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Öğe 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, AbdurrahmanObjective 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.Öğe Bölgemiz gebelerinde triple test ile prenatal tarama sonuçları ve sitogenetik değerlendirilmeleri(Perinatal Tıp Vakfı, 2004) Kaya, Halil; Çerçi, Sevim Süreyya; Kömek, Halil; Yayla, Murat; Alp, M. Nail; Oral, Diclehan; Budak, TurgayAmaç: Doğurganlık oranının yüksek olduğu ve ileri yaş gebeliklerin sık görüldüğü bölgemizde, triple test ile ilgili yanlış pozitifliği, yaş dağılımını ve kromozom anomalilerini öngörme durumunu belirlemektir. Yöntem: Bu amaçla 1841 gebede Radio Immun Assay yöntemiyle triple test çalışılmıştır. Gebelerden alınan serum örneklerinde total human koryonik gonadotropin, alfa feto-protein ve ankonjuge estriol değerleri tespit edilerek ticari olarak oluşturulmuş bilgisayar programında hastaya ait diğer veriler ile birlikte analiz edilmiş ve klasik eşik değerlere göre riskler belirlenmiştir. Bulgular: Tarama yapılan popülasyonun yaş aralığı 17-47 arasında değişmekte olup, 35 yaş ve üzerindeki gebe oranı %17,60'tır. Gebelerin 106'sı (%5,75) Down sendromu, yedisi (%0,38) Trizomi 18 yönünden pozitif olup genel test pozitifliği %6,13'tür. Down sendromu ve Trizomi 18 riski pozitif olan 113 gebeden 44'ü (%38,94) amniyosentez / kordosentez sonrası sitogenetik olarak değerlendirilmiş ve iki olguda Down sendromu, bir olguda trizomi 18, bir olguda da 47,XXX saptanmıştır. Down sendromu için pozitif prediktif değer %5.13 bulundu. İnvaziv girişim için yanlızca yaş sınırı kriter alınsaydı girişim önerisinin %65 daha yüksek olacağı belirlendi. Triple testin bu gereksinimi azalttığı bulundu. Sonuç: Triple testteki yanlış pozitiflik ve kromozom anomalilerini öngörme oranımız literatür ile uyumlu bulunmuştur. Doğurganlık ve geç gebelik oranının yüksek olduğu bölgemizde ekonomik şartlar da gözönüne alındığında invazif test sayısını azaltmak amacı ile tarama testlerine öncelik verilmesi ve genç yaştaki gebelere de bu testlerin önerilmesi yerinde olacaktır.Öğe 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, BahriObjective 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.Öğe Efficacy of Ga-68-PSMA PET/CT-derived whole-body volumetric parameters in predicting response to second-generation androgen receptor axis-targeted therapy, and the prognosis in metastatic hormone-refractory prostate cancer patients(Lippincott William & Wilkins, 2021) Oruç, Zeynep; Güzel, Yunus; Ebinç, Senar; Kömek, Halil; Küçüköner, Mehmet; Kaplan, Muhammet Ali; Oruç, İdris; Urakçı, Zuhat; Işıkdoğan, AbdurrahmanIntroduction The present study investigates the role of Ga-68-PSMA PET/CT-derived whole-body metabolic and volumetric parameters in the prediction of treatment response and prognosis among metastatic hormone-refractory prostate cancer patients undergoing second-generation androgen receptor axis-targeted therapy (abiraterone or enzalutamide). Materials and methods This retrospective study included 44 metastatic hormone-refractory prostate cancer patients undergoing Ga-68-PSMA PET/CT, including 29 enzalutamide-treated and 15 abiraterone-treated patients. Results Of the 44 patients included in the study, 29 received enzalutamide and 15 received abiraterone. During treatment, the changes in PET parameters were correlated with the PSA (biochemical) response. More specifically, a positive correlation was noted between PSA response and percent change in TLP (Delta TLP) response, and there was concordance between the results (r = 0.652, k = 0.42, P < 0.001). Baseline PSA (P =0.05), high MTVw (P = 0.005), the increase in Delta PSA (P = 0.036), Delta TLP (P = 0.039) and percent change in MTV (Delta MTV) (P = 0.049) values were identified as factors associated with mortality risk.Multivariate analysis showed that PSA1 [odds ratio (OR): 1.005, 95% confidence interval (CI) 1.002-1.008, P = 0.004], Delta PSA (OR: 14.7, 95% CI 1.50-143.7, P = 0.02) and MTVw1 (OR: 11.4, 95% CI 1.11-116, 6, P = 0.04) were independent prognostic factors associated with mortality risk. Conclusion A statistically significant concordance and correlation was noted between Ga-68-PSMA PET/CT-derived whole-body metabolic parameters (Delta TLP and Delta MTV) and Delta PSA. In addition, the baseline PSA, Delta PSA, Delta TLP, Delta MTV and TMTV were identified as predictive factors for mortality risk.