Researcher:
Seymen, Hülya

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Hülya

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Seymen

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Seymen, Hülya

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2020 - 202310

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    F-18-FDG PET/CT texture analysis of anthracotic lymph nodes detected with EBUS and comparison with cytological findings
    (Hellenic Soc Nuclear Medicine, 2022) N/A; N/A; Falay, Fikri Okan; Meriçöz, Çisel Aydın; Demirtaş, Elif; Bulutay, Pınar; Seymen, Hülya; Fırat, Pınar Arıkan; Demirkol, Mehmet Onur; Çağlayan, Benan Niku; Teaching Faculty; Teaching Faculty; Master Student; Teaching Faculty; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; Graduate School of Health Sciences; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 246484; 162418; N/A; 133565; 350778; 207545; 196946; 230719
    Objective: Lymph node metastasis is the most important factor both in the selection of treatment since many alternatives have been created in recent years, and in the evaluation of prognosis in lung cancer. The most unpredictable cause of lymph node false positivity in fluorine-18-fluorodeoxyglucose (F-18-FDG) positron emission tomography/computed tomography(PET/CT) is anthracosis. The aim of this study is to compare F-18-FDG PET/CT texture information of anthracotic (ALN) and metastatic (MLN) lymph nodes, after reevaluation of the cytological samples obtained from anthracotic lymph nodes by EBUS-TBNA. Subjects and Methods: Ninety nine patients, 78 of whom had primary lung cancer were included in the study. Two hundred and three lymph nodes from 99 patients sampled by EBUS-TBNA and diagnosed cytologically as ALN or MLN were evaluated retrospectively. All ALN were classified as grades 1, 2 and 3 cytologically. Volume of interest (VOI) of 203 lymph nodes was re-drawn and maximum standardized uptake value (SUVmax), metabolic tumor volume (MN) and total lesion glycolysis (TLG) values were recorded. Results: There was a statistically significant difference in MTV and TLG values in MLN and all ALN grades. However, only grade 1-2 ALN could be differentiated from MLN with SUVmax, and no statistically significant difference was found in grade 3 ALN and MLN. Metabolic tumor volume and TLG values over 4.10cm(3) and 26.57 showed 60% and 59% sensitivity and 83% and 94 specificity respectively for the identification of MLN. Conclusions: The contribution of MTV and TLG values of F-18-FDG PET/CT to the differential diagnosis of ALN is much more valuable than SUVmax values, especially for grade 3 anthracosis. It was thought that cytological reporting of only grade 3 ALN could make a better contribution to the F-18-FDG PET/CT evaluation analysis.
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    Posttherapeutic critical organ dosimetry of extensive lu-177- PSMA inhibitor therapy with metastatic castration-resistant prostate cancer one center results
    (Lippincott Williams & Wilkins, 2020) Uçar, Burcu; Özkan, Ahu; Yarar, Yasemin Yıldız; N/A; N/A; N/A; Seymen, Hülya; Falay, Fikri Okan; Demirkol, Mehmet Onur; Teaching Faculty; Teaching Faculty; Faculty Member; School of Medicine; School of Medicine; School of Medicine; 350778; 246484; 196946
    Purpose: Lu-177-PSMA inhibitor peptide receptor radioligand therapy (RLT) is playing an increasing role in metastatic castration-resistant prostate cancer. We aimed to estimate the absorbed radiation doses for critical organs (eg, kidneys, parotid glands, submandibular glands, and lacrimal glands) of patients treated with 4 to 6 cycles by Lu-177-PSMA inhibitor RLT, retrospectively, and to evaluate the findings extensively in order to determine the critical organ radiation-absorbed limitations and the number of prospective RLT. Materials and Methods: A total of 51 cycles Lu-177-PSMA inhibitor RLT in 10 patients was analyzed. Therapies have been applied in 4 to 6 cycles with 8 to 10 weeks' intervals. Dosimetric estimates of kidneys, parotid glands, submandibular glands, and lacrimal glands have been calculated based on MIRD scheme pamphlet no. 16. Regions of interest were drawn with GE Xeleris Functional Imaging Workstation. OLINDA/EXM 1.1 simulation software was used to calculate radiation-absorbed doses. Results: Mean radiation-absorbed doses were 0.70 +/- 0.24 Gy/GBq for kidneys, 1.34 +/- 0.78 Gy/GBq for parotid glands, 0.94 +/- 0.45 Gy/GBq for submandibular glands, and 2.28 +/- 1.29 Gy/GBq for lacrimal glands. Conclusions: Due to the critical target organ risks and the optimal therapy doses, patient-specific dosimetry is a deterministic factor in radionuclide therapy. Even when the absorbed kidney doses were above the ICRP critical dose limits in patients who had 4 to 6 cycles of therapy, mortality due to nephrotoxicity has not been observed. Mild increased tolerated radiation dose is acceptable for the patient groups with very low survival rate.
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    [Ga-68]Ga-PSMA-11 and [F-18]FDG uptake of venous tumor thrombus in inferior vena cava and left common iliac vein from prostate cancer on positron emission tomography
