Browsing by Author "Polack, Berna Degirmenci"

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The Comparison of Three Different Malignacy Evaluation Criteria of Cervical Lymph Nodes in Oral Cavity Cancer Using F-18 Fdg Pet-Ct
(Carbone Editore, 2015) Surucu, Erdem; Demir, Yusuf; Polack, Berna Degirmenci
Aims: Our aim was to evaluate the diagnostic role of Fluorine-18 fluorodeoxyglucose Positron emission tomography-computed tomography (F-18 FDG PET-CT) using three different criteria published in the literature and to compare the diagnostic value of these three parameters in patients with oral cavity cancers (OCC). Materials and methods: 16 patients (4 female; 12 male, 29-81 years) were included in this study. Malignancy in the lymph nodes was evaluated according to these 3 criteria: 1: Visual assessment 2: The ratio of maximum standard uptake value (SUVmax) in tumor/ adjacent muscle tissue (T/M), 3: SUVmax adjusting to the size of lymph nodes. The histopathological evaluation of the surgery was recorded according to the neck levels. The sensitivity, specificity, negative predictive values (NPV) and positive predictive values (PPV) of F-18 FDG PET-CT for each malignancy criteria and receiver operating characteristic (ROC) curves were obtained for SUVmax and T/M. Results: Histopathological evaluations revealed 5 patients had metastatic lymph nodes (N+) whereas 11 patients had benign lymph nodes (N-). 14 of 43 lymph nodes that were visualized in CT of F-18 FDG PET-CT were evaluated as malignant whereas 29 of 43 lymph nodes were evaluated as benign. The average of SUVmax and T/M ratios of visually malignant lymph nodes were 7.67 +/- 4.95 and 7.10 +/- 3.18, respectively. The average of SUVmax and T/M ratios of visually benign lymph nodes were 1.69 +/- 0.43 and 1.49 +/- 0.48, respectively. The highest sensitivity, specificity, NPV and PPV were obtained in the criteria of T/M ratios with the threshold value of SUVmax (regardless from the size) as 3.4 and T/M ratio as 3.2 which is obtained from our population using ROC curve, 93% sensitivity, 96% specificity were calculated. Conclusion: This study indicates that F-18 FDG PET-CT is a reliable method for the correct evaluation of primary tumor and N staging in OCC. This study showed that T/M ratios in the lymph nodes could be used to evaluate malignancy with a highest diagnostic accuracy.
Dual-Phase F-18 Fdg Pet-Ct in Staging and Lymphoscintigraphy for Detection of Sentinel Lymph Nodes in Oral Cavity Cancers
(Elsevier Science inc, 2015) Surucu, Erdem; Polack, Berna Degirmenci; Demir, Yusuf; Durmusoglu, Mehmet; Ekmekci, Sumeyye; Sarioglu, Alien; Ikiz, Ahmet Omer
Aim: Our objective was to evaluate the diagnostic role of dual-phase fluor-18 fluorodeoxyglucose (F-18 FOG) positron emission tomography-computed tomography (PET-CT) and planar lymphoscintigraphy in patients with oral cavity cancer (OCC). We also investigated the combined impact of F-18 FOG PET-CT and sentinel lymph node biopsy (SLNB) in decision making for patients with OCC. Methods: Sixteen patients (4 female, 12 male; age range, 29-81 years) were included in this prospective study. F-18 FDG PET-CT [1 (early) and 2 h (delayed) after injection] and planar lymphoscintigraphy (2 h before the surgery) were performed for all the patients before surgery. The sensitivity, specificity, and negative and positive predictive values in F-18 FOG PET-CT for the early and the delayed scans and tumor/liver uptake (T/L) in the lymph nodes were calculated. Receiver operating characteristic curves were obtained for standardized uptake value (SUV)max and T/L. Results: Histopathological evaluations revealed that 5 patients had metastatic lymph nodes (pN+) whereas 11 patients had benign lymph nodes (pN). Out of 43 lymph nodes visualized as cN(+) in F-18 FDG PET-CT, 14 were pathologically positive for malignancy, whereas 29 were pathologically benign. There was no statistical difference between the N(+) and N(-) patients in terms of age, depth of primary tumor, and the number of mitoses. However, there was a significant difference between the N(+) and N(-) patients (P=.011) in terms of early and delayed F-18 FOG uptake of primary tumors. There was a statistically significant difference in the value of SUVmax between the early and the delayed scans for the malignant lymph nodes (P=.00). Conclusion: This study indicates that F-18 FOG PET-CT is a reliable method for the correct evaluation of primary tumor and N staging in OCCs. Delayed phase of F-18 FOG imaging may increase primary lesion detectability due to higher FDG uptake in primary tumors compared to the early phase of imaging. F-18 FOG PET-CF might demonstrate skip metastasis in lymph nodes which can be missed with SLNB. Although SUV values increased in the delayed phase of F-18 PET-CF imaging in detecting lymph node metastases, the specificity and positive predictive value did not increase. (C) 2015 Elsevier Inc. All rights reserved.