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Öğe Clinical Significance of Incidental Colonic Focal Lesions Detected by FDG PET/CT(Soc Nuclear Medicine Inc, 2015) Elboga, Umut; Sahin, Ertan; Kalender, Ebuzer; Basibuyuk, Mustafa; Demir, Hasan Deniz; Celen, Y. Zeki[Abstract Not Available]Öğe Clinical significance of incidental FDG uptake in the prostate gland detected by PET/CT(E-Century Publishing Corp, 2015) Sahin, Ertan; Elboga, Umut; Kalender, Ebuzer; Basibuyuk, Mustafa; Demir, Hasan Deniz; Celen, Yusuf ZekiThe value of FDG-positron emission tomography/computed tomography (PET/CT) for detecting prostate cancer is unknown. We aimed to investigate the clinical value of incidental prostate FDG uptake on PET/CT scans. We reviewed 6128 male patients who underwent FDG-PET/CT scans and selected cases that reported hypermetabolic lesion in the prostate. The patients who have prior history of prostate carcinoma or prostate surgery were excluded from the study. We have analyzed the correlation between PET/CT findings and serum prostate-specific antigen (PSA) levels, imaging (USG), urological examinations and biopsy. Incidental 18F-FDG uptake of the prostate gland was observed in 79 patients (1.3%). While sixteen of them were excluded due to inadequate clinical data, the remaining 63 patients were included for further analysis. The patients were divided into two groups; 8 patients (12.7%) in the malignant group and 55 patients (87.3%) in the benign group. The SUVmax values were not significantly different between the two groups. In 6 (75%) patients with prostate cancer, FDG uptake was observed focally in the peripheral zone of the prostate glands. There was no significant correlation between the SUVmax and the PSA levels. Incidental 18F-FDG uptake in the prostate gland is a rare condition, but a substantial portion of it is associated with the cancer. Benign and malignant lesions of the prostate gland in FDG-PET/CT imaging could not be reliably distinguished. The peripheral focally FDG uptake of prostate glands should be further examined with the clinical and labaratory evaluations.Öğe Clinical Significance of Incidental FDG Uptake in the Prostate Gland Detected by PET/CT(Soc Nuclear Medicine Inc, 2015) Sahin, Ertan; Elboga, Umut; Kalender, Ebuzer; Basibuyuk, Mustafa; Demir, Hasan Deniz; Celen, Y. Zeki[Abstract Not Available]Öğe Effect of short term thyroxin withdrawal on health related quality of life in differentiated thyroid carcinoma patients(In House Publications, 2015) Elboga, Umut; Elboga, Gülçin; Kalender, Ebuzer; Demir, Hasan Deniz; Sahin, Ertan; Basibuyuk, Mustafa; Aydogan, FusunBackground: We aimed to study the HRQL in patients with differentiated thyroid carcinoma (DTC) during hypothyroidism due to thyroxin withdrawal, which is induced routinely for iodine-131 (I-131) whole body scan and ablative treatment. Methods: Between September 2011 and March 2012, eligible patients with DTC who were referred to our institution for diagnostic or therapeutic radioiodine administration under hypothyroid conditions due to thyroid hormone withdrawal were asked to complete the psychological instruments rating their HRQL and psychological status. HRQL was studied using the Short Form (SF-36), Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), the total mood disturbance (TMD) score, Beck Depression Inventory (BDI).One hundred and forty three hypothyroid patients with DTC (F=101, M=42, age=58.7 yrs) who were also on low-iodine diet were included in this study. Hypothyroidism was induced by withdrawal of thyroxin replacement in all patients. Results: The results of SF-36 showed that the HRQL was significantly impaired in hypothyroid patients during withdrawal of thyroxin (physical component scale: 44.3 ± 9.5, mental component scale: 40.8 ± 10.2, p ? 