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Öğe 18-FDG PET/CT ile Belirlenen Kahverengi Yağ Dokusu Glukoz Uptake’i ile Açlık Kan Glukozunun İlişkisi(2019) Tuzcu, Şadiye AltunAmaç: Enerji metabolizması ve kahverengi yağ dokusu arasındaki ilişki birçok çalışmada gösterildiğinden, supraklaviküler kahverengi yağdokusunun glukoz uptake’ini, prediyabetli bireylerde 18F-FDG PET / CT görüntüleme yöntemi kullanılarak etkilenip etkilenmediğiniaraştırmayı amaçladık.Gereç ve Yöntemler: Gazi Yaşargil Eğitim ve Eğitim Hastanesi Nükleer Tıp Kliniğine Şubat-Mayıs ayları arasında başvuran kanserhastalarının retrospektif bir derlemesini yaptık. Yüz otuz bir hasta açlık kan glukoz düzeylerine göre iki gruba ayrıldı: normoglisemikgrup (kan glukoz düzeyi ?99 mg / dl, n=71) ve prediyabetik grup (kan glukoz düzeyi?100mg/dl, n=60). Tüm hastaların vücut kütleindeksi hesaplandı. Ortalama SUVmax ve SUVmean kahverengi adipoz dokusu ve deri altı adipoz dokusu verileri, 18-FDG PET / CT ileölçüldü. Bu çalışma Dicle Üniversitesi etik kurulu (119-2019) tarafından onaylandı. İstatistiksel analiz için iki ortalama arasındaki farkınönemlilik testi ve ki-kare testi kullanıldı.Bulgular: Normoglisemik grup ile prediyabetik grup arasında ağırlık, boy ve VKİ açısından fark yoktu. Her iki grupta cinsiyet dağılımındafark yoktu. Supraklaviküler bölgeden normoglisemik grubun kahverengi yağ dokusu SUVmax ve SUVmean değerleri prediyabetik grubagöre anlamlı derecede yüksekti (sırasıyla p= 0,022, p=0,034).Sonuç: Çalışmamızda, prediyabetli bireylerde 18-FDG PET / BT ile belirlenen glukoz alımının düşük olduğu gÖğe 18f-fluorodeoxyglucose pet/ct can be an alternative method to assessment of insulin resistance(Acta Endocrinologica Foundation, 2019) Tuzcu, Şadiye Altun; Çetin, F. A.; Pekkolay, Zafer; Tuzcu, Alpaslan KemalBackground. Insulin resistance is routinely measured by homeostasis model assessment of insulin resistance (HOMA-IR).Positron emission tomography of 18F-fluorodeoxyglucose combined with computed tomography (18F-FDG PET/CT) is a valuable assessment tool for patients with cancer or staging tumors. 18F-FDG PET/CT imaging can also be utilised to detect the metabolic activity of glucose in the adipose tissue, liver and muscles. The aim of this study was to determine insulin sensitivity in the liver, muscle visceral adipose and subcutaneous adipose tissue separately via18F-FDG PET/CT. Materials and method. Sixty three adult patients who underwent whole body 18F-FDG PET/CT scanning for clinical purposes (diagnosis or staging of cancer) between July and August of 2016 were included in the study. Patients were divided into two groups according to their BMI (Group 1: BMI<25kg/m2, Group 2: BMI>25kg/ m2). HOMA-IR,fasting glucose,insulin, triglycerides, total cholesterol, HDL levels were measured. We calculated SUV as the tissue activity of the ROI (MBq/g)/(injected dose [MBq]/ body weight [g]) on PET images and measured the maximum SUVs (SUVmax) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT),liver and rectus muscle ROIs (2 cm). SUV corrected by blood glucose level (SUVgluc) was calculated as SUVmax×blood glucose level/100. Student-t test, Chi-square test and Pearson correlation test were used for statistical analysis. Results. Mean glucose,insulin,HOMA-IR levels of the group-2 were statistically higher than of group-1. Muscle SUVmax and liver SUVmax of group-1 were statistically higher than of group-2. Muscle SUVgluc of group-1 was statistically higher than of group-2. HOMA-IR was negatively correlated with both SUVmax(r=-0.340, p=0.01) and muscle SUVmax(r=-0.373, p=0.005) Conclusion. 18F-FDG PET/CT has shown that the muscle tissue maximum FDG uptake was lower in the insulin resistance group. Therefore, 18-FDG PET/CT could be a valuable tool for diagnosing insulin resistance.