fluorodeoxyglucose (F-18-FDG) and Gallium-68 labeled fibroblast activator protein inhibitor (Ga-68-FAPI)-04 PET/CT in the tumor-node-metastasis (TNM) staging of patients with nonsmall cell lung cancer (NSCLC) and investigate whether adenocarcinoma (ADC) and squamous cell cancer (SCC) exhibit different uptake patterns on Ga-68-FAPI-04 PET/CT. Materials and method Twenty-nine patients with a histopathologically-confirmed diagnosis of NSCLC, who had no history of previous radiation therapy or chemotherapy and underwent F-18-FDG PET/CT and Ga-68-FAPI-04 PET/CT imaging between January 2021 and December 2021 were included in this retrospective study. Staging was performed using the 8th edition of the TNM staging system on both F-18-FDG PET/CT and Ga-68-FAPI-04 PET/CT images. Standardized uptake value (SUV)(max) and tumor-to-background ratios (TBR) were calculated on primary lesions and metastases. Results There was no statistically significant difference in primary lesions in terms of SUVmax and TBR values. However, Ga-68-FAPI-04 PET/CT was significantly superior to F-18-FDG PET/CT in terms of the number of lymph nodes and bone metastases revealed. The SUVmax and TBR values of lymph nodes, hepatic lesions and bone lesions were significantly higher on Ga-68-FAPI-04 PET/CT than on F-18-FDG PET/CT. Ga-68-FAPI-04 PET/CT changed the disease stage of three patients (10.9%). The diagnostic accuracy of Ga-68-FAPI-04 PET/CT was 100%, whereas the diagnostic accuracy of F-18-FDG PET/CT was 89.6% (P = 0.250). Conclusion Although Ga-68-FAPI-04 PET/CT detected more lesions and higher diagnostic accuracy than F-18-FDG PET/CT in NSCLC, neither method was statistically superior to each other in terms of diagnostic accuracy in TNM staging.
Comparison of F-18-FDG PET/CT and Ga-68-FAPI-04 PET/CT in the staging and restaging of gastric adenocarcinoma
(Lippincott William & Wilkins, 2022) Gündoğan, Cihan; Kömek, Halil; Can, Canan; Yıldırım, Özgen Ahmet; Kaplan, İhsan; Erdur, Erkan; Poyraz, Kerem; Güzel, Yunus; Oruç, Zeynep; Çakabay, Bahri
Objective In this study, we aimed to evaluate the diagnostic sensitivities of Ga-68-FAPI-04 PET/CT and F-18-FDG PET/CT in the primary tumor, and nodal, peritoneal and distant organ metastases of primary and recurrent gastric adenocarcinoma (GAc) with patient and lesion-based comparison. Materials and method Twenty-one patients with histopathologically proven newly diagnosed or recurrent GAc who underwent F-18-FDG and Ga-68-FAPI-04 imaging were included in the study. Both imaging techniques were evaluated visually according to the intensity of organ-based uptake. SUVmax and tumor-to-background ratio (TBR) values obtained from primary tumor/relapse and metastatic organs were compared statistically. Results Ga-68-FAPI-04 uptake was positive in all 15 newly diagnosed patients, while two patients among them who had mucinous and signet ring cell carcinoma did not exhibit F-18-FDG uptake. The sensitivity and specificity of Ga-68-FAPI-04 PET/CT in detecting primary gastric were 100%, while the sensitivity and specificity of F-18-FDG were 86.6 and 100%, respectively. Ga-68-FAPI-04 imaging revealed diffuse stomach uptake in seven patients, while F-18-FDG could only show two of them. The sensitivity and specificity of in-patient-based detection of lymph node metastases were 100 and 95.2%, respectively, while these values were 71.4 and 93.7%, respectively, for F-18-FDG. For peritoneal involvement Ga-68-FAPI-04 had a sensitivity and specificity of 100%, whereas F-18-FDG had a sensitivity of 40% and a specificity of 100%. Conclusion Ga-68-FAPI-04 PET/CT is an imaging modality with the potential of yielding more sensitive and specific findings F-18-FDG PET/CT. This modality may help avoid invasive diagnostic procedures that may be frequently required in GAc.
