Browsing by Author "Yapar, Ali Fuat"

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A Case of a Man With Isolated Breast Metastasis From Lung Adenocarcinoma Incidentally Detected by FDG PET/CT
(2016) Erhamamci, Seval; Reyhan, Mehmet; Canpolat, Tuba; Nursal, Gul Nihal; Yapar, Ali Fuat; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0002-5302-4386; https://orcid.org/0000-0003-1715-4180; 26562574; AAJ-5242-2021; AAK-8107-2021; R-3735-2016; AAI-8973-2021
Breast metastases from an extramammary primary tumor are very rare, particularly in men. In this study, we present a case of a 74-year-old man with isolated breast metastasis from lung adenocarcinoma as an incidental finding on PET/CT and diagnosed concomitantly with the primary tumor. Detection of isolated incidental metastatic lesions in the breast on PET/CT imaging has a significant clinical impact on patients with known malignant disease due to change of disease stage, management, and also treatment method.
A Case of Primary Colon Carcinoma Demonstrated by FDG PET/CT Imaging After Detection of a Solitary Brain Metastasis
(2015) Erhamamci, Seval; Reyhan, Mehmet; Nursal, Gul Nıhal; Torun, Nese; Yapar, Ali Fuat
The detection of brain metastases as the initial manifestation of colorectal carcinoma without liver or lung involvement is extremely rare. Herein we present a case of a 52-year-old male patient with an unusual presentation of colon cancer, with primary lesions demonstrated by fluorine- 18-labeled fluorodeoxyglucose (FDG) Positron-emission tomography/computed tomography (PET/CT) after detection of a solitary brain metastasis. Brain CT images revealed a brain tumor. Histopathologic evaluation indicated metastatic poorly differentiated adenocarcinoma, while his physical examination was normal. The PET/CT revealed abnormal intense FDG uptake in the right parietal region and in descending colon, with no other abnormal FDG uptake elsewhere in the body. The histopathologic diagnosis of the descending colon lesion revealed moderately differentiated adenocarcinoma. This case indicates that FDG PET/CT imaging may have a positive impact on the evaluation of patients with brain metastasis from an unknown primary.
Choroidal Metastasis of Papillary Thyroid Carcinoma Demonstrated on SPECT-CT
(2016) Torun, Nese; Reyhan, Mehmet; Yapar, Ali Fuat; Karatas, Muge; https://orcid.org/0000-0002-5597-676X; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0003-1715-4180; 26825205; AAE-2718-2021; AAJ-5242-2021; AAI-8973-2021
We report a 68-year-old woman with papillary thyroid carcinoma metastasizing to choroid. The choroid metastasis was diagnosed with SPECT-CT and then was treated with high-dose radioactive iodine therapy.
Demonstration of Cerebrospinal Fluid Leakage on Radionuclide Cisternography by SPECT/CT
(2015) Nursal, Gul Nihal; Yapar, Ali Fuat; 0000-0002-5302-4386; 0000-0003-1715-4180; 25072925; R-3735-2016; AAI-8973-2021
The effect of androgen deprivation therapy on 68GA-PSMA-tracer uptake in nonmetastatic prostate cancer patients
(2020) Cem, Onal; Guler, Ozan Cem; Torun, Nese; Reyhan, Mehmet; Yapar, Ali Fuat; 0000-0002-5597-676X; 0000-0003-1715-4180; 0000-0001-8550-3368; 0000-0001-6908-3412; AAE-2718-2021; AAI-8973-2021; AAJ-5242-2021; AAC-5654-2020
The effect of androgen deprivation therapy on Ga-68-PSMA tracer uptake in non-metastatic prostate cancer patients
(2020) Onal, Cem; Guler, Ozan Cem; Torun, Nese; Reyhan, Mehmet; Yapar, Ali Fuat; 0000-0002-5597-676X; 0000-0001-8550-3368; 0000-0003-1715-4180; 0000-0001-6908-3412; 0000-0002-2742-9021; 31732768; AAE-2718-2021; AAJ-5242-2021; AAI-8973-2021; AAC-5654-2020; D-5195-2014
