Person: ERDİL, TANJU YUSUF
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ERDİL
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TANJU YUSUF
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Publication Open Access Langerhans Hucreli Histiyositoz Tanili Hastada Soliter Kemik Lezyonunun Takibinde Kemik Sintigrafi ve SPECT/BT'nin Rolu(GALENOS YAYINCILIK, 2021-10-01) TUROĞLU, HALİL TURGUT; Kesim, Selin; Turoglu, Halil Turgut; Inanir, Sabahat; Ozguven, Salih; Erdil, Tanju YusufLangerhans' cell histiocytosis (LCH) is a rare disease observed in childhood characterized by the proliferation of Langerhans' cells resulting in focal or systemic manifestations (including the bones). Here, we present a pediatric case with a localized biopsy-proven LCH, who underwent progression from solitary to multifocal form detected on bone scintigraphy and single photon emission computerized tomography/computed tomography (SPECT/CT) performed within four months. Emphasizing on localized bone pain (predictive of osseous LCH) and local tenderness and swelling usually guides the nuclear physician to perform additional SPECT/CT with presumably an improvement of the diagnostic accuracy as demonstrated in our case.Publication Open Access Unexpected radiation pneumonitis after SIRT with significant decrease in DLCO with internal radiation exposure: a case report(BMC, 2020-12) TÜRELİ, DERYA; Kesim, Selin; Ones, Tunc; Eryuksel, Emel; Baltacioglu, Feyyaz; Tureli, Derya; Ozguven, Salih; Erdil, Tanju YusufBackground In the last years, Selective Internal Radiation Therapy (SIRT), using biocompatible Yttrium-90 (90Y) labeled microspheres have emerged for the treatment of malignant hepatic tumors. Unfortunately, a significant part of 90Y-labeled microspheres may shunt to the lungs after intraarterial injection. It can be predictable by infusing technetium-99 m-labeled macro-aggregated albumin particles through a catheter placed in the proper hepatic artery depending on the lobe to be treated with performing a quantitative lung scintigraphy. Radiation pneumonitis (RP) can occur 1 to 6 months after the therapy, which is a rare but severe complication of SIRT. Prompt timing of steroid treatment is important due to its high mortality rate. On the other hand, pulmonary diffusion capacity measured by carbon monoxide (DLCO) is an excellent way to measure the diffusing capacity because carbon monoxide is present in minimal amount in venous blood and binds to hemoglobin in the same manner as oxygen. Some authors reported that the most consistent changes after radiation therapy (RT) are recorded with this quantitative reproducible test. The relationship between the proportional reductions in DLCO and the severity of RP developing after this therapy may prove to be clinically significant. Case presentation We herein present a patient who developed RP after SIRT that could be quantified using DLCO. To the best of our knowledge, this case is the first who developed unexpected RP after SIRT with significant decrease in DLCO with internal radiation exposure. Conclusions RP is a very rare complication and may lead to a fatal outcome. Decline in DLCO could be a valuable parameter for follow-up and to identify potential candidates for RP and could be also another trigger for administration of steroid therapy with prompt timing in this patient group.Publication Open Access Long-Term Results of Fixed High-Dose I-131 Treatment for Toxic Nodular Goiter: Higher Euthyroidism Rates in Geriatric Patients(GALENOS YAYINCILIK, 2015-10-05) DEDE, FUAT; Aktas, Gul Ege; Turoglu, Halil Turgut; Erdil, Tanju Yusuf; Inanir, Sabahat; Dede, FuatObjective: Geriatric patient population has special importance due to particular challenges. In addition to the increase in incidence of toxic nodular goiter (TNG) with age, it has a high incidence in the regions of low-medium iodine intake such as in our country. The aim of this study was to evaluate the overall outcome of high fixed dose radioiodine (RAI) therapy, and investigate the particular differences in the geriatric patient population. Methods: One hundred and three TNG patients treated with high dose I-131 (370-740 MBq) were retrospectively reviewed. The baseline characteristics; age, gender, scintigraphic patterns and thyroid function tests before and after treatment, as well as follow-up, duration of antithyroid drug (ATD) medication and achievement