Person: ERDOĞAN, EZGİ BAŞAK
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Publication Open Access Incidental detection of prostate-specific antigen-negative metastatic prostate cancer initially presented with solitary pulmonary nodule on fluorodeoxyglucose positron emission tomography/computed tomography(2015-01-01) ERDOĞAN, EZGİ BAŞAK; Buyukpinarbasili, NUR; ZİYADE, SEDAT; AKMAN, Tolga; TÜRK, HACI MEHMET; AYDIN, MEHMET; ERDOĞAN, EZGİ BAŞAK; BÜYÜKPINARBAŞILI, NUR; ZİYADE, SEDAT; TÜRK, HACI MEHMET; AYDIN, MEHMETA 71-year-old male patient with solitary pulmonary nodule underwent fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) showing slightly increased FDG uptake in this nodule. In addition, PET/CT detected hypermetabolic sclerotic bone lesions in the right second rib and 7(th) thoracic vertebrae, which were interpreted as possible metastases, and mildly increased FDG uptake in the prostate gland highly suspicious of malignancy. The patient's prostate-specific antigen (PSA) level was within normal range (3.8 ng/dL). The histopathological examination of the lung nodule and right second rib lesion proved metastases from prostate cancer, then the prostate biopsy-confirmed prostate adenocarcinoma. The unique feature of this case is to emphasize the importance of performing PET/CT for solitary pulmonary nodule in detecting PSA-negative metastatic prostate cancer. This case indicated that it should be kept in mind that, even if the PSA is negative, a lung metastasis of prostate cancer may be an underlying cause in patients evaluated for solitary pulmonary nodule by FDG PET/CT.Publication Open Access The role of PET and MRI in evaluating the feasibility of skin-sparing mastectomy following neoadjuvant therapy.(2018-02-01) MALYA, FATMA ÜMİT; KADIOGLU, HÜSEYİN; BEKTASOGLU, HÜSEYİN KAZIM; Gucin, ZÜHAL; YILDIZ, S; GUZEL, MEHMET; ERDOGAN, EZGİ BAŞAK; YUCEL, S; ERSOY, YELİZ EMİNE; MALYA, FATMA ÜMİT; KADIOĞLU, HÜSEYİN; BEKTAŞOĞLU, HÜSEYİN KAZIM; GÜCİN, ZÜHAL; YILDIZ, ŞEYMA; GÜZEL, MEHMET; ERDOĞAN, EZGİ BAŞAK; ERSOY, YELIZ EMINEAbstract Objective: To investigate the role of positron emission tomography (PET) and magnetic resonance imaging (MRI) in evaluating the feasibility of skin-sparing mastectomy in patients with locally-advanced breast cancer (LABC) who will undergo neoadjuvant chemotherapy (NAC) by evaluating the sensitivity and specificity of PET and MRI compared with skin biopsy results before and after NAC treatment. Methods: Patients with LABC who were treated with NAC between November 2013 and November 2015 were included in this study. Demographic, clinical, radiological and histopathological features of the patients were recorded. Results: A total of 30 patients were included in the study with a mean age of 52.6 years (range, 35– 70 years). Sensitivity and specificity for detecting skin involvement in LABC was 100%/10% (62%/ 85%) with MRI and 60%/80% (12%/92%) with PET before (after) NAC, respectively. When radiological skin involvement was assessed in relation to the final histopathological results, the preNAC PET results and histopathological skin involvement were not significantly different; and there was no difference between postNAC MRI and histopathological skin involvement. Conclusions: As preNAC PET and postNAC MRI more accurately determined skin involvement, it might be possible to use these two radiological evaluation methods together to assess patient suitability for skin-sparing mastectomy in selected patients.Publication Open Access Investigation of Added Value of Imaging Performed in a Prone Position to Standard 18 F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging for Staging in Patients with Breast Cancer(2022-02-02T00:00:00Z) Erdoğan, Ezgi Başak; Aydın, MEHMET; ERDOĞAN, EZGİ BAŞAK; AYDIN, MEHMETObjectives: To investigate whether additional imaging in a prone position has any value to the supine whole-body 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) images by comparing the visual and quantitative data about a local disease in the breast and axilla for the initial