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Background To evaluate the power of volumetric and radiomic tissue data obtained from the images of the lesions in predicting the histopathological diagnosis in patients with incidental colorectal focal FDG uptake detected by 18-F FDG PET/CT imaging. Methods Electronic records of patients who underwent 18F-FDG PET/CT for various malignancies between January 2016 and January 2020 were retrospectively reviewed. 98 lesions of 80 patients with colonoscopic and histopathological results were included in the study. The lesions were divided into 3 groups according to their histopathological diagnosis as benign, premalign and malign. 18F-FDG PET/CT images obtained from the patients were evaluated using LIFEx software. Volumetric and radiomic textural features were obtained by establishing the region of interest (ROI) of the primary tumor. The 18 F FDG PET/CT parameters of the lesions were compared between the groups. In order to evaluate the predictive power of the parameters obtained with 18 F FDG PET/CT, the area under the curve (AUC), sensitivity and selectivity values, negative and positive predictive values were calculated by ROC analysis. Results The volumetric and radiomic tissue analysis parameters of the lesions in the malignant group were significantly different when compared to the other groups. Our study showed that SUVmax value can be used as a marker in the diagnosis of pathological malignancy (AUC=0.737 and p=0.001 95% CI (0.619-0.855)). Contrast and Entropy parameters of GLCM matrix, which are radiomic texture features, were found to be used in the prediction of malignancy (AUC=0.685 and AUC=0.692, p=0.041 and p=0.035, respectively. Similarly, parameters of NLGDM, GLRLM and GLZLM matrices were shown to have statistically significant diagnostic values in predicting malignancy. However, no superiority of these parameters over each other in predicting malignancy was observed. Conclusions In our study, the parameters of radiomic textural analysis together with volumetric parameters have been shown to have diagnostic value in noninvasively determining lesion characterization and defining tissue in lesions with incidental colorectal focal FDG uptake detected by 18F-FDG PET / CT imaging.

Purpose: The aim of this study was to evaluate treatment response and survival with post-therapy images in patients who received one cycle of Lu-177 PSMA I&T treatment. Material and Methods: After Lu-177 PSMA I&T treatment was administered to 54 patients, maximum count, pixel count (tumor extent) and sum (total tumor burden) values were calculated with a semiautomatic program. The images after the first treatment were evaluated as basal disease images. Images obtained after the second treatment were considered the response to the first cycle treatment. Results: It was determined that the number of maximum counts (p: 0.015) and tumor extent (p: 0.014) were significantly reduced after one cycle of Lu177 PSMA treatment. No significant change in total tumor burden (p:0.206) was detected. After one treatment cycle the maximum count in 46% of the patients and the total tumor burden in 63% of the patients. The number of pixels (tumor prevalence) in 41% of the patients decreased by >= 25%. Based on the Naive-Bayes method, one-year survival accuracy was 71.6%. Conclusion: With the texture analysis and machine learning of the Lu-177 PSMA post-therapy images, treatment response and survival were determined with high accuracy.

Agriculture is affected by climate change, such as extreme increases or decreases rainfall and temperature patterns. It is possible to research that effect by using trend analysis methodologies. This paper investigates trends of monthly total rainfall and mean temperature data of nine selected stations from agricultural regions of Turkey between 1969 and 2020. To the end, the classical Mann-Kendall, Innovative Trend Significance Test (ITST), and Innovative Polygon Trend Analysis (IPTA) with Star Graph methods providing the opportunity to examine seasonal behavior were used for trend analysis. The analysis reveals that about 96% of all monthly rainfall in the Mann-Kendall test has no trend. However, nearly all stations tend to decrease (increase) in November (September) in both innovative approaches. For temperature, it is seen that increasing trend or no trend dominated in general. There were increasing trends in the innovative approaches throughout the year except for April. Temperatures have increased significantly throughout the year in all regions over the last decades. With the help of IPTA, it was also concluded that the seasonal internal variability of rainfall over the entire time and in the last 30 years is quite complex and persists in all agricultural regions. The results show that irregular changes in rainfall and rising temperatures in all stations negatively affected crop yield and/or required more irrigation. In addition, according to the results obtained by comparing trend methods, innovative approaches are very insistent on determining of trend and provide additional information through a visual review of trend behaviors.

