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The efficacy of 18F-FDG PET/CT in the preoperative evaluation of pancreatic lesions
Atilgan Tolga Akcam,Zafer Teke,Ahmet Gokhan Saritas,Abdullah Ulku,Isa Burak Guney,Ahmet Rencuzogullari 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.98 No.4
Purpose: Since the treatment strategy for benign and malignant pancreatic lesions differ, we aimed to evaluate the clinical value of PET/CT in the diagnosis and management of pancreatic lesions. Methods: Ninety patients who had a histologically confirmed pancreatic lesion were studied. Receiver operating characteristic (ROC) curve analysis was used to investigate the ability of PET/CT to differentiate malignant lesions from benign tumors. Results: The malignant and benign groups comprised 64 and 26 patients, respectively. Despite the similarity in the size of primary tumors (P = 0.588), the mean maximum standardized uptake values (SUVmax) obtained from PET/CT imaging were significantly higher in malignant lesions (9.36 ± 5.9) than those of benign tumors (1.04 ± 2.6, P < 0.001). ROC analysis showed that the optimal SUVmax cutoff value for differentiating malignant lesions (to an accuracy of 91%; 95% confidence interval, 83%–98%) from benign tumors was 3.9 (sensitivity, 92.2%; specificity, 84.6%). Conclusion: PET/CT evaluation of pancreatic lesions confers advantages including fine assessment of malignant potential with high sensitivity and accuracy using a threshold SUVmax value of 3.9.
Koca, Gokhan,Ozsoy, Hakan,Atilgan, Hasan Ikbal,Demirel, Koray,Dincel, Veysel Ercan,Korkmaz, Meliha The Korea Society of Nuclear Medicine 2012 핵의학 분자영상 Vol.46 No.3
After surgical therapy of diffuse pigmented villonodular synovitis (DPVNS), recurrence is seen in almost half of the patients. The effectiveness of radiosynovectomy (RSV) in preventing recurrence and complaints of DPVNS is well known. Elbow involvement in DPVNS is a very rare condition; therefore, RSV in elbow hasn't been experienced widely. The aim of this case report is to show the effectiveness of RSV with rhenium-186 (Re-186) sulfide colloid. We applied Re-186 sulfide colloid to the elbow joint of DPVNS patients six weeks after arthroscopic synovectomy. As a result, the patient did not have any complaints, and our findings are compatible with residue or recurrence on magnetic resonance imaging (MRI) in sixth and twentieth month controls after administration. We concluded that Re-186 is an effective adjuvant therapy for the prevention of recurrence and complaints.
Diffuse Myocardial Uptake of 99mTc-HDP in Multiple Myeloma
Koray Demirel,Murat Sadic,Meliha Korkmaz,Aylin Comak,Hasan Ikbal Atilgan,Gökhan Koca 대한핵의학회 2013 핵의학 분자영상 Vol.47 No.3
Soft tissue uptake is a rare finding in bone scintigraphy,with an incidence of 2%. Although the mechanism has not yet been fully clarified, several causes have been reported for this unusual uptake pattern. This paper presents a case of diffuse myocardial accumulation of technetium-99m hydroxymethylene diphosphonate (99mTc-HDP) without either solid/visceral organ or soft tissue with multiple myeloma (MM) in skeletal scintigraphy. A 93-year-old man with hypertension and chronic heart failure for 14 years underwent bone scanning due to a 2-month history of back pain within a 1-year period of MM. Three hours later,99mTc-HDP late static images showed diffuse myocardial radiotracer accumulation and there were no other sites of abnormal soft tissue or visceral uptake. Myocardial accumulation had disappeared on 24-h delayed static images. This accumulation was thought to be related with AL-type amyloidosis associated with MM.
Xanthogranulomatous cholecystitis: a rare gallbladder pathology from a single-center perspective
Ahmet Gokhan Saritas,Mehmet Onur Gul,Zafer Teke,Abdullah Ulku,Ahmet Rencuzogullari,Ishak Aydin,Atilgan Tolga Akcam 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.99 No.4
Purpose: The aim of this study was to review patients with xanthogranulomatous cholecystitis (XGC). Methods: A total of 79 patients diagnosed with XGC were included in the study. The criteria for XGC in the pathology specimens were the presence of histiocytes, cholesterol deposits, lipids, and focal or widespread wall enlargement. Results: Patients were diagnosed with XGC, of which 52 (65.8%) were male and 27 (34.2%) were female, creating a male-to-female ratio of 2:1. The mean age was 65.8 ± 14.3 years (range, 36–97 years). The most common presenting symptom was abdominal pain (63.3%), and the least common presenting symptom was jaundice (8.9%). Of the total, 25 patients were found to have pathological conditions with the potential to obstruct the bile duct or to slow bile flow. A frozen section examination was performed on 20 patients due to suspicion of a tumor by intraoperative macroscopic examination. However, no malignancy was detected in the cases who underwent a frozen section examination. An increase in wall thickness of the gallbladder was observed in 81.6% (n = 31) of the patients on computed tomography scans and in 81.8% (n = 18) of the patients on magnetic resonance imaging scans in which possible tumor lesions were reported, but no tumor was detected. Conclusion: It is difficult to diagnose XGC either preoperatively or intraoperatively, and further imaging methods are needed in the preoperative period other than ultrasonography. However, a definitive diagnosis depends exclusively on pathologic examination.