Comparison of the role of 18F-fluorodeoxyglucose PET/computed tomography and 68Ga-labeled FAP inhibitor-04 PET/CT in patients with malignant mesothelioma
(Lippincott Williams & Wilkins, 2023) Guezel, Yunus; Koemek, Halil; Can, Canan; Kaplan, Ihsan; Kepenek, Ferat; Ebinc, Senar; Bueyuekdeniz, Mehmet Perver
ObjectiveIn this study, we aimed to compare the role of Ga-68-labeled FAP inhibitor (Ga-68-FAPI)-04 PET/computed tomography (CT) and F-18-fluorodeoxyglucose (F-18-FDG) PET/CT in the evaluation of primary tumor and metastases in patients diagnosed with malignant mesothelioma. Materials and methodsOur prospective study included 21 patients with histopathological diagnosis of malignant mesothelioma who underwent both Ga-68-FAPI-04 PET/CT and F-18-FDG PET/CT imaging between April 2022 and September 2022. Maximum standardized uptake value (SUVmax), metabolic tumor volume, total lesion glycolysis, tumor-to-background ratio (TBR) and highest SUVpeak (HPeak) values and lesion numbers were calculated from primary and metastatic lesions on FDG and FAPI PET/CT images. Findings obtained from FAPI and FDG PET/CT were compared. ResultsMore lesions were detected in Ga-68-FAPI-04 PET/CT compared to F-18-FDG PET/CT in primary tumor and lymph node metastases. Statistically significantly higher SUVmax and TBR values were found with FAPI PET/CT (primary lesion SUVmax and TBR, P = 0.001 and P < 0.001, respectively; lymph node SUVmax and TBR, P = 0.016 and P = 0.005, respectively). With FAPI PET/CT, upstage was observed according to tumor-node-metastasis staging in a total of seven patients including three patients with pleural origin, three patients with peritoneal origin and one patient with pericardial origin. ConclusionIn addition to the stage change with Ga-68-FAPI-04 PET/CT in malignant mesothelioma patients, a statistically significant superiority was observed in SUVmax, TBR and volumetric parameters in primary tumors and metastases.
Correlations between whole body volumetric parameters of 68Ga-PSMA PET/CT and biochemical-histopathological parameters in castration-naive and resistant prostate cancer patients
(Springer, 2021) Yildirim, Ozgen Ahmet; Gundogan, Cihan; Can, Canan; Poyraz, Kerem; Erdur, Erkan; Komek, Halil
Objective To evaluate the relationship between whole body volumetric (Wbv) results of Ga-68-PSMA PET/CT with biochemical and histopathological parameters. Methods One hundred twenty-one prostate cancer patients who underwent Ga-68-PSMA PET/CT between January 2018 and December 2019 were included. Imaging was conducted for staging upon new diagnosis with moderate- and high-risk disease and for confirming the progression of castration resistance. The relationships between the Wbv Ga-68-PSMA PET/CT parameters and prostate-specific antigen (PSA) levels, PSA doubling time and Gleason score (GS) were evaluated. Results The median GS and mean PSA levels were similar between the castration-naive and resistant patients. The PSA levels were positively correlated with MTVwb (p: 0.009, r: 0.286) and TLPwb (p: 0.002, r: 0.344). Gleason scores were positively correlated with MTVwb (p: 0.050, r: 0.216), TLPwb (p: 0.007, r: 0.296) and highest standard uptake value (HSUV) max (p: 0.047, r: 0.220). In the castration-naive group, Gleason scores (from p < 0.001 to p = 0.04 and r = 0.331 to 0.549) and PSA levels (from p = 0.002 to p = 0.045 and from r = 0.323 to 0.473) correlated with all Ga-68-PSMA-PET/CT parameters. PSA doubling time was negatively correlated with whole-body metabolic tumour volume (MTVwb) (p: 0.050, r: 0.232) and whole-body total lesion PSMA (TLPwb) (p: 0.026, r: 0.262). The MTVwb, TLPwb and HSUVpeak values of the patients with biochemical recurrence (BR) of 0-6 months (n = 18) were higher than those with BR > 2 years (n = 35) (p = 0.046, 0.047 and 0.042, respectively). Conclusions Wbv Ga-68-PSMA PET/CT results were correlated with PSA levels and Gleason scores. The correlation was relatively stronger in the castration-naive group. The prognostic accuracy of PSA in the resistant group may be weaker than in the naive group. The difference in volumetric parameters of patients with short BR compared to long BR supports the idea that Ga-68-PSMA PET/CT can distinguish patients with rapid relapse from others.