    (Springer, 2023) Kabaoğlu, Zeynep Ünal; N/A; Seymen, Hülya; Esen, Barış; Kulaç, İbrahim; Aksoy, Murat; Demirkol, Mehmet Onur; Kordan, Yakup; Teaching Faculty; Teaching Faculty; Faculty Member; Other; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 350778; 199167; 170305; N/A; 196946; 157552
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    Can Ga-68 PSMA PET/CT replace conventional imaging modalities for primary lymph node and bone staging of prostate cancer?
    (Elsevier, 2020) Kılıç, Mert; N/A; Esen, Tarık; Seymen, Hülya; Acar, Ömer; Demirkol, Mehmet Onur; Faculty Member; Teaching Faculty; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 50536; 350778; 237530; 196946
    Imaging is critical for primary staging of prostate cancer. Traditional imaging modalities (computerized tomography scan and nuclear medicine bone scans) are limited by their suboptimal diagnostic performance. Recent meta-analyses have demonstrated that nuclear imaging with Ga-68-labeled prostate-specific membrane antigen ligand (Ga-68-PSMA) using positron emission tomography/computed tomography (PET/CT) has higher sensitivity and specificity in this setting compared to conventional imaging techniques. Ga-68-PSMA PET/CT for whole-body assessment can be used as the sole imaging modality for primary lymph node and bone staging of prostate cancer. Patient summary: There is a rapidly growing body of evidence that nuclear imaging with Ga-68-labeled prostate-specific membrane antigen ligand using positron emission tomography/computed tomography has a higher detection rate for lymph node and bone metastases in prostate cancer patients. This approach has strong potential to replace conventional techniques in the primary setting in the near future. (C) 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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    Contribution of fluorodeoxyglucose-positron emission tomography late imaging to diagnosis and correlation with histopathology in invasive lobular breast cancer
    (Galenos Yayincilik, 2020) N/A; N/A; Falay, Fikri Okan; Seymen, Hülya; Teaching Faculty; Teaching Faculty; School of Medicine; School of Medicine; 246484; 350778
    Objective: The aim of this study was to investigate tie correlation between primary lesion and contralateral breast tissue metabolic parameters in standard and delayed images obtained on preoperative F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and tie correlation with pathological variables of primary lesion in invasive lobular breast cancer (ILC). Methods: Seventeen ILC cases in which standard and late FDG-PET imaging were performed between 2007 and 2018 were included in the study. SUVmax, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values and change rates (Delta) of primary malignant lesion and contralateral breast control area were recorded. T and N stages, Histological and nuclear grades of primary malignancy, estrogen receptor (ER), progesterone receptor, presence of human epidermal growth factor receptor (HER)-2 and Ki-67 values are compared with FDG-PET values. Results: No statistically significant correlation was found between metabolic parameters and histopathological components of 17 ILC patients (median age: 45 years) after surgery (11 breast conserving surgery, 6 mastectomy). Among the metabolic parameters obtained from contralateral breast tissue, SUVmax-based ones [standard(s) SUVmax, late(g)-SUVmax, Delta SUVmax] showed statistically significant differences with malignancy (p<0.000). Conclusion: Especially the negative median value of tie control SUVmax suggests that late imaging may provide additional contribution, especially in the dense breast tissue, in the ILC wits high probability of multifocality/multicentricity Although there was no statistically significant difference with histopatnological components, parallel results (such as high Delta-TLG in presence of lymph node metastasis, HER-2 positive and high SUVmax, MTV and TLG median values in ER negative cases) were seen with the literature mostly consisting of invasive ductal carcinoma. Confirmation of this important information obtained only from ILC patients is required in multicentre studies or meta analyzes in which the number of cases will be higher.
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    Diagnostic accuracy of ultrasound for the evaluation of lateral compartment lymph nodes in papillary thyroid carcinoma
    (Bentham Science Publ Ltd, 2020) Çolakoğlu, Bülent; Alis, Deniz; N/A; Seymen, Hülya; Teaching Faculty; School of Medicine; 350778