Öğe Alternative methods for the diagnosis of macroprolactinemia: urine prolactin level and serum / urine prolactin ratio(Dicle Üniversitesi Tıp Fakültesi, 2019) Pekkolay, Zafer; Tuna, Mazhar Müslüm; Güven, Mehmet; Tuzcu, Şadiye Altun; Kaplan, İbrahim; Akkuş, Zeki; Tuzcu, Alpaslan KemalObjective: The aim of this study was to investigate the urine prolactin and serum/urine prolactin ratio for accuracy diagnosis of macroprolactinemia. Methods: In the retrospective cross-sectional analysis, prolactin levels (high or normal) in the reproductive period of men and women were included in the study. Polyethylene glycol (PEG) precipitation method was used for the detection of macroprolactinemia. Then, patients were divided into three groups as macroprolactinemia, prolactinoma and healthy control group. In patients, prolactin values in spot urine with simultaneous serum prolactin values were calculated. The non-parametric Kruskal-Wallis test was used to compare the groups. The receiver-operating characteristic (ROC) curve was determined to evaluate the predictive power of serum/urine prolactin ratio Results: A total of 41 patients were included in the study. Female/male:36 (87.8%)/ 5 (12.2%). Urinary prolactin median(minimum-maximum) values were macroprolactinemia, prolactinoma and control group, respectively; 0.06(0.05-0.10), 0.11(0.02-0.95), 0.08(0.05-0.25) ng/ml. Serum/urine ratio median (minium-maximum) values were macroprolactinemia, prolactinoma, and control group, respectively; 633(51-1032), 990(104-9635), 395.5(138-953). When the groups were compared, the patients with prolactinoma had higher urinary prolactin levels(p <0.01). Serum/urine prolactin ratio was found to be the highest in prolactinoma patients and the lowest in the control group and a significant difference was observed in groups (p <0.01). ROC analysis(control-macroprolactin) for serum/urine prolactin ratio (Sensitivity 84.6 specificity 93.7 cut off >549,5 AUC=0.83) p<0.01 Conclusion: Urinary prolactin level and serum/urine prolactin ratio may be used in diagnosis of macroprolactinemia.Öğe Evaluation of metabolic parameters of microsatellites stable and instable colorectal cancer patients via PET/CT(2024) Tuzcu, Şadiye Altun; Çetin, İlbey Erkin; Güzel, Fatih; Çetinkaya, Erdal; Taşdemir, Bekir; Büyükbayram, HüseyinAims: Microsatellite instability has been determined as an important indicator in selecting chemotherapy drugs in colorectal cancer. Within the scope of this research, we aimed to elucidate the pathology reports and determine whether the metabolic parameters detected by PET/CT differ in MSI-positive and negative patients. Methods: A total of 35 patients were analyzed retrospectively. The patient population consisted of patients who applied to the Nuclear Medicine Department with a diagnosis of colon or rectum cancer, underwent PET/CT imaging for staging purposes, and were operated on. Results: A total of 35 colon or rectum cancer patients were included in this retrospective analysis. When microsatellite instability was analyzed among the patients, it was found that female patients comprised 4 microsatellite instability-positive and 16 microsatellite instability-negative individuals. On the other hand, 5 of the males were microsatellite instability positive, and 10 were microsatellite instability negative. The mean SUVmax value was 16.4±8.2, SUVmean was 8.1±1.9, TLG was 392.4±520.8, and MTV was 26.5±25.4 in the microsatellite instability-positive individuals. On the other hand, the mean SUVmax value was 22.7±9.7, SUVmean was 5.2±2.2, TLG was 316.4±325.7, and MTV was 21.7±21.7 in the microsatellite instability-negative individuals. Conclusion: With the advancement of image analysis technology, MTV, and TLG, volumetric indexes derived from 18F-FDG PET have been proposed for risk stratification of cancer patients. Regarding the outcomes of this research, the semiquantitative and metabolic parameters obtained by PET/CT are not different in colorectal cancer cases with instable and stable microsatellites.