Ecology and genomics of an important crop wild relative as a prelude to agricultural innovation
(Nature Publishing Group, 2018) Von Wettberg, Eric J.B.; Chang, Peter L.; Başdemir, Fatma; Carrasquila-Garcia, Noelia; Korbu, Lijalem Balcha; Moenga, Susan M.; Bedada, Gashaw; Greenlon, Alex; Moriuchi, Ken S.; Singh, Vasantika; Cordeiro, Matilde A.; Noujdina, Nina V.; Dinegde, Kassaye Negash; Shah Sani, Syed Gul Abbas; Getahun, Tsegaye; Vance, Lisa; Bergmann, Emily; Lindsay, Donna; Mamo, Bullo Erena; Warschefsky, Emily J.; Dacosta-Calheiros, Emmanuel; Marques, Edward; Yılmaz, Mustafa Abdullah; Çakmak, Ahmet; Rose, Janna; Migneault, Andrew; Krieg, Christopher P.; Saylak, Sevgi; Temel, Hamdi; Friesen, Maren L.; Siler, Eleanor; Akhmetov, Zhaslan; Özçelik, Hüseyin; Kholova, Jana; Can, Canan; Gaur, Pooran; Yıldırım, Mehmet; Sharma, Hari; Vadez, Vincent; Tesfaye, Kassahun; Woldemedhin, Asnake Fikre; Tar'An, Bunyamin; Aydoğan, Abdulkadir; Bükün, Bekir; Penmetsa, R. Varma; Berger, Jens; Kahraman, Abdullah; Nuzhdin, Sergey V.; Cook, Douglas R.
Domesticated species are impacted in unintended ways during domestication and breeding. Changes in the nature and intensity of selection impart genetic drift, reduce diversity, and increase the frequency of deleterious alleles. Such outcomes constrain our ability to expand the cultivation of crops into environments that differ from those under which domestication occurred. We address this need in chickpea, an important pulse legume, by harnessing the diversity of wild crop relatives. We document an extreme domestication-related genetic bottleneck and decipher the genetic history of wild populations. We provide evidence of ancestral adaptations for seed coat color crypsis, estimate the impact of environment on genetic structure and trait values, and demonstrate variation between wild and cultivated accessions for agronomic properties. A resource of genotyped, association mapping progeny functionally links the wild and cultivated gene pools and is an essential resource chickpea for improvement, while our methods inform collection of other wild crop progenitor species.