The present study aims to evaluate long-term wave power (Pwave) trends over the Mediterranean Sea using innovative and classical trend analysis techniques, considering the annual and seasonal means. For this purpose, the data were selected for the ERA5 reanalysis with 0.5° × 0.5° spatial resolution and 1 h temporal resolution during 60 years between 1962 and 2021. Spatial assessment of the annual and seasonal trends was first performed using the innovative trend analysis (ITA) and Mann–Kendall (MK) test. To obtain more detailed information, innovative polygon trend analysis (IPTA), improved visualization of innovative trend analysis (IV-ITA), and star graph methods were applied to annual, seasonal, and monthly mean Pwave at 12 stations selected. The results allow us to identify an increasing trend above the 10% change rate with the innovative method and above the 95% confidence level with the Mann–Kendall test in mean wave power in the Levantine basin and the Libyan Sea at all timescales. The use of various innovative methods offered similar results in certain respects and complemented each other.

Amaç: Serviks kanseri dünya çapında kadınlar arasında önemli bir sağlık sorunudur. Diğer yaygın kanserlerin aksine, insan papilloma virüsü (HPV) tabanlı tarama stratejileri ile neredeyse tamamen önlenebilir. Bu çalışmanın amacı tıp fakültesi öğrencilerinin HPV enfeksiyonu ile ilgili bilgi düzeylerini ve HPV aşısı ile ilgili düşüncelerini analiz etmektir. Gereç ve Yöntemler: Çalışma, eğitimlerinin ilk 3 yılındaki tıp fakültesi öğrencilerini ve birinci derece yakınları ile yürütüldü. Yapılan anketin temel verileri arasında HPV enfeksiyonu ve ilişkili hastalıkların bilgi düzeyi, HPV aşısı hakkındaki bilgi düzeyi ve HPV aşısına karşı tutum hakkında 29 çoktan seçmeli soru bulunmaktaydı. Bulgular: Çalışmaya katılan 191 öğrenciden 158 (% 82.7)’inin HPV enfeksiyonunu duyduğu, 66 öğrenci yakınının 38 (% 57.6)' inin HPV enfeksiyonunu duyduğu ve bu iki grup arasında anlamlı fark bulunduğu saptandı (p

Objective In this study, our aim was to evaluate the relationship of the quantitative data obtained from pretreatment 68Ga prostate-specific membrane antigen (PSMA) PET-computerized tomography (PET/CT) with treatment response of the patients with the diagnosis of metastatic castrationresistant prostate cancer (mCRPC) who received 177Lu-PSMA radioligand therapy (RLT). Methods The patients who were given three or four cycles of 177Lu-PSMA RLT between January 2016 and June 2018 were evaluated retrospectively. Volumetric data; PSMA tumor volume (TV) and total lesion (TL) PSMA, were obtained from 68Ga-PSMA PET/CT for whole (PSMA-TVT and TL-PSMA(T)). The distance between the two furthest lesions (D-max) was calculated. Posttreatment early prostate-specific antigen (PSA) values on the fourteenth day after treatment were obtained. According to the PSA responses, the patients were divided into two groups as progressed and nonprogressed. In univariate analysis, the relationship of PET quantitative data with biochemical response groups was evaluated with Mann-Whitney U test. Logistic regression was used in multivariate analysis. Results A total of 38 patients were included in the study. In univariate analysis, D-max, PSMA-TVT and TL-PSMA(T) values were obtained at lower levels in the progressed group. In multivariate analysis, only D-max was found to be a prognostic factor in predicting early biochemical response. Conclusion D-max is the most prognostic parameter in predicting the early biochemical response in patients with mCRPC; high total tumor volume and burden are also parameters that give us an idea about the response to treatment. The success rate will be higher if 177Lu-PSMA RLT treatment is planned for patients with higher tumor volume and spread.