of euthyroid or hypothyroid state were evaluated. The patient population was divided into two groups as those=>65 years and those who were younger, in order to assess the effect of age. Results: Treatment success was 90% with single dose RAI therapy. Hyperthyroidism was treated in 7 +/- 7, 2 months after RAI administration. At the end of the first year, overall hypothyroidism rate was 30% and euthyroid state was achieved in 70% of patients. Age was found to be the only statistically significant variable effecting outcome. A higher ratio of euthyroidism was achieved in the geriatric patient population. Conclusion: High fixed dose I-131 treatment should be preferred in geriatric TNG patients in order to treat persistent hyperthyroidism rapidly. The result of this study suggests that high fixed dose RAI therapy is a successful modality in treatni g TNG, and high rates of euthyroidism can be achieved in geriatric patients.Publication Open Access False Positive FDG PET/CT Resulting from Fibrous Dysplasia of the Bone in the Work-Up of a Patient with Bladder Cancer: Case Report and Review of the Literature(KOWSAR PUBL, 2012-12-27) DANE, FAYSAL; Aras, Mustafa; Ones, Tunc; Dane, Faysal; Nosheri, Omid; Inanir, Sabahat; Erdil, Tanju Yusuf; Turoglu, Halil TurgutFibrous dysplasia of the bone (FDB) is a common, genetic, developmental disorder with a benign course. FDB can be seen anywhere throughout the skeleton. It is usually asymptomatic and found incidentally on imaging studies that are performed for other purposes. Although whole body 18 F-flourodeoxyglucose PET/CT (FDG PET/CT) is widely used in tumor imaging, infections and benign pathologies like FDB may cause false positive results. Herein we report the case of a 48-year-old FDB patient with transitional cell carcinoma of the urinary bladder. Restaging FDG PET/CT showed multiple mild to moderate hypermetabolic bone lesions which were initially misinterpreted as bone metastases. In this case report, we aimed to guide physicians in evaluating bone lesions in cancer patients with FDB in the light of the literature.Publication Open Access Mickey Mouse Sign on Bone Scan in the Monostotic Form of Paget's Disease Mimicking Osseous Metastasis(GALENOS YAYINCILIK, 2020-10-01) TUROĞLU, HALİL TURGUT; Kesim, Selin; Turoglu, Halil Turgut; Ozguven, Salih; Ones, Tunc; Erdil, Tanju YusufPaget's disease is a chronic benign bone disease characterized by excessive and abnormal bone remodeling. Monostotic Paget's disease accounts for only 20% of the cases, and the monostotic form involving the vertebra with the Mickey Mouse sign is very rare. Herein, we report a case of suspected bony metastasis in the second lumbar vertebra that was diagnosed as Paget's disease because of the Mickey Mouse sign on bone scintigraphy, and the diagnosis was confirmed by biopsy. Therefore, bone scintigraphy may provide a positive contribution to the diagnosis, and may help to avoid unnecessary biopsy in cases with specific signs and patterns.Publication Open Access The effect of selective internal radiation therapy with yttrium-90 resin microspheres on lung carbon monoxide diffusion capacity(SPRINGER, 2017-12) CEYHAN, BERRİN; Ones, Tunc; Eryuksel, Emel; Baltacioglu, Feyyaz; Ceyhan, Berrin; Erdil, Tanju YusufBackground: Selective internal radiation therapy (SIRT) with embolization of branches of the hepatic artery is a valuable therapeutic tool for patients with hepatic malignancies; however, it is also associated with lung injury risk due to shunting. Diffusion capacity of the lungs for carbon monoxide (DLCO) is a clinically significant lung function test, and worsening in DLCO is suggested to reflect a limited gas exchange reserve caused by the potential toxicity of chemoradiotherapy or it may be a marker of related lung injury. This study aimed to examine the changes in DLCO during SIRT with resin microspheres in newly treated and retreated patients. Forty consecutive patients who received SIRT for a variety of malignant conditions were included. All subjects were treated with Yttrium-90 labelled resin microspheres. DLCO tests were performed after the procedures. In addition, patients were specifically followed for radiation pneumonitis. Results: The mean DLCO did not significantly change after the first (82.8 +/- 19.4 vs. 83.1 +/- 20.9, p = 0.921) and the second treatments (87.4 +/- 19.7 vs. 88.6 +/- 23.2, p = 0.256). Proportion