Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-3735-2016Static 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.Item Predictors Determining the Status of Axilla in Breast Cancer: Where is PET/CT on That?(2015) Aytac, Huseyin Ozgur; Colacoglu, Tamer; Nursal, Gul Nihal; Nursal, Tarik Zafer; Bolat, Filiz Aka; Yabanoglu, Hakan; Yildirim, Sedat; Moray, Gokhan; 0000-0002-3583-9282; 0000-0003-0268-8999; 0000-0003-2498-7287; 0000-0002-5735-4315; 0000-0002-5302-4386; 0000-0002-3462-7632; 0000-0002-1161-3369; 0000-0003-2031-7374; 26537078; AAJ-7913-2021; AAK-2011-2021; AAE-1041-2021; AAF-4610-2019; R-3735-2016; IQV-1169-2023; AAJ-8097-2021; AAJ-7865-2021; HJZ-1654-2023Purpose: 18 F-FDG PET/CT has an acceptable specificity but a low sensitivity on the prediction of axillary lymph node (ALN) metastasis in breast cancer. We analyzed the factors that could possibly affect this prediction. Methods: The records of 270 patients with T1-2 invasive breast cancer who underwent surgery, 116 of whom had been evaluated by preoperative 18 F-FDG PET/CT were reviewed. Prediction of ALN status by PET/CT according to tumor stage, estrogen receptor (ER), progesterone receptor (PgR) and HER2 status, histology, age and sentinel node properties was assessed. Results: ALN metastasis was present in 62 of 131 T1 (43.7%) and 106 of 142 T2 tumors (74.6%), 20 of 46 (43.5%) ER(-) and 146 of 222 (65.8%) ER(+) tumors, 38 of 71 (53.5%) PgR(-) and 127 of 200 (63.5%) PgR(+) tumors. On multivariate analysis only the tumor size (>2 cm) independently correlated with ALN metastasis (Odds ratio/OR=3.1). None of the other parameters had statistical significance in terms of ALN prediction on FDG-PET/CT. Conclusion: Though T2 tumors showed increased tendency to metastasize to the axilla, prediction of ALN metastasis in preoperative FDG-PET/CT was not associated with any of the predictive factors.Item Can Computed Tomography Aid in Diagnosis of Intramural Hematomas of the Intestinal Wall?(2015) Ulusan, Serife; Pekoz, Burcak; Sariturk, Cagla; 0000-0002-4130-1059; 26712050; AAS-7129-2021Background : We sought to use computed tomography (CT) data to support the correct differential diagnosis of patients with spontaneous intramural hematomas of the gastrointestinal tract, to aid in the clinical management of those using oral anticoagulants. Methods : Patient data were retrospectively analyzed and patients were divided into two groups. The first group contained 10 patients (5 females, 5 males, median age 65 years [range 3579 years]) who had been diagnosed with spontaneous intramural hematomas of the gastrointestinal tract. The second group contained nine patients (5 females, 4 males, median age 41 years [range 24-56 years]) who exhibited intestinal wall thickening on CT, and who had been diagnosed with ulcerative colitis, Crohn's disease, ameboma, and lymphoma. The enhancement patterns in the CT images of the two groups were compared by an experienced and inexperienced radiologist. The differences in values were subjected to ROC analysis. Results : Inter-observer variability was excellent (0.84) when post-contrast CT images were evaluated, as were the subtraction values (0.89). The subtracted values differed significantly between the two groups (p = 0.0001). A cutoff of +31.5 HU was optimal in determining whether a hematoma was or was not present. Conclusions : Contrast enhancement of an intestinal wall hematoma is less than that of other intestinal wall pathologies associated with increased wall thickness. If the post-contrast enhancement of a thickened intestinal wall is less than +31.5 HU, a wall hematoma is possible.Item Relationship between chest computed tomography findings and clinical conditions of coronavirus disease (COVID-19): A multicentre experience(2021) Yilmaz Demirci, Nilgun; Ugras Dikmen, Asiye; Tasci, Canturk; Dogan, Deniz; Arslan, Yakup; Ocal, Nesrin; Tasar, Mustafa; Bozlar, Ugur; Artuk, Cumhur; Yilmaz, Gulden; Karacaer, Zehra; Avci, Ismail Yasar; Tuncer Ertem, Gunay; Erdinc, Fatma Sebnem; Kinikli, Sami; Altun Demircan, Serife; Ergun, Elif; Nercis Kosar, Pinar; Karakoc, Ayse Esra; Gokcek, Atila; Aloglu, Melike; Gulgosteren, Sevtap; Atikcan, Sukran; Akcay, Sule; Erol, Cigdem; Hekimoglu, Koray; Cerit, Mahi