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18F-FDG PET-CT and USG/CT in benign and malignant ovarian tumors with postoperative histopathological correlation
(Studio K, 2011) Kuyumcuoglu, Umur; Irfan, Guzel Ali; Celik, Yusuf; Erdemoglu, Mahmut; Komek, Halil
Objectives: The role of F-18-FDG (F-18 fluorodeoxyglucose) PET/CT** (Positron emission tomography) in the diagnosis, treatment and follow up of benign and malignant ovarian tumors had been investigated previously. The objective of the following study was to evaluate the predictive value of PET/CT in benign and malignant ovarian tumors and compare with computerized tomography and post-operative pathology. Materials and methods: In this retrospective study a total of sixty nine cases with benign or malignant pelvic masses underwent laparotomy at our clinic. Postoperative pathology of the patients was recorded and PET/CT results were compared with ultrasonography, computerized tomography and postoperative pathology. Results: The ROCs and AUCs values four predictors were shown in Figure 1. The AUCs (95 % CI) values calculated for CA 125, ultrasonography (USG), PET/CT and CT were as follows: 0.855(0.752-0.958), 0.703(0.540-0.866), 0.681(0.514-0.848) and 0.631(0.463-0.799) respectively. CA 125 has the highest AUC value in order to predict the malignant potential of the patient. USG has the highest AUC value between the imaging techniques, following PET/CT and CT. Conclusion: According to this study among four modalities that distinguish malignant potential preoperatively; CA 125 is the best parameter. USG and PET provide similar benefits in detecting malignant ovarian masses preoperatively. Both of these parameters are superior to CT. Combination of CA 125, USG and PET/CT may be useful in detecting malignant ovarian masses preoperatively, resulting in less invasive surgeries. **F-18-FDG (F-18 fluorodeoxyglucose) PET/CT will be used as the PET/CT, later in this article.
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-FAPI-04 PET/CT Versus 18F-FDG PET/CT in Malignant Peritoneal Mesothelioma
(Lippincott Williams & Wilkins, 2022) Gundogan, Cihan; Guzel, Yunus; Komek, Halil; Etem, Hulya; Kaplan, Ihsan
[Abstract Not Available]
Abdominal wall endometriosis imaged with scintigraphy: report of a case
(2005) Kılınç, Nihal; Çerçi, Sevim Süreyya; Balcı, Tansel Ansal; Çerçi, Celal; Komek, Halil
Endometriyozis üreme çağı kadınlarında oldukça sık görülen bir jinekolojik patolojidir.Rektus abdominis kasının içine yerleşen endometriyozis nadir görülen ve özellikle sezaryen ameliyatı sonrası ortaya çıkan bir patolojidir. Nadir görülen hastalığın günümüz gelişmiş görüntüleme yöntemlerine rağmen tanısmdaki zorluklar devam etmektedir. Ultrasonografi (USG), Bilgisayarlı Tomografi (BT), Manyetik Rezonans Görüntüleme, İnce İğne Aspirasyon Biopsisi kullanılan tanı yöntemleridir. Yirmisekiz, yaşındaki kadın hastaya menstrual döneminde yapılan USG ve BT'de her iki rektus kılıfı arasında yerleşim gösteren 2 cm çaplı kesin tanısı belirlenemeyen kitle tespit edildi. Yapılan eritrosit işaretleme sintigrafisinde kitle lokalizasyonunda radyotracer akümülasyonu görüldü. Tc-99m eritrosit işaretleme sintigrafisinin abdominal endometriyozis tanısında faydalı olabileceği düşünüldü.