Öğe Evaluation of metabolic parameters of microsatellites stable and instable colorectal cancer patients via PET/CT(MediHealth Academy Yayıncılık, 2024) Tuzcu, Şadiye Altun; Çetin, İlbey Erkin; Güzel, Fatih; Çetinkaya, Erdal; Taşdemir, Bekir; Büyükbayram, HüseyinAims: Microsatellite instability has been determined as an important indicator in selecting chemotherapy drugs in colorectal cancer. Within the scope of this research, we aimed to elucidate the pathology reports and determine whether the metabolic parameters detected by PET/CT differ in MSI-positive and negative patients. Methods: A total of 35 patients were analyzed retrospectively. The patient population consisted of patients who applied to the Nuclear Medicine Department with a diagnosis of colon or rectum cancer, underwent PET/CT imaging for staging purposes, and were operated on. Results: A total of 35 colon or rectum cancer patients were included in this retrospective analysis. When microsatellite instability was analyzed among the patients, it was found that female patients comprised 4 microsatellite instability-positive and 16 microsatellite instability-negative individuals. On the other hand, 5 of the males were microsatellite instability positive, and 10 were microsatellite instability negative. The mean SUVmax value was 16.4±8.2, SUVmean was 8.1±1.9, TLG was 392.4±520.8, and MTV was 26.5±25.4 in the microsatellite instability-positive individuals. On the other hand, the mean SUVmax value was 22.7±9.7, SUVmean was 5.2±2.2, TLG was 316.4±325.7, and MTV was 21.7±21.7 in the microsatellite instability-negative individuals. Conclusion: With the advancement of image analysis technology, MTV, and TLG, volumetric indexes derived from 18F-FDG PET have been proposed for risk stratification of cancer patients. Regarding the outcomes of this research, the semiquantitative and metabolic parameters obtained by PET/CT are not different in colorectal cancer cases with instable and stable microsatellites.Öğe Exploring 18F-FDG uptake patterns in liver, spleen, and bone marrow: Implications for inflammatory and infectious conditions(2024) Tuzcu, Şadiye Altun; Çetinkaya, Erdal; GÇzel, Fatih; Çetin, İlbey Erkin; Mete, Ümit; Argın, Eşref; Taşdemir, BekirOBJECTIVE: This study aimed to explore the relationship between fluorine-18-fluorodeoxyglucose (18F-FDG) uptake in the liver, spleen, and bone marrow and inflammatory markers such as c-reactive protein (CRP), albumin, and erythrocyte sedimentation rate (ESR) in patients undergoing positron emission tomography/computed tomography (PET/CT) imaging for cancer diagnosis. SUBJECTS AND METHODS: This retrospective cross-sectional study included a total of 708 patients with a diagnosis of malignancy. Fluorine-18-FDG PET/CT images acquired between January 2021 and December 2022. Exclusion criteria comprised prior chemotherapy, radiotherapy, hematological malignancies, or liver/spleen tumors. Statistical analysis included correlation analysis, univariate, and multivariate regression analysis. RESULTS: C-reactive protein levels demonstrated a significant positive correlation with 18F-FDG uptake in the spleen (r=0.104, P=0.006) and bone marrow (r=0.112, P=0.003). Albumin showed a negative correlation with liver 18F-FDG uptake (r=-0.220, P<0.001). Regression analysis revealed ESR's impact on spleen-to-liver (P=0.023) and bone marrow-to-liver (P=0.012) 18F-FDG uptake. CONCLUSION: This study demonstrates the association between inflammatory markers and 18F-FDG uptake in liver, spleen and bone marrow. C-reactive protein and ESR showing significant correlations with spleen and bone marrow 18F-FDG uptake, and albumin correlated with liver 18F-FDG uptake negatively. Erythrocyte sedimentation rate had significant impact on spleen and bone marrow 18F-FDG uptakes. These findings suggest the potential of 18F-FDG PET/CT in diagnosing inflammatory conditions, warranting further investigation into its clinical implications.