Objectives: The current study evaluates the value of cardiac hybrid imaging (CHI), performed by the fusion of functional and anatomic cardiac images, in the detection of hemodynamically significant ...coronary stenosis in cases with multiple coronary stenosis. Methods: A total of 36 patients (10 female, 26 male) in whom ischemia or infarction was detected on gated myocardial perfusion single photon emission computed tomography (gMPS) and multiple coronary stenosis were concomitantly detected on coronary computed tomography angiography (CCTA) and undergone invasive coronary angiography (ICA) was included in this study. Statistical analyses were performed using SPSS 22 Windows software. McNemar test was applied to show concordance between coronary CT angiography, ICA and CHI in the detection of anatomically or hemodynamically significant stenosis in three major coronary arteries. Comparison results of coronary arteries responsible for perfusion defects on CHI and gMPS are presented as percentages (%). Results: There was total accordance between coronary arteries leading to perfusion defects detected by gMPS and CHI in 50% of patients. It was observed a partial accordance in 36.1% of the patients. Additionally, it was also detected perfusion defects originated from side branches in 25% of the patients. Between results of CCTA and ICA, no statistically significant difference was noted in the detection of anatomically significant stenoses in the left main coronary artery, left anterior descending artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA) (p=1.000, 0.070, 0.549, and 1.000, respectively). In addition, no statistically significant difference was found in the detection of anatomically and hemodynamically significant stenoses in LAD, LCx and RCA by CCTA and CHI (p=0.344, 0.629, and 0.219, respectively). No statistically significant difference was observed in the detection of anatomically and hemodynamically significant stenoses in LAD, LCx and RCA by ICA and CHI (p=0.804, 1.000, and 0.344, respectively). Conclusion: It is possible to detect hemodynamically significant coronary stenosis directly by CHI modality in patients with multiple coronary stenosis, wide perfusion defects.
Fibrous dysplasia (FD) is a benign fibroosseous bone disorder. It has poliostotic and monostotic patterns. Monostotic FD is frequently asymptomatic and is usually discovered incidentally by ...radiologic imaging performed for other reasons. Bone scintigraphy is valuable for identifying disease extent. Craniofacial FD (CFD) is a form of the disease where lesions are limited to contiguous bones of the craniofacial skeleton. We presented a case with monostotic CFD who was detected incidentally on bone scintigraphy single-photon emission computed tomography/computerized tomography while being investigated for inflammatory arthropaties.
Objectives: Radioactive iodine (RAI) therapy is a radionuclide treatment for hyperthyroidism and well-differentiated thyroid cancer. One of the most popular sources of information for patients on the ...internet is YouTube. This study aimed to examine the quality of videos about RAI treatment. Methods: This cross-sectional study was performed by using videos in YouTube. The terms "radyoaktif iyot tedavisi" and "radioactive iodine treatment" were used to search related videos in June 2021. The quality of the videos was assessed by using the Journal of the American Medical Association (JAMA) benchmark criteria, the DISCERN scale, and the global quality scale (GQS). Results: Of the total 88 videos evaluated, 56 videos (30 in English, 26 in Turkish) were analyzed according to the inclusion and exclusion criteria. Seven (12.5%) videos were assigned to the high-quality group, 16 (28.58%) to the intermediate quality group, and 33 (58.92%) to the low quality group. The findings of this study showed that the most popular videos with the highest video power index (VPI) scores and the highest number of video likes and comments belonged to the intermediate quality group. Contrarily, popularity level, number of video likes, and number of video views were the lowest in the high-quality group. The analysis of video sources revealed that viewers most preferred non-physician-sourced videos, with average total views of 59307.80 standard deviation (SD): 122554.13. The