Çevresel asbest maruziyetinde kapiller epitelyal permeabilite ile yüksek rezolüsyonlu bilgisayarlı tomografi korelasyonu
(2005) Tanrıkulu, A. Çetin; Işık, Recep; Abakay, Abdurrahman; Acemoğlu, Hamit; Kaya, Halil; Dağlı, Canan Eren; Komek, Halil
Amaç: Çevresel asbest maruziyetine bağlı oluşan hastalıklar Güneydoğu Anadolu Bölgesinde önemli bir sağlık sorunudur. Çalışmamızda amacımız, çevresel asbest maruziyetinde oluşabilecek pulmoner kapiller epitelyal permeabilite (KEP) değişikliğini ve KEP değeri ile yüksek rezolüsyonlu bilgisayarlı tomografi (YRBT) bulguları arasındaki korelasyonu incelemektir. Gereç ve yöntem: Çalışmaya asbestli toprağı kullanma hikayesi olan toplam 47 olgu ile asbest maruziyeti olmayan 22 kontrol vakası alındı. Çalışma grubuna YRBT ve Tc-99m DTPA aerosol inhalasyon sintigrafısi çekildi. Kontrol grubuna ise Tc-99m DTPA aerosol sintigrafısi çekildi. Akciğer membran permeabilitesinin bir indeksi olan dakikalık aktivite azalma yüzdesini ifade eden KEP değeri hesaplandı. Bulgular: Plevral plak YRBT'de en sık saptanan lezyondu. Asbest maruziyeti olan olguların KEP ortalama değeri kontrol grubuna göre anlamlı düşük bulundu (0.952-1.287 %/dk) (p=0.003). YRBT'de lezyon saptanmayan asbest maruziyetli olguların ortalama KEP değeri kontrol grubuna göre anlamlı düşük bulundu (0.994-1.287 %/dk) (p=0.012). YRBT'de lezyon saptanan ve hiçbir lezyon saptanmayan çalışma grubu olgularının KEP değerleri arasında ise anlamlı fark saptanmadı (0.939-0.994 %/dk) (p=0.9). YRBT'de interstisyel fıbrozis saptanan çalışma grubunun KEP değeri kontrol grubuna göre anlamlı düşük saptandı (1.025-1.287 %/dk) (p=0.03). İnterstisyel fıbrozis saptanan çalışma grubunun KEP değeri, interstisyel fıbrozis saptanmayan çalışma grubuna göre ise anlamlı farklı bulunmadı (p=0.4). Sonuç: Çevresel asbest maruziyetinde KEP değerinin kontrol grubuna göre azaldığı görüldü. Radyolojik olarak herhangi bir değişiklik görülmeden önce KEP'in etkilenebileceği ve erken dönemdeki fıbrozisi göstermede noninvaziv hassas bir parametre olabileceği saptandı. Geniş serili çalışmalar ile KEP'in asbeste bağlı fıbrozisi göstermede erken bir prediktör olup olamayacağının gösterileceğini düşünmekteyiz.
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.
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.
The effect of coronavirus disease 2019 pneumonia on myocardial ischemia detected by single-photon emission computed tomography myocardial perfusion imaging
(Lippincott Williams & Wilkins, 2022) Bilge, Onder; Komek, Halil; Kepenek, Ferat; Tastan, Ercan; Gundogan, Cihan; Tatli, Ismail; ozturk, Cansu
Objective We aimed to examine the effects of COVID-19 pneumonia on cardiac ischemia detected by myocardial perfusion imaging with single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) in patients presenting with chest pain and shortness of breath after recovery from COVID-19. Materials and method Patients with a history of COVID-19 confirmed by reverse transcriptase-PCR test who underwent SPECT-MPI for the evaluation of ischemia with the complaints of chest pain and shortness of breath were screened for this study. Patients who underwent thorax CT during the acute period of the COVID-19 were included. Patients with and without pneumonia were determined based on computed tomographic criteria. The patients with a summed stress score of at least 4 on SPECT-MPI were considered to have abnormal MPI in terms of ischemia. Results A total of 266 patients were included in the study. Sixty-five (24%) patients had ischemia findings on SPECT-MPI. Thorax CT showed pneumonia in 152 (57%) patients, and the patients were divided into two groups as pneumonia and nonpneumonia. Abnormal SPECT-MPI scores, which represented myocardial ischemia, were higher in the pneumonia group. Multivariate logistic regression analyses showed that the presence of hyperlipidemia and pneumonia on CT increased the risk of ischemia on SPECT-MPI (OR, 2.08; 95% CI, 1.08-3.99; P-value = 0.029; and OR, 2.90; 95% Cl, 1.52-5.54; P-value = 0.001, respectively). Conclusion COVID-19 pneumonia was identified as an independent predictor of ischemia on SPECT-MPI. Symptoms including chest pain and shortness of breath in patients who have had COVID-19 pneumonia may be attributed to coronary ischemia.