Objective: This study evaluated how much of the myocardium was hibernating in patients with left ventricle dysfunction and/or comorbidities who planned to undergo either surgical or interventional revascularization. Furthermore, this study also identified which irrigation areas of the coronary arteries presented more scar and hibernating tissue. Methods: At rest, Tc-99m MIBI SPECT and cardiac F-18 FDG PET/CT images collected between March 2009 and September 2016 from 65 patients (55 men, 10 women, mean age 64±12) were retrospectively analyzed in order to evaluate myocardial viability. The areas with perfusion defects that were considered metabolic were accepted as hibernating myocardium, whereas areas with perfusion defects that were considered non-metabolic were accepted as scar tissue. Results: Perfusion defects were observed in 26% of myocardium, on average 48% were associated with hibernation whereas other 52% were scar tissue. In the remaining Tc-99m MIBI images, perfusion defects were observed in the following areas in the left anterior descending artery (LAD; 31%), in the right coronary artery (RCA; 23%) and in the Left Circumflex Artery (LCx; 19%) irrigation areas. Hibernation areas were localized within the LAD (46%), LCx (54%), and RCA (64%) irrigation areas. Scar tissue was also localized within the LAD (54%), LCx (46%), and RCA (36%) irrigation areas. Conclusion: Perfusion defects are thought to be the result of half hibernating tissue and half scar tissue. The majority of perfusion defects was observed in the LAD irrigation area, whereas hibernation was most often observed in the RCA irrigation area. The scar tissue development was more common in the LAD irrigation zone.

Background: Infective endocarditis (IE) is an infection of the heart’s endocardial surface. In recent years, nuclear imaging methods have gained importance in the diagnosis of IE. The present study aims to investigate the imaging potential of 99mTc-labeled vancomycin (99mTc-Vancomycin) as a new agent that would enable the diagnosis of IE in its early stages when it is difficult to diagnose or has small vegetation in the experimental rat model. Methods: 99mTc-Vancomycin scintigraphy was evaluated for its accumulation in IE with Staphylococcus aureus performed in an experimental rat model. Serial planar scintigraphic and biodistribution analysis of infected vegetations are compared to rats with sterile vegetations. The heart was identified as an infected organ, the liver was identified as a non-infected organ and the heart/liver uptake ratio (T / NT ratio) was compared between infective endocarditis and sterile endocarditis groups. Results: Planar scintigrams (in vivo measurements) showed more uptake in the heart of rats in the infective endocarditis group compared to the uptake in the heart of rats in the sterile endocarditis group, but this difference was not statistically significant (p>0.05). From the ex vivo measurements, the 99mTc-Vancomycin heart uptake increased significantly (p = 0.016), liver uptake was significantly decreased (p = 0.045) and the T/NT ratio was significantly higher (p = 0.014) in the infective endocarditis group compared to the sterile endocarditis group. Conclusions: In this experimental study, 99mTc-Vancomycin scintigraphy ensured the detection of ex vivo infected tissue in a rat model of IE. In addition, the absence of significant 99mTc-Vancomycin uptake in the sterile endocarditis group indicates that this agent targeted the infected tissue instead of the sterile inflammatory tissue. Finally, this agent should also be evaluated with animal- specific imaging devices.

