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    Diagnostic value of PET/CT in differentiating benign from malignant solitary pulmonary nodules
    (Imprimatur Publications, 2013) Dalli, A.; Sen, H. Selimoglu; Coskunsel, M.; Komek, H.; Abakay, O.; Sergi, C.; Tanrikulu, A. Cetin
    Purpose: Solitary pulmonary nodules (SPNs) are round or oval lesions with a clear border with the surrounding parenchymal tissue and a radiologic diameter smaller than 3 cm which are not associated with atelectasis, pneumonia, lymphadenopathy, or chest wall pathologies. The purpose of the present study was to evaluate the efficacy of positron emission tomography (PET) / computerized tomography (CT) in differentiating benign from malignant SPNs. Methods: In this retrospective study, 209 patients, who were diagnosed with SPN by thoracic CT and demonstrated positive or negative results for malignancy in the PET/CT examination between January 2007 and June 2010, were enrolled. Among the 91 patients who gave consent for interventional procedures, performed were bronchoscopic endobronchial biopsy in 10, transbronchial biopsy in 15, bronchoscopic brushing in 4, transthoracic needle biopsy in 11, video-assisted thoracoscopy (VATS) in 4, lobectomy in 22, pneumonectomy in 2, and wedge resection in 23. The materials were histo pathologically examined. Results: 129 (61.72%) of the SPN cases were benign and 80 (38.27%) malignant. The mean SUVmax value for the benign SPNs was 2.06 +/- 3.29 and 7.39 +/- 5.69 for the malignant SPNs (p=0.000). Positive correlation was found between the nodule diameter and risk for malignancy. A SUVmax value of 4 was found to have the best sensitivity and specificity. Conclusion: PET/CT was shown to be an accurate method in the differential diagnosis of benign from malignant solitary pulmonary nodules.
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    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.
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    Pulmonary Alveolar Microlithiasis: Radiologic Findings of Eight Cases in Turkey
    (Ortadogu Ad Pres & Publ Co, 2010) Tanrikulu, A. Cetin; Dagli, Canan Eren; Senyigit, Abdurrahman; Nazaroglu, Hasan; Babayigit, Cenk
    Objective: Pulmonary alveolar microlithiasis (PAM) is a rare idiopathic disease characterized by presence of diffuse innumerable minute calculi called microliths The aim of this report was to describe the radiographic findings of PAM with particular attention to features provided by chest X-ray and high resolution computerized tomography (HRCT). Material and Methods: We diagnosed three index cases of PAM who came from the same village in 1996. In 2005 we performed a study including 279 residents of that village by using microfilm screening to determine undiagnosed cases. Five additional cases of PAM were detected and underwent HRCT. HRCT and chest X-ray images of eight cases were assessed specifically for patterns, distribution, and profusion of pulmonary abnormalities. Results: Of eight cases, four were adults and four were children. Diffuse typical microcalcifications were detected in chest X-ray in three cases while reticulonodular pattern was seen in three cases and reticular pattern in two cases. Fine microcalcification, parenchymal band and fisssural prominence were the most common findings on HRCT. Small subpleural cysts were detected in five cases but only case 1 showed black pleural line in chest X-ray. One case had small subpleural bullae and bronchiectatic changes in both lower lobes predominantly in the left lung in HRCT. Conclusion: Relatives of a patient with PAM having reticular or reticulonodular pattern in chest X-ray must be investigated in detail for PAM because it can be the early stage of the disease. HRCT has a major importance for the detection of the rapid progression.
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    Risk factors for drug resistant tuberculosis in southeast Turkey
    (Royal Soc Medicine Press Ltd, 2008) Tanrikulu, A. Cetin; Hosoglu, Salih; Ozekinci, Tuncer; Abakay, Abdurrahman; Gurkan, Fuat
    We undertook a cross-sectional survey of 116 patients at Dicle Hospital,Turkey, who had with bacteriologically confirmed tuberculosis (TB). Demographic and clinical features, including age, gender, pulmonaryTB history, associated diabetes mellitus, previousTB treatment, residential area and education, were collected from charts. Eighty-four of the strains were found to be susceptible to all drugs. The resistance to one or more drug(s) was found in 32 strains. Multi-drug resistant (MDR) TB was found in 13 strains (11.3% of the total and 40.7% of the drug resistant strains). The resistance to isoniazid was the most frequently seen (25 strains, 21.5%). In the multivariable analysis, only previousTB treatment (P = 0.000) remained a significant predictor for drug resistance; in MDR, previousTB treatments (P = 0.002) remained significant in the final model. The patient's educational status was found to be negatively correlated with the risk of MRD-TB (P = 0.035). PreviousTB treatment and low educational status were found to important risk factors for the development of MDR-TB.