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Author: search.filters.author.Guler, Ozan CemSubject: search.filters.subject.Breast cancer

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    The use of 18F-FDG positron emission tomography to detect mediastinal lymph nodes in metastatic breast cancer
    (2020) Onal, Cem; Findikcioglu, Alper; Guler, Ozan Cem; Reyhan, Mehmet; 0000-0001-6908-3412; 0000-0002-2742-9021; 33125983; AAC-5654-2020; D-5195-2014
    Background: To assess the predictive value of F-18-fluorodeoxyglucose positron-emission tomography (FDG-PET/CT) in detecting mediastinal lymph node metastasis with histopathologic verification in breast cancer (BC) patients. Materials and methods: Between February 2012 and October 2019, 37 BC patients who underwent histopathological verification for FDG-PET positive mediastinal lymph nodes were retrospectively analyzed. Nine patients (24%) were screened before beginning treatment, while 27 (76%) were screened at the time of disease progression, an average of 39 months after completion of initial treatment. Results: The histopathologic diagnosis revealed lymph node metastasis from BC in 15 patients (40%) and benign disease in 22 patients (60%). The standardized uptake value (SUVmax) of mediastinal lymph nodes was significantly higher in patients with lymph node metastasis compared to those with benign histology (9.0 +/- 3.5 vs. 5.9 +/- 2.4; P = 0.007). The cut-off value of SUVmax after the ROC curve analysis for pathological lymph node metastasis was 6.4. Two of the 15 patients with mediastinal SUVmax <= 6.4 and 13 of the 22 patients with SUVmax > 6.4 had lymph node metastasis. Age and pathological findings were prognostic factors for overall survival in univariate analysis. The treatment decision was changed in 19 patients (51%) after mediastinoscopic evaluation of the entire cohort. Conclusions: This is the first study to support the need for pathologic confirmation of a positive PET/CT result following evaluation of mediastinal lymph nodes for staging BC, either at initial diagnosis or at the time of progression. Treatment decisions were consequently altered for nearly half of the patients. (C) 2020 The Author(s). Published by Elsevier Ltd.
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    Prognostic Value of Metabolic Response Measured by FDG-PET-CT in Patients with Breast Cancer Liver Metastasis Treated with Stereotactic Body Radiotherapy
    (2018) Guler, Ozan Cem; Torrun, Nese; Akkus Yildirim, Berna; Onal, Cem; 0000-0001-6908-3412; AAC-5654-2020
    OBJECTIVE To investigate the impact of metabolic response measured by 18-fluorodeoxyglucose positron emission tomography and computed tomography (FDG-PET-CT) in patients with breast cancer liver metastasis (BCLM) treated with stereotactic body radiotherapy (SBRT). METHODS The medical records of 17 patients with BCLM treated with SBRT between March 2013 and October 2017 were investigated retrospectively. Patients received SBRT for their liver metastasis, and thereafter, a second FDG-PET-CT was performed for response assessment in a median of 4.1 (2.2-8.2) months. A total of 54 Gy in three fractions were delivered to liver metastatic lesions. The standardized uptake value (SUV) and survival rates were evaluated. RESULTS After a median follow-up time of 11.5 (3.2-48.9) months, there was a significant difference between pre- and post-SBRT SUVs (p<0.001). Complete metabolic response was observed in 14 (82%) patients, partial metabolic response was observed in 2 (12%) patients, and stable metabolic disease/progressive metabolic disease was observed in 1 (6%) patient at post-treatment PET-CT. The 1- and 2-year overall survival rates were 68% and 57%, respectively, and the 1- and 2-year progression-free survival rates were 38% and 25%, respectively. CONCLUSION PET-CT is an effective tool for response monitoring in patients with BCLM treated with SBRT.