Purpose The aim of this study was to evaluate the ability of(18)F-FDG PET/CT texture analysis to predict the exact pathological outcome of thyroid incidentalomas. Methods F-18-FDG PET/CT images between March 2010 and September 2018 were retrospectively reviewed in patients with focal(18)F-FDG uptake in the thyroid gland and who underwent fine needle aspiration biopsy from this area. The focal uptake in the thyroid gland was drawn in 3D with 40% SUVmax threshold. Features were extracted from volume of interest (VOI) using the LIFEx package. The features obtained were compared in benign and malignant groups, and statistically significant variables were evaluated by receiver operating curve (ROC) analysis. The correlation between the variables with area under curve (AUC) value over 0.7 was examined; variables with correlation coefficient less than 0.6 were evaluated with machine learning algorithms. Results Sixty patients (70% train set, 30% test set) were included in the study. In univariate analysis, a statistically significant difference was observed in 6 conventional parameters, 5 first-, and 16 second-order features between benign and malignant groups in train set (p < 0.05). The feature with the highest benign-malignant discriminating power was GLRLM(RLNU)(AUC:0.827). AUC value of SUVmax was calculated as 0.758. GLRLM(RLNU)and SUVmax were evaluated to build a model to predict the exact pathology outcome. Random forest algorithm showed the best accuracy and AUC (78.6% and 0.849, respectively). Conclusion In the differentiation of benign-malignant thyroid incidentalomas, GLRLM(RLNU)and SUVmax combination may be more useful than SUVmax to predict the outcome.

Infective endocarditis (IE) is an infection of the heart's endocardial surface. In recent years, nuclear imaging methods have gained importance in the diagnosis of IE. The present study aims to investigate the imaging potential ofPlanar scintigrams (in vivo measurements) showed more uptake in the heart of rats in the infective endocarditis group compared to the uptake in the heart of rats in the sterile endocarditis group, but this difference was not statistically significant (p0.05). From the ex vivo measurements, theIn this experimental study

Objective: To compare imaging results and pathology, laboratory results and to analyze the relationship between them in patients who were performed PSMA PET/CT due to prostate cancer.Materials and Methods: 123 patients who were performed PSMAPET/CT for “staging” and “re-staging” were analyzed retrospectively. SUVmax values were measured for prostate, lymph node, bone and visceral organs. The correlation between these values and Gleason score/grade and laboratory results were evaluated. The differences between the patients who were detected and not detected to have pathological findings on PET/CT were evaluated with regard to pathology and laboratory results. Results: A significant difference was detected between the patients who were detected and not detected to have bone involvement on PET/CT with regard to ALP and Ca values (p=0.010, p=0.003, respectively). A very weak correlation was detected between the highest SUVmax and LDH (r=0.19). There was a significant difference between the patients with and without peri-neural invasion with regard to maximum SUVmax (p=0.012). In staging group, a moderate correlation was detected between prostate SUVmax, the highest SUVmax and GG and PSA (r=0.42, r=0.5, r=0.54, r=0.53, respectively). A significant difference was detected between the patients whose GG was ≤2 and GG>2 with regard to prostate SUVmax and the highest SUVmax (p=0.005, p=0.002; respectively). There was a significant difference between the patients whose PSA was ≤20 and >20 ng/ml with regard to prostate SUVmax (p=0.045). PSA, GS, GG showed significant differences between the patients who were negative and positive on PET/CT (p, Amaç: Prostat kanseri nedeniyle Ga-68 PSMA PET/BT görüntülemesi yapılan hastaların görüntülemelerinde saptanan bulguları; patoloji, laboratuvar bulguları ile karşılaştırmaktır.Gereç ve Yöntem: “Evreleme" ve “yeniden evreleme” amaçlı PSMA PET/BT görüntülemesi yapılan 123 hasta retrospektif olarak incelendi. Tüm hastaların prostat, lenf nodu, kemik, visseral organ ve en yüksek SUVmax değerleri ölçüldü. Bu değerler ile “Gleason Skoru”, “Gleason Grade” ve laboratuvar bulguları arasındaki korelasyon değerlendirildi. PSMA PET/BT’de patolojik bulgu saptanmayan hastalar ile saptananlar arasında patoloji ve laboratuvar bulguları arasındaki farklılıklar incelendi.Bulgular: Tüm grupta PSMA PET/BT’de kemik tutulumu saptanmayan hastalar ile saptananlar arasında ALP ve Ca değerleri anlamlı farklılık göstermektedir(sırasıyla p: 0,010,p: 0,003). En yüksek SUVmax değerleri ile LDH değerleri arasında çok zayıf korelasyon saptanmıştır (r=0,19). Perinöral invazyonu olmayan hastalar ile olan hastaların en yüksek SUVmax değerleri anlamlı farklılık göstermektedir (p=0,012). Evreleme grubunda prostat SUVmax ve en yüksek SUVmax değerleri ile GG ve PSA değerleri arasında orta düzeyde korelasyon saptanmıştır (sırasıyla r=0,42, r=0,5, r=0,54, r=0,53). “Gleason Grade” 2 ve altında olan hastalar ile 2’nin üzerinde olan hastaların, prostat SUVmax ve en yüksek SUVmax değerleri anlamlı farklılık göstermektedir (sırasıyla p=0,005, p=0,002). PSA değeri 20 ng/ml ve altında olan hastalar ile 20 ng/ml’nin üzerinde olan hastaların prostat SUVmax değerleri anlamlı farklılık göstermektedir (p= 0,045). Yeniden evreleme grubunda visseral organ ve en yüksek SUVmax değerleri ile PSA değerleri arasında orta düzeyde korelasyon saptanmıştır (sırasıyla r=0,56, r=0,43). Ga-68 PSMA PET/BT’de patolojik bulgu saptanmayan hastalar ile patolojik bulgu saptanan hastalar arasında; PSA değerleri, GS, GG anlamlı farklılık göstermektedir (sırasıyla p