most liked videos were non-physician-made videos, with average total likes of 424.35 (SD: 639.41). The mean VPI scores were the highest in non-physician-made videos, with 25.18 (SD: 25.69). The average JAMA (1.92, SD: 0.50), DISCERN (34.31, SD: 14.33), and GQS scores (2.61, SD: 0.99) were the highest in physician-made videos. Conclusion: Although high-quality videos on YouTube may inform and encourage patients positively, unprofessional, incorrect, and incomplete information can be also uploaded on YouTube and may mislead patients. Keywords: Video, radioactive iodine, treatment, internet Amac: Radyoaktif iyot (RAI) tedavisi, hipertiroidizm ve iyi diferansiye tiroid kanseri icin bir radyonuklid tedavisidir. Internette hastalar icin en populer bilgi kaynaklarindan biri YouTube'dir. Bu calisma, RAI tedavisi ile ilgili videolarin kalitesini incelemeyi amaclamaktadir. Yontem: Bu kesitsel calisma YouTube kullanilarak gerceklestirilmistir. Haziran 2021'de ilgili videolarin aranmasinda "radyoaktif iyot tedavisi" ve "radioactive iodine treatment" terimleri kullanildi. Videolarin kalitesi, Amerikan Tip Dernegi Dergisi (JAMA) benchmark kriterleri, DISCERN olcegi ve kuresel kalite olcegi kullanilarak (GQS) degerlendirildi. Bulgular: Toplam 88 video degerlendirildi ve toplam 56 video (30 Ingilizce, 26 Turkce) dahil edilme ve haric tutulma kriterlerine gore analiz edildi. Yedi video (%12,5) yuksek kaliteli grup, 16 video (%28,58) orta kaliteli grup ve 33 video (%58,92) dusuk kaliteli grup olarak siniflandirildi. Calismamizin bulgulari, en yuksek video guc indeksi puanina sahip en populer videolar ile en fazla begeni ve yorum sayisina sahip videolarin orta kalite grubundaki videolar oldugunu gosterdi. Aksine, populerlik duzeyi, video begeni sayisi ve video izlenme sayisi yuksek kaliteli video grubunda en dusuk bulundu. Video kaynaklarinin analizinde; izleyiciler tarafindan en cok tercih edilen videolarin, ortalama 59307,80 standart sapma (SS): 122554,13 izlenme sayisi ile hekim kaynakli olmayan videolar oldugu saptandi. En cok begenilen videolar ise ortalama 424,35 (SS: 639,41) begeni ile hekim olmayanlara aitti. Video guc indeksi puanlarinin ortalamasi en yuksek 25,18 (SS: 25,69) olarak saptanmis ve hekim olmayanlara ait videolarda bulunmustur. Doktorlara ait videolarda ortalama JAMA (1,92, SS: 0,50), DISCERN (34,31, SS: 14,33) ve GQS puanlari (2,61, SS: 0,99) en yuksek olarak saptanmistir. Sonuc: Her ne kadar YouTube'deki yuksek kaliteli videolar, hastalari olumlu yonde bilgilendirebilmekte ve tesvik edici olabilmekte ise de; yanlis ve eksik bilgilendirmelerin de bu platforma yuklenebilecegi ve hastalari yaniltabilecegi unutulmamalidir. Anahtar kelimeler: Video, radyoaktif iyot, tedavi, internet
Nearly 40% of colorectal cancer (CRC) recurs within 2 years after resection of primary tumor. Imaging with fluorine-18-fluorodeoxyglucose (
F-FDG) positron emission tomography/computed tomography ...(PET/CT) is the most recent modality and often applied for the evaluation of metastatic spread during the follow-up period. Our goal was to study the diagnostic importance of
F-FDG-PET/CT data of maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and the difference of SUVmax on dual-time imaging in CRC.
We examined the SUVmax value of lesions on control or restaging
F-FDG-PET/CT of 53 CRC patients. All lesions with increased SUVmax values were confirmed by colonoscopy or histopathology. We compared PET/CT results with conventional imaging modalities (CT, MRI) and tumor markers (carbohydrate antigen 19-9 Ca 19-9, carcinoembryonic antigen CEA).
Mean SUVmax was 6.9 ± 5.6 in benign group, 12.7 ± 6.1 in malignant group. Mean TLG values of malignant group and benign group were 401 and 148, respectively.
F-FDG-PET/CT was truely positive in 48% of patients with normal Ca 19-9 or CEA levels and truely negative in 10% of cases with elevated Ca 19-9 or CEA. CT or MRI detected suspicious malignancy in 32% of the patients and
F-FDG-PET/CT was truely negative in 35% of these cases. We found the most important and striking statistical difference of TLG value between the groups with benign and recurrent disease.
Although SUVmax is a strong metabolic parameter (p = 0.008), TLG seems to be the best predictor in recurrence of CRC (p = 0.001); both are increasing the specificity of
F-FDG-PET/CT.