0.001). Depression scores were in the normal or non-clinically relevant range: 4.1 ± 3.8 on the HADS-Depression and 8.3 ± 6.6 on the Beck Depression Index. However, the mean score of 28.8 ± 25.2 on the POMS TMD was within normal range. Conclusion: HRQL is impaired in hypothyroid patients with DTC during thyroxine withdrawal before I-131 whole body scan and radioiodine therapy. © 2015 Elboga U, et al.Öğe The Evaluation of Patients with Hyperthyroidism Treated with Radioactive Iodine-131(Derman Medical Publ, 2015) Basibuyuk, Mustafa; Elboga, Umut; Celen, Y. Zeki; Kalender, Ebuzer; Demir, H. Deniz; Sahin, Ertan; Ozkaya, MesutAim: Hyperthyroidism is a condition in which the thyroid gland produces and secretes excessive amounts of the thyroid hormones into circulation. It is one of the common endocrinologic disorders. There are three methods in treatment of hyperthyroidism. These are antithyroid medication, radioactive iodine-131 (RAI) therapy and surgery. In this study, we aimed to evaluate RAI treatment efficacy in patients with hyperthyroidism in the light of laboratory results and clinical pictures. Material and Method: Two hundred and seventy six patients with hyperthyroidism (average age: 50.9 years, age range: 1882 years) who received RAI treatment and then followed up for at least 6 months were included in the study. Patients' medical recordings were analysed retrospectively. Results: Seventy one patients were men (average age: 51.2 years, age range: 18-80 years), the rest were women (average age: 50.7 years, age range: 18-82 years). According to thyroid ultrasound or physical examination findings, 102 patients had diffuse thyroid hyperplasia, the other patients had nondiffuse hyperplasia (nodular or multinodular). RAI was given to the patients once or twice, or three times if necessary. In first RAI treatment, average 13.1 mCi, in second, average 16.6 mCi, in third, average 25 mCi RAI were given orally. Treatment was accepted as successful if the patients had become hypothyroid or euthyroid. Success rate of RAI treatment was 76%. The highest success rate was obtained in patients who have diffuse thyroid hyperplasia. Serious side-effects were not observed in our patients. Discussion: In treatment of hyperthyriodism with RAI in our clinic we observed approximately similar success rates with the reported results in the literature, and also side-effects of RAI treatment were low. We believe that RAI treatment should be first choice for treatment of hyperthyroidism in selected patients, because it is easy to perform and its side- effects are very low.Öğe The Evaluation of Solid Phase Gastric Emptying in Patients with Behcet's Disease(Derman Medical Publ, 2015) Dogramaci, Asena Cigdem; Yalcin, Hulya; Balci, Didem Didar; Ucar, Edip; Yenin, Julide Zehra; Kalender, EbuzerAim: Behcet's disease is a multisystemic disease that includes the mucocutaneous, ocular, cardiovascular, renal, pulmonary, joint and central nervous system involvement. Gastrointestinal system involvement is rare in Behcet's disease. Current study was planned to investigate the rate of gastric emptying in patients with Behcet's disease by using gastric emptying scintigraphy. Material and Method: In order to determine gastric emptying rate of solids, 14 patients with Behcet's disease and 14 healthy controls were studied scintigraphically. After an overnight fast, all subjects ingested a Tc-99m DTPA labeled solid meal consisted of an egg and toasted white bread. Immediately after ingestion of the meal, subjects