Journal of Istanbul Faculty of Medicine

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Research Article


DOI :10.26650/IUITFD.2019.0019   IUP :10.26650/IUITFD.2019.0019    Full Text (PDF)

THE ROLE OF 18F-FDG PET-CT IN DIAGNOSIS AND PREDICTION OF PROGNOSIS IN MALIGNANT PLEURAL MESOTHELIOMA

Duygu Has Şimşek, Serkan Kuyumcu, Yasemin Şanlı, Zeynep Gözde Özkan, Berker Özkan, Cüneyt Türkmen, Emine Dilek Yılmazbayhan, Ayşe Mudun

Objective: The purpose of this study is to evaluate the performance of 18F-FDG PET/CT in the differential diagnosis of malignant and benign pleural disease as well as its prognostic value in the malignant pleural mesothelioma (MPM). 

Methods: Fifty-eight patients who underwent 18F-FDG PET/ CT due to diffuse or nodular pleural thickening determined on conventional CT were retrospectively analyzed.18F-FDG PET/ CT scans were evaluated visually and semiquantitatively using maximum standardized uptake value (SUVmax). Mediastinal blood pool SUVmax was used as a threshold value for defining positive/negative accumulation of tracer. 18F-FDG PET/CT findings were compared with histopathological and survival data. Patients were followed up clinically/radiologically. 

Results: Thirty-eight of fifty-eight patients (65.5%) had FDG (+) pleural lesions; 28/38 patients (73.6%) were diagnosed MPM and 10/38 patients (26.4%) were determined benign pleural disesase histopathologically. 20/58 scans (34.5%) were negative, and 18 of them were assumed benign based on two years follow-up, whereas 2 patients were diagnosed MPM by biopsy due to radiologic progression. Sensitivity, specificity, accuracy, positive predictive, and negative predictive values were 93%, 64%, 79%, 73%, and 90% respectively. Median overall survival was found to be 14.5 months. Higher SUVmax level (SUVmax>7.4) was associated with shorter survival (13 vs. 24 months)(p=0.032). 

Conclusion: 18F-FDG-PET/CT is a sensitive imaging method for differential diagnosis of malignant/benign pleural lesions, indicates the target of biopsy, and effects the management of patients. SUVmax of MPM has a potential role for predicting the prognosis. 
Keywords: Mesothelioma, PET/CT, FDG
DOI :10.26650/IUITFD.2019.0019   IUP :10.26650/IUITFD.2019.0019    Full Text (PDF)

MALIGN PLEVRAL MEZOTELYOMA AYIRICI TANISI VE PROGNOZUNDA 18F-FDG PET/BT’NİN ROLÜ

Duygu Has Şimşek, Serkan Kuyumcu, Yasemin Şanlı, Zeynep Gözde Özkan, Berker Özkan, Cüneyt Türkmen, Emine Dilek Yılmazbayhan, Ayşe Mudun

Amaç: Bu çalışmanın amacı, malign ve benign plevral hastalığın ayırıcı tanısında 18F-FDG PET/BT’nin performansı ve malign plevral mezotelyomadaki (MPM) prognostik değerini incelemektir. 

Yöntem: Konvansiyonel BT’de saptanan diffüz ya da nodüler plevral kalınlaşma nedeniyle 18F-FDG PET/BT çekilen 58 hasta retrospektif olarak incelendi. 18F-FDG PET/BT taramaları, maksimum standartlaştırılmış uptake değeri (SUVmax) kullanılarak görsel ve yarı kantitatif olarak değerlendirildi. Pozitif/negatif tutulum ayrımında eşik değeri olarak mediastinal kan havuzu SUVmax değerleri kullanıldı. 18F-FDG PET/BT bulguları, histopatolojik bulgular ve sağkalım verileri ile karşılaştırıldı. Hastalar klinik ve radyolojik olarak takip edildi. 

Bulgular: 58 hastanın 38’inde (%65,5) plevral lezyonlar FDG pozitifti; 28/38 hastada (%73,6) MPM ve 10/38 hastada (%26,4) benign plevral hastalık tanısı histopatolojik olarak saptandı. Negatif 20/58 taramanın (%34,5) 18’i iki yıllık takip ile benign hastalık kabul edilirken radyolojik progresyon saptanan 2 hastaya MPM tanısı kondu. Duyarlılık, özgüllük, doğruluk, pozitif prediktif ve negatif prediktif değerler sırasıyla %93, %64, %79, %73 ve %90 idi. Ortanca genel sağkalım süresi 14,5 ay olarak bulundu. Daha yüksek SUVmax düzeyi (SUVmax> 7,4), daha kısa sağkalım ile ilişkili bulundu (13 ay; 24 ay) (p=0,032). 