Öğe 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, BahriAbstract 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.Öğe Measuring the knowledge and attitudes of physicians towards patients with HIV/AIDS: study of Anatolian group(Emerald Group Publishing, 2021) Kaya, Şafak; Araç, Eşref; Akgül, Fethiye; Çomoğlu, Şenol; Kaya, Şehmuz; Araç, Songül; Yıldız, Yeşim; Büyüktuna, Seyit Ali; Kayaaslan, Bircan; Parlak, Emine; Baysal, Birol; Karakeçili, Faruk; Balık, Elif Zelal; Akkoç, Ali; Özdemir, Kevser; Kavak, Şeyhmus; Doğan, Suat Ali; Günay, Emrah; Karabela, Şemsi Nur; Cabalak, Mehmet; Çağ, Yasemin; Avcı, Veli; Durdu, Yasemin; Kaya, Zehra; Kılıç, Damla; Yerlikaya, Halis; Tarakçı, Hüseyin; Menteş, Osman; Tartar, Ayşe Sağmak; Köse, Adem; Alakuş, Ömer Faruk; Aktaş, Ulaş; Kömek, Halil; Aksöz, SelçukThis paper aims to determine the knowledge and attitudes of the physicians regarding human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), to emphasize that these patients exist and they will exist in the future and to raise awareness so as to prevent that their rights to treatment are revoked. Design/methodology/approach The survey was conducted via a link sent through an online system. Random physicians from 81 cities of the country were invited to the survey. The survey has 41 questions regarding knowledge and attitudes in total, including epidemiological information such as age, gender and title. Findings A total of 3,107 physicians has voluntarily participated in the study. In total, 2,195 (70.7%) are internal physicians and 912 (29.3%) are surgical physicians among the participant physicians. In total, 1,452 (46.7%) of the participants are specialist physicians, 608 (19.6%) of the participants are practising physician and the rest of it is physician assistants, academicians and dentists, respectively. Originality/value In this study, it has been found out that the physicians have a lack of knowledge on HIV/AIDS and they adopt a discriminatory attitude towards HIV-positive persons. HIV-positive patients who are exposed to discrimination and scared of being uncovered refrain from applying to hospitals for treatment, which puts public health into jeopardy due to the high viral load and these patients are faced with difficulties in coping with both medical and emotional load of the disease.Öğe Myokardiyal viabilitenin değerlendirilmesinde Tc99m-MIBI infüzyon ve Tc99m-MIBI +kısa süreli GİK(glikoz, insülin, potasyum) infüzyon çalışmalarının karşılaştırılması(2016) Kömek, Halil; Kaya, HalilRevaskularizayon işleminden fayda görecek kişilerin seçiminde canlı myokard dokusunun gösterilmesi önemlidir. Bu çalışmadaki amacımız, bölgesel myokardial viabilitenin gösterilmesinde MİBİ infüzyon ve MIBI infuzyon + GIK infuzyon protokollerinin etkinliğinin değerlendirilmesidir. Çalışmamıza ekolarında sol ventrikül disfonksiyonu saptanan ; anjiografileri ve treadmil EKG leri yapılmış 21 hasta dahil edildi Tüm hastalara inisiyal Tc 99 MİBÎ infüzyonu ve 2 gün sonra Tc99m MİBİ infüzyon+GİK ( %30 dextroz 50U insulm 80 meq KC1 )infüzyon protokolleri saatte 2-5 ml/kg olacak şekilde 2 saat boyunca uygulandı ve lsaat sonra SPET imajlar alındı., sonuçlar vizüel olarak ve polar mab kullamlarak değerlendirildi MİBİ infüzyon+GİK infüzyon çalışmasında elde edilen TPS ve bölgesel reversibilite indeks sonuçlan, MİBİ infüzyon çalışmasında elde edilen sonuçlarla, mann-Whitney-U testine göre karşılaştırıldı.Bu iki grup arasındaki sonuçlar anlamlı bulundu p<0,05 Sonuç olarak MIBI nfüzyon+GIK infüzyon çalışma protokolü myokardial viabilitenin gösterilmesinde kullanılabilecek bir yöntem olduğu sonucuna vardık. Sonuç olarak: myokardial viabilitenin gösterilmesinde MIBI infüzyon+ GİK infüzyonunun kullanılabileceği sonucuna vardık. Anahtar kelimeler: myokardial viabilite, Mibi infüzyon, GİK infüzyon, myokard perfuzyon spectÖğe 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, AbdurrahmanObjective: 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.Öğe 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, AbdurrahmanObjective: 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.