Öğe Importance of parathyroid hormone needle aspiration washout in adenoma localization in primary hyperparathyroidism(International Scientific Information, Inc., 2019) Pekkolay, Zafer; Tuzcu, Şadiye AltunBACKGROUND: Primary hyperparathyroidism is an endocrine disease characterized by excessive secretion of parathyroid hormone and hypercalcemia. Although scintigraphy is commonly used for pre-operative localization, it does not always localize the parathyroid lesion. In such patients, ultrasonography can visualize the suspected lesion and needle washout sample for parathyroid hormone titer can be used to confirm parathyroid tissue. The aim of this study was to investigate the accuracy of the parathyroid hormone needle aspiration washout method in detecting the localization of parathyroid adenoma. MATERIAL AND METHODS: Patients with primary hyperparathyroidism who underwent surgery between 2010 and 2017 at the Dicle University Medical Faculty Hospital were retrospectively evaluated using medical records. Patients undergoing parathyroid hormone needle aspiration washout were performed in the suspected lesion were included in the study. Accompanied by ultrasonography, the suspected area was penetrated with needle, and negative aspiration was performed. Pre-operative scintigraphic data of patients were evaluated. Patients with positive scintigraphy, negative scintigraphy or patients who did not undergo scintigraphy were included in our study. Demographic data were presented as continuous data means ± standard deviation. Categorical variables were presented as frequency and percentage. RESULTS: Forty-nine patients (female/male, 40/9) who underwent parathyroid hormone needle aspiration washout were included in the study. Parathyroid hormone washout result was positive in 47 patients (47/49) and negative in 2 patients (2/49), sensitivity/positive predictive value (PPV) 95.91%. Twenty-six patients who had negative/suspicious scintigraphic results were diagnosed using the parathyroid hormone needle aspiration washout method (24/26, 92.3% accuracy). Parathyroid hormone needle aspiration washout without scintigraphy was performed in 13 patients (13/13, 100% accuracy). CONCLUSIONS: Parathyroid adenoma localization can be easily done using parathyroid hormone needle aspiration washout in centers experienced in adenoma localization in primary hyperparathyroidism cases in which scintigraphic results are negative or scintigraphy cannot be performed. We believe that primary parathyroid hormone needle aspiration washout can be a new localization method for adenoma localization.Öğe Increased arterial PET/CT F-18-fluorodeoxyglucose uptake in obese and overweight patients(Elsevier, 2021) Tuzcu, Şadiye Altun; Çetin, F.A.; Pekkolay, Zafer; Gezici, Ayten; Tuzcu, Alpaslan KemalObjectives. – We aimed to investigate the association between BMI and early atherosclerotic activity in cancer patients. We also compared the inflammatory and macroscopic calcification processes of atherosclerosis in the aortic segments and large arteries by 18F-FDG PET/CT of between normal and high BMI patients. Methods. – We conducted a retrospective review of cancer patients presented to our institution within the period between February and May 2018. Patients were classified according to their BMI into two groups: normal BMI group and high BMI group. Data of average SUVmax and SUVmean for four segments of the aorta, common iliac arteries, and femoral arteries were estimated and compared between both groups. Moreover, the macroscopic calcification on CT images for each vascular section was also reported. Results. – Ninety-eight patients were classified into two groups: normal BMI group (n = 52; 53.1%), and high BMI group (n = 46; 46.9%). Average SUVmax was significantly higher in obese participants in all arterial segments (P < 0.05). However, the SUVmean was significantly higher in obese patients in only three arterial segments aortic arch, left femoral artery and descending thoracic aorta (P < 0.05).Moreover, the differences between the two study groups in terms of the frequency of macroscopic calcifications were not statistically significant for all vascular segments. BMI positively correlated with SUVmax and SUVmean of the vascular segments (r value from 0,219 to 0,575/p value between 0,023 and 0,0001). Conclusions. – Fluorine-18-FDG PET/CT imaging revealed that patients with high BMI have more accelerated atherosclerotic inflammatory process in their major vessels compared to their age-matched controls with normal BMI. Future studies should assess the associated between these findings and the cardiovascular events in the long term.