staging of breast cancer (BC). Methods: In this study, a total of 91 female patients with the BC were studied. Both the supine and prone images were examined based on the axial diameter, number and location of the primary tumor, local invasion signs of the tumor, the number of axillary lymph nodes with a suspected metastasis, metabolic parameters of the primary tumor and axillary lymph nodes, and registration artifacts of the PET and CT images were evaluated individually. These findings were compared with the histopathological data obtained after a surgery. Results: In the evaluation of a supine and prone imaging, tumor diameter and metabolic tumor volume (MTV) values of the breast lesions were greater in the supine position than in the prone position. However, there was no significant difference found between the other metabolic parameters of a primary tumor and axilla in both positions. In the supine and prone images, accuracy for skin involvement was 84% and 91.3%, respectively. Conclusion: In our study, we observed that, obtaining additional images in the prone position does not significantly benefit the evaluation of a local disease. The average values of the primary tumor diameter and MTV in the prone position appear to be smaller than the one in the supine position. However, the prone imaging in the patients with a newly diagnosed BC may be beneficial in selected patients and may contribute to preventing the false-positive results especially in patients with a suspected skin involvement. Keywords: 18F-fluorodeoxyglucose (18F-FDG); Breast cancer; positron emission tomography/computed tomography (PET/CT); prone position.Publication Open Access Synchronous Hepatocellular Carcinoma and Cholangiocellular Carcinoma on F-18-FDG PET/CT(2018-10-01) Erdogan, EZGİ BAŞAK; Turk, HACI MEHMET; Tekce, ERTUĞRUL; Aydin, MEHMET; ERDOĞAN, EZGİ BAŞAK; TÜRK, HACI MEHMET; AYDIN, MEHMETA 43-year-old male patient presented with a mass lesion on the right liver lobe, segment 5, in radiological imaging and elevated alpha-fetoprotein levels (323 ng/mL) compatible with hepatocellular carcinoma (HCC). Positron emission tomography/computed tomography (PET/CT) images showed background level 18F-FDG uptake in the mass lesion. In addition, a secondary focus of increased 18F-FDG uptake was detected on the left liver lobe, segment 2, approximately 1,5 cm in diameter. Histopathological examination revealed HCC in the larger mass lesion with a lower 18F-FDG uptake, and cholangiocellular carcinoma in the smaller mass lesion with a higher 18F-FDG uptake. To our knowledge, this is the first case report of two histopathologically different primary malignant liver tumors in two distinct segments of the liver detected by PET/CT.Publication Open Access New Fetal Dose Estimates from F-18-FDG Administered During Pregnancy: Standardization of Dose Calculations and Estimations with Voxel-Based Anthropomorphic Phantoms(2016-11-01) Zanotti-Fregonara, Paolo; Chastan, Mathieu; Edet-Sanson, Agathe; Ekmekcioglu, Ozgul; Erdogan, EZGİ BAŞAK; Hapdey, Sebastien; Hindie, Elif; Stabin, Michael G.; ERDOĞAN, EZGİ BAŞAKData from the literature show that the fetal absorbed dose from 18F-FDG administration to the pregnant mother ranges from 0.5E-2 to 4E-2 mGy/MBq. These figures were, however, obtained using different quantification techniques and with basic geometric anthropomorphic phantoms. The aim of this study was to refine the fetal dose estimates of published as well as new cases using realistic voxel-based phantoms. Methods: The 18F-FDG doses to the fetus (n = 19; 5-34 wk of pregnancy) were calculated with new voxel-based anthropomorphic phantoms of the pregnant woman. The image-derived fetal time-integrated activity values were combined with those of the mothers' organs from the International Commission on Radiological Protection publication 106 and the dynamic bladder model with a 1-h bladder-voiding interval. The dose to the uterus was used as a proxy for early pregnancy (up to 10 wk). The time-integrated activities were entered into OLINDA/EXM 1.1 to derive the