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Öğe Incidental Detection of Previously Unknown Breast Cancer on Tc-99M Mibi Scintigraphy(Trakya Üniversitesi, 2021) İşkan, Nur Gülce; Orun, Şeyma Gizem; Gökdemir, Ezgi; Altun, Gülay DurmuşAims: Tc-99m methoxyisobutylisonitrile scintigraphy is a diagnostic method commonly used for cardiac perfusion imaging. It is also used for parathyroid, lung, breast, thyroid, brain, melanoma, lymphoma, bone, and soft tissue primary and secondary tumors imaging. Our case aims to report a breast cancer incidentally revealed by Tc-99m methoxyisobutylisonitrile scintigraphy. Case Report: A 49-year-old female patient was admitted to the cardiology depart- ment with atypical angina. Tc-99m methoxyisobutylisonitrile scintigraphy showed myocardial perfusion was within normal limits but a focal uptake was detected in the lateral superior quadrant of the left breast. Ultrasonography detected a lesion with irregular borders in the outer quadrant of the left breast and a lymph node with increased thickness of the cortex in the left axilla. Magnetic resonance imaging showed a mass with a spiculated contour in the outer quadrant of the left breast and lymph nodes with increased cortex thickness in both axillae. By the histopathologic examination, the specimen was diag- nosed with invasive ductal carcinoma. Conclusion: Although Tc-99m methoxyisobutylisonitrile scintigraphy is mainly used for myocardial perfusion imag- ing, the entire image area should be examined in detail and further investigation should be done for incidental focal lesions that were previously undetected.Öğe A Case Report: the Role of Prostate-Specific Membrane Antigen Labeled Theranostic Agents in the Diagnosis and Treatment of Prostate Cancer(Trakya Üniversitesi, 2019) Avul, Ali Rıza; Özdemir, Büşra; Altun, Gülay DurmuşAims: Prostate cancer is one of the most prevalent cancers worldwide and sometimes it can be deadly which brings out a high quantity of the prostate specific membrane antigen. Gallium-68 prostate specific membrane antigen PET scan is used to detect primary tumors and metastases of prostate cancer. In addition, Lutetium-177 prostate-specific membrane antigen is used for treatment in some special cases. Our case report aims to show the roles of prostate specific membrane antigen labeled theranostic agents in the diagnosis, staging, and treatment of prostate cancer and evaluate the response to the treatment of metastatic castration-resistant prostate cancer. Case Report: A 78-year-old male patient was admitted to Trakya University Hospital Nuclear Medicine Department with the diagnosis of prostate cancer for cancer staging and treatment. Gallium-68 prostate specific membrane antigen was firstly used to detect any metastases and then to evaluate response to the treatment. Lutetium-177 prostate specific membrane antigen was used for treatment. Conclusion: After 3 cures of Lutetium-177 therapy, the patient underwent Gallium - 68 prostate specific membrane antigen PET which demonstrated regression of the metastatic tumor. There was a decrease in the uptake of Gallium-68 prostate specific membrane antigen in the primary tumor and lymph nodes metastases. Also, bone metastases have been cleared. Hence, Lutetium-177 seems to be a promising treatment modality to treat metastatic prostate cancerÖğe Gastrointestinal Tract Multiple Lymphomatous Polyposis Presented As Mantle Cell Lymphoma(Trakya Üniversitesi, 2019) Akay, Fatih Erkan; Can, Nuray; Cezik, Mert; Kırkızlar, Hakkı Onur; Soyluoğlu, Fatma Selin; Öz Puyan, FulyaAims: Mantle cell lymphoma is a mature B cell non-Hodgkin lymphoma which may be presented with the involvement of the gastrointestinal tract as multiple lymphomatous polyposis. The aim of this case report is to increase the awareness of including lymphomatoid polyposis as an entity in the differential diagnosis of multiple polyposis of the gastrointestinal tract. Case Report: A 69-year-old male patient was admitted to the Trakya University Emergency Department with acute abdominal pain. His cli-nical findings were anorexia that started 3-4 months ago together with constipation and nausea causing him to lose 10-15 kg in 7-8 months, with denial of other parameters of B-symptoms (fevers and night sweats). Endoscopic biopsies that were taken from bulbus and duodenum were investigated and he was diagnosed with mantle cell lymphoma. The patient went through an ileoce-cal resection due to his intussusception that caused abdominal pain in the first place. Conclusion: Although being an infrequent disease, gastrointestinal lymphomatoid polyposis should be an entity comprised in differential diagnosis for multiple polyposis of the gastrointestinal tract. On the other hand, there