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    A Lesion based and Sub-regional Comparison of FDG PET/CT and MDP Bone Scintigraphy in Detection of Bone Metastasis in Breast Cancer
    (Bentham Science Publ Ltd, 2017) Demir, Selin S.; Aktas, Gul E.; Yenici, Fusun U.
    Background: The aim of this study was to compare sensitivity, specificity and accuracy of 18F-FDG PET/CT and bone scintigraphy (BS) in detection of bone metastases in breast cancer patients; particularly according to anatomical regions, CT characteristics, tumor markers and hormone receptor status. Methods: Fifty patients, who received both FDG PET/CT and BS were retrospectively analyzed. Patients' information including age, histological tumor type, hormone receptor positivity, c-erb B-2 oncogenes, tumor markers, clinical stages and subsequent clinical courses were reviewed. Lesion by lesion, regional and overall analyses was performed. The extent of metastases was assessed with twelve regions segmented bone scan index (BSI). The final diagnosis was established by histopathology, imaging and follow-up. Results: Overall sensitivity, specificity and accuracy were 83.2%, 100% and 87.6% for PET/CT, and 69.8%, 76.1% and 71.5% for BS. PET/CT was found to be more sensitive, specific and accurate for all regions, except cranium. While PET/CT was more sensitive in detecting osteolytic lesions, BS was more sensitive in detecting osteoblastic lesions. CA 15-3 levels were correlated with number of metastases for both techniques (P<0.05). Although PET/CT detected more metastatic lesions, the number of lesions detected with both techniques and the calculated BSI's were not significantly different (p=0.061, p=0.053, respectively). BSI and number of totally detected metastases with both techniques were correlated with the final assessment. Conclusion: The sensitivity, specificity and accuracy of PET/CT in detecting overall and sub-regional bone lesions were significantly higher. Although PET/CT detected more metastatic lesions, both techniques seemed to supply complementary information to each other.
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    Prognostic significance of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography-derived metabolic parameters in surgically resected clinical-N0 nonsmall cell lung cancer
    (Lippincott Williams & Wilkins, 2018) Aktas, Gul E.; Karamustafaoglu, Yekta A.; Balta, Cenk; Sut, Necdet; Sarikaya, Ismet; Sarikaya, Ali
    Objective Our aim was to assess the significance of metabolic positron emission tomography (PET) parameters for the prediction of occult mediastinal lymph node metastasis (OLM) and recurrence in patients with clinical-N0 nonsmall cell lung cancer (NSCLC) after surgical resection and lymph node dissection. Materials and methods We evaluated 98 patients with NSCLC [52 adenocarcinoma (ADC), 46 squamous cell carcinoma (SQCC)] who had undergone initial/preoperative fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT). Eligibility criteria for participation were clinically staged as N0 and no FDG uptake in mediastinal lymph nodes on preoperative PET/CT. Clinicopathological characteristics and the diagnosis of recurrence were obtained by reviewing the hospital records. Metabolic parameters [maximum standardized uptake value, mean standardized uptake value, metabolic tumor volume (MTV), total lesion glycolysis] were determined on F-18-FDG PET/CT images. The association of metabolic parameters with OLM and recurrence was assessed. Results OLM was found in 26 (26.53%) patients. T-stage, central location, and lymphovascular invasion were associated with OLM (respectively, P = 0.007, 0.011, <0.001). None of the metabolic parameters was associated with OLM. Metabolic parameters of the tumor were significantly higher in patients with recurrence when the cohort was evaluated as a whole (P = 0.002, 0.005, 0.016, and 0.004, respectively). In particular, there was a significant association between recurrence and tumor size, grade, stage, MTV (P < 0.001), and TLG (P < 0.001) in ADC. This association was not found in SQCC. Multivariate analysis showed that MTV was an independent prognostic factor for recurrence and associated with disease-free survival. Conclusion Metabolic parameters of the primary tumor on preoperative 18F-FDG PET/CT could not predict OLM in patients with clinical-N0 NSCLC. MTV was an independent risk factor for recurrence in ADC, but not in SQCC. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.