Objectives: BioNTech (Pfizer) and CoronaVac (Sinovac) vaccines are two of the most administered coronavirus disease-2019 (COVID-19) vaccines worldwide. Vaccination against severe acute respiratory ...syndrome-coronavirus-2 has caused a diagnostic challenge in oncological .sup.18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) studies. The aim of our study was to evaluate the .sup.18F-FDG PET/CT findings of the two most commonly administered vaccines worldwide. Methods: Patients over 18 years old who underwent .sup.18F-FDG PET/CT for oncological purposes in our institution between January 13, 2021 and January 31, 2022, who received a single or second dose of the BioNTech or CoronaVac vaccines in the last two months, were included in the study. Descriptive analyses were presented as mean, standard deviation, frequency and ratio. Additionally, chi-square test was used to analyze categorical variables. Results: Ipsilateral deltoid muscle hypermetabolism was observed in 6.9% (n=15) and 14.3% (n=22) patients who received CoronaVac and BioNTech vaccines, respectively. Ipsilateral axillary lymph node hypermetabolism was observed in 11% (n=24) and 41.6% (n=64) patients who received CoronaVac and BioNTech vaccines, respectively. Synchronous deltoid muscle and axillary lymph node hypermetabolism was observed in 4.14% (n=9) and 12.33% (n=19) patients who received CoronaVac and BioNTech vaccines, respectively. Significant differences were detected between CoronaVac and BioNTech vaccines in terms of ipsilateral deltoid muscle hypermetabolism, ipsilateral axillary lymph node hypermetabolism and synchronous deltoid muscle and axillary lymph node hypermetabolism (p<0.05). Conclusion: COVID-19 vaccination may result in ipsilateral axillary lymph node hypermetabolism, ipsilateral deltoid muscle hypermetabolism, or synchronous deltoid muscle and axillary lymph node hypermetabolism with different frequencies depending on the type of vaccination. Although synchronous deltoid muscle and axillary lymph node hypermetabolism can reduce misinterpretation of .sup.18F-FDG PET/CT, to avoid misinterpretation, it is important to question the vaccination history during ongoing COVID-19 vaccination process. Keywords: .sup.18F-FDG PET/CT, CoronaVac, BNT162b2, hypermetabolism, axillary lymph node Amac: BioNTech (Pfizer) ve CoronaVac (Sinovac) asilari, dunya capinda en cok uygulanan koronavirus hastaligi-2019 (COVID-19) asilarindan ikisi olmustur. Siddetli akut solunum yetmezligi sendromu-koronavirus-2'ye karsi asilama, onkolojik .sup.18F-florodeoksiglukoz (FDG) pozitron emisyon tomografisi/bilgisayarli tomografi (PET/BT) calismalarinda tanisal zorluklara neden olmaktadir. Calismamizin amaci, dunya capinda en sik uygulanan iki asinin .sup.18F-FDG PET/BT bulgularini degerlendirmektir. Yontem: 13 Ocak 2021 ile 31 Ocak 2022 tarihleri arasinda kurumumuzda onkolojik amacli .sup.18F-FDG PET/BT yapilan ve goruntuleme oncesi son iki ayda tek veya ikinci doz BioNTech veya CoronaVac asisi yapilmis 18 yas ustu hastalar calismaya dahil edildi. Tanimlayici analizler ortalama, standart sapma, frekans ve oran olarak sunuldu. Ayrica kategorik degiskenlerin analizinde ki-kare testi kullanildi. Bulgular: CoronaVac ve BioNTech asisi olan hastalarin sirasiyla %6,9'unda (n=15) ve %14,3'unde (n=22) ipsilateral deltoid kas hipermetabolizmasi gozlendi. CoronaVac ve BioNTech asisi olan hastalarin sirasiyla %11'inde (n=24) ve %41,6'sinda (n=64) ipsilateral aksiller lenf nodu hipermetabolizmasi gozlendi. Senkron deltoid kas ve aksiller lenf nodu hipermetabolizmasi, CoronaVac ve BioNTech asilari yapilan hastalarin sirasiyla; %4,14'unde (n=9) ve %12,33'unde (n=19) gozlendi. CoronaVac ve BioNTech asilari arasinda ipsilateral deltoid kas hipermetabolizmasi, ipsilateral aksiller lenf nodu hipermetabolizmasi ve senkron deltoid kas ve aksiller lenf nodu hipermetabolizmasi acisindan anlamli fark saptandi (p<0,05). Sonuc: COVID-19 asisi, asi tipine bagli olarak farkli siklikta ipsilateral aksiller lenf nodu hipermetabolizmasi, ipsilateral deltoid kas hipermetabolizmasi veya senkron deltoid kas ve aksiller lenf nodu hipermetabolizmasi ile sonuclanabilir. Senkron deltoid kas ve aksiller lenf nodu hipermetabolizmasi .sup.18F-FDG PET/BT'nin yanlis yorumlanmasini azaltabilse de, yanlis yorumlamayi onlemek icin devam eden COVID-19 asilama surecinde asi gecmisini sorgulamak onemlidir. Anahtar kelimeler: .sup.18F-FDG PET/BT, CoronaVac, BNT162b2, hipermetabolizma, aksiller lenf nodu
Selective intraarterial radionuclide therapy (SIRT) with Yttrium-90 (Y-90) resin microspheres has been applied for hepatocellular carcinoma (HCC) lately. The aim of this study is to present our ...clinical experience of radiomicrosphere therapy in the treatment of unresectable HCC and determine the proper cases who could benefit from this therapy according to response results yielded by initial staging and control imaging modalities.