PURPOSE: The aim of this study was to evaluate the ability of (18)F-FDG PET/CT texture analysis to predict the exact pathological outcome of thyroid incidentalomas. METHODS: (18)F-FDG PET/CT images between March 2010 and September 2018 were retrospectively reviewed in patients with focal (18)F-FDG uptake in the thyroid gland and who underwent fine needle aspiration biopsy from this area. The focal uptake in the thyroid gland was drawn in 3D with 40% SUVmax threshold. Features were extracted from volume of interest (VOI) using the LIFEx package. The features obtained were compared in benign and malignant groups, and statistically significant variables were evaluated by receiver operating curve (ROC) analysis. The correlation between the variables with area under curve (AUC) value over 0.7 was examined; variables with correlation coefficient less than 0.6 were evaluated with machine learning algorithms. RESULTS: Sixty patients (70% train set, 30% test set) were included in the study. In univariate analysis, a statistically significant difference was observed in 6 conventional parameters, 5 first-, and 16 second-order features between benign and malignant groups in train set (p

Colorectal cancer is the third most common cancer worldwide with a high mortality rate at the advanced stages. However, colorectal cancer is not a single type of tumor; its pathogenesis depends on the anatomical location of the tumor and differs between right side and left side of the colon. Tumors in the proximal colon (right side) and distal colon (left side) exhibit different molecular characteristics and histology. In the right-sided tumors, mutations in the DNA mismatch repair pathway are commonly observed; and these tumors generally have a flat histology. In the left-sided tumors, chromosomal instability pathway-related mutations, such as KRAS, APC, PIK3CA, p53 mutations are observed and these tumors demonstrate polypoid-like morphology. Therapy responses are totally different between these tumor entities. Left-sided colorectal cancer (LCRC) patients benefit more from adjuvant chemotherapies such as 5-fluorouracil (5-FU)-based regimes, and targeted therapies such as anti- epidermal growth factor receptor (EGFR) therapy, and have a better prognosis. Right-sided colorectal cancer (RCRC) patients do not respond well to conventional chemotherapies, but demonstrate more promising results with immunotherapies because these tumors have high antigenic load. For the development of effective therapy regimes and better treatment options, it is essential to evaluate right-sided and left-sided tumors as separate entities, and design the therapy regime considering the differences between these tumors.

