Pozytonowa emisyjna tomografia komputerowa z 18F-FDG, ultrasonografia i tomografia komputerowa w łagodnych i złośliwych guzach jajnika w korelacji z pooperacyjnym wynikiem histopatologicznym

Abstract Objectives: The role of 18F-FDG (18F fluorodeoxyglucose) PET/CT** (Positron emission tomography) in the diagnosis, treatment and follow up of benign and malignant ovarian tumors had been investigated previously. The objective of the following study was to evaluate the predictive value of PET/CT in benign and malignant ovarian tumors and compare with computerized tomography and post-operative pathology. Materials and methods: In this retrospective study, a total of sixty nine cases with benign or malignant pelvic masses underwent laparotomy at our clinic. Postoperative pathology of the patients was recorded and PET/CT results were compared with ultrasonography, computerized tomography and postoperative pathology. Results: The ROCs and AUCs values four predictors were shown in Figure 1. The AUCs (95 % CI) values calculated for CA 125, ultrasonography (USG), PET/CT and CT were as follows: 0.855(0.752-0.958), 0.703(0.540-0.866), 0.681(0.514-0.848) and 0.631(0.463-0.799) respectively. CA 125 has the highest AUC value in order to predict the malignant potential of the patient. USG has the highest AUC value between the imaging techniques, following PET/CT and CT. Conclusion: According to this study, among four modalities that distinguish malignant potential preoperatively; CA125 is the best parameter. USG and PET provide similar benefits in detecting malignant ovarian masses preoperatively. Both of these parameters are superior to CT. Combination of CA125, USG and PET/CT may be useful in detecting malignant ovarian masses preoperatively, resulting in less invasive surgeries. ** 18F-FDG (18F fluorodeoxyglucose) PET/CT will be used as the PET/CT, later in this article.Streszczenie Cel pracy: Rola 18F-FDG PET w diagnozowaniu łagodnych i złośliwych guzów jajnika w diagnozowaniu oraz obserwacji po leczeniu była już tematem badań. Celem tej pracy jest ocena wartości predykcyjnej PET/CT w łagodnych i złośliwych guzach jajnika i porównanie tej metody z tomografią komputerową i pooperacyjnym wynikiem histopatologicznym. Materiał i metody: Badanie retrospektywne przeprowadzono na grupie 69 pacjentek z łagodną bądź złośliwą zmianą w miednicy mniejszej, które poddano laparotomii w naszej klinice. Wynik pooperacyjny histopatologiczny porównano z wynikiem badania PET/CT, USG, tomografią komputerową. Wyniki: Obliczone wartości AUC (95%CI) dla CA125, USG, PET/CT i tomografii komputerowej wyniosły odpowiednio: 0,855 (0,752-0,958), 0,703 (0,540-0,866), 0,681 (0,514-0,848) i 0,631 (0,463-0,799). Marker CA125 miał najwyższą wartość AUC dla przewidywania złośliwych zmian. USG miało najwyższą wartość AUC wśród technik obrazowania, następnie PET/CT i tomografia komputerowa. Wnioski: Według tego badania, spośród analizowanych czterech metod przedoperacyjnego prognozowania charakteru guza, CA125 jest najlepszym parametrem. USG i PET mają podobną siłę wykrywania zmian złośliwych przed operacją. Kombinacja badania CA125, USG i PET/CT może być przydatną metodą wykrywania złośliwych guzów jajnika przed operacją i wykonywania mniej inwazyjnych operacji

Prognostic Value of Lymph Node and Spleen Activity in [18F]FDG PET-CT in Lung Adenocarcinoma and Squamous Cell Carcinoma

Objective: We aimed to investigate the prognostic value of primary mass, spleen and lymph node metabolic activity in [18F]FDG PET-CT as well as the prognostic value of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (TLR) in patients with lung adenocarcinoma and squamous cell carcinoma. Methods: Seventy-four patients, with pathological data, complete blood count and [18F]FDG PET-CT images, were retrospectively evaluated. Patients were grouped as lung adenocarcinoma (n = 32) or squamous cell carcinoma (n = 42). The time between [18F]FDG PET-CT imaging and death was calculated. Standardized uptake value (SUVmax) of primary lesion was calculated (lung or mediastinum). The SUVmax value of the spleen was used as an indicator of RES activity. Metabolic activity of lymph node was calculated from the lymph node having the highest activity independent of localization. Results: The SUVmax spleen/liver and SUVmax lymph node/liver ratios were significantly higher in the exitus subgroup of squamous cell carcinoma (p=0.025, p=0.043; respectively). The SUVmax lymph node/liver ratio was found to be a predictor for survival in squamous cell carcinoma (p=0.019, OR:1.282). The SUVmax spleen/liver and SUVmax lymph node/liver ratios were similar between subgroups of adenocancer. Conclusions: The SUV ratios of the spleen were not a predictor for survival in both groups. The SUVmax lymph node/liver ratio was found to be a predictor for survival in squamous cell carcinoma. However, NLR and PLR were not found to be prognostic factors

Intraoperative gamma probe application in patients prediagnosed with osteoid osteoma

