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Permanent URI for this collectionhttps://hdl.handle.net/11443/932

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Author: search.filters.author.Vardareli, ErkanHas files: No

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    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.
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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.