The use of phylogeny in ecology has gained attention due to its benefits in understanding biological diversity and adaptation processes. In this study, phylogenetic positions of 12 Astragalus taxa were evaluated by comparing with 419 Astragalus taxa sequences in a database. Additionally, the influence of ecological traits on morphology was assessed. Although the samples were grouped according to subgenera or sections they belong to, this division was not striking. The phylogenetic relationships of the nine endemic and three common Astragalus taxa based on nrDNA region sequences and morphological features as well as their interplay with the environment were examined. Furthermore, soil characteristics of the fields where each Astragalus taxon grows were determined. Analysis of the sequences revealed that the 12 taxa were grouped into three clades using the Bayesian Inference method. A cladogram of 431 Astragalus taxa showed that the samples were divided into ten major clades. Morphological traits were found to be correlated with soil properties, which could indicate adaptation to environmental conditions of these taxa.

Purpose The primary aim of this study was to evaluate the volumetric therapy response via Ga-68 PSMA I&T PET/CT in patients treated with Lu-177 PSMA I&T therapy. The secondary purpose was to determine the impact of volumetric parameter responses to overall survival. Methods PSMA tumor volumes (PSMA-TV) and tumor lesion PSMA expressions (TL-PSMA) were calculated with a semi-automatic program on Ga-68 PSMA I&T PET/CT images that were obtained before and after Lu-177 PSMA I&T therapies with 19 patients. The median overall survival was compared with PSMA-TV, TL-PSMA, SUVmax, PSA, and alteration in PERCIST criteria. Results PSMA-TV values were decreased in 12 patients (63%), and TL-PSMA values were decreased in 15 patients (79%) following the therapy. The SUVmax and the PSA values were also decreased in 14 (74%) and 10 (53%) patients, respectively. The complete remission (CR) was observed in two patients (10%). The partial response (PR) and progressive disease were observed in 6 (32%) and 11 (58%) patients, respectively, according to PRECIST criteria. The survival rates were statistically significant in patients with a decrease in PSMA-TV and TL-PSMA values than patients without any decrease (p 0.001, p < 0.001, respectively). However, the survival rates did not differ in responders (PR or CR) and non-responders according to the PERCIST criteria (p 0.232). The survival rates did not also differ in responders and non-responders according to the SUVmax and PSA values (p 0.140, p 0.206, respectively). Conclusions Molecular and volumetric parameters are beneficial in the assessment of Lu-177 PSMA I&T therapy response. Although the number of patients is small, TL-PSMA response, which includes both the tumor volume and PSMA expression in tumor, may be considered as the most valuable parameter for the evaluation of the therapy response and the prediction of survival rate.

OBJECTIVE To investigate the relationship between lymph node (LN) size and localization and prostate-specific membrane antigen (PSMA) uptake in patients with prostate cancer. PATIENTS AND METHODS Between February 2015 and February 2017, a total of 178 patients diagnosed with prostate adenocarcinoma by gallium-68 PSMA PET/computed tomography were evaluated. Seventy-eight patients with LN PSMA uptake were included in the study.The short-axis diameter and maximum and mean standardized uptake values (SUV) were measured from axial images of LNs with PSMA uptake. LN conglomerates were considered a single lesion. Patients were divided into two groups according to the presence (group 1) or absence (group 2) of bone uptake in addition to the LN uptake; subgroups were constituted according to the short-axis diameter and PSMA-positive LN region for each group. LNs were classified according to their localization as pelvic, abdominal, or cervical/thoracic. RESULTS In both groups, the SUV were significantly higher in LNs with short-axis diameters more than 8 mm than those with diameters up to 8 mm (P < 0.001 and < 0.001, respectively). Also, both groups showed a moderate correlation between the LN size and SUV.When the analysis was carried out according to the localization, but after excluding the LN conglomerates, the correlation between the pelvic and abdominal LNs was higher in the second group. CONCLUSION The highest significant positive correlation between LN size and SUV was in patients with pelvic and abdominal LN metastases without bone involvement according to the gallium-68 PSMA PET/computed tomography images in our study.