Purpose To evaluate the effect of neoadjuvant androgen deprivation treatment (ADT) on prostate-specific membrane antigen (PSMA) tracer uptake demonstrated in Ga-68-PSMA-positron emission tomography (PET/CT) in non-metastatic hormone-naive prostate cancer (PC) patients. Materials and methods The clinical data of 108 PC patients who received neoadjuvant ADT were retrospectively analyzed. All patients had a baseline Ga-68-PSMA-PET/CT scan, and a second scan was delivered median of 2.9 months after the initiation of ADT. The maximum standardized uptake value (SUVmax) of primary tumor (SUVp) and metastatic lymph nodes (SUVln) as well as PSA response were assessed between pre- and post-ADT Ga-68-PSMA-PET/CT scans. Results There were significant decreases in posttreatment serum PSA, SUVp, and SUVln. A decrease in SUVp was seen in 91 patients (84%) with a median value of 66% (range, 5-100%), while 17 patients (16%) had no change in or an increase in PSMA tracer uptake with a median value of 24% (range, 0-198%). Patients with Gleason score (GS) of 7 had significantly higher metabolic response rates compared to other patients. The disease progression was significantly higher only in patients with GS > 7 disease compared to GS 7 disease. The PSA response to ADT was the lowest in patients with ISUP high-grade tumors. A total of 16 patients (15%) had progressive disease, and in 9 patients (8%), radiotherapy decisions were modified according to posttreatment Ga-68-PSMA-PET/CT scans. Conclusions The current study includes the largest number of patients analyzed to date and demonstrates that ADT causes a significant decrease in serum PSA values and SUVp and SUVln. The authors demonstrate that Ga-68-PSMA-PET/CT may be used as a quantitative imaging modality after neoadjuvant ADT in hormone-naive non-metastatic PC patients.
Elastofibroma Dorsi Incidentally Detected by 18F-FDG PET/CT Imaging
(2015) Erhamamci, Seval; Reyhan, Mehmet; Nursal, Gul Nihal; Torun, Nese; Yapar, Ali Fuat; Findikcioglu, Alper; Canpolat, Tuba; 0000-0003-1715-4180; 0000-0002-5597-676X; 0000-0002-5302-4386; 0000-0001-8550-3368; 25666569; AAI-8973-2021; AAE-2718-2021; R-3735-2016; AFT-2303-2022; AAK-8107-2021; AAJ-5242-2021
Elastofibroma dorsi (ED) is a rare pseudotumor of the soft tissues that can also show 18F-fluorodeoxyglucose (F-18-FDG) uptake on positron emission tomography combined with computed tomography (PET/CT) imaging. The aim of this retrospectively study was to describe the metabolic characteristics of ED incidentally detected by F-18-FDG PET/CT imaging. Between November 2009 and August 2013 at our institution, 10,350 consecutive PET/CT examinations were retrospectively investigated. In 176 of these patients, ED was recorded as an incidental finding. Fifty-five of 176 patients also had follow-up scans after chemoradiotherapy. A total of 231 scans with ED in 176 patients were identified. To determine the metabolic activity of ED, the maximum standardized uptake value (SUVmax) was calculated semiquantitatively. For measurement size of ED, the longest axis of transaxial CT images was used. Seven of the 176 patients underwent surgery due to suspected metastases and/or invasion of primary malignancy and/or symptoms or incidental during surgery. The prevalence of ED in our series was 1.7 %. The lesions were located in the subscapular region in all patients, except in one case with a lesion in the infrascapular region. A total of 419 ED lesions in 231 scan of 176 patients were evaluated. Mean +/- A SD SUVmax and long axis values for these 419 lesions were 2.31 +/- A 0.61 (range 1.0-4.30) and 56.78 +/- A 17.01 mm (range 19-112 mm), respectively. Of these 176 patients, 141 (80.1 %) had bilateral lesions and 35 (19.9 %) had unilateral lesions. There were statistically significant differences in the SUVmax and long axis values between the right and left side in the bilateral lesions (p = 0.001). No significant differences in the SUVmax and long axis values of the lesion were found between pre- and posttreatment in the patients with follow-up scans. Elastofibroma dorsi located in the scapular region is usually bilateral, asymmetric and with mild or moderate metabolic activity on PET/CT imaging. In addition, the metabolic activity and size of ED remained stable after chemoradiotherapy. Awareness of these metabolic characteristics of ED is important for preventing misinterpretation during F-18-FDG PET/CT studies.