were positioned supine under the gamma camera and serial images were recorded continuously for 90 minutes. Half empyting time (t 1/2) and percentage of radioactive material remaining in the stomach at 60 min. were calculated. Results: The mean ages of Behcet's patients was 41.00 +/- 10.25 years and 40.57 +/- 10.05 years in control group. T 1/2 of Behcet's patients was found 85 +/- 61 min. and 63 +/- 22 min. in control cases (p=0.122). Percentage of radioactive material remaining in the stomach at 60 min. was 69.3 +/- 14.0 % and 54.6 +/- 22.0 % in Behcet's patients and controls, respectively (p=0.035). Discussion: Although there was not a significant difference between half gastric emptying times, we determined that percentage of radioactive material remaining in the stomach at 60 min. was significantly greater in Behcet's patients than that in controls. As a result, gastric stasis could be seen in Behcet's patients due to multisystemic involvement.Öğe The evaluation of solid phase gastric emptying in patients with Behcet’s disease(2015) Doğramacı, Asena Çiğdem; Yalçın, Hülya; Balcı, Didem Didar; Uçar, Edip; Yenin, Julide Zehra; Kalender, EbuzerAmaç: Behçet Hastalığı mukokutanöz sistem, göz, kardiyovasküler sistem, böbrek, akciğer, eklem ve merkezi sinir sistemi tutulumu ile seyredebilen multisistemik bir hastalıktır. Behçet Hastalığında gastrointestinal sistem tutulumu nadirdir. Bu çalışmada mide boşalma sintigrafisi ile Behçet Hastalarında mide boşalma oranlarının araştırılması amaçlandı. Gereç ve Yöntem: Solid mide boşalma oranlarının tesbiti amacıyla 14 Behçet Hastası ile 14 sağlıklı kontrol grubu sintigrafik olarak incelendi. Bir gece açlıktan sonra tüm olgular Tc-99m DTPA ile işaretli yumurta ve kızarmış beyaz ekmekten oluşan solid gıda aldı. Yemek yenilmesinden hemen sonra olgular gamma kamera altı- na sırt üstü yatırıldı ve 90 dakika boyunca sürekli görüntüler alındı. Mide yarı boşalma zamanı (T ½) ve 60. dakikada midede kalan radyoaktif madde oranı hesaplandı. Bulgular: Behçet Hastalarının ortalama yaşı 41.00±10.25, kontrol grubunun ise 40.57±10.05 idi. Behçet Hastalarının T ½ değeri 85± 61 dakika olarak bulunurken kontrol vakalarında 63±22 dakika olarak bulundu (p=0.122). 60. dakikada midede kalan radyoaktif madde oranı Behçet Hastalarında ve kontrol vakalarında sırasıyla % 69.3 ± 14.0 ve % 54.6± 22.0 idi (p=0.035). Tartışma: Mide yarı boşalma zamanları arasında belirgin bir farklılık olmamasına rağmen 60. dakikada midede kalan radyoaktif madde oranı Behçet Hastalarında kontrol grubuna göre belirgin yüksekti. Sonuç olarak gastrik staz Behçet Hastalarında multisistemik tutulum sonucu görülebilir.Öğe Kemik metastazlarının iskelet sistemindeki bölgesel dağılımı(2014) Aydoğan, Füsun; Kalender, Ebuzer; Rifaioğlu, Murat; Dokuyucu, RecepGiriş: Kemik metastazları iskelet sisteminin en sık görü- len malign lezyonlarıdır. Çalışmamızın amacı sintigrafik olarak tespit edilen kemik metastazlarının iskelet sistemindeki bölgesel dağılımını belirlemektir. Yöntemler: Çalışmaya Ocak 2012 ve Ağustos 2013 tarihleri arasında kliniğimizde kemik sintigrafisi çekimi yapı- lan primer maligniteli 97 hasta (53 erkek, 44 kadın) dahil edildi. Hastaların yaş ortalaması 59,0±15,9 (yaş aralığı, 19-84) yıl idi. Kemik metastazı olan hastalar ve bu metastazların bölgesel dağılımı tespit edildi. Bulgular: Hastaların 38’inde (%39,2) kemik metastazı tespit edildi. Otuz iki (%84,2) hastada metastazlar multipl, 6 (%15,8) hastada ise soliter (tek) idi. Kemiğe metastaz yapan malignitelerin 15’i (%39,5) prostat kanseri, 8’i (%21) meme kanseri, 2’si (%5,3) akciğer kanseri, 3’ü (%7,9) mesane kanseri, 10’u (%26,3) ise diğer malignitelerden (rektum, mide, serviks, lenfoma vs) oluşmaktaydı. Doksan iki adet metastaz bölgesi saptandı. Bunların 24’ü (%26,1) vertebra, 15’i (%16,3) pelvik kemikler, 17’si (% 18,5) kosta, 6’sı (% 6,5) üst ekstremite, 12’si (% 13) alt ekstremite, 5’i (% 5,45) kalvaryum, 6’sı (% 6,5) sternum, 4’ü (% 4.35) skapula, 3’ü (% 3,3) klavikula idi. Sonuç: Kemik metastazları metastatik kanser olgularının 2/3’ünde saptanmaktır. Kemik metastazlarının en sık izlendiği bölge aksiyel iskelet sistemidir ve bu sistem içerisinde de vertebralar ilk sırayı almaktadır. Kemik metastazlarının değerlendirilmesinde kullanılan en önemli görüntüleme yöntemi ise kemik sintigrafisidir.Öğe Overview of 99mTc-anti-TNF-? scintigraphy: Diagnostic applications(2014) Elboga, Umut; Kalender, Ebuzer; Yalcin, HulyaTumor necrosis factor alpha (TNF-?) has a role in the pathogenesis of several inflammatory diseases such as rheumatoid arthritis, Crohn's disease, and ulcerative colitis. As TNF-? plays a role in the pathogenesis of different inflammatory diseases, anti-TNF-? agents (monoclonal antibodies [mAbs]) such as infliximab, adalimumab, and certolizumab have been developed and investigated for the treatment of these conditions. In recent years, these mAbs also have been used for diagnosis, monitoring, follow-up of disease activity, and therapy decision-making for inflammatory diseases, especially rheumatoid arthritis, after labeling with 99mTc. However, 99mTc-anti-TNF-? imaging might have severe adverse effects and is expensive. In contrast, scintigraphic imaging before therapy with radiolabeled mAbs may be a cost-effective solution for therapy decisions. © 2014 Elboga et al.Öğe Regional Distributions of Distant Metastases Detected in Differentiated Thyroid Cancers(Derman Medical Publ, 2015) Kalender, Ebuzer; Elboga, Umut; Aydogan, Fusun; Basibuyuk, Mustafa; Demir, Hasan Deniz; Sahin, Ertan; Celen, Y. ZekiAim: The aim of our multicenter study is to determine retrospectively the regional distributions of distant metastases which are detected in differentiated thyroid cancers (DTC). Material and Method:Thirty-two of 960 patients with distant metastases who were given radioiodine (RAI) treatment in Gaziantep University School of Medicine and Mustafa Kemal University School of Medicine were included to study. Six of patients were male, 26 of them were female. Mean age was 52 15.4. Hystopathological diagnoses were reported as papillary thyroid cancer in 23 patients and folliculary thyroid cancer in 9 patients. The distant metastasis ratio, metastasis regions and distributions were determined. Results: It was observed only lung metastasis in 18 (56.25 b), only bone metastasis in 6 (18.75 To), combination of lung and bone metastases in 3 (9.4 %), other organ metastases accompanying to bone and lung metastases in 5 (9.4 %) (liver, soft tissue, mediastinum) and multipl organ involvoment in 2 (6.2 96) of patients. It was determined single metastasis region in 24 (75 To), 2 metastasis regions in 6 (18.75 glo) and multipl metastasis regions in 2 (6.25 WO of patients. Discussion: Distant metastases are the biggest problem in treatment and follow-up of DTCs. It is very important to diagnosis of metastases and determine the regions of involvoment in these patients.