Effects of the changes between pre- and post-treatment 18F-FDG PET-CT volumetric parameters on overall survival in pleural mesothelioma
(Via Medica, 2023) Tuzun, Faris; Ebinc, Senar; Kaplan, Muhammet Ali; Kaplan, Ihsan; Komek, Halil; Oruc, Zeynep; Tuzcu, Sadiye Kemal
Introduction. This study aimed to examine the efficacy of positron emission tomography in fusion with computed tomography (PET-CT) parameters in predicting survival outcomes for patients with malignant pleural mesothelioma.Material and methods. This study retrospectively evaluated the data of 250 patients who were followed up after a diagnosis of malignant pleural mesothelioma. The relationship of pre-treatment [maximum standardized uptake value (SUVmax1), metabolic tumor volume (MTV1), total lesion glycolysis (TLG1), tumor/background (TBR1), pleural thickness1), post-treatment (SUVmax2, MTV2, TLG2, TBR2, pleural thickness2], and APET-CT parameters with survival was retrospectively evaluated in 36 patients whose pre-and post-treatment CT scan examinations were complete.Results. The median age of the patients was 57.5 years, ranging from 35 to 76. Median follow-up time was 16 months, with a range of 7 to 42 months. Median survival was calculated as 18.8 months for all patients. Based on the determined cut-off values, overall survival was determined as 29.9 months in patients with TLG2 <= 158 compared to 16 months in patients with TLG2 > 158 (p = 0.009) and as 30.9 months in patients with ATLG <= -62.58 compared to 16 months in patients with ATLG > -62.58 (p = 0.001). In addition, median overall survival (OS) was determined as 29.9 months in patients with MTV2 <= 63.9 compared to 16 months in patients with MTV2 > 63.9 (p = 0.007) and as 29.9 months in patients with AMTV <=-54.03 compared to 16 months in patients with AMTV > -54.03 (p = 0.002). When evaluated with respect to TBR2; median OS was 29.9 months in patients with TBR2 <= 1.84 compared to 16 months in patients with TBR2 > 1.84 (p = 0.039).Conclusions. Our research findings indicate a correlation between OS and volumetric PET-CT measures, specifically TLG and MTV.
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.
F-18-FDG PET/BT’de kolanjiosellüler kanseri taklit eden Fasciola hepatica vakası
(2018) Kaya, Muhsin; Tuncel, Elif Tuğba; Ebik, Berat; Yalçın, Kendal; Kaçmaz, Hüseyin; Komek, Halil; Uçmak, Feyzullah
İnsan fasioliazisi, Fasciola hepatica ve Fasciola gigantica’nın neden olduğu, dünya genelinde nadir görülen zoonotik bir hastalıktır. Genellikle çiftlik hayvanlarını etkileyen bir trematod olup insan rastlantısal ara konakçıdır. Spesifik olmayan semptom ve bulgularının birçok hepatobiliyer hastalıkta izlenebilmesi nedeniyle fasioliazisin tanı ve tedavisi gecikebilmektedir. Elli üç yaşında kadın hasta 18-Florodeoksi-glukoz pozitron emisyon bilgisaya-ralı tomo-grafi incelemesinde ekstrahepatik safra yollarında yüksek florode-oksi-glukoz tutulumu nedeniyle kliniğimize başvurdu. Hastada son 3 aydır süren karın ağrısı, kaşıntı ve halsizlik yakınmaları mevcuttu. Kolanjiyosellü-ler kanseri taklit eden ve serolojik olarak tanısı konan biliyer fasioliazisli bu vakayı sunacağız.
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.
Küçük hücreli dışı akciğer kanseri olan olgularda prognostik faktörler ve PET/BT’deki SUV max değerinin prognostik önemi
(2012) Şenyiğit, Abdurrahman; Sezgi, Cengizhan; Selimoğlu, Hatice Şen; Kaya, Halide; Abakay, Abdurrahman; Tanrıkulu, A. Çetin; Komek, Halil
Giriş: Çalışma küçük hücreli dışı akciğer kanseri (KHDAK) olan olgularda, florodeoksiglukoz-pozitron emisyon tomogra- fi/bilgisayarlı tomografi (FDG-PET/BT)’de maksimum standart uptake değerinin (SUV max) sağkalım ile ilişkisini belirle- mek ve olguların demografik, klinik ve laboratuvar verilerinin sağkalıma etkilerini araştırmak amacıyla planlandı. Materyal ve Metod: Mayıs 2006-Mart 2011 tarihleri arasında merkezimize başvuran, kesin tanı almış ve evrelemesinde FDG-PET/BT kullanan 101 KHDAK’lı olgunun dosyaları retrospektif olarak incelendi. Başta kitlenin FDG-PET/BT’deki SUV max’ı olmak üzere, prognozu etkileyen klinik, histopatolojik, laboratuvar ve tedavi parametreleri kaydedilerek istatistiksel analiz yapıldı. Bulgular: Hastaların 88 (%87.1)’i erkek, 13 (%12.9)’ü kadındı. Ortalama sağkalım süresi 10.6 ± 8.5 (1- 49 ay) ay idi. Has- taların demografik, klinik, laboratuvar ve radyolojik parametreleri SUV max’ın medyan değeri (12.0) ile iki gruba ayrılarak karşılaştırıldı. İki grup arasında sağkalım açısından, anlamlı bir fark yoktu (p= 0.807). Çalışmada, ileri evre, metastaz var- lığı, yüksek laktat dehidrogenaz (LDH) düzeyi, yüksek lökosit düzeyi, kitlenin inoperabl olması, düşük albumin düzeyi ve düşük performans düzeyinin sağkalımı olumsuz etkilediği görüldü. Sonuç: Sonuçlar, KHDAK’lı olguların, sağkalım süresinde kitlenin FDG-PET/BT’deki SUV max değerinin önemli rolü olma- dığını düşündürtmüştür. Performans durumu, serum LDH, lökosit ve albumin değerlerinin bilinmesi daha iyi prognostik değerlendirme sağlayabilir.