Öğe Prognostic value of lymph node and spleen activity in [18F]FDG PET-CT in lung adenocarcinoma and squamous cell carcinoma(Dicle Üniversitesi Tıp Fakültesi, 2019) Kömek, Halil; Akdeniz, Nadiye; Urakçı, Zuhat; Can, Canan; Altındağ, SerdarObjective: We aimed to investigate the prognostic value of primary mass, spleen and lymph node metabolic activity in [18F]FDG PET-CT as well as the prognostic value of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (TLR) in patients with lung adenocarcinoma and squamous cell carcinoma. Methods: Seventy-four patients, with pathological data, complete blood count and [18F]FDG PET-CT images, were retrospectively evaluated. Patients were grouped as lung adenocarcinoma (n = 32) or squamous cell carcinoma (n = 42). The time between [18F]FDG PET-CT imaging and death was calculated. Standardized uptake value (SUVmax) of primary lesion was calculated (lung or mediastinum). The SUVmax value of the spleen was used as an indicator of RES activity. Metabolic activity of lymph node was calculated from the lymph node having the highest activity independent of localization. Results: The SUVmax spleen/liver and SUVmax lymph node/liver ratios were significantly higher in the exitus subgroup of squamous cell carcinoma (p=0.025, p=0.043; respectively). The SUVmax lymph node/liver ratio was found to be a predictor for survival in squamous cell carcinoma (p=0.019, OR:1.282). The SUVmax spleen/liver and SUVmax lymph node/liver ratios were similar between subgroups of adenocancer. Conclusions: The SUV ratios of the spleen were not a predictor for survival in both groups. The SUVmax lymph node/liver ratio was found to be a predictor for survival in squamous cell carcinoma. However, NLR and PLR were not found to be prognostic factors.Öğe Prognostic value of the lymphocyte-to-monocyte ratio and other inflammatory markers in malignant pleural mesothelioma(Springer Tokyo, 2016) Tanrıkulu, Abdullah Çetin; Abakay, Abdurrahman; Kömek, Halil; Abakay, ÖzlemObjectives: Inflammation plays a role in malignant pleural mesothelioma (MPM) prognosis and symptoms. We investigated the roles of the new and old inflammatory indexes and markers in MPM prognosis. Methods: Two hundred and ninety-two MPM patients (167 male and 125 female) were included in this retrospective study. Demographic parameters were collected from the patients’ files. Kaplan–Meier curves and multivariate Cox regression analyses were used for the analysis of prognosis. Results: The mean age of the patients was 58.4 years. The mean survival time was 14.6 ± 13.0 months. Twenty-four potential prognostic factors associated with a poor outcome were calculated in the univariate analysis, and 16 potential prognostic factors were associated with a poor prognosis. These 16 potential prognostic factors were also analyzed in multivariate analysis. Multivariate analysis showed that increased age, stage 3–4 disease, the non-epithelial type, a low Karnofsky performance score, a high white blood cell count, and a low lymphocyte-to-monocyte ratio (LMR) were associated with a poor prognosis. The results of the multivariate analysis showed that a decreased LMR was associated with poor survival. Patients with LMR ≤2.6 had poor survival compared with those with LMR >2.6 (mean 9.6 vs. 17.0 months, respectively; p = 0.004). Conclusions: LMR is an independent marker of prognosis in patients with MPM and is superior to the other inflammation-based markers. The inexpensive nature and easy reproducibility of the hemogram should encourage the use of the LMR in clinical practice.Öğe The relationship between inflammation markers, positron emission tomography/ /computed tomography parameters and disease prognosis in advanced non-small-cell lung cancer patients(Via Medica, 2024) Pirinççi, Esra; Oruç, Zeynep; Ebinç, Senar; Güzel, Yunus; Kömek, Halil; Küçüköner, Mehmet; Urakçı, Zuhat; Taşdemir, Bekir; Işıkdoǧan, Abdurrahman; Kaplan, Muhammet Ali; 0009-0008-5307-8342; 0000-0002-7931-2941; 0000-0002-0878-6525; 0000-0002-8555-0460; 0000-0001-8168-136X; 0000-0001-7336-871X; 0000-0003-3878-988X; 0000-0002-7787-0341; 0000-0002-7451-7286; 0000-0003-0882-0524Introduction. Inflammation is known to be related to the development, spread, prognosis, and treatment response in cancer patients. Our study aimed to evaluate the correlation between inflammation indices and positron emission tomography-computed tomography (PET/CT) parameters and investigate their relationship with progression-free survival (PFS) and overall survival (OS) in patients diagnosed with stage-IV non -small cell lung cancer (NSCLC). Material and methods. Demographic, clinicopathological, laboratory, and PET/CT data of 179 