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    Overall survival and prognostic factors in lung cancer patients with brain metastases
    (2020) Demir, Fadime; Yanarates, Ahmet; Budak, Emine
    Aim: The aim of this study was to investigate overall survival in patients with lung cancer with brain metastasis. Our other aim was to investigate prognostic value of the maximum standardized uptake value (SUVmax) of primary tumor on 18Fluorine-fluorodeoxyglucose positron emission tomography / computed tomography (18F-FDG PET / CT) FDG PET / CT and other clinicopathological parameters. Material and Methods: Fifty-eight patients with lung cancer who underwent for oncologic purpose and had metastatic lesions in the brain were included in the study. The location of the primary lung mass and whether other organ metastases presence was evaluated on the 18F-FDG PET / CT. In axial images, the volume of interest (VOI) was plotted semi-automatically to include lung tumor tissue and SUVmax of the primary lung tumor was measured. Survival analyzes were performed with Kaplan-Meier survival analysis. The prognostic value of the parameters was evaluated using Cox regression analysis.Results: Of the 58 patients included in the study, 6 (10%) were female and 52 (90%) were male. The mean age was 64.8 ± 9.5 years. The mean SUVmax of primary tumor was 10.4 ± 4.5. Median survival was 7 months. Patient age and localization of the primary tumor were prognostic factors for survival in univariate analysis, whereas sex, SUVmax of primary tumor, presence of distant metastasis outside the brain, histologic subtype, surgical status of the metastatic brain mass and treatment type were not. Overall survival was lower in patients with primary tumor located in the left lung than in the right lung.Conclusion: In conclusion, age and localization of primary tumor are prognostic factors, whereas SUVmax of primary tumor does not appear to be a prognostic factor in lung cancer patients with brain metastases.
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    The relationship between bone marrow activity detected on PET / CT and prognosis in patients with lymphoma
    (2020) Yanarates, Ahmet; Budak, Emine
    Aim: In this study, we aimed to evaluate the relationship between survival of patients with lymphoma who were considered to be negative for bone marrow (BM) infiltration and BM FDG uptake on PET / CT.Material and Methods: This retrospective study included 55 patients diagnosed with lymphoma (33 HL and 22 NHL), with no BM infiltration (by biopsy or clinically negative) and having pre-treatment PET / CT. According to the pattern of BM FDG uptake on PET / CT the patients were divided into three groups as; those with focal FDG uptake (F-FDG), those with diffuse increased FDG uptake (D-FDG) and those with normal FDG uptake (N-FDG). The overall survival (OS) and progression-free survival (PFS) curves of the patients were plotted with Kaplan Meier method. The OS and PS of patients who were grouped according to the pattern of BM FDG uptake on PET / CT, gender, disease stage and lymphoma type were compared with Log Rank test.Results: The mean follow-up period of our study was 23.7 ± 2.1 months (1-53 months). The mean OS was 41.9 ± 2.8 months, and the mean PFS was 37.8 ± 3 months. Ten patients showed focal or multifocal FDG uptake of BM on PET / CT (F-FDG). 28 patients had diffuse increased FDG uptake in the BM (D-FDG). In 17 patients, BM FDG uptake was within normal limits (N-FDG). There was no significant difference between OS and PFS of patients grouped according to gender, stage of disease, type of lymphoma and BM FDG uptake pattern (p> 0.05). Older age was associated with shorter OS and PFS.Conclusion: In our study, no significant relationship was found between BM FDG uptake on PET / CT and survival of patients with lymphoma with negative BM infiltration. However, although PET / CT does not completely replace BM biopsy, it may be helpful in detecting early infiltration of BM.
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    The role of PET/CT in determining egfr mutation and ALK rearrangement in patients with lung adenocarcinoma
    (2020) Budak, Emine; Yanarates, Ahmet
    Aim: The aim of the present study is to evaluate the role of tumor FDG uptake in a non-invasive method and the use of positron emission tomography / computed tomography (PET/CT) in estimating epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements in cases of adenocarcinoma of the lung.Material and Methods: A total of 115 patients with the diagnosis of an adenocarcinoma of the lung that underwent F-18 FDG PET/CT for staging and whose EGFR mutation and ALK rearrangement status were analyzed were retrospectively analyzed. The association of the PET parameters (SUVmax, SUVmean, MTV and TLG) of primary tumor with the molecular profile was analyzed.Results: EGFR mutations (EGFR+ group) and ALK rearrangements (ALK+ group) were found in 15 (13%) and 10 (8.7%) of 115 patients; and 90 patients (78.3%) had no EGFR mutation or ALK rearrangement (EGFR/ALK-). EGFR mutations were found to be significantly higher among the never-smoked group (p=0.009). No significant association was identified between the SUVmean, MTV and TLG values and EGFR mutations; however, patients with a low SUVmax value were found to have a significantly higher rate of EGFR mutation (p=0.034). No statistically significant differences were found between the ALK+ and ALK- group in terms of age, sex, cigarette smoking status, tumor stage, or PET parameters.Conclusion: Our study results suggest that a low SUVmax value in lung adenocarcinomas is associated with EGFR mutation, although the diagnostic efficacy is not high.