We administered 43 Y-90 microsphere therapy to 34 patients with unresectable HCC (twice in 9 patients). Patients with histopathologically confirmed HCC having a life expectancy of ≥3 months; Child A-B, Okuda stage 1-2 and BCLC stage A-B-C classifications were included in the study. The patients were divided into two groups: Group A consisted of 29 patients who responded to Y-90 therapy (complete response, partial response and stable disease), Group B 5 of non-responders (progressive disease). Predefined parameters were evaluated for response to SIRT and compared between two groups.
We found a significant decrease in platelet and lymphocyte counts one month after therapy (p=0.02, p=0.01, respectively). On control imaging tests performed 3 months later, we observed complete response in 19% (n=6), partial response in 44% (n=15), stable disease in 25% (n=8) and progressive diease in 12% (n=5) of the patients. Mean overall survival (OS) was 19 (median value: 14) months.
Y-90 microsphere therapy is a safe and effective treatment option for the patients with unresectable HCC without any serious side effect. Mean tumor dose delivery and lack of bilobar disease seem the best predictors for treatment success.
Selective intraarterial Radionuclide therapy, Yttrium-90, hepatocellular carcinoma.
Objectives: The current study evaluates the value of cardiac hybrid imaging (CHI), performed by the fusion of functional and anatomic cardiac images, in the detection of hemodynamically significant ...coronary stenosis in cases with multiple coronary stenosis. Methods: A total of 36 patients (10 female, 26 male) in whom ischemia or infarction was detected on gated myocardial perfusion single photon emission computed tomography (gMPS) and multiple coronary stenosis were concomitantly detected on coronary computed tomography angiography (CCTA) and undergone invasive coronary angiography (ICA) was included in this study. Statistical analyses were performed using SPSS 22 Windows software. McNemar test was applied to show concordance between coronary CT angiography, ICA and CHI in the detection of anatomically or hemodynamically significant stenosis in three major coronary arteries. Comparison results of coronary arteries responsible for perfusion defects on CHI and gMPS are presented as percentages (%). Results: There was total accordance between coronary arteries leading to perfusion defects detected by gMPS and CHI in 50% of patients. It was observed a partial accordance in 36.1% of the patients. Additionally, it was also detected perfusion defects originated from side branches in 25% of the patients. Between results of CCTA and ICA, no statistically significant difference was noted in the detection of anatomically significant stenoses in the left main coronary artery, left anterior descending artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA) (p=1.000, 0.070, 0.549, and 1.000, respectively). In addition, no statistically significant difference was found in the detection of anatomically and hemodynamically significant stenoses in LAD, LCx and RCA by CCTA and CHI (p=0.344, 0.629, and 0.219, respectively). No statistically significant difference was observed in the detection of anatomically and hemodynamically significant stenoses in LAD, LCx and RCA by ICA and CHI (p=0.804, 1.000, and 0.344, respectively). Conclusion: It is possible to detect hemodynamically significant coronary stenosis directly by CHI modality in patients with multiple coronary stenosis, wide perfusion defects. Keywords: Cardiac hybrid imaging, coronary stenosis, myocardial perfusion scintigraphy, coronary CT angiography Amaç: Bu çalismanin amaci, fonksiyonel ve anatomik kardiyak görüntülerin füzyonu ile gerçeklestirilen kardiyak hibrid görüntülemenin (KHG), multipl koroner darliklari ve perfüzyon defektleri olan olgularda, hemodinamik olarak ciddi koroner darliklari saptamadaki katkisini degerlendirmektir. Yöntem: ?alismaya gated miyokard perfüzyon sintigrafisi tek foton emisyonlu bilgisayarli tomografi (gMPS) tetkikinde iskemi veya enfarkt ve koroner bilgisayarli tomografi anjiyografi (KBTA) tetkikinde birden fazla koroner darlik saptanarak girisimsel koroner anjiyografi (GKA) yapilan toplam 36 hasta (10 kadin, 26 erkek) dahil edildi. Anatomik ve fonksiyonel görüntüler CardIQ Fusion yazilimi (GE Healthcare, IL, ABD) ile birlestirildi. Istatistiksel analizler SPSS 22 yazilimi kullanilarak yapildi. ?