Evaluation of dual time-point fluorodeoxyglucose PET/computed tomography imaging in gastric cancer
(Lippincott Williams & Wilkins, 2020) Tasdemir, Bekir; Guzel, Yunus; Komek, Halil; Can, Canan
Background We aimed to evaluate the efficiency of dual time-point fluorodeoxyglucose (FDG) PET/computed tomography (CT) imaging in detecting primary and metastatic lesions in gastric cancer. Methods Between May 2019 and January 2020, 52 patients with gastric carcinoma were prospectively involved in our study. And dual time-point FDG PET/CT imaging performed to the patients. Of detected primary and metastatic lesions, the ones that are better visualized or only appear in delayed imaging were visually identified. Also, maximum standardized uptake value (SUVmax) of the primary and metastatic lesions and the intact liver tissue were measured in early and delayed imaging. Acquired SUVmax values and SUVmax ratios were compared statistically. Results In delayed images, lesions were better visualized in 32 patients (61.5%) and extra lesions were detected in 4 patients (7.7%). SUVmax of primary tumor, SUVmax of liver metastases, SUVmax of lymph node metastases, primary tumor SUVmax/liver SUVmax ratio and lymph node metastasis SUVmax/liver SUVmax ratio were significantly higher in delayed images (P < 0.001, P = 0.022, P < 0.001, P < 0.001, P < 0.001, respectively). However, SUVmax of liver parenchyma was significantly lower in delayed images (P < 0.001). Conclusions There is a visually and statistically significant increase in the number and detectability of lesions seen in delayed images and dual time-point FDG PET/CT imaging seems useful in detecting primary and metastatic lesions in gastric cancer.
False-Positive 68Ga-Fibroblast Activation Protein-Specific Inhibitor Uptake of Benign Lymphoid Tissue in a Patient With Breast Cancer
(Lippincott Williams & Wilkins, 2021) Gundogan, Cihan; Guzel, Yunus; Can, Canan; Alabalik, Ulas; Komek, Halil
Ga-68-fibroblast activation protein-specific inhibitor (FAPI)-04 PET/CT was performed in a patient with left lower outer quadrant breast cancer who had F-18-FDG PET/CT imaging. Ga-68-FAPI-04 PET/CT showed higher accumulation of radiotracer in primary tumor and axillary lymph nodes than F-18-FDG PET/CT. In addition, focal increased FAPI uptake was observed in another nodular lesion in the lower inner quadrant in the same breast, which was considered malignant. However, Tru-Cut biopsy of this lesion was reported as benign lymphoid tissue. This case showed that all FAPI accumulation in breast tissue should not be interpreted in favor of malignancy; histopathological confirmation is required.
Ga-68-FAPI-04 PET/CT, a new step in breast cancer imaging: a comparative pilot study with the F-18-FDG PET/CT
(Springer, 2021) Kömek, Halil; Can, Canan; Güzel, Yunus; Oruç, Zeynep; Gündoğan, Cihan; Yıldırım, Özgen Ahmet; Kaplan, İhsan; Erdur, Erkan; Yıldırım, Mehmet Serdar; Cakabay, Bahri
Abstract Aim We aimed to compare the roles of Ga-68-FAPI-04 PET/CT and F-18-FDG PET/CT in the evaluation of primary tumor and metastases in primary and recurrent breast cancer. Materials and method Twenty female patients with histopathologically confirmed primary and recurrent breast cancer were included in the prospective study. All patients underwent FDG and FAPI PET/CT imaging in the same week. The number of primary and metastatic lesions, SUVmax values, and tumor-to-background ratios (TBR) were recorded from both scans. Data obtained were statistically compared. Results FAPI PET/CT was superior to FDG in detecting breast lesions, as well as hepatic, bone, lymph node, and cerebral metastases in terms of patient- and lesion-based assessments. The sensitivity and specificity of FAPI in detecting primary breast lesions were 100% and 95.6%, respectively, while the sensitivity and specificity of FDG were 78.2% and 100%, respectively. The SUVmax values of primary breast tumors, lymph nodes, lung metastases, and bone metastases were significantly higher on FAPI imaging than FDG imaging (p < 0.05). However, SUVmax values of hepatic metastases did not exhibit a statistically significant difference between two imaging techniques (p > 0.05). Also, FAPI imaging yielded significantly higher TBR in breast lesions as well as hepatic, bone, brain and lung metastases compared to FDG (p < 0.05). Conclusion (68) Ga-FAPI-04 PET/CT is superior to F-18-FDG PET/CT in detecting the primary tumor in patients with breast cancer with its high sensitivity, high SUVmax, and high TBR. (68) Ga-FAPI-04 PET/CT is also superior to F-18-FDG PET/CT in detecting lymph node, hepatic, bone, and cerebral metastases because it has lower background activity and higher uptake in subcentimetric lesions.