is still not a therapeutic protocol with a definitive cure for gastrointestinal tract mantle cell lymphoma. Elderly patients in high risk group such as our patient should be given treatment by taking their conditions into consideration. Keywords: Mantle cell lymphoma, polyp, non-Hodgkin lymphomaÖğe Effectiveness of Pet/Ct in Evaluation of the Lymphoma(Trakya Üniversitesi, 2019) Atnallar, Göktuğ; Özdemir, Büşra; Ümit, Elif Gülsüm; Durmuş Altun, GülayAims: Prognosis and survival of Hodgkin lymphoma have been improved dramatically by the development of treatments as well as the sensitivity of evaluation tools. In this case report, we aimed to emphasize the importance of positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography in the initial staging of Hodgkin’s lymp-homa, evaluating the response to treatment, and to demonstrate residual tissue or recurrence. Case Report: A 25-year-old male patient presented to Trakya University Hospital with swelling in the right groin and was diagnosed with Hodgkin’s lymphoma. Positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography scan was used for initial staging and assessment of response to treatment. Conclusion: Positron emission tomography is a feasible imaging modality for the evaluation of lymphomas. It is sensitive to detect minimal recurrence as well as alterations of lesions’ metabolic activity. Keywords: Positron emission tomography, lymphoma, hodgkin diseaseÖğe Does valproate therapy decrease the bone mineral density in one-year follow-up in children?(2009) Bostancıoğlu, Musa; Öner, Naci; Küçükuğurluoğlu, Yasemin; Kaya, Meryem; Çiftdemir, Nükhet Aladağ; Çeltik, Coşkun; Karasalihoğlu, Serap TevhideAmaç: Epilepsi uzun sureli antiepileptik tedavi gerektiren kronik bir hastalıktır. Bu çalışmanın amacı, en sık kullanılan antiepileptik ilaç olan valproatın kemik mineral metabolizmasına olan yan etkilerini değerlendirmektir. Hastalar ve Yöntemler: Bu çalışma epilepsi veya febril konvulziyon profilaksisi amacıyla valproat başlanan 61 hastada (38 kız, 28 erkek; ort. yaş 81.2±44.5 ay; dağılım 12-168 ay) yapıldı. Bütün olgularda valproat tedavisi öncesinde ve 12 ay sonrasında, kemik mineral metabolizmasındaki bozukluklar açısından kemik mineral dansitesi ve biyokimyasal parametrelere bakıldı. Bulgular: Bir yıllık valporat tedavisi sonrasında kemik mineralizasyon bozukluğunu gösterebilecek kalsiyum, fosfor, alkalen fosfatazda istatistiksel olarak anlamlı farklılık tespit edilmemiştir. İki hastada (%3.3) osteoporoz tespit edilmiştir. Sonuç: Valproatın kemik mineral metabolizması üzerine yan etkileri tartışmalıdır. Osteopeni belirtilerini değerlendirmek için, kemik biyokimyası, 25-hidroksi D vitamini, hormonal parametreler ve kemik mineral dansitesinin tek başlarına değerlendirilmesi yetersizdir, mutlaka bu parametreler birlikte değerlendirilmelidir. Biyokimyasal parametreler bozulmadan, kemik mineral dansitesi değişiklikleri olacağından, valproat tedavisi alan hastalarda yıllık kemik mineral dansitesi ölçümleri yapılmalıdır.Öğe Multimodal imaging with PET-CT in oncology(2006) Bıersack, Hans-Jürgen; Yüksel, Mahmut; Palmedo, Holger; Rödel, Roland; Reınhardt, Michael; Jaeger, UrsulaPozitron-emisyon tomografi (PET) ile bilgisayarlı tomografinin (BT) birlikte kullanımı (PET-BT) PET'in klinik kullanımını önemli ölçüde artırmıştır. PET-BT, BT'nin yüksek çüzünürlüğünü PET'in yüksek duyarlığıyla birleştirmektedir. PET ve BT sonuçlarının tek incelemede ve aynı cihazla elde edilmesi nedeniyle her iki prosedürün en uygun birleşimi mümkündür. PET ve BT görüntülerinin klasik birleştirilmesine oranla, PET-BT ile PET'in doğruluğu yaklaşık %15 oranında artırılabilir. PET-BT'nin gücünden tam olarak yararlanmak sadece oral veya intravenöz kontrast ajanların kullanılmasıyla mümkündür. BT'nin X- ışını aynı zamanda atenüasyon düzeltmesi için kullanılır. Bu makalede ağırlıklı olarak akciğer kanseri, malign melanom, baş-boyun tümörleri, tiroid tümörleri ve kolorektal kanserler üzerinde durulmuş ve PET-BT'nin görsel gücü olgulara ait görüntüler aracılığıyla ortaya konmuştur.