Öğe Retrospective Analysis of Indication of Bone Scintigraphy Performed in Our Clinic(Derman Medical Publ, 2015) Aydogan, Fusun; Kalender, Ebuzer; Dokuyucu, RecepAim: Bone scintigraphy is one of the commonly used radionuclide imaging and it is successfully used in the diagnosis and follow-up of many diseases. The aim of this study is to determine the indications and filming protocols of bone scintigraphy which was performed in our clinic. Material and Method: Two hundred and fifty two patients (132 male, 120 female) who was performed bone scintigprapy in our clinic between December 2011 and June 2013 included the study. Mean age was 50.1 +/- 20.2 years. Scintigraphic protocols were made in two ways as late static whole body imaging and three-phase bone scintigraphy according to the type of the diseases. Indications of scintigraphies and scintigraphic protocols were detected. Results: Bone scintigraphy was performed for diagnosis and monitoring of metastatic bone disease to 102 patients (40,5 %), for orthopedic applications to 57 patients (22,6 %), for diagnosis and monitoring of primary bone tumors to 29 patients (11,5 %), for diagnosis of osteomyelitis to 17 patients (6,7 %), for differential diagnosis of infection and loosening of the prosthesis to 12 patients (4,8 %), investigate the viability of the graft in 14 patients (4,6 %), for rheumatologic diseases to 9 patients (3,6 %), for investigate the pathological vertebral fractures and osteoporosis to 4 patients (1,6 %), for diagnosis the metabolic bone disease to 2 patients (0,8 %), for diagnosis of otitis externa to 5 patients (1,98 %) and for for suspicion of malignancy to 1 patient (0,4 %). Late static whole body imaging protocol was applied to 136 patients (54 %) and three-phase imaging protocol was applied to 116 patients (46 %). Discussion: The most common use of bone scintigraphy is the diagnosis and follow-up of metastatic bone disease. It is followed by reasons such as orthopedic applications, monitoring and diagnosis of primary bone tumors and diagnosis of osteomyelitis.Öğe Retrospective analysis of indication of bone scintigraphy performed in our clinic(2015) Aydoğan, Füsun; Kalender, Ebuzer; Dokuyucu, RecepAmaç: Kemik sintigrafisi sık kullanılan radyonüklid görüntüleme yöntemlerindendir ve birçok hastalığın tanı ve takibinde başarıyla kullanılmaktadır. Çalışmamızın amacı kliniğimizde yapılan kemik sintigrafisi çekimlerinin endikasyonlarını ve çekim protokollerini belirlemektir. Gereç ve Yöntem: Çalışmaya Aralık 2011 ve Haziran 2013 tarihleri arasında kliniğimizde kemik sintigrafisi çekimi yapılan 252 hasta (132 erkek, 120 kadın) dahil edildi. Hastaların yaş ortalaması 50.1±20.2 idi (yaş aralığı 6-84). Sintigrafik protokoller hastalığın çeşidine göre geç statik tüm vücut görüntüleme ve üç fazlı kemik sintigrafisi olmak üzere iki şekilde yapıldı. Çekim endikasyonları ve sintigrafik pro- tokoller tesbit edildi. Bulgular: 102 hastaya (% 40,5) metastatik kemik hastalıklarının tanı ve takibi amacıyla, 57 hastaya (% 22,6) ortopedik uygulamalar amacıyla, 29 hastaya (% 11,5) primer kemik tümörlerinin tanı ve takibi amacıyla, 17 hastaya (% 6,7) osteomyelit tanısı amacıyla, 12 hastaya (% 4,8) protez enfeksiyonu ve gevşemesi ayrıcı tanısının yapılması amacıyla, 14 hastaya (% 5,6) gref canlılığının araştırılması amacıyla, 9 hastaya (% 3,6) romatoid artrit-sakroileit gibi romatolojik hastalıklar nedeniyle, 4 hastaya (% 1,6) osteoporoz-vertebralarda patolojik kırık araştırılması amacıyla, 2 hastaya (% 0,8) metabolik kemik hastalığı nedeniyle, 5 hastaya (% 1,98) otitis eksterna tanısı amacıyla ve 1 hastaya (% 0,4) sedimantasyon-CRP yüksekliği gibi nedenlerden dolayı malignite şüphesi nedeniyle kemik sintigrafisi çekimi yapıldı. Hastaların 136’sına (% 54) geç statik tüm vücut görüntüleme, 116’sına (% 46) ise üç fazlı görüntüleme protokolü uygulandı. Tartışma: Kemik sintigrafisinin en sık kullanıldığı alan metastatik kemik hastalıklarının tanı ve takibidir. Bunu ortopedik uygulamalar, primer kemik tümörlerinin tanı-takibi ve oste- omyelit tanısı gibi nedenler takip etmektedir.