Incidental Detection of a Type B3 Thymoma on 68Ga-FAPI-04 PET/CT Imaging
(Lippincott Williams & Wilkins, 2023) Kepenek, Ferat; Gundogan, Cihan; Kaplan, Ihsan; Sogutcu, Nilguen; Can, Canan
F-18-FDG PET/CT performed for staging of colon cancer in a 60-year-old woman revealed a thymic neoplasm with increased radiopharmaceutical uptake in the anterior mediastinum. Ga-68-FAPI PET/CT showed low FAPI uptake in the anterior mediastinal mass. The patient was diagnosed with type B3 thymoma by histopathologic evaluation. In this case, thymoma demonstrated lower uptake with FAPI than FDG. Larger studies are required for the differentiation of malignant and benign mediastinal masses with FAPI.
Nivolumab-Related Dry Mouth and Dry Eye: Cross-Sectional Study
(Taylor & Francis Inc, 2021) Yildirim, Ozgen Ahmet; Poyraz, Kerem; Erdur, Erkan; Can, Canan; Gundogan, Cihan; Guzel, Yunus; Etem, Hulya
To evaluate ICIs related dry eye and dry mouth in nivolumab therapy, 24 patients receiving nivolumab (group 1), 30 patients in remission without treatment for 6 months (group 2), 30 healthy participants (group 3) were cross-sectionally examined. Schirmer's 1, 2, TSH blood tests, serological analysis, salivary flow scintigraphy and minor-salivary gland biopsy were performed. Schirmer's tests were performed with anesthetic (1) and without anesthetic (2). Schirmer's scores were lower in group 1 with more frequent reduced tear production (p < 0.001). TSH levels negatively correlated with Schirmer's scores. Functional insufficiency was detected by salivary flow scintigraphy in 7 out of 10 patients with Schirmer's test positivity. In Schirmer's positive patients, lymphocytic sialadenitis was confirmed in 4 patients (focus score > 1) and CD4 T lymphocyte precipitation was observed in 6 patients. Nivolumab therapy may be associated with ICIs related immune sicca.
Osteoid osteomanın intraoperatif lokalizasyonunun belirlenmesinde gama prob uygulaması
(2015) Can, Canan; Kaya, Halil
Osteoid osteoma, benign ancak ağrılı bir kemik tümörüdür ve nidusun eksizyonu ile tedavi edilir. Erişilmesi zor yerleşimli olduklarından tümörün komplet eksizyonu için ve çevresindeki kemik dokunun gereksiz rezeksiyonunun olmaması için intraoperatif lokalizasyona ihtiyaç duyulmaktadır. Bu çalışmada, osteoid osteomanın preoperatif planlamasında ve intraoperatif lokalizasyonunda kullanılan yöntemlerden biri olan intraoperatif gama prob uygulamasının etkinliğini değerlendirmeyi amaçladık Çalışmaya, klinik ve radyolojik bulgular sonucu osteoid osteoma ön tanısı konmuş ve operasyon planlanan, 10'u kadın, 16'sı erkek, yaş ortalaması 19.6 (6-45 yaş) olan 26 hasta dahil edildi. Tüm hastalar, preoperatif 15-20 mCi erişkin dozu ve çocuklar için azaltılmış dozda Tc99m MDP intravenöz verildikten 3 saat sonra yapılan kemik sintigrafisini takiben operasyona alındı. Tüm operasyonlar gama prob rehberliğinde yapıldı. İnsizyondan önce lezyon bölgesi gama prob sayımlarına göre belirlendi. İnsizyondan sonra lezyon bölgesi ve periferindeki normal kemik doku yüzeyinden ve eksizyon sonrası kaviteden gama prob ile radyoaktivite sayımları alındı. Kavite, radyoaktif sayımları periferindeki normal doku düzeyine yaklaşıncaya kadar genişletildi. Klinik sonuçlar postoperatif ağrı değerlendirmesiyle yapıldı ve eksize edilen kemik doku paraçaları