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  • Küçük Resim
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    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.
  • Küçük Resim
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    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.
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    Öğe
    Is there a relationship between the liver SUVmax values in FDG-PET/CT imaging and non-alcoholic fatty liver disease score?
    (2021) Yalçın, Kendal; Güzel, Fatih; Kaplan, İhsan; Güzel, Yunus; Taşdemir, Bekir; Uyar, Ali; Tuzcu, Şadiye Altun
    Aim: Non-alcoholic fatty liver disease is one of the most common causes of liver disease worldwide with an estimated prevalence of 20%–30% in adult population. Following the widespread utilization of PET in the evaluation of malignant diseases, F-18 FDG have also been reported to be used in non-malignant processes. The aim of this study is to elucidate whether the FDG SUVmax values determined by PET/CT in different adipose tissue samples and the liver change according to NAFLD score. During our desktop research we did not find any published article therefore, it is the first study in this field. Materials and Method: A total of 230 patients who applied to Dicle University Faculty of Medicine, Department of Nuclear Medicine between March and April 2020 and who have been conducted FDG PET/CT for diagnosis, staging, restaging and evaluation of response to treatment were included in the study. Patients were divided into three groups according to their NAFLD score as patients with fibrosis score <-1,455 (the group in which severe fibrosis was excluded) as group-1, and those with NAFLD score between -1.455-0.676 (inter-mediate score) as group-2. and patients with a NAFLD score >0.676 (severe fibrosis group) group-3. Results: Liver SUVmax levels were found to be significantly higher in group-3 than group-1. No significant difference was observed between group-2 and group-3. SUVmax levels measured from supracalvicular region, posterior scapular region and mesentery region were not different from each other in all three groups. Glucose-corrected liver SUVglu levels were found to be significantly lower in group-1 than group-3 (p=0.001). In terms of liver SUVglu levels, group-1 and group-2 and group-2 and group-3 did not differ statistically from each other. Supracalvicular SUVglu, posterior scapular SUVglu and mesenteric SUVglu groups were not different from each other. Conclusions: The most important result of this study could be elaborated with increased FDG uptake in NAFLD. Liver FDG uptake increases as the severity of NAFLD increases as demonstrated by the NAFLD score.
  • Küçük Resim
    Öğe
    Malign plevral mezotelyoma tanısında 18F-FDG pet / BT görüntülemenin rolü
    (Dicle Üniversitesi, Tıp Fakültesi, 2020) Kaplan, İhsan; Gezici, Ayten
    Amaç: MPM ön tanısı ile FDG PET/BT görüntülemesi yapılan hastalarda plevral kalınlığın boyutu, plevral kalınlığın SUVmaks'ı, mediastinal lenf nodunun boyutu ve mediastinal lenf nodunun SUVmaks'ının hastalığın tanı veya ayırıcı tanısında yardımcı olabilirliğini araştırdık. Materyal ve Metod: Mayıs 2018 ile Şubat 2020 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Nükleer Tıp Anabilim Dalına, MPM ön tanısıyla başvuran ve FDG PET/BT görüntülemesi yapılan 54 hastayı retrospektif olarak inceledik. FDG PET/BT görüntüleme sonrası yapılan histopatolojik inceleme sonucu 23'ü MPM (Grup 1), 11'i mezotelyoma dışı malignite (Grup 2), 11'i normal (Grup 3), 9'u plevrit (Grup 4) ve 20'si benign (Grup 5) (normal ve plevrit toplamı) olduğu anlaşıldı. MPM ile diğer grupların plevral kalınlığın boyutu, plevral kalınlığın SUVmaks'ı, mediastinal lenf nodunun boyutu ve mediastinal lenf nodunun SUVmaks parametrelerini karşılaştırdık. Bulgular: MPM ile diğer plevral patolojiler karşılaştırıldığında plevral kalınlığın SUVmaks'ını istatistiksel olarak anlamlı fark bulduk (p<0,001). MPM ile mezotelyoma dışı maligniteler grubunu karşılaştırdığımız parametreler istatistiksel olarak anlamlı fark bulmadık. MPM ile normal grubu karşılaştırıldığında plevral kalınlığın SUVmaks'ını istatistiksel olarak anlamlı fark bulduk (p=0,001). MPM ile plevrit grubunu karşılaştırdığımız parametreler istatistiksel olarak anlamlı fark bulmadık. MPM ile benign grubu karşılaştırıldığında plevral kalınlığın SUVmaks'ını istatistiksel olarak anlamlı fark bulduk (p=0,005). Sonuç: MPM'yı diğer plevral patolojilerden ayırt etmede plevral kalınlığın SUVmaks değerini kullanılabileceğinin sonucuna vardık. MPM ile mezotelyoma dışı malignite grubunu kullandığımız parametrelerle ayırt edilemeyeceğinin sonucuna ulaştık. MPM ile normal grubunu plevral kalınlığın SUVmaks değeriyle ayırt edebileceğimizin sonucuna vardık. MPM ile plevrit grubunu kullandığımız parametrelerle ayırt edilemeyeceğinin sonucuna ulaştık. MPM ile benign grubunu plevral kalınlığın SUVmaks değeriyle ayırt edebileceğimizin sonucuna vardık.
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    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, Canan
    A 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.
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    Öğe
    The relationship between 68Ga-PSMA uptake and Gleason Score and PSA levels in patients with prostate cancer
    (MediHealth Academy Yayıncılık, 2021) Altuntuzcu, Şadiye; Taşdemir, Bekir; Kaplan, İhsan; Uyar, Ali; Güzel, Fatih; Güzel, Yunus; Dağgülli, Mansur
    Aim: PSMA expression has been observed in increased levels in patients with high Gleason scores. Current information on Ga-68 PSMA PET/CT shows that primary staging with PET/CT is important in patients with high-risk PC. Ga-68 PSMA PET/CT may also have a place in patients with intermediate risk PC, but only a few data are available at present. In this study, we aimed to elucidate the relationship between PSMA expression value in the prostate gland, total PSA levels and GS in patients diagnosed with prostate cancer. Material and Method: A total of 98 patients who were pathologically diagnosed with prostate cancer that did not receive any treatment and underwent Ga-68 PSMA PET/CT imaging for staging were included in the study. Findings detected in Ga-68 PSMA PET/CT imaging were categorized as prostate, lymph node, bone, and visceral organ. The focal increased PSMA expression values ??observed in the prostate gland were recorded as SUVmax. The patients were divided into two separate groups according to their GS score (GS>7 and GS?7). Correlations between prostate PSMA SUVmax, GS score and total PSA scores were investigated. Results: PSMA SUVmax levels of the group with a Gleason score of >7 were found to be significantly higher than the group with a Gleason score of ?7 (p=0.03). The rates of lymph node metastasis, bone metastasis and visceral organ metastases were found to be significantly higher in the group with a Gleason score >7 compared to the group with a Gleason score ?7. A positive correlation was observed between PSMA SUVmax and Total PSA (r=0.260, p=0.01). A positive correlation was observed between PSMA SUVmax and Gleason score (r=0.260, p=0.01). A positive correlation was observed between total PSA and Gleason score (r=0.320, p=0.001). Conclusion: In conclusion, PSMA SUVmax and Total PSA levels were higher in the group with high Gleason score. There is a positive correlation between PSMA SUVmax and total PSA. Clinicians should be careful in this regard, as the possibility of metastasis will be high in groups with high Gleason scores.