dose with the classic anthropomorphic phantoms of pregnant women, then into OLINDA/EXM 2.0 to assess the dose using new voxel-based phantoms. Results: The average fetal doses (mGy/MBq) with OLINDA/EXM 2.0 were 2.5E-02 in early pregnancy, 1.3E-02 in the late part of the first trimester, 8.5E-03 in the second trimester, and 5.1E-03 in the third trimester. The differences compared with the doses calculated with OLINDA/EXM 1.1 were +7%, +70%, +35%, and -8%, respectively. Conclusion: Except in late pregnancy, the doses estimated with realistic voxelwise anthropomorphic phantoms are higher than the doses derived from old geometric phantoms. The doses remain, however, well below the threshold for any deterministic effects. Thus, pregnancy is not an absolute contraindication of a clinically justified 18F-FDG PET scan.Publication Open Access Does Early PET/CT Assesment of Response to Chemotherapy Predicts Survival in Patients With Advanced Stage Non-Small-Cell Lung Cancer?(2014-12-01T00:00:00Z) Ordu, Çetin; Selcuk, Nalan A.; ERDOĞAN, EZGİ BAŞAK; Angın, Gülden; Güral, Zeynep; Memiş, Hatice; Yencilek, E; Dalsuna, Sinem; Pilancı, K; ERDOĞAN, EZGİ BAŞAKThe aim of this study is to determine the prognostic role and the timing of metabolic response to chemotherapy, based on F-18-fluorodeoxyglucose positron emission tomography (F-18-FDG-PET), in patients with metastatic non-small-cell lung cancer (NSCLC). The study included 55 patients with metastatic NSCLC that were analyzed in terms of prognostic factors and survival. F-18 -FDG-PET/CT findings were evaluated in patients separated into 3 groups, before and after 1st, 2nd, 3rd cycle of the first line chemotherapy. Metabolic response was assessed according to PET Response Criteria in Solid Tumors (PERCIST 1.0). Among the 55 patients, 34 (62%) died, and 21 (38%) remained alive during a mean follow-up of 13.5months. Median overall survival (OS) was 11.69 months (range 2-26.80 months) and median progression-free survival (PFS) was 6.27 months (range 1.37-20.43 months). Univariate analysis showed that the only favorable prognostic factor for OS in all the patients was the achievement of metabolic response. Metabolic response according to PERCIST, and weight lose <= 5% were also independent favorable prognostic factors predictive of survival in all patients based on multivariet analysis (metabolic response: P = 0.002, OR; 1.90, 95% CI 1.26-2.89, and weight lose <= 5%: P = 0.022, OR; 2.24, 95% CI 1.12-4.47). Median OS in all patients with partial response (PR)-according to the PERCIST 1.0-was significantly longer than in those with progressive disease (PD) (16.36 months vs 8.14 months, P = 0.008). Median OS in the patients with PR was significantly longer than in those with PD based on PET/CT performed after 2nd and 3rd cycles of chemotherapy (18.35 months vs 7.54 months, P = 0.012 and 18.04 months vs 7.43 months, P < 0.001, respectively), whereas, median OS did not differ significantly between patients with PR and those with PD based on PET/CT performed after the 1st cycle of chemotherapy (8.01 months vs 5.08 months, P = 0.290). Metabolic response according to PERCIST and weight loss are independent factors predictive of OS. PET/CT performed after second cycle of chemotherapy may be the earliest predictor of treatment response in patients with advanced stage NSCLC.Publication Open Access Epithelioid Myofibroblastoma in an Old-Male Breast: A Case Report with MRI Findings.(2015-01-01) YILDIZ, ŞEYMA; GÜCİN, ZÜHAL; ERDOĞAN, EZGİ BAŞAK; YILDIZ, ŞEYMA; GÜCİN, ZÜHAL; ERDOĞAN, EZGİ BAŞAKMyofibroblastoma of the breast (MFB) is a very rare benign stromal tumor. In recent years, increase in mammographic screenings has resulted in increased diagnosis of MFB. Most cases are old males and postmenopausal women. MFB may be confused as malignant, clinically, morphologically, or by imaging. Immunohistochemistry is essential for final diagnosis in these cases. We report a case of a pathologically diagnosed MFB in an 80-year-old male patient who had coexisting prostate cancer and describe its imaging