histopatolojik olarak değerlendirildi. Operasyondan önce yapılan üç fazlı kemik sintigrafisi, tüm hastalarda BT'de tariflenen lezyon alanında artmış uptake gösterdi. İntraoperatif olarak, gama prob ile lezyon bölgesi tüm olgularda lokalize edildi. Lezyon periferindeki normal kemik bölgesinden alınan radyoaktivite sayımlarının ortalaması 221.330±91.93 iken, lezyon bölgesinin 897.110±208.088 olarak elde edildi ve aradaki farklılığın anlamlı olduğu görüldü (p<0.001). Lezyon/normal doku oranı ortalama 4/1 idi. Olgularımızda, rezeksiyon sonrası patolojik dokunun eksizyonundan sonra temizlenen kavitede radyoaktivite sayımları ortalama %62 (%30-%90) oranında azaldı. Rezeksiyondan sonra kaviteden alınan radyoaktivite sayımlarının ortalaması 338.111±153.647 olup, bu değer rezeksiyon öncesi lezyon bölgesinden alınan sayımların ortalaması 897.110±208.088 ile karşılaştırıldığında düşük ve anlamlı bulundu (p<0.001 Histopatolojik inceleme sonucu 26 hastanın 21'i osteoid osteoma tanısı aldı. Postoperatif, 1 hasta dışında hastaların tümünde ağrıda iyileşme izlendi. Ortalama 18 aylık (8-25 ay) takip periyodunda 1 olgumuzda rekürrens gelişti. Osteoid osteoma dışında 5 olgumuzun 2'si enfeksiyon, 2'si enkondrom ve 1'i osteosarkom olarak tanı aldı. Osteosarkom tanılı olgu hariç, diğer 4 olgumuzda lezyon gama prob tekniği ile başarıyla eksize edildi. Sonuç olarak; Tc99m MDP'nin preoperatif enjeksiyonu sonrasında gama probun intraoperatif lokalizasyonda kullanımı; osteoid osteoma nidusunun operasyon esnasında lokalizasyonuna yardımcı olan, tümörün sınırlı ancak komplet cerrahi rezeksiyonuna rehberlik eden kullanımı basit ve güvenli bir tekniktir.
The prognostic role of baseline 18F-FDG PET/CT SUVmax and SUVmax change in patients with node-positive breast cancer receiving neoadjuvant chemotherapy
(Ediciones Doyma, S.L., 2022) Can, Canan; Akdeniz, Nadiye; Kömek, Halil; Gündogan, Cihan; Urakçı, Zuhat; Işıkdoǧan, Abdurrahman
Objective: This study aimed to determine the prognostic role of baseline maximum standardized uptake value (SUVmax) obtained by pretreatment PET/CT and the change in SUVmax (?SUVmax [%]) in patients with axillary lymph node–positive breast cancer receiving neoadjuvant chemotherapy (NAC). Methods: One hundred and eighty patients with baseline SUVmax and 121 patients with SUVmax measurement after treatment were evaluated in the study. The baseline SUVmax value of the breast (SUVmaxBI) and axilla (SUVmaxAI) and the change in the SUVmax of the breast (?SUVmaxB) and axilla (?SUVmaxA) were measured. The optimal cut-off value of SUVmax and ?SUVmax were determined by ROC curve analysis. Disease-free survival (DFS) and overall survival (OS) were calculated using Kaplan–Meier curves. Results: ?SUVmaxB, pCRB, pCRA, and pCR parameters were found to be associated with relapse (p < 0.001, p = 0.033, p = 0.016, and p = 0.013, respectively). ?SUVmaxB and SUVmaxAI were associated with mortality (p = 0.001 and p = 0.006, respectively). Multiple Cox regression analyses revealed that ?SUVmaxB value was an independent prognostic factor for relapse and mortality (p = 0.013 and p = 0.010, respectively). Conclusion: The results showed that ?SUVmaxB was an independent prognostic factor for relapse and mortality in patients with axillary lymph node–positive breast cancer who received NAC.