Sonuç: 18F-FDG PET/BT, malign/benign plevral lezyonların ayırıcı tanısı için duyarlı bir görüntüleme yöntemi olup biyopsi hedefinin belirlenmesi ve hastaların yönetiminde etkilidir. MPM SUVmax değeri prognozu öngörme potansiyeline sahiptir. 
Keywords: Mezotelyoma, PET/BT, FDG

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APA

Şimşek, D., Kuyumcu, S., Şanlı, Y., Özkan, Z., Özkan, B., Türkmen, C., Yılmazbayhan, E., & Mudun, A. (2019). THE ROLE OF 18F-FDG PET-CT IN DIAGNOSIS AND PREDICTION OF PROGNOSIS IN MALIGNANT PLEURAL MESOTHELIOMA. Journal of Istanbul Faculty of Medicine, 82(4), 168-173. https://doi.org/10.26650/IUITFD.2019.0019


AMA

Şimşek D, Kuyumcu S, Şanlı Y, Özkan Z, Özkan B, Türkmen C, Yılmazbayhan E, Mudun A. THE ROLE OF 18F-FDG PET-CT IN DIAGNOSIS AND PREDICTION OF PROGNOSIS IN MALIGNANT PLEURAL MESOTHELIOMA. Journal of Istanbul Faculty of Medicine. 2019;82(4):168-173. https://doi.org/10.26650/IUITFD.2019.0019


ABNT

Şimşek, D.; Kuyumcu, S.; Şanlı, Y.; Özkan, Z.; Özkan, B.; Türkmen, C.; Yılmazbayhan, E.; Mudun, A. THE ROLE OF 18F-FDG PET-CT IN DIAGNOSIS AND PREDICTION OF PROGNOSIS IN MALIGNANT PLEURAL MESOTHELIOMA. Journal of Istanbul Faculty of Medicine, [Publisher Location], v. 82, n. 4, p. 168-173, 2019.


Chicago: Author-Date Style

Şimşek, Duygu Has, and Serkan Kuyumcu and Yasemin Şanlı and Zeynep Gözde Özkan and Berker Özkan and Cüneyt Türkmen and Emine Dilek Yılmazbayhan and Ayşe Mudun. 2019. “THE ROLE OF 18F-FDG PET-CT IN DIAGNOSIS AND PREDICTION OF PROGNOSIS IN MALIGNANT PLEURAL MESOTHELIOMA.” Journal of Istanbul Faculty of Medicine 82, no. 4: 168-173. https://doi.org/10.26650/IUITFD.2019.0019


Chicago: Humanities Style

Şimşek, Duygu Has, and Serkan Kuyumcu and Yasemin Şanlı and Zeynep Gözde Özkan and Berker Özkan and Cüneyt Türkmen and Emine Dilek Yılmazbayhan and Ayşe Mudun. “THE ROLE OF 18F-FDG PET-CT IN DIAGNOSIS AND PREDICTION OF PROGNOSIS IN MALIGNANT PLEURAL MESOTHELIOMA.” Journal of Istanbul Faculty of Medicine 82, no. 4 (Apr. 2024): 168-173. https://doi.org/10.26650/IUITFD.2019.0019


Harvard: Australian Style

Şimşek, D & Kuyumcu, S & Şanlı, Y & Özkan, Z & Özkan, B & Türkmen, C & Yılmazbayhan, E & Mudun, A 2019, 'THE ROLE OF 18F-FDG PET-CT IN DIAGNOSIS AND PREDICTION OF PROGNOSIS IN MALIGNANT PLEURAL MESOTHELIOMA', Journal of Istanbul Faculty of Medicine, vol. 82, no. 4, pp. 168-173, viewed 20 Apr. 2024, https://doi.org/10.26650/IUITFD.2019.0019


Harvard: Author-Date Style

Şimşek, D. and Kuyumcu, S. and Şanlı, Y. and Özkan, Z. and Özkan, B. and Türkmen, C. and Yılmazbayhan, E. and Mudun, A. (2019) ‘THE ROLE OF 18F-FDG PET-CT IN DIAGNOSIS AND PREDICTION OF PROGNOSIS IN MALIGNANT PLEURAL MESOTHELIOMA’, Journal of Istanbul Faculty of Medicine, 82(4), pp. 168-173. https://doi.org/10.26650/IUITFD.2019.0019 (20 Apr. 2024).


MLA

Şimşek, Duygu Has, and Serkan Kuyumcu and Yasemin Şanlı and Zeynep Gözde Özkan and Berker Özkan and Cüneyt Türkmen and Emine Dilek Yılmazbayhan and Ayşe Mudun. “THE ROLE OF 18F-FDG PET-CT IN DIAGNOSIS AND PREDICTION OF PROGNOSIS IN MALIGNANT PLEURAL MESOTHELIOMA.” Journal of Istanbul Faculty of Medicine, vol. 82, no. 4, 2019, pp. 168-173. [Database Container], https://doi.org/10.26650/IUITFD.2019.0019


Vancouver

Şimşek D, Kuyumcu S, Şanlı Y, Özkan Z, Özkan B, Türkmen C, Yılmazbayhan E, Mudun A. THE ROLE OF 18F-FDG PET-CT IN DIAGNOSIS AND PREDICTION OF PROGNOSIS IN MALIGNANT PLEURAL MESOTHELIOMA. Journal of Istanbul Faculty of Medicine [Internet]. 20 Apr. 2024 [cited 20 Apr. 2024];82(4):168-173. Available from: https://doi.org/10.26650/IUITFD.2019.0019 doi: 10.26650/IUITFD.2019.0019


ISNAD

Şimşek, Duygu Has - Kuyumcu, Serkan - Şanlı, Yasemin - Özkan, Zeynep Gözde - Özkan, Berker - Türkmen, Cüneyt - Yılmazbayhan, Emine Dilek - Mudun, Ayşe. “THE ROLE OF 18F-FDG PET-CT IN DIAGNOSIS AND PREDICTION OF PROGNOSIS IN MALIGNANT PLEURAL MESOTHELIOMA”. Journal of Istanbul Faculty of Medicine 82/4 (Apr. 2024): 168-173. https://doi.org/10.26650/IUITFD.2019.0019



TIMELINE


Submitted01.03.2019
Accepted12.07.2019
Published Online26.08.2019

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