characteristics, especially magnetic resonance imaging (MRI). In this paper, histopathological and MRI findings of the MFB were discussed.Publication Open Access The Role of Post-treatment FDG-PET/CT Scanning after the First-line Chemotherapy in Predicting Prognosis in Patients with Hodgkin Disease and High-grade Non-Hodgkin Lymphoma: A Comparative Study with Clinical Prognostic Risk Scoring Data(2022-06-01T00:00:00Z) ERDOĞAN, EZGİ BAŞAK; Guner, Sebnem; SÖNMEZOĞLU, KERİM; ERDOĞAN, EZGİ BAŞAKObjective: We aimed to evaluate the role of fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) performed after the first-line therapy in predicting prognosis of lymphomas and compare the results with the pretreatment prognostic risk scoring (PRS) indices. Methods: One hundred three patients with histopathologically confirmed Hodgkin (HD) and high-grade non-Hodgkin lymphoma (NHL) were included in the study. All patients received FDG-PET/CT imaging after the end of primary treatment. After intraveneus application of FDG, whole body PET/CT from the upper thigh to the vertex was performed. Results: The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of post-treatment FDG-PET/CT imaging in predicting remission status were 73.6%, 91.6%, 88%, 66.6%, and 94.0%, respectively. Those values were 63.0%, 62.0%, 62.0%, 27%, and 88.0% respectively, for pretreatment clinical risk scoring (p<0.001). Among the patients with positive PET scans after ending of the first-line therapy, 71.4% of those with only single lymph node station involvement stayed in remission, whereas 12.5% of the patients who had involvement of multiple lymph node stations and 16.7% of the patients who had extranodal disease could sustain in remission (p<0.05). Conclusion: We found that FDG-PET performed after first-line therapy was superior to clinical PRS systems in predicting prognosis of HD and NHL disease as conclusions. Although it was more successful to predict patients who would stay in remission with its high NPV, FDG-PET/CT imaging had a lower PPV due to false positive results. However, persistent FDG uptake in multinodal lymphatic stations and/or in extranodal sites on the post-therapy PET/CT scanning was more suggestive in predicting risk for recurrence.Publication Open Access Radioembolization Treatment for Liver Cancer(2016-04-01) Erdogan, EZGİ BAŞAK; Ozdemir, HÜSEYİN; Aydin, MEHMET; ERDOĞAN, EZGİ BAŞAK; ÖZDEMİR, HÜSEYIN; AYDIN, MEHMETAlthough curative treatment is surgery (resection/transplantation) and for small lesions ablative strategies, in primary liver carcinomas such as hepatocellular carcinoma and cholangiocellular carcinoma, palliative treatment is used for most of these patients because of lack of surgical options. These treatments are regional treatments such as transarterial chemoembolization, radiofrequency ablation, or microwave ablation and systemic treatments such as tyrosine kinase inhibitors. Surgery and chemotherapy are the main treatment options for metastatic liver tumors, particularly in colorectal tumors, although local treatment options are used for these patients. In recent years, transarterial radioembolization with yttrium-90 microsphere has emerged as a local treatment option in primary and metastatic liver tumors. The aim of this treatment is to provide an effective radiation dose distribution for the tumor in the liver tissue and to give the lowest dose in order to not harm the intact liver tissue. Radioembolization has proven to be as effective as other available palliative treatments in primary and secondary liver tumors and is a treatment method that is well tolerated. It has a risk for serious life-threatening complications, although this rate is low. Toxicity can be kept at a minimum with adequate technical and rigorous application in experienced hands and in accordance with multidisciplinarity. It is hoped that the effectiveness of radioembolization is further increased in the future by technological developments, researches on dosimetry, its use along with radiosensitizing agents, and various treatment combinations.