F-18-FDG PET/CT Imaging in an Unusual Case of Cutaneous Melanoma Arising From Congenital Melanocytic Nevus in a Two-year-old Girl
(2021) Erhamamci, Seval; Reyhan, Mehmet; Bal, Nebil; Torun, Nese; Yapar, Ali Fuat; 0000-0001-5016-4650; 0000-0001-8550-3368; 34082516; AAJ-5242-2021
Focal 99mTc-DMSA Uptake in Lung Parenchyma Without Structural Alterations on SPECT/CT
(2015) Nursal, Gul Nihal; Reyhan, Mehmet; Yapar, Ali Fuat; 0000-0003-1715-4180; 0000-0001-8550-3368; 0000-0002-5302-4386; 26053717; AAI-8973-2021; AAJ-5242-2021; R-3735-2016
Static renal scintigraphy with Tc-99m-DMSA is commonly used for the evaluation of renal morphology and function. Extrarenal uptake of Tc-99m-DMSA is a rare finding described previously on sites such as bone metastasis, hemangioma, and splenic amyloidosis. We report a case with Tc-99m-DMSA activity in the lungs.
Gigant Malign Germ Cell Tumor Occured in Intraabdominal Undescended Testis
(2015) Reyhan, Mehmet; Guvel, Sezgin; Yapar, Ali Fuat; 0000-0001-6534-9981; 0000-0003-1715-4180; 0000-0001-8550-3368; AAL-4363-2021; AAI-8973-2021; AAJ-5242-2021
Is PET/CT Necessary in the Management of Early Breast Cancer?
(2016) Nursal, Gul Nihal; Nursal, Tarik Zafer; Aytac, Huseyin Ozgur; Hasbay, Bermal; Torun, Nese; Reyhan, Mehmet; Yapar, Ali Fuat; https://orcid.org/0000-0002-5302-4386; https://orcid.org/0000-0002-3583-9282; https://orcid.org/0000-0002-5597-676X; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0003-1715-4180; 26914560; R-3735-2016; IQV-1169-2023; AAJ-7913-2021; AAE-2718-2021; AAJ-5242-2021; AAI-8973-2021
Purpose Advanced imaging methods in early breast cancers are not recommended before surgery. In contrast to the accepted guidelines, some recent studies have shown some benefits with the use of PET/CT in early-stage breast cancer. In this study, we aimed to document the efficacy of PET/CT in detection of distant metastasis as well as other primary cancers. Patients and Methods In this retrospective study, we reviewed the records of all women patients diagnosed with early breast cancer between March 2012 and December 2014. Besides demographics, we recorded the clinical TNM stage, histology of the tumor, and hormone receptor status. As PET/CT imaging is a routine procedure in our center for early breast cancer, tumor size, lymph node status, distant metastasis, and possible other primary malignancies detected by PET/CT were also recorded. Results Of the 419 women included in the study, 24.8% were clinically staged as stage I while the rest were stage II. Distant metastases were detected in 42 patients (10%). The yield of PET/CT in detecting metastasis was significant in stage II patients compared with stage I patients (12.4% vs 2.9%). In subgroup analysis of stage II patients, the performance of PET/CT in detecting metastasis was still evident in stage IIA patients (9.5%). In logistic regression analysis of the significant and near-significant factors (as detected by univariate analysis) effecting PET/CT detected distant metastasis, only nodal status (P = 0.053) was found to be significant. Conclusions We suggest the use of PET/CT in investigating metastasis in axilla positive and clinically stage II early breast cancer patients.
Is there a correlation between Gleason score and maximum standardized uptake value in locally advanced prostate cancer patients?
(2019) Cem, Onal; Torun, Nese; Guler, Ozan Cem; Reyhan, Mehmet; Yildirim, Berna Akkus; Yapar, Ali Fuat; 0000-0001-6908-3412; AAC-5654-2020
Long-term outcomes of cervical cancer patients with complete metabolic response after definitive chemoradiotherapy
(2021) Onal, Cem; Guler, Ozan Cem; Reyhan, Mehmet; Yapar, Ali Fuat; 0000-0002-2742-9021; 34378362; D-5195-2014
Objective: We investigated the importance of metabolic parameters measured with F-18-fluorodeoxyglucose positron-emission tomography integrated with computed tomography (FDG-PET/CT) for predicting progression-free survival (PFS) and overall survival (OS) in cervical cancer with complete metabolic response (CMR) after chemoradiotherapy (ChRT). Methods: The clinical data and PET parameters including standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of 122 patients having CMR in post-treatment F-18-FDG-PET/CT delivered a median of 3.9 months after ChRT completion were analyzed. Results: With a median follow-up of 8.4 years, 55 patients (45%) presented with disease a median of 19.7 months after ChRT. For SUVp, MTVp, TLGp, SUVln, MTVln, and TLGp, the cut-off values for OS determined by receiver operating curve analysis were 15.8, 48.7 cm(3), 552.3, 8.7, 7.0 cm(3), respectively. All metabolic PET parameters were significant prognostic factors for OS and PFS in univariate analysis. International Federation of Gynecology and Obstetrics (FIGO) stage was predictive of both OS and PFS, while pelvic and/or para-aortic lymph node metastasis were predictive of OS only. In multivariate analysis, FIGO stage >= IIB, MTVp >= 49.8 cm(3), and TLGp >= 597.4 were predictive of worse OS. Advanced stage, presence of lymph node metastasis, higher TLGp, and larger MTVln were significant factors for poor PFS rates. Conclusion: We found that advanced stage and higher TLGp values were significant predictors for poor survival and higher progression rates. Volumetric PET parameters could be used to predict treatment outcomes in patients with CMR after definitive ChRT.