Öğe Combined effect of parathyroid hormone and strontium ranelate on bone healing in ovariectomized rats(WILEY, 2018) Goker, Funda; Ersanli, Selim; Arisan, Volkan; Cevher, Erdal; Guzel, Emine Elif; Issever, Halim; Omer, Beyhan; Altun, Gulay Durmus; Morina, Deniz; Yilmaz, Tugba Ekiz; Dervisoglu, Elmire; Del Fabbro, MassimoObjectiveParathyroid hormone (PTH) enhances bone healing. Strontium ranelate (SR) is an antiresorptive agent that increases bone formation. Reports about combined effects of PTH and SR on local bone regeneration in osteoporotic subjects are limited. We aimed at investigating the efficacy of PTH and SR for promoting new bone formation in critical-sized defects of ovariectomized rats. Materials and MethodsParathyroid hormone- and/or SR-containing poloxamer implant tablets with/without chitosan microparticles were delivered locally to calvarial defects of 90 Wistar rats. Biopsies were analyzed histologically and histomorphometrically at 4 and 8weeks of healing. ResultsHistomorphometry revealed that PTH alone promoted new bone formation at 4weeks but the efficiency declined in 8weeks. There was no positive effect of SR alone on bone formation at 4 or 8weeks. Calvarial defects treated with PTH+SR combinations showed statistically significant greater new bone formation than either treatment alone at both time intervals. Tissue responses were modest and supported the good biocompatibility of the biomaterials used. ConclusionParathyroid hormone and SR combinations can be effective for calvarial bone regeneration of ovariectomized rats. PTH plus SR may have potential use as bone graft material in orthopedic and dental surgery to enhance bone healing and osseointegration.Öğe 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, AliObjective 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.Öğe F-18 fluoride uptake in primary breast cancer(Springer, 2018) Sarikaya, Ismet; Sharma, Prem; Sarikaya, AliObjectiveBone-specific radiotracers are known to accumulate in breast lesions. Tc-99m diphosphonates have been widely studied in differentiating breast lesions. In this retrospective study, we aimed to assess the uptake of the bone-specific PET radiotracer, F-18 fluoride (NaF), in primary breast cancers to determine its sensitivity and to identify any differences in NaF uptake between calcified and non-calcified tumors, histological subtypes, and patients with or without axillary lymphadenopathy.MethodsNaF positron emission tomography/computed tomography (PET/CT) images of 69 newly diagnosed breast cancer patients were reviewed. F-18 fluoride uptake as maximum standardized uptake value (NaF SUVmax) was measured in the primary tumor, enlarged axillary lymph nodes and contralateral normal/non-tumoral breast tissue. Low-dose CT images were reviewed to locate the primary tumor and grossly assess its calcification and check for ipsilateral axillary lymphadenopathy. Whole body NaF PET/CT images were reviewed to search for bone metastases. Eighteen patients also underwent F-18 fluorodeoxyglucose (FDG) PET/CT study.ResultsThe primary breast tumor was clearly seen as focal or diffuse uptake on NaF PET images in 27 of 69 patients (39%) (mean NaF SUVmax: 2.01.0). In the rest, there was only mild bilateral diffuse breast uptake. When analyzing images per histological subtype (42 patients, 43 tumors), 14 of 31 invasive ductal carcinomas (IDC) (45%) and 3 of 4 ductal carcinoma in situ (DCIS) were visible on PET. Five invasive lobular carcinomas, 2 invasive mammary carcinomas, and 1 mucinous carcinoma were not visible on PET. Mean NaF SUVmax of contralateral normal/non-tumoral breast tissue was 1.0 +/- 0.4. There was no significant difference in mean NaF SUVmax of primary tumor in cases with and without calcification or with and without axillary lymphadenopathy (p 0.892 and 0.957). There was no correlation between NaF SUVmax and FDG SUVmax values of the primary tumors (r 0.072, p 0.797, Pearson correlation).ConclusionNaF PET has relatively low sensitivity in detecting breast cancer. However, abnormal breast uptake on NaF PET requires further evaluation. F-18 fluoride uptake in the primary breast tumor does not seem to be correlated with axillary lymphadenopathy (metastasis potential), gross tumor calcification or metabolic activity of the tumor.Öğe Current status of F-18-FDG PET brain imaging in patients with dementia(Soc Nuclear Medicine Inc, 2018) Sarikaya, Ismet; Sarikaya, Ali; Elgazzar, Abdelhamid H.F-18-FDG PET brain imaging is commonly used in the early detection and differential diagnosis of various subtypes of dementias.F- 18-FDG PET images are mainly evaluated visually, and semiquantitative analysis programs are also commonly used in many centers. However, visual and semiquantitative analysis carry certain limitations. Visual assessment is subjective and dependent on expertise. Commercially available semiquantitative analysis programs have certain limitations such as suboptimal selection of brain areas or erroneous uptake normalization procedures that may provide inaccurate results, and physicians reporting semiquantitative results should be aware of these. In this pictorial review article, we will discuss the current status of F-18-FDG PET brain imaging in patients with dementia and present figures and semiquantitative analysis results of various sub-types of dementias as well as certain artifacts seen on F-18-FDG PET brain imaging studies.