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 AltunAim: 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.Öğe Low bone density and high sclerostin in non-functioning pituitary adenoma(Elsevier Inc., 2023) Pekkolay, Zafer; Yıldırım, Devran Varhan; Tuzcu, Şadiye Altun; Taşdemir, Bekir; Tuzcu, Alpaslan KemalPurpose: Sclerostin reduces bone formation by inhibiting the Wnt signaling pathway in bone tissue. This study evaluated the serum sclerostin level in non-functioning pituitary adenoma (NFPA) patients and analyzed its relationship with bone metabolism. Method: The data of the patients who applied to the Dicle University Endocrinology, diagnosed with non-functioning pituitary adenoma, and the control group consisting of healthy individuals were included in the study. Serum sclerostin levels and DXA analysis parameters were evaluated and compared with healthy control groups. Results: The study consisted of 39 patients (F / M: 27/12) with NFPA (patient group) and 43 control groups (F / M: 26/17). There was no difference in terms of gender, age, height, weight and serum calcium, phosphorus, creatinine, 25-OH vitamin D, parathyroid hormone levels. Serum sclerostin levels (32.31 ± 1.53 ng / ml) in the patient group was found to be significantly higher than the control group (22.45 ± 8.9 ng / ml) (p < 0.001). BMD (Patients groups vs control group); total lumbar BMD (0.951-1.56 gr / cm2) (p < 0.001), femoral neck BMD (0.752-1.15 g / cm2) (p < 0.001), femoral total BMD (0.995- 1.63 gr / cm2) (p < 0.001), were found to be statistically significantly lower. Conclusion: This study provides the first evidence that serum sclerostin levels were increased in non-functioning pituitary adenomas, which showed that bone parameters were negatively affected.Öğe Olgu sunumu: Werner sendromu(Dicle Üniversitesi Tıp Fakültesi, 2013) Kılınç, Faruk; Tuzcu, Alpaslan Kemal; Beyaz, Coşkun; Tuzcu, Şadiye AltunWerner sendromu (WS) skleroderma benzeri deri değişiklikleri, alopesi, bacak ülserleri, kısa boy, katarakt, erken ateroskleroz, osteoporoz, hipogonadizm, diyabetes mellitus ve malignitelere yatkınlıkla karakterize otozomal resesif kalıtım gösteren ve oldukça nadir görülen erken yaşlanma sendromudur. Tipik olarak hayatın üçüncü veya dördüncü dekatında tanınabilmektedir. WS’li hastalar genellikle aterosklerotik komplikasyonlar ve malign tümörler nedeni ile 40-50’li yaşlarda kaybedilmektedir. Bundan dolayı, WS’nin erken tanısı, önemli mortalite ve morbidite nedenleri olan maling tümörler, ateroskleroz, diyabet veya osteoporozun erken evrede tespit edilmesi için ve genetik danışmanlık açısından büyük önem taşımaktadır. Bu makalede, büyüme gelişme geriliği, erken yaşlanma, erken katarakt, hipergonadotropik hipogonadizm bulgularıyla kliniğimize yatırılan ve werner sendromu tanısı konulan 19 yaşındaki erkek olguyu sunduk.Öğe A rare cause of acromegaly: McCune-Albright syndrome(Dicle Üniversitesi Tıp Fakültesi, 2015) Bodakçi, Erdal; Tuna, Mazhar Müslüm; Kılınç, Faruk; Pekkolay, Zafer; Soylu, Hikmet; Tuzcu, Şadiye Altun; Tuzcu, Alpaslan KemalMcCune-Albright syndrome is characterized by polyostatic fibrous dysplasia, brown spots on the skin (café au lait pigmentation) and autonomous endocrine hyperfunction. Early puberty and other endocrinological manifestations, such as acromegaly, gigantism and hypercortisolism are widely observed in the syndrome. Acromegaly is seen in 20% of patients. We report a case of acromegaly accompanied with this syndrome