Prognostic Value of 18F-Fluorodeoxyglucose Uptake in Pelvic Lymph Nodes in Patients with Cervical Cancer Treated with Definitive Chemoradiotherapy
(2015) Onal, Cem; Guler, Ozan C.; Reyhan, Mehmet; Yapar, Ali Fuat; 0000-0001-6908-3412; 0000-0003-1715-4180; 0000-0002-2742-9021; 0000-0001-8550-3368; 25641567; AAC-5654-2020; AAI-8973-2021; D-5195-2014; AAJ-5242-2021; HOC-5611-2023
Purpose. To evaluate the prognostic significance of the maximum standardized uptake (SUVmax) value for pelvic lymph nodes in patients with cervical cancer and its impact on treatment response, disease control, and survival. Methods. Ninety-three patients with pelvic or para-aortic metastasis detected by PET/CT and treated with definitive chemoradiotherapy were evaluated. The impact of pelvic lymph node SUVmax on prognostic factors and treatment outcomes was assessed. Results. The size and SUVmax of pelvic lymph nodes were significantly correlated (r = 0.859; p < 0.001). Patients with pelvic and para-aortic lymph node metastases had significantly higher SUVmax values for both primary tumor (23.4 +/- 9.2 vs. 18.5 +/- 73; p = 0.01) and pelvic lymph nodes (11.4 +/- 4.6 vs. 7.4 +/- 3.8; p = 0.001). Patients with pelvic lymph node SUVmax >= 7.5 had significantly higher primary tumor SUVmax, larger pelvic lymph nodes, higher rates of para-aortic lymph node metastasis, and lower post-therapy complete response rates. Overall survival (OS) and disease-free survival (DFS) rates were significantly higher in patients with SUVmax < 7.5 compared to patients with SUVmax >= 7.5. In a multivariate analysis, pelvic lymph node SUVmax and post-therapy metabolic response were significant prognostic factors for both OS and DFS for all patients, but no significant prognostic factors were found in pelvic lymph node metastasis only. Conclusions. Patients with highly FDG-avid pelvic lymph nodes have a higher risk of disease recurrence with worse survival. Identification of these patients may assist in the evaluation of the clinical benefits of additional treatments. (C) 2015 Elsevier Inc. All rights reserved.
Simultaneous Occurrence of Medullary and Differentiated Thyroid Carcinomas. Report of 4 Cases and Brief Review of The Literature
(2014) Erhamamci, Seval; Reyhan, Mehmet; Kocer, Nazim Emrah; Nursal, Gul Nihal; Torun, Nese; Yapar, Ali Fuat; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0002-5943-9283; https://orcid.org/0000-0002-5302-4386; https://orcid.org/0000-0002-5597-676X; https://orcid.org/0000-0003-1715-4180; 24997082; AAJ-5242-2021; AAM-5436-2021; R-3735-2016; AAE-2718-2021; AAI-8973-2021
Simultaneous occurence of medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) in a single patient is an unusual event. The incidence, cell origin, histopathology features and prognosis of these two carcinomas are considered completely different. The aim of this retrospective study was to describe clinical, pathologic characteristics and the prevalence of diagnosing such patients in our clinic. Between October 2003 and December 2013, 1.420 consecutive patients diagnosed by histology as having differentiated thyroid carcinoma (DTC) and treated with radioactive iodide (RAI) were retrospectively investigated. Of these, 4 patients were diagnosed by histology as having simultaneous MTC and PTC. The clinical and pathology characteristics of these patients are described. The prevalence of simultaneous MTC and PTC of these 4 patients in our clinic was 0.28% of all patients with DTC.The age of the 4 patients ranged from 44 to 63 years and were three females and one male.These patients are currently alive without disease from either of the two types of cancer. In two of these patients, MTC was located in the left and PTC in the right thyroid lobe. One patient had MTC in the right lobe and PTC in both lobes. The remaining patient had both cancers in the left lobe as a mixed tumor. We are able to present the pathology of only 2 of these 4 patients. In these 2 patients MTC was located in the left and PTC in the right thyroid lobe, one of them was female and the other was male, aged 44 and 49, respectively. In conclusion, our results suggested that simultaneous occurrence of MTC and PTC had a prevalence in our clinic of 0.28% among 1420 consecutive patients with DTC or 0.14%, if only the 2 patients in whom we are able to present their pathology slides are considered. Our cases suggest that these two tumors are usually independent and coincidental events in patients.
