Browsing by Author "Aksoy, Tamer"

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Colonic Malignant Melanoma: F-18-FDG PET/CT Findings
(GALENOS YAYINCILIK, 2018-01-01) Kaya, Eser; Aksoy, Tamer; Guner, Ahmet Levent; Temiz, Hakan; Vardareli, Erkan
Primary malignant melanoma occurs most often in the skin and much less frequently in the choroid layer of the eyes, in the leptomeninges, oral cavity, nasal mucosa, pharynx, esophagus, bronchus, under the nail and vaginal or anorectal mucosa. Primary melanoma of the gastrointestinal tract has been confirmed for lesions occurring in the esophagus, stomach, small bowel, and anorectum through several published reports, as these are the areas where melanocytes normally exist. The occurrence of primary malignant melanoma in the colon is relatively rare, because melanocytes are embryologically absent in the large bowel. Herein we report a patient whose colonic malignant melanoma was diagnosed and disseminated metastatic lesions were revealed with F-18-FDG PET/CT scan. There were multiple nodular lesions showing increased F-18-FDG uptake in both lungs. There was a soft tissue lesion with slightly increased F-18-FDG uptake, which extended to the intraluminal region of the thoracic esophagus. Increased metabolic activity was detected in the asymmetric stomach wall thickening site and in a soft tissue lesion located on the gall bladder wall that was filling the lumen. Multiple hypodense/hyper-metabolic lesions were identified in the liver. Multiple hyper-metabolic polypoid soft tissue lesions were visualized in almost the entire colonic segments. Multiple hyper-metabolic peritoneal implants were noted in all abdominal quadrants. Increased F-18-FDG uptake was detected at the right surrenal gland soft tissue lesion. There was a hyper-metabolic soft tissue lesion on the posterior wall of the rectum. Hyper-metabolic lytic lesions were seen at the thoracal and lumbar vertebrae, left scapula, left iliac bone, sacrum and left femur. There was no evidence of F-18-FDG avid skin lesions in both attenuation corrected and non-corrected images.
Comparison of serum NEDD-9, CA 15-3, and CEA levels and PET metabolic parameters in breast cancer patients with 18 F-FDG PET/CT
(ASSOC MEDICA BRASILEIRA, 2020-01-01) Arslan, Esra; Aral, Hale; Aksoy, Tamer; Afsar, Cigdem Usul; Karabulut, Senem; Trabulus, Fadime Didem Can; Gursu, Riza Umar; Cermik, Tevfik Fikret
OBJECTIVE: Analyze the over expression of neural precursor cell expressed developmentally down-regulated protein 9 (NEDD-9) deregulated associated with a poor prognosis in various carcinomas. Our objective was to investigate the relationship between the levels of NEDD-9, CA 15-3, and CEA and PET (SUVmax, MTV40, TLG40) with the clinical parameters of patients with breast cancer (BC). METHODS: One hundred and eleven patients (82 BC patients who underwent 18F-FDG PET/CT and 29 healthy controls) were evaluated. SUVmax, MTV, and TLG of the primary tumor were compared with the molecular and histopathological subtypes. 18F-FDG, MTV, and TLG were evaluated based on the clinical data, i.e., nodal involvement, distant metastasis, ER and PR status, Ki-67, serum levels of NEDD-9, CA15-3, and CEA. We compared the NEDD-9 in the BC and healthy control groups. RESULTS: The mean +/- SD of SUVmax in the 82 patients was 13.0 +/- 8.6. A statistically significant relationship (p = 0.022) was found between the molecular subtypes and 18F-FDG uptake. The relationship between 18F-FDG uptake and TLG measured in patients <50 years, ER-PR negativity, and HER2 positivity were statistically significant (p=0.015, 0.007, 0.046, and 0.001, respectively). MTV40, TLG40, and CA 15-3 in metastatic patients were statistically significant (p=0.004, 0.005, and 0.003, respectively). NEDD-9 in the BC group was significantly higher than in the healthy group (p=0.017). There was a positive correlation between SUVmax and 1(167 and CA 15-3
Comparison of wire-guided localization and radio-guided occult lesion localization in preoperative localization of nonpalpable breast lesions
(TUBITAK SCIENTIFIC \& TECHNICAL RESEARCH COUNCIL TURKEY, 2016-01-01) Kanat, Nazim Baris; Tuncel, Murat; Aksoy, Tamer; Firat, Aysegul; Demirkazik, Figen; Onat, Demirali; Caglar Tuncali, Meltem; Caner, Biray Emine
Background/aim: Breast lesions that are not palpable on physical examination but considered suspicious for malignancy on mammography or ultrasonography should be marked before surgery. Wire-guided localization (WGL) is the most frequently used method for preoperative marking of nonpalpable breast lesions (NPBLs). An alternative is marking by a radioactive agent (radio-guided occult lesion localization