Perirenal Infiltration of Signet Ring Cell Colon Carcinoma Shown by 68Ga-FAPI PET/CT
(Lippincott Williams & Wilkins, 2022) Guzel, Yunus; Kaplan, Ihsan; Kepenek, Ferat; Sogutcu, Nilgun; Komek, Halil
A soft tissue lesion surrounding the left kidney was detected in F-18-FDG PET/CT performed with suspicion of recurrence in a patient who was operated for descending colon cancer and showed mild FDG uptake. Intense fibroblast activation protein-specific inhibitor (FAPI) uptake in the perirenal soft tissue was observed in Ga-68-FAPI-04 PET/CT. Tru-cut biopsy of the left perirenal lesion revealed signet ring cell colon carcinoma metastasis. This case demonstrated that Ga-68-FAPI-04 PET/CT could be a promising radiopharmaceutical for the evaluation of signet ring cell colon carcinomas.
Prognostic factors in non-small cell lung cancer patients and prognostic importance of PET/CT SUV max value
(Turkish Assoc Tuberculosis & Thorax, 2012) Erdem, Vedat; Sen, Hatice Selimoglu; Komek, Halil; Tanrikulu, A. Cetin; Abakay, Abdurrahman; Sezgi, Cengizhan; Kaya, Halide
Introduction: This study planned to investigate the maximum standard uptake values (SUV max) at fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) whether associated with survival or not and the effect of demographic, clinical and laboratory data on survival in non-small cell lung cancer (NSCLC) patients. Materials and Methods: This study was created by examining retrospectively the records of 101 patients with NSCLC that received a definitive diagnosis and FDG-PET/CT used for staging in our center between May 2006-March 2011. Especially FDG-PET/CT, SUV max and the other clinical, histopathologic, laboratory and treatment parameters that effects prognosis were recorded and statistical analysis was performed. Results: Eighty eight (87.1%) of the patients were men and 13 (12.9%) were women. The average survival period was 10.6 +/- 8.5 (1-49 months) months. The demographic, clinical, laboratory and radiological parameters were divided into two groups with the median value of SUV max (12.0). There was not a significant difference in survival between the two groups (p= 0.807). The study showed that advanced stage, presence of metastasis, high lactate dehydrogenase (LDH) levels, high white blood cell levels, inoperability, low albumin levels and low performance effect negative on survival. Conclusion: It was considered that SUV max does not play an important role in the survival period of NSCLC patients. Knowledge of performance condition, serum LDH, leukocyte and albumin values may provide a better prognostic evaluation.
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.