Objective The aim of this study was to determine the change in volumetric and radiomics parameters of fluorine-18 fluorodeoxyglucose (F-18-FDG) PET/computed tomography (CT) imaging in local/locally advanced cancer patients according to immunohistochemical findings. Patients and methods A total of 72 patients who were diagnosed with local/locally advanced breast cancer and then examined by F-18-FDG PET/CT for staging were included in this study. Immunohistochemical prognostic factors [estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (Her-2), p53 mutation, Ki-67 proliferation index] and histological grades were determined. Standardized uptake value (SUV)-based, volume-based, and radiomics findings were obtained from F-18-FDG PET/CT images. Results In cases of ER and PR negativity, Her-2 positivity, presence of the p53 mutation, and Ki-67 index of at least 20% patients, total volumetric parameters were significantly higher in paired comparisons. The results of the ER-negative group were significantly higher than those of ER-positive patients in GLRLM_GLNU, GLRLM_RLNU, GLZLM_GLNU, and GLZLM_ZLNU comparisons. In grade 3 patients, mean SUV, maximum SUV, and GLRLM_LRHGE values were higher than those of grade 2 patients. SUV and volumetric parameters were significantly higher in patients with Ki-67 index of at least 20% than those with less than 20%. Maximum SUV, breast tumor lesion glycolysis values, and entropy in nuclear polymorphism in the 3+ patient group were found to be higher compared with the 2+ patient group. Moreover, patients with mitosis 3+ had significantly higher breast metabolic tumor volume, breast tumor lesion glycolysis, and kurtosis values than the 1+ group. Conclusion ER negativity, triple negativity, high tumor grade, and high nuclear polymorphism were associated with tumor heterogeneity. With respect to ER negativity, PR negativity, high tumor grade, high mitosis number, high Ki-67 index, Her-2 positivity, and the presence of p53 mutation, an increased tumor load were observed. In addition to immunohistochemical parameters, the use of radiomics data is believed to contribute to breast cancer management.

Ochronosis (alkaptonuria) is an autosomal recessive inherited metabolic disease that causes pigmentation by accumulation of homogenous acid in the connective tissue. The most important causes of morbidity are ochronotic arthropathy and cardiovascular involvement seen in fourth and sixth decades, respectively. In this case report, we report the prevalence of F-18-FDG PET/BT findings in a 48-year-old man with ochronosis who underwent F-18-FDG PET/BT imaging for the evaluation of mediastinal lymphadenopathy.

Prostate large cell neuroendocrine tumor is a rare disease. In this case, metastatic areas showing FDG uptake, somatostatin receptor positivity, and PSMA expression are shown in F-18-FDG PET/CT, Ga-68-DOTATATE PET/CT, and Ga-68-PSMA PET/CT in a 70-year-old man with the diagnosis of prostate large cell neuroendocrine carcinoma.