ç ana koroner arterde anatomik ve hemodinamik olarak ciddi koroner darlik tespitinde, KBTA, GKA ve KHG arasindaki uyumu göstermek için McNemar testi uygulandi. KHG ve gMPS'de perfüzyon defektlerinden sorumlu koroner arterlerin karsilastirildigi sonuçlar yüzde olarak sunuldu. Bulgular: Hastalarin %50'sinde, gMPS ve KHG ile perfüzyon defektlerinden sorumlu oldugu düsünülen koroner arterler arasinda tam bir uyum vardi. Hastalarin %36,1'inde kismi uyum gözlenirken, %13,9'unda ise gMPS ile KHG tamamen uyumsuzdu. Hastalarin %25'inde, KHG sayesinde, perfüzyon defektlerinden koroner yan dallardaki darliklarin sorumlu oldugu saptandi. Sol ana koroner arter, sol ön inen arter, sol sirkumfleks arter ve sag koroner arterde anatomik olarak ciddi darliklarin saptanmasinda; KBTA ve GKA sonuçlari arasinda istatistiksel olarak anlamli bir fark saptanmadi (sirasiyla; p=1,000, 0,070, 0,549 ve 1,000). Ayrica sol ön inen arter, sol sirkumfleks arter ve sag koroner arterde; anatomik ve hemodinamik olarak ciddi darliklarin saptanmasinda, KBTA ve KHG sonuçlari arasinda istatistiksel olarak anlamli fark bulunmadi (sirasiyla; p=0,344, 0,629 ve 0,219). Ayrica sol ön inen arter, sol sirkumfleks arter ve sag koroner arterde; anatomik ve hemodinamik olarak ciddi darliklarin saptanmasinda, GKA ve KHG arasinda istatistiksel olarak anlamli bir fark gözlenmedi (sirasiyla; p=0,804, 1,000 ve 0,344). Sonuç: Multipl koroner darliklari ve genis perfüzyon defektleri olan hastalarda, KHG yöntemi ile iskemiden sorumlu olan, hemodinamik olarak ciddi koroner darliklarin dogrudan tespit edilmesi mümkündür. Anahtar kelimeler: Kardiyak hibrid görüntüleme, koroner stenoz, miyokard perfüzyon sintigrafisi, koroner BT anjiyografi
Fibrous dysplasia (FD) is a benign fibroosseous bone disorder. It has poliostotic and monostotic patterns. Monostotic FD is frequently asymptomatic and is usually discovered incidentally by ...radiologic imaging performed for other reasons. Bone scintigraphy is valuable for identifying disease extent. Craniofacial FD (CFD) is a form of the disease where lesions are limited to contiguous bones of the craniofacial skeleton. We presented a case with monostotic CFD who was detected incidentally on bone scintigraphy single-photon emission computed tomography/computerized tomography while being investigated for inflammatory arthropaties. Keywords: Craniofacial fibrous dysplasia, technetium-99m-methylene diphosphonate bone scintigraphy, single-photon emission computed tomography/computed tomography Oz Fibroz displazi (FD) kemiklerin iyi huylu bir fibroosseoz bozuklugudur. Poliyostatik ve monostatik formlari vardir. Monostatik FD siklikla asemptomatiktir ve genellikle radyolojik goruntulerde tesadufen fark edilir. Kemik sintigrafisi hastaligin yayilimini belirlemede degerlidir. Kraniyofasiyal FD (CFD) hastaligin kraniyofasiyal iskeletin kemiklerine sinirli oldugu bir formudur. Enflamatuvar artropati yonunden arastirilirken tesadufen kemik sintigrafisinde tek-foton emisyon bilgisayarli tomografi/bilgisayarli tomografi ile tespit edilen bir monostatik CFD olgusunu takdim ediyoruz. Anahtar kelimeler: Kraniyofasiyal fibroz displazi, teknesyum-99m-metilen difosfonat kemik sintigrafisi, tek-foton emisyon bilgisayarli tomografi/bilgisayarli tomografi
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