INTRODUCTION: Osteoid osteoma is a benign but painful bone tumor that is treated with the excision of the nidus. Due to difficulties in reaching the tumor, intraoperative localization may be needed for complete excision without unnecessary resection of the surrounding bone. AIM: The aim of this study was to evaluate the effectiveness of intraoperative gamma probe application in the preoperative planning and for intraoperative localization of osteoid osteoma. MATERIALS AND METHODS: The study included a total of 26 patients, comprising 10 females and 16 males with a mean age of 19.6 years (range: 6–45 years), who were prediagnosed with osteoid osteoma based on clinical and radiological findings. All patients were admitted for surgery following bone scintigraphy. All operations were performed with the use of a gamma probe. RESULTS: Clinical results were obtained from the postoperative pain evaluation, and excised bone tissue fragments were evaluated histopathologically. Localization of the lesion area was made intraoperatively using a gamma probe in all patients. A statistically significant difference was determined between the radioactivity counts in the normal peripheral bones of the lesion and the lesion area itself (P < 0.001). The ratio of lesion to normal tissue was 4/1 on average. The radioactivity level dropped by 62% on average (30%–90%) in the cavity cleaned after postresectional excision of the pathological tissue. The radioactivity counts in the cavity after resection was found to be significantly lower than those of the lesion area before resection (P < 0.001). CONCLUSION: The use of a gamma probe in intraoperative localization following a preoperative injection of99mTc-methylene diphosphonate, is an easy and safe method that helps in the localization of osteoid osteoma nidus during surgery and guides a limited but complete resection of the tumor

The Prognostic Value of F-18-FDG PET/CT Metabolic Parameters in Predicting Treatment Response Before EGFR TKI Treatment in Patients with Advanced Lung Adenocarcinoma

Objectives: This study makes a retrospective examination of exploring the prognostic value of (18)fluorine-fluorodeoxyglucose (F-18-FDG) positron emission tomography/computed tomography (PET/CT) related metabolic-volumetric variables, nutritional status, and immune and inflammatory markers on progression-free survival (PFS) and overall survival (OS) in advanced adenocarcinoma patients with positive epidermal growth factor receptor (EGFR) mutations undergoing EGFR tyrosine kinase inhibitor (TKI) therapy. Methods: A retrospective examination was made of patients diagnosed with lung adenocarcinoma who underwent F-18-FDG PET/CT imaging for staging maximum four weeks before starting treatment, between January 2015 and July 2020. Included in the study were 68 patients identified histopathologically to have locally advanced/metastatic EGFR mutation-positive adenocarcinoma, and who underwent EGFR TKI therapy. The laboratory data of the patients, obtained 15 days before imaging performed for PET/CT staging, were evaluated. Results: Metabolic tumor volume, modified Glasgow prognostic score and locally advanced disease were identified as independent prognostic parameters for PFS (p= 0.004, p=0.029, p=0.016, respectively). A univariate Cox regression analysis revealed albumin/alkaline phosphatase and tumor size to be significant parameters for prognosis (p=0.033, p=0.043, respectively). A multivariate Cox regression analysis revealed that none of the parameters were predictive or OS. Conclusion: The parameters of F-18-FIDG PET/CT, especially the volumetric parameters, were found to be strong prognostic factors with statistical significance for predicting PFS. We believe that these parameters are important prognostic markers that should be evaluated together in the management and follow-up of patients with EGFR mutation-positive adenocarcinoma

Measuring the knowledge and attitudes of physicians towards patients with HIV/AIDS: study of Anatolian group

Purpose: This paper aims to determine the knowledge and attitudes of the physicians regarding human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), to emphasize that these patients exist and they will exist in the future and to raise awareness so as to prevent that their rights to treatment are revoked. Design/methodology/approach: The survey was conducted via a link sent through an online system. Random physicians from 81 cities of the country were invited to the survey. The survey has 41 questions regarding knowledge and attitudes in total, including epidemiological information such as age, gender and title. Findings: A total of 3,107 physicians has voluntarily participated in the study. In total, 2,195 (70.7%) are internal physicians and 912 (29.3%) are surgical physicians among the participant physicians. In total, 1,452 (46.7%) of the participants are specialist physicians, 608 (19.6%) of the participants are practising physician and the rest of it is physician assistants, academicians and dentists, respectively. Originality/value: In this study, it has been found out that the physicians have a lack of knowledge on HIV/AIDS and they adopt a discriminatory attitude towards HIV-positive persons. HIV-positive patients who are exposed to discrimination and scared of being uncovered refrain from applying to hospitals for treatment, which puts public health into jeopardy due to the high viral load and these patients are faced with difficulties in coping with both medical and emotional load of the disease. © 2021, Emerald Publishing Limited

Measuring the knowledge and attitudes of physicians towards patients with HIV/AIDS: study of Anatolian group

Article; Early AccessPurpose This paper aims to determine the knowledge and attitudes of the physicians regarding human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), to emphasize that these patients exist and they will exist in the future and to raise awareness so as to prevent that their rights to treatment are revoked. Design/methodology/approach The survey was conducted via a link sent through an online system. Random physicians from 81 cities of the country were invited to the survey. The survey has 41 questions regarding knowledge and attitudes in total, including epidemiological information such as age, gender and title. Findings A total of 3,107 physicians has voluntarily participated in the study. In total, 2,195 (70.7%) are internal physicians and 912 (29.3%) are surgical physicians among the participant physicians. In total, 1,452 (46.7%) of the participants are specialist physicians, 608 (19.6%) of the participants are practising physician and the rest of it is physician assistants, academicians and dentists, respectively. Originality/value In this study, it has been found out that the physicians have a lack of knowledge on HIV/AIDS and they adopt a discriminatory attitude towards HIV-positive persons. HIV-positive patients who are exposed to discrimination and scared of being uncovered refrain from applying to hospitals for treatment, which puts public health into jeopardy due to the high viral load and these patients are faced with difficulties in coping with both medical and emotional load of the disease