Effects of the changes between preand post-treatment 18F-FDG PET-CT volumetric parameters on overall survival in pleural mesothelioma

Introduction. This study aimed to examine the efficacy of positron emission tomography in fusion with computed tomography (PET-CT) parameters in predicting survival outcomes for patients with malignant pleural mesothelioma.  Material and methods. This study retrospectively evaluated the data of 250 patients who were followed up after a diagnosis of malignant pleural mesothelioma. The relationship of pre-treatment [maximum standardized uptake value (SUVmax1), metabolic tumor volume (MTV1), total lesion glycolysis (TLG1), tumor/background (TBR1), pleural thickness1), post-treatment (SUVmax2, MTV2, TLG2, TBR2, pleural thickness2], and DPET-CT parameters with survival was retrospectively evaluated in 36 patients whose pre- and post-treatment CT scan examinations were complete.  Results. The median age of the patients was 57.5 years, ranging from 35 to 76. Median follow-up time was 16 months, with a range of 7 to 42 months. Median survival was calculated as 18.8 months for all patients. Based on the determined cut-off values, overall survival was determined as 29.9 months in patients with TLG2 ≤ 158 compared to 16 months in patients with TLG2 > 158 (p = 0.009) and as 30.9 months in patients with DTLG ≤ –62.58 compared to 16 months in patients with DTLG > –62.58 (p = 0.001). In addition, median overall survival (OS) was determined as 29.9 months in patients with MTV2 ≤ 63.9 compared to 16 months in patients with MTV2 > 63.9 (p = 0.007) and as 29.9 months in patients with DMTV ≤ –54.03 compared to 16 months in patients with DMTV > –54.03 (p = 0.002). When evaluated with respect to TBR2; median OS was 29.9 months in patients with TBR2 ≤ 1.84 compared to 16 months in patients with TBR2 > 1.84 (p = 0.039).  Conclusions. Our research findings indicate a correlation between OS and volumetric PET-CT measures, specifically TLG and MTV

The relationship between inflammation markers, positron emission tomography/ /computed tomography parameters and disease prognosis in advanced non-small-cell lung cancer patients

Introduction. Inflammation is known to be related to the development, spread, prognosis, and treatment response in cancer patients. Our study aimed to evaluate the correlation between inflammation indices and positron emission tomography-computed tomography (PET/CT) parameters and investigate their relationship with progression-free survival (PFS) and overall survival (OS) in patients diagnosed with stage-IV non-small cell lung cancer (NSCLC).  Material and methods. Demographic, clinicopathological, laboratory, and PET/CT data of 179 patients diagnosed with stage-IV NSCLC who presented to the Oncology Department of Dicle University, Faculty of Medicine between 2010–2020 were retrieved from patient files and the hospital database system.  Results. The median age at diagnosis was 64 (27–87) years. All patients included in the study had NSCLC: 72.6% had adenocarcinoma, 21.2% had squamous cell carcinoma, and 6.1% had other histological types. Of the 78 patients who were subjected to molecular analysis, 26 (33.3%) were EGFR-mutation positive. During the 10-month median follow-up, median first-line PFS was 6 months (95% CI 5.00–6.99), and median OS was 10 months (95% CI 7.8–12.1). The multivariate analysis performed for first-line PFS determined hemoglobin (HR = 1.01; 95% CI 1.003–1.02; p = 0.005) and PET total lesion glycolysis (TLG) (HR = 1.002; 95% CI 1.001–1.003; p = 0.003) values as independent prognostic factors. The multivariate analysis for OS determined positive EGFR mutation status (HR = 0.385; 95% CI 0.213–0.696; p = 0,014) and performance status (HR = 1.88; 95% CI 1.092–3.238; p = 0,008) as independent prognostic factors.  Conclusions. Our study determined the hemoglobin level and PET TLG from PET/CT parameters to be independent prognostic factors for PFS, and performance status and EGFR mutation positivity to be independent prognostic factors for OS

The importance of background correction during calculation of the major salivary gland function in salivary gland scintigraphy

Objective: The aim of this study was to compare the parotid (P) and submandibular (SM) glands uptake and excretion ratios of 99mTc-pertechnetate, which were calculated by using the backgrounds drawn on five different areas. Methods: Ninety-eight P and 98 SM glands of totally 48 patients were included in the study. 99mTc-pertechnetate salivary gland scintigraphy was performed in all patients. Oral stimulation with lemon juice was made at 15th minute of the imaging. The 99mTc-pertechnetate uptake and excretion ratios of the P and SM glands were calculated separately without using any background, and by using the backgrounds drawn on wide frontal, narrow frontal, temporal, cervical and shoulder regions. These values were statistically compared with each other in pairwise manner. Results: The radioactivity uptake and excretion ratios of the P and SM glands calculated without using any background correction were statistically different from that calculated by using any background correction. In addition, the radioactivity uptake and excretion ratios of the P and SM glands calculated by using the backgrounds drawn on five different areas were mostly found statistically different from each other (p<0.05). Conclusion: Background correction is important during the calculation of the uptake and excretion ratios of P and SM glands. This study demonstrates that calculated uptake and excretion ratios of P and SM glands may differ according to the used background area

Our clinical experience on laparoscopic splenectomy: Outcomes of 38 patients

Objective: Laparoscopic splenectomy has gained widespread acceptance in the treatment of hematological diseases in recent years. In this study, we aimed to present the outcomes of the patients who underwent laparoscopic splenectomy. Methods: Between 2012 and 2015, the data of 38 patients, who underwent laparoscopic splenectomy for hematological diseases at our clinic, were evaluated retrospectively. Results: 15 males and 23 females patients were underwent laparoscopic splenectomy, and the average age was 33.9 ± 12.9 years. Indications for splenectomy were idiopathic thrombocytopenic purpura (ITP) in 34 patients, and hereditary spherocytosis in 4 patients. During the surgical exploration, accessory spleen was detected in 7 patients, and removed. Laparoscopic cholecystectomy was performed at the same session in 2 hereditary spherocytosis patients who had stones in the gallbladder. One patient was converted to the open surgery due to the bleeding which was eliminated the exposure during the dissection. At the postoperative period, we observed atelectasis in one patient, and wound fat necrosis in one patient. In addition, thrombocytosis was observed in one patient. Hematological treatment was continued because of persistent refractory thrombocytopenia in two patients, and temporary thrombocytopenia in four patients. An accessory spleen was detected with splenic scintigraphy in one of these patients at the postoperative period. The average hospitalization time was 2.6 ± 0.7 days. Conclusion: Laparoscopic splenectomy for hematological diseases may be considered as first-line therapy with less hospital stay and morbidity