patients diagnosed with stage-IV NSCLC who presented to the Oncology Department of Dicle University, Faculty of Medicine between 2010-2020 were retrieved from patient files and the hospital database system. Results. The median age at diagnosis was 64 (27-87) years. All patients included in the study had NSCLC: 72.6% had adenocarcinoma, 21.2% had squamous cell carcinoma, and 6.1% had other histological types. Of the 78 patients who were subjected to molecular analysis, 26 (33.3%) were EGFR-mutation positive. During the 10-month median follow-up, median first -line PFS was 6 months (95% CI 5.00-6.99), and median OS was 10 months (95% CI 7.8-12.1). The multivariate analysis performed for first -line PFS determined hemoglobin (HR = 1.01; 95% CI 1.003-1.02; p = 0.005) and PET total lesion glycolysis (TLG) (HR = 1.002; 95% CI 1.001-1.003; p = 0.003) values as independent prognostic factors. The multivariate analysis for OS determined positive EGFR mutation status (HR = 0.385; 95% CI 0.213-0.696; p = 0,014) and performance status (HR = 1.88; 95% CI 1.092-3.238; p = 0,008) as independent prognostic factors. Conclusions. Our study determined the hemoglobin level and PET TLG from PET/CT parameters to be independent prognostic factors for PFS, and performance status and EGFR mutation positivity to be independent prognostic factors for OS.Öğe The role of basal 18F-FDG PET/CT maximum standard uptake value and maximum standard uptake change in predicting pathological response in breast cancer patients receiving neoadjuvant chemotherapy(Lippincott William & Wilkins, 2021) Akdeniz, Nadiye; Kömek, Halil; Küçüköner, Mehmet; Kaplan, Muhammet A.; Urakçı, Zuhat; Oruç, Zeynep; Işıkdoğan, AbdurrahmanObjective The aim of this study was to determine the role of 18F-FDG PET/CT in predicting pathological response among patients diagnosed with local or locally advanced breast cancer and receiving neoadjuvant chemotherapy (NAC). Methods Basal SUVmax value were analyzed in 212 patients and 142 of these patients had posttreatment SUVmax value. Overall pathological complete response (pCR(C)) was defined as no evidence of residual invasive cancer in breast (pCR(B)) and axilla (pCR(A)). Basal SUVmax value of the breast (SUVmax(B)I) and axilla (SUVmax(A)I) and change in SUVmax of the breast (Delta SUVmax(B)) and axilla (Delta SUVmax(A)) were measured. The optimal cutoff value of SUVmax and Delta SUVmax were determined by receiver operating characteristic curve analysis. Results The number of patients with pCR(B) was 85 (40.1%), pCR(A) was 76 (42.5%) and pCR(C) was 70 (33%). In the artificial neural network-based analysis the Delta SUVmax(B) (100%) was the most important variable for predicting pCR(B). Delta SUVmax(A) (100%) was the most important variable in estimation of pCR(A). When pCR(C) was evaluated, the highest relation was found with Delta SUVmax(B). When the Delta SUVmax(B) cutoff value for pCR(B) and pCR(C) accepted as <=-87.9%, its sensitivity was 82.3 and 82.4%, and specificity was 72.5% and 65.9%, respectively (P < 0.001 and P < 0.001, respectively). When the Delta SUVmax(A) cutoff value for pCR(A) and pCR(C) accepted as <=-86.6%, its sensitivity was 94.3% and 97.6%, and specificity was 31.3% and 28.2%, respectively (P = 0.017 and P = 0.024, respectively). Conclusion Albeit varies according to the molecular subtypes of the breast cancer during NAC, Delta SUVmax value seems to be the most strong factor associated with pCR.Öğe Superiority of 68 Ga-Trivehexin PET/CT Over 18 F-FDG PET/CT in the Evaluation of Lymph Nodes in Patients With Breast Cancer(Lippincott Williams and Wilkins, 2024) Kömek, Halil; Güzel, Yunus; Kaplan, İhsan; Yilmaz, Ece Eşsiz; Can, CananA patient with left upper quadrant breast cancer who had 18F-FDG PET/CT imaging underwent 68Ga-Trivehexin PET/CT. 68Ga-Trivehexin PET/ CT showed higher radiotracer accumulation in the primary tumor, left internal mammary lymph nodes, and axillary lymph nodes compared with 18F-FDG PET/CT. However, Trivehexin uptake was not observed in FDG-positive lymph nodes in the mediastinum and left hilar region. Benign cytological findings were noted in the biopsy of the subcarinal lymph node. This case demonstrates that the use of 68Ga-Trivehexin PET/CT in suspicious lymph nodes in areas difficult to biopsy in breast cancer cases can contribute to accurate staging. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