The prognostic role of baseline F-18-FDG PET/CT SUVmax and SUVmax change in patients with node-positive breast cancer receiving neoadjuvant chemotherapy
(Elsevier Espana SLU, 2022) Can, Canan; Akdeniz, Nadiye; Kömek, Halil; Gündoğan, Cihan; Urakçı, Zuhat; Işıkdogan, Abdurrahman
Objective: This study aimed to determine the prognostic role of baseline maximum standardized uptake value (SUVmax) obtained by pretreatment PET/CT and the change in SUVmax ( ASUVmax [90]) in patients with axillary lymph node -positive breast cancer receiving neoadjuvant chemotherapy (NAC). Methods: One hundred and eighty patients with baseline SUVmax and 121 patients with SUVmax measurement after treatment were evaluated in the study. The baseline SUVmax value of the breast (SUVmaxBI) and axilla (SUVmaxAl) and the change in the SUVmax of the breast (ASUVmaxp,) and axilla (ASUVmaxA) were measured. The optimal cut-off value of SUVmax and ASUVmax were determined by ROC curve analysis. Disease-free survival (DFS) and overall survival (OS) were calculated using Kaplan -Meier curves. Results: \SUVmax5, pCRB, pCRA, and pCR parameters were found to be associated with relapse (P<.001, P=.033, P=.016, and P=.013, respectively). ASUVmaxB and SUVmaxAl were associated with mortality (P=.001 and P=.006, respectively). Multiple Cox regression analyses revealed that \SUVmax5 value was an independent prognostic factor for relapse and mortality (P=.013 and P=.010, respectively). Conclusion: The results showed that ASUVmax5 was an independent prognostic factor for relapse and mortality in patients with axillary lymph node -positive breast cancer who received NAC. 0 2021 Sociedad Espanola de Medicina Nuclear e lmagen Molecular. Published by Elsevier Espana, S.L.U. All rights reserved.
Prognostic value of 68Ga PSMA I&T PET/CT SUV parameters on survival outcome in advanced prostat cancer
(Springer, 2018) Komek, Halil; Can, Canan; Yilmaz, Ugur; Altindag, Serdar
ObjectiveTo determine the association of 68Ga-PSMA-I&T PET/CT SUV parameters with survival outcome in advanced prostate cancer patients.MethodsA total of 148 consecutive patients mean age: 69.37.8years with advanced prostate cancer who underwent 68Ga-PSMA-I&T PET/CT were included in this retrospective study. Data on previous treatments, serum PSA levels (ng/mL), 68Ga-PSMA-I&T PET/CT findings metastases as well as survival data were recorded.ResultsMultivariate regression analysis revealed that Level 1 LN SUV/Liver SUV ratios>2.17 (OR 4.262; 95% CI 1.104-16.453, p=0.035), bone SUV>10.7(OR 23.650; 95% CI 4.056-137.888, p<0.001), bone SUV/spleen SUV ratio>1.842 (OR 25.324; 95% CI 4.204-152.552, p<0.001), highest SUVmax/liver SUV ratio>2.32 (OR 19.309; 95% CI 1.730-209.552, p=0.016) and highest SUVmax/spleen SUV ratio>1.842 (OR 22.354; 95% CI 2.637-189.493, p=0.004) were significant in the determination of increased mortality risk in advanced prostate cancer patients.Conclusion p id=Par4 Our findings, for the first time in literature, provided evidence on potential utility of tracer uptake (SUV) cut-off values on 68Ga-PSMA PET/CT in identification of the survival outcome of patients with metastatic disease and thereby in assisting in the selection of individualized therapeutic strategies tailored to the expected prognosis.

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