Evaluating the Role of Routine Prone Acquisition on Visual Evaluation of SPECT Images
(SOC NUCLEAR MEDICINE INC, 2015-01-01) Guner, Levent A.; Caliskan, Billur; Isik, Ilknur; Aksoy, Tamer; Vardareli, Erkan; Parspur, Afsin
Attenuation artifacts reduce our ability to evaluate perfusion of affected myocardial segments. The aim of this study was to evaluate the impact of routine prone-position image evaluation within a stepwise visual interpretation of myocardial perfusion studies. Methods: We have included 279 consecutive patients who were referred for evaluation of myocardial ischemia. All patients underwent routine electrocardiogram-gated supine SPECT imaging and non-electrocardiogram-gated prone-position SPECT imaging. Three nuclear medicine physicians interpreted the images in the following order: polar maps, supine images, raw images, motion-frozen gated images, and prone images, using a scale of 0-4. Segments with perfusion abnormalities were noted. Results: All physicians reported lower proportions of equivocal evaluations after evaluating prone images (18.3\% vs. 4.7\%, 19\% vs. 11.1\%, and 12.2\% vs. 6.1\%, P < 0.0001, P = 0.0077, and P = 0.0125, respectively). At the prone stage, normalcy rates were 89\%, 87\%, and 91\%. Two physicians had significantly increased normalcy rates at the prone stage (72\%-89\%, P = 0.039, and 66\%87\%, P = 0.006). At the prone stage, a decision reversal to normal or probably normal was observed in 40\% (29/72), 33\% (17/51), and 43\% (21/48). In men, apical, mid, and basal inferior walls and in women apical and mid parts of anterior walls were more likely to be attributed to attenuation. The 2 steps that increased normalcy rates for interpreters were the review of raw images and of prone images. Conclusion: Routine prone imaging increases interpretive certainty and interobserver agreement and changes the final evaluation in a substantial number of patients and significantly decreases the number of equivocal evaluations.
Retrospective analysis of melanoma patients who had undergone PET-CT examination
(DERI ZUHREVI HASTALIKLAR DERNEGI, 2013-01-01) Bakar, Ozgur; Vardareli, Erkan; Sahin, Sedef; Yuksel, Selcen; Aksoy, Tamer
Background and Design: Pet positivity was found in 21 (37.5\%) the incidence of melanoma is increasing significantly in Turkey and in the whole world. Thus, Positron Emission Tomography-Computed Tomography (PET-CT), which is being reimbursed by the government for the documentation of metastases of clinically suspicious patients with stages 1 b and higher, is becoming widely used. This study aims to analyze, the histopathological features of the tumors and the clinical and demographic data on melanoma patients who had undergone PET-CT examination for the screening of metastases. Materials and Methods: We collected data on 57 melanoma patients who had undergone PET-CT evaluation in the Nuclear Medicine Department between 2004 and 2011. On the basis of PET-CT positivity, we retrospectively analyzed SUV (Standard uptake value), demographic data, Breslow thickness, primary tumor location, presence of histopathologically documented ulceration, perineural, vascular and lymphatic invasion, and metastases detected by other screening methods as well as the proposed treatment modalities. Results: PET-CT positivity was found in 22 (39\%) patients. The mean Breslow thickness was 5.12 +/- 6.29mm., 1 patient (\%7) with <= 1mm, 5 (36\%) with 2-4mm and 8 patients (57\%) with >4mm of Breslow thickness had distant metastases. Statistically significant correlation was found between Breslow thickness and positive PET-CT findings. The distribution of the primary tumor site was 35.3\%left-sided, 25.5\%right-sided and 39.2\%on the midline. All patients with scalp involvement had distant metastases. There was no statistically significant correlation of PET-CT positivity with histopathologically proven ulceration and perineural, vascular and lymphatic invasion. Thirty-one percent positive correlation was found between Breslow thickness and SUV. Forty-five percent of PET-CT positive patients had metastases documented with other screening methods as well. All but 2 patients with distant metastases had undergone wide tumor resection and adjuvant chemotherapy or radiotherapy. Conclusion: PET-CT complementing conventional imaging methods gains much importance in the treatment planning for some selected high-risk melanoma patients