Treatment Outcomes of Patients with Cervical Cancer with Complete Metabolic Responses After Definitive Chemoradiotherapy
(2014) Onal, Cem; Reyhan, Mehmet; Guler, Ozan C.; Yapar, Ali Fuat; https://orcid.org/0000-0002-2742-9021; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0001-6908-3412; https://orcid.org/0000-0003-1715-4180; 24562649; HOC-5611-2023; AAJ-5242-2021; AAC-5654-2020; AAI-8973-2021
Purpose We sought to evaluate failure patterns and prognostic factors predictive of recurrences and survival in cervical cancer patients who are treated with definitive chemoradiotherapy (ChRT), who have a subsequent complete metabolic response (CMR) with (18) F-fluorodeoxyglucose positron-emission tomography (FDG-PET) after treatment. Methods The records of 152 cervical cancer patients who were treated with definitive chemoradiotherapy were evaluated. All patients underwent pre-treatment positron emission tomography (PET-CT), and post-treatment PET-CT was performed within a median of 3.9 months (range, 3.0-9.8 months) after the completion of ChRT. The prognoses of partial response/progressive disease (PR/PD) cases (30 patients, 18 %) and CMR cases (122 patients, %82) were evaluated. Univariate and multivariate analysis effecting the treatment outcome was performed in CMR cases. Results The median follow-ups for all patients and surviving patients were 28.7 (range, 3.3-78.7 months) and 33.2 months (range, 6.23-78.7 months), respectively. Four-year overall survival (OS) rate was significantly better in patients with CMR compared to patients with PR/PD (66.9 % vs. 12.4 %, p < 0.001, respectively). Patients with PR/PD had higher maximum standardized uptake value (SUVmax) of primary cervical tumor (26.4 +/- 10.1 vs. 15.9 +/- 6.3; p < 0.001) and larger tumor (6.4 cm +/- 2.3 cm vs. 5.0 cm +/- 1.4 cm; p < 0.001) compared to patients with CMR. Of the 122 patients with post-treatment CMRs, 25 (21 %) developed local, locoregional, or distant failure. In univariate analysis, tumor size a parts per thousand yen 5 cm, 'International Federation of Obstetricians and Gynecologists' (FIGO) stage a parts per thousand yenaEuro parts per thousand IIB, and pelvic and/or para-aortic lymph node metastasis were predictive of both overall survival (OS) and disease-free survival (DFS), while histology was predictive of only OS. In multivariate analysis, tumor size, stage and lymph node metastasis were predictive of OS and DFS. Conclusion Although CMR is associated with better outcomes, relapses remain problematic, especially in patients with bulky tumors (a parts per thousand yen 5 cm), extensive stage (a parts per thousand yen IIB) or pelvic and/or para-aortic lymph node metastasis. These findings could support the need for more aggressive treatment or adjuvant chemotherapy regimens.
Venous thrombosis of sarcoidosis as an unusual incidental finding on 18F-fluorodeoxyglucose positron emission tomography/computed tomography
(2015) Erhamamci, Seval; Reyhan, Mehmet; Yapar, Ali Fuat; Canpolat, Tuba; 26430325
Sarcoidosis is defined as a multisystem granulomatous disorder of unknown cause. Venous thrombosis (VT) in the sarcoidosis is rare. The routine use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has resulted in clinicians detecting many incidental findings, which have proven to be clinically significant such as thrombosis. Here, we present a case with VT of sarcoidosis in the inferior vena cava and portal vein as an unusual incidental finding on 18F-FDG PET/CT.