The role of (68Ga)PSMA I&T in biochemical recurrence after radical prostatectomy: detection rate and the correlation between the level of PSA, Gleason score, and the SUVmax
(Springer, 2019) Yilmaz, Ugur; Komek, Halil; Can, Canan; Altindag, Serdar
ObjectiveThe aim of the study was to retrospectively evaluate the recurrence detection rate of Gallium-68-prostate-specific membrane antigen [(Ga-68)PSMA] imaging and therapy (I&T) positron emission tomography/computed tomography (PET/CT) at different PSA levels, which enables early detection of patients with radical prostatectomy. We also aimed to compare Gleason scores, used drugs (LHRH analogs and antiandrogens), PSA levels with SUVmax values, and detection rates.MethodThis retrospective study included 107 patients who underwent radical prostatectomy and who underwent (Ga-68)PSMA I&T PET/CT imaging between January 2015 and December 2018 for the early detection of recurrence. The PSA values, Gleason scores, treatments, lesions detected on (Ga-68)PSMA I&T, and SUVmax values were recorded for all patients.ResultsPatients with a median PSA level of 1.22ng/mL were divided into seven groups according to the PSA values. The lowest lesion detection rate was found to be 7/16 patients (43.8%) when the PSA was<0.2 ng/ml, and the highest lesion detection rate was found to be 33/33 patients (100%) when the PSA was>3.5ng/ml. There was a positive correlation between PSA level and ppSUV(max) (per patient SUVmax) value of the patients with lesions (p<0.001 and r=0.49). As the Gleason score increased, the lesion detection rates also increased and there was a significant correlation between these values (p<0.001 and r=0.360). A positive correlation was determined between the Gleason scores and ppSUV(max) values in patients with lesions (p=0.007 and r=0.302). A statistically significant correlation was found between bicalutamide use and lesion detection on (Ga-68)PSMA I&T (p<0.001). A similar relationship was also determined in patients undergoing maximal androgen blockade (MAB) (p=0.003). Patients determined with lesions on (Ga-68)PSMA I&T and who were administered luteinizing hormone-releasing hormone (LHRH) agonists were found to have statistically significantly higher ppSUV(max) values than those who were not administered LHRH agonists (p<0.001). In binary logistic regression test, when PSA levels and Gleason scores were selected as continuous variables, both PSA levels and Gleason scores were demonstrated as significant covariates (p=0.006 and p=0.022) for lesion detection; by contrast, bicalutamide and MAB were not found as significant factors.ConclusionIn the present study, (Ga-68)PSMA I&T was found to be quite successful in determining lesions in the biochemical recurrence, which is consistent with the findings of other I&T studies and studies conducted with different PSMA ligands. Thus, it can be considered that the use of (Ga-68)PSMA I&T will become increasingly common.
Role of 68Ga-PSMA PET/CT parameters in treatment evaluation and survival prediction in prostate cancer patients compared with biochemical response assessment
(Hellenic Soc Nuclear Medicine, 2021) Can, Canan; Gundogan, Cihan; Yildirim, Ozgen Ahmet; Poyraz, Kerem; Guzel, Yunus; Komek, Halil
Objective: In this study, we aimed to evaluate the concordance of biochemical treatment response with gallium-68-prostate specific membrane antigen (Ga-68-PSMA) positron emission tomography/computed tomography (PET/CT) treatment response in prostate cancer (PCa) and investigate their prognostic effects on survival. Materials and Methods: One hundred and fifty-one patients with PCa, who underwent Ga-68-PSMA PET/CT imaging in our clinic between May 2016 and December 2019, were on treatment, and had pre-treatment and post-treatment imaging studies were included in our study. The treatment patients received and prostate-specific antigen (PSA) levels at the time of PET/CT imaging were recorded. Pre- and post-treatment whole-body metabolic tumor volume (MTVw), whole-body total lesion PSMA (TLPw), percent change in PSA (Delta PSA), Delta MTV, and Delta TLP values were calculated in all patients. Survival time of all patients was measured from the time of initial PET imaging. Results: Median age of patients included in our study was 71 years (range: 51-88). When Delta PSA response and Delta TLP response were evaluated together (r:0.71, P<0.001 and k:0.541, P<0.001), statistically significance strong correlation and moderate concordance was observed. Delta PSA response and Delta MTV treatment response had statistically significant moderate correlation and moderate concordance (r: 0.66, P<0.01 and k: 0.454, P<0.001, significantly). Between Delta PSA response and Delta TLP and Delta MTV response had stronger correlation and higher concordance when PSA levels were above 10. Multivariate analyses using multiple Cox regression analysis revealed MTVw1 and Delta MTV parameters to be independent prognostic factors for mortality (P:0.003 and P:0.001, respectively). Conclusion: We observed that biochemical response and whole-body volumetric Ga-68-PSMA PET/CT parameter response showed correlation and concordance in all groups with PCa, which was more significant when PSA level was >= 10ng/mL. MTVw1 and Delta MTV parameters obtained via Ga-68-PSMA PET/CT were independent prognostic factors for mortality in Pca. Gallium-68-PSMA PET/CT is a valuable imaging technique for diagnostic purposes as well as follow-up and prognostic evaluation.

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