Nur; Erbas, Gonca; Ozger, Hasan Selcuk; Bozdayi, Gulendam; Senol, Esin; Yurdakul, Ahmet Selim; Yilmaz, Aydin; 0000-0002-2535-2534; 0000-0002-0805-0841; 34105857; AAJ-1219-2021; AAD-9097-2021Aims This study aimed to investigate the clinical and chest computed tomography (CT) features associated with clinical parameters for coronavirus disease (COVID-19) in the capital of Turkey, Ankara. Materials and methods Epidemiological, clinical features, laboratory findings and radiological characteristics of 1563 hospitalised patients with COVID-19 in Ankara were collected, reviewed and analysed in this study. The risk factors associated with disease severity were investigated. Results Non-severe (1214; 77.7%) and severe cases (349; 22.3%) were enrolled in the study. Compared with the non-severe group, the severe group were significantly older and had more comorbidities (ie, hypertension, diabetes mellitus, cardiovascular disease and chronic kidney disease). Smoking was more common in the severe group. Severe patients had higher respiratory rates and higher incidences of cough and dyspnoea compared with non-severe patients. Compared with the non-severe patients, the severe patients had increased C-reactive protein (CRP), procalcitonin, neutrophil to lymphocyte ratio (NLR) and CRP/albumin ratio and decreased albumin. The occurrence rates of consolidation, subpleural sparing, crazy-paving pattern, cavity, halo sign, reversed halo sign, air bronchogram, pleural thickening, micronodule, subpleural curvilinear line and multilobar and bilateral involvement in the CT finding of the severe patients were significantly higher than those of the non-severe patients. Conclusions Many factors are related to the severity of COVID-19, which can help clinicians judge the severity of the patient and evaluate the prognosis. This cohort study revealed that male sex, age (>= 55 years), patients with any comorbidities, especially those with cardiovascular disease, dyspnoea, increased CRP, D-dimer and NLR, and decreased lymphocyte count and CT findings of consolidation and multilobar involvement were predictors of severe COVID-19.Item Efficacy of positron emission tomography and computed tomography in clinical staging of cutaneous malignant melanoma(2020) Yilmaz, Harun; Orhan, Erkan; Sahin, Ertan; Olguner, Anil A.; Arpaci, Enver; 32160381Accurate staging is very important for determining the prognosis and appropriate treatment for malignant melanoma (MM). The aim of this study is to determine the effectiveness of positron emission tomography and computed tomography (PET/CT) imaging in staging MM. Patients diagnosed with MM who then underwent PET/CT metastasis before treatment were assessed retrospectively. For each patient, the following variables were recorded: Breslow thickness, Clark's level, number of mitoses, the presence of ulceration detected in the pathology report, and the presence of lymph nodes and/or distant metastases detected by PET/CT. The pathology and PET/CT reports of 139 patients (79 female and 60 male) were retrospectively evaluated for staging after MM diagnosis. Patients with a Breslow thickness greater than 3.4 mm and Clark's level of 4 to 5 were found to be statistically significantly higher with regional lymph node metastasis after PET/CT scans. Patients with Breslow thickness greater than 2.85 mm and Clark's level of 4 to 5 were found to be statistically significantly higher with distant metastasis after PET/CT scan. The results of our study suggest that PET/CT imaging for metastasis scanning, starting with T2 patients, may be used in MM staging to reduce the need for sentinel lymph node (SLN) biopsy and lymph node dissection.Item Primary Hepatocellular Carcinoma With Intense Ga-68-PSMA Uptake But Slight F-18-FDG Uptake on PET/CT Imaging(2020) Erhamamci, Seval; Aslan, Nesrin; 31977478Ga-68-PSMA PET/CT imaging is an emerging imaging modality in prostate cancer. PSMA expression is also reported for nonprostate malignancies, including primary hepatocellular carcinoma. Herein, we present a case of a 74-year-ald man with recently diagnosed hepatocellular carcinoma who was