Purpose: This study aims to evaluate the serum PSA response, Ga-68 PSMA PET/CT response, hematological/nephrological toxicity and survival results of patients with castration-resistant metastatic prostate cancer who are receiving Lu-177 PSMA therapy.Methods: The data of 57 patients with a mean age of 68 years who were treated with Lu-177 PSMA I&T were retrospectively reviewed. Secondary toxicity to treatment was determined using the criteria of the Common Toxicity Criteria for Adverse Events v5.0. The Kaplan Meier method was used for survival and progression-free survival analysis.Results: Forty percent of patients’ serum PSA values’ showed >25% regression after the first cycle of treatment. Serum PSA values were stable/regressed in 75% of the patients. While 2/57 patients showed grade 3 anemia, none showed grade 3 leukopenia or thrombocytopenia. One of 57 patient showed transient nephrotoxicity. Hematological and nephrological toxicity were not observed after treatment of eight cycles, and the serum PSA values of the patients were decreased by 97%. The mean survival time was 11.6 months in all patients, and 17.2 months in patients with serum PSA response. Progression-free survival was an average of 9.9 months.Conclusion: Providing a stable or regressed disease via single cycle treatment in 75% of patients with progression despite the treatments improving survival is an indicator of the success of the therapy. The low rate of hematological and nephrological toxicity in patients none of the patients that received eight cycles suggests that the treatment is reliable. Survival was longer in patients with serum PSA response after treatment

Objective: The aim of this study was to compare images from Tc-99m MDP bone scan (BS) and Ga-68 PSMA PET/CT of patients with prostate cancer in terms of bone metastases. Methods: Overall, 34 patients exhibited a mean age of 66 ± 9.5 (50-88) years, mean PSA of 51 ± 159ng/ml (0-912), and mean Gleason score of 8 (6-9). BS and Ga-68 PSMA PET/CT were applied to 34 patients within 30 days, and the results were evaluated, retrospectively. In both tests, radiopharmaceutical uptake in bones were compared. Results: In 7 patients (20.5%), uptake was not significant on BS and Ga-68 PSMA PET / CT images, which is related to metastasis. In 14 (41%) patients, bone metastases were observed in both examinations. However, more metastatic lesions were observed in the Ga-68 PSMA PET/CT of 3 patients and in the bone scintigraphy of 2 patients. PSMA expression was not observed on Ga-68 PSMA PET / CT in 13 (38%) patients with increased activity in bone scintigraphy. Two (6%) of these patients were thought to be metastatic, 2 (6%) were suspicious for metastasis, and 9 (26%) had no metastasis. When a lesion-based evaluation was performed, a total of 480 activities were evaluated: increased activity uptake was found in 305 BS, and 427 PSMA expression activity was detected. Furthermore, 435 of these activities were evaluated as metastatic. Conclusion: Ga-68 PSMA PET/CT provides an additional contribution to the BS evaluation of activity areas because of the presence of PSMA expression and anatomical lesions. In 6% of the patients, activity on BS and metastatic appearance in CT images were observed and the presence of lesions in the absence of PSMA was determined. This suggests that bone metastases without PSMA expression may also be present.

Tail gut cysts are rare congenital lesions developing from postanal primitive gut remnants. They are mostly benign but carry a potential of malignant transformation, such as adenocarcinoma, neuroendocrine tumor, adenosquamous carcinoma, and pseudomyxoma peritonei. We present a 39-year-old woman with a neuroendocrine tumor arising within a tail gut cyst. She underwent complete resection in 2011. After 4 years, she was admitted with breast nodules, left proptosis, and gaze difficulties. Ga-DOTATATE PET/CT demonstrated extensive metastases including pelvic, lymph node, adrenal gland, bone, retro-orbital, cardiac, breast, skin, and subcutaneous metastases.

A 72-year-old man was diagnosed with well-differentiated neuroendocrine tumor of unknown primary with liver metastasis. All liver lesions were detectable only on Ga-68-DOTATATE PET/CT and were negative on F-18-FDG PET/CT. Intrahepatic Y-90 radioembolization therapy was planned, but the hepatopulmonary shunt fraction was found to be 31.6%. Because the hepatopulmonary shunt fraction greater than 20% is an absolute contraindication to radioembolization, we decided to give him Lu-177-DOTATATE therapy. He received 4 courses of Lu-177-DOTATATE and showed regression in posttherapy Ga-68-DOTATATE PET/CT imaging. The hepatopulmonary shunt fraction was reduced to 8% after Lu-177-DOTATATE therapy.