of patients with impaired DLCO at baseline was not altered significantly after the first (37.5 vs. 45.0%, p = 0.581) and the second treatments (27.3 vs. 27.3%, p = 1.000). Also, percent change in DLCO values did not correlate with radiation dose, lung shunt fraction, or lung exposure dose (p > 0.05 for all comparisons). None of the patients developed radiation pneumonitis. Conclusions: Our results suggest that no significant change in DLCO in association with SIRT occurs, both after the first or the second treatment sessions. Further larger studies possibly with different protocols are warranted to better delineate DLCO changes after SIRT in a larger spectrum of patients.Publication Open Access Şiddetli kaudal regresyon sendromu olan pediatrik bir hastada tek foton emisyonlu bilgisayarlı tomografi/bilgisayarlı tomografi ile hibrid renal kortikal görüntüleme(2022-02-01) KESİM, SELİN; TUROĞLU, HALİL TURGUT; ÖZGÜVEN, SALİH; ERDİL, TANJU YUSUF; ÖNEŞ, TUNÇ; KESİM S., TUROĞLU H. T., ÖZGÜVEN S., ÖNEŞ T., ERDİL T. Y.© 2022 by Turkish Society of Nuclear Medicine Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi.Caudal regression syndrome (CRS) or sacral agenesis is a rarely seen malformation with a varying degree of structural abnormalities, including multiorgan system dysfunctions, reported with higher incidence among children of mothers with diabetes, as in this case. Spinal anomalies can range from coccyx hemiagenesis to the total absence of lower lumbar vertebrae and sacrum in most severe cases. Herein, we have presented a 9-year-old patient with CRS who had renal failure. Technetium-99m dimercaptosuccinic acid renal scintigraphy revealed bilaterally non-functioning kidneys with no renal cortical uptake. Renal anomalies in CRS with vertebral, anorectal, cardiac, trachea-esophageal, renal, and limb anomalies association include one-sided renal agenesis, multicystic dysplastic kidneys, and ureter duplications.Publication Open Access 2-(fluorine-18)-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography after breast conserving surgery: Correlation with molecular markers of breast cancer(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) TUROĞLU, HALİL TURGUT; Ozguven, Salih; Inanir, Sabahat; Turoglu, Halil Turgut; Erdil, Tanju Yusuf; Ugurlu, Mustafa Umit; Gulluoglu, BahadirAim: To investigate the role of 2-(fluorine-18)-fluoro-2-deoxy-D-glucose (F-18-FDG) positron emission tomography/computed tomography (PET/CT) early after breast-conserving surgery (BCS) in patients with breast cancer (BC) and whether we can determine which molecular biomarkers of breast carcinoma put the patients at risk. Materials and Methods: This retrospective study involved 88 patients with histologically proven T1 or T2 BC, who were treated with BCS and underwent F-18-FDG PET/CT study. The correlation between biological markers (estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 [HER2], and Ki-67) of the primary tumor and F-18-FDG PET/CT findings was analyzed. Results: F-18-FDG PET/CT demonstrated the presence of BC disease (locoregional disease [LRD], distant metastases, or contralateral BC) in 26 of 88 patients (29.5%). Regarding immunohistochemical profiles, BC expressing high levels of Ki-67 were associated with an increased percentage of LRD, which was the major recurrence pattern on F-18-FDG PET/CT. Although the BC disease was observed more commonly in patients with HER2 positivity compared to those of HER2 negative, the difference did not reach statistical significance. The patients with T2 tumor or a higher histopathological grade had a higher percentage of BC disease. Conclusions: This study demonstrated that patients with early stage BC treated with BCS have a remarkable risk of the presence of BC even early after surgery, and there was a clinically important relationship between F-18-FDG PET/CT findings and biological markers of BC. These findings suggest that high-risk molecular biomarkers (Ki-67, HER2) can be taken into account in the decision-making the process for both preoperative imaging and planning of the surgical approach.Publication Open Access CAN A ONE-HOUR QUANTITATIVE ASSESSMENT OF FDG-PET-CT (MODIFIED-PETVAS) BE USEFUL IN TAKAYASU'S ARTERITIS?(BMJ PUBLISHING GROUP, 2019-06) ALİBAZ ÖNER, FATMA; Tahra, Sema Kaymaz; Ozguven, Salih; Unal, Ali Ugur; Alibaz-Oner, Fatma; Ones, Tunc; Erdil, Tanju Yusuf; Direskeneli, Haner