referred for F-18-FDG PET/CT imaging for initial staging. The patient underwent F-18-FDG PET/CT as part of staging procedure; he also underwent Ga-68-PSMA PET/CT. PET/CT images revealed only slight F-18-FDG uptake in the liver lesion, but intense Ga-68-PSMA uptake, without any metastatic lesion seen elsewhere in the body.Item Integration of 68Ga-PSMA-PET/CT in Radiotherapy Planning for Prostate Cancer Patients(2019) Onal, Cem; Torun, Nese; Akyol, Fadil; Guler, Ozan Cem; Hurmuz, Pervin; Yildirim, Berna Akkus; Caglar, Meltem; Reyhan, Mehmet; Ozyigit, Gokhan; 0000-0001-6908-3412; 31283600Purpose To assess the role of (68)Gallium-labeled-prostate-specific membrane antigen PET/CT (Ga-68-PSMA-PET/CT) in risk group definition and radiotherapy planning in the initially planned definitive radiotherapy (RT) for prostate cancer patients. Methods The clinical data of 191 prostate cancer patients treated with definitive intensity-modulated RT were retrospectively analyzed. All patients were initially staged with thoracoabdominal CT and bone scintigraphy, and the second staging was performed using Ga-68-PSMA-PET/CT. Both stages were evaluated for the decision making of RT and any change in RT target volumes. Results After staging with Ga-68-PSMA-PET/CT, 26 patients (13.6%) had risk group changes, 16 patients (8.4%) had an increase in risk group, and 10 patients (5.2%) had a decrease in risk group. Down-staging occurred in 22 patients (11.5%), and upstaging was observed in 30 patients (15.7%). A total of 26 patients (13.6%) had nodal stage changes. After the Ga-68-PSMA-PET/CT scans, the number of metastatic patient increased to 17 (8.9%), with 4 of them moving from oligo- to polymetastatic disease. An additional irradiation of pelvic lymphatics and metastatic site was performed in 13 patients (6.8%) and 6 patients (3.2%), respectively. The RT was aborted in 4 patients (2.1%) because of parenchymal or distant site metastasis observed in the Ga-68-PSMA-PET/CT. Conclusions We found that Ga-68-PSMA-PET/CT causes considerable migration in stage, risk group, and RT field arrangements, especially in high-risk patients regardless of the GS and baseline prostate-specific antigen values alone. Ga-68-PSMA-PET/CT seems to have a great influence on RT decision making in prostate cancer patients.Item One of the Rare Causes of Acute Abdomen Leading to Subileus: Jejunal Diverticulitis(2016) Aydin, Elcin; Yerli, Hasan; Avci, Tevfik; Yilmaz, Tugbahan; Gulay, Huseyin; 27308082Background: Jejunal diverticulitis is one of the rare causes of acute abdomen generally seen in the elderly. Jejunal diverticulosis was defined as the herniation of the mucosa and the submucosa from the inside of the muscular layer of the bowel wall on the mesenteric side of the intestine. Case Report: We presented the intraoperative and pathological findings of a 69-year-old male patient who had presented with complaints about abdominal pain, nausea, and vomiting and been operated upon due to subileus and peritonitis induced by large-sized jejunal diverticulitis, along with his computed tomography (CT) findings. Conclusion: Jejunal diverticulitis is uncommon and may be a disease which might be difficult to diagnose when it develops on the basis of the large-sized diverticula resembling intestinal ansae. To the best of our knowledge, the computed tomography and intraoperative findings of a case in which partial resection is applied to the jejunum due to subileus have not been previously presented in the literature.Item Perforation without manifestations of acute abdomen after ERCP(2016) Karadeli, Elif; Tok, Sermin; Erbay, Gurcan; 0000-0002-0352-8818; 0000-0002-1706-8680; AAK-5399-2021; AAK-5370-2021Perforations are rare after endoscopic retrograde cholangiography (ERCP) but they are serious complications. Perforations may occur due to patient-related factors or procedural technique. The mortality rate is higher than 37.5%. We are presenting a patient with perforation detected on a computed tomography (CT) scan after ERCP for obstructive jaundice that was treated conservatively. Perforation after ERCP can be operated or treated conservatively according to the patient's condition.