    Aims: To evaluate the diagnostic accuracy of ultrasound (US) assessing the lateral compartment lymph node metastasis in patients with primary papillary thyroid carcinoma (PTC), and to demonstrate the incidence and patterns of the lateral lymph node metastasis. Methods: We retrospectively reviewed 198 patients with primary PTC who underwent thyroidectomy in addition to modified lateral neck dissections (MLND) involving level II to level V due to clinically positive lateral neck disease. A skilled and experienced single operator performed all US examinations. Surgical pathology results were accepted as the reference method and sensitivity, specificity, and diagnostic accuracy of US in detecting metastatic lymph nodes established using level-by-level analysis. Results: In the study cohort, 10.1% of the patients had lateral compartment lymph node metastases without any central compartment involvement. For the lateral compartment, 48.5% had level II, 74.7% had level III, 64.6% had level IV, and 29.3% of the patients had level V metastasis. None of the patients had isolated level V metastasis. The sensitivity, specificity, and diagnostic accuracy of US in identifying lateral lymph compartment metastasis ranged from 87% to 91.4%, 92% to 98.6% 92.4% to 96%, respectively. However, the sensitivity (74.7%) and diagnostic accuracy (76.2%) of US significantly decreased for the central compartment while specificity (90%) remained similar. Conclusion: US performed by a skilled operator has an excellent diagnostic accuracy for the evaluation of lateral cervical lymph nodes in primary PTC; thus, might enable precise tailoring of the management strategies. Moreover, the high incidence of level V involvement favors MLND over selective approaches.
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    Diagnostic ability of Ga-68 PSMA PET to detect dominant and non-dominant tumors, upgrading and adverse pathology in patients with PIRADS 4–5 index lesions undergoing radical prostatectomy
    (Springernature, 2021) Kilic, Mert; Vural, Metin; N/A; Köseoğlu, Ersin; Kordan, Yakup; Şal, Oğuzhan; Seymen, Hülya; Kiremit, Murat Can; Armutlu, Ayşe; Baydar, Dilek Ertoy; Altınmakas, Emre; Falay, Fikri Okan; Canda, Abdullah Erdem; Balbay, Mevlana Derya; Demirkol, Mehmet Onur; Esen, Tarık; Faculty Member; Faculty Member; Undergraduate Student; Teaching Faculty; Faculty Member; Teaching Faculty; Faculty Member; Other; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; 350876; 157552; N/A; 350778; 222920; 133567; 8025; 143682; 246484; 116202; 153320; 196946; 50536
    Background To evaluate the additive role of Ga-68 PSMA PET as a primary staging tool in patients bearing prostate cancer in single PIRADS 4 or 5 index lesions. Methods Eighty-one biopsy-naive patients with preoperative mpMRI and Ga-68 PSMA PET who underwent radical prostatectomy (RP) were evaluated retrospectively. Forty-nine patients had PIRADS 4 and 32 had PIRADS 5 index lesions. The localization, grade, and volumetric properties of dominant (DT) and non-dominant tumors (NDT) in RP were compared to the index lesions of mpMRI and Ga-68 PSMA PET. Results The median age and PSA level were 62 (IQR; 59-69) years and 7 (IQR; 2-8) ng/ml, respectively. Ga-68 PSMA PET detected DTs in 100% of the patients including 13 patients in whom mpMR failed. In 45 patients an NDT was reported in RP. Ga-68 PSMA PET accurately detected NDT in 24 of 45 (53.3%) patients. Six patients (12.2%) in PIRADS 4 and 8 (25%) in PIRADS 5 group showed upgrading. In PIRADS 4, Ga-68 PSMA PET localized DT in all patients with upgraded tumors whereas mpMRI missed exact location in 2 of 6 (33.3%). In PIRADS 5 both mpMRI and Ga-68 PSMA PET accurately located all DTs. Overall detection rates of extracapsular extension (ECE) and seminal vesicle invasion (SVI) by mpMRI were 51.1% and 53.8%, respectively. Ga-68 PSMA PET detected ECE and SVI in 27.9% and 30.7%, respectively. When mpMRI and Ga-68 PSMA PET were used in combination detection rates of ECE and SVI increased to 65.1 and 61.5%. Ga-68 PSMA PET-detected six of ten patients with positive lymph nodes whereas mpMRI could not identify any. Conclusions Ga-68 PSMA PET has a better diagnostic accuracy in detecting DT, NDT, upgrading, adverse pathology in patients with PIRADS 4 index lesions. However, mpMRI better predicted ECE and SVI than Ga-68 PSMA PET.
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    Ga-68-PSMA-11 positron emission tomography/computed tomography for primary lymph node staging before radical prostatectomy: central review of imaging and comparison with histopathology of extended lymphadenectomy
    (Elsevier, 2021) N/A; Esen, Tarık; Falay, Fikri Okan; Tarım, Kayhan; Armutlu, Ayşe; Köseoğlu, Ersin; Kılıç, Mert; Seymen, Hülya; Sarıkaya, Ahmet Furkan; Kiremit, Murat Can; Balbay, Mevlana Derya; Canda, Abdullah Erdem; Baydar, Dilek Ertoy; Kordan, Yakup; Demirkol, Mehmet Onur; Tilki, Derya; Faculty Member; Teaching Faculty; Researcher; Teaching Faculty; Faculty Member; Doctor; Teaching Faculty; Resaercher; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Other; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 50536; 246484; 327605; 133567; 350876; N/A; 350778; 327615; 222920; 153320; 116202; 8025; 157552; 196946; N/A
    Background: Results from prospective trials have shown higher accuracy of prostate-specific membrane antigen (PSMA)-based positron emission tomography (PET)/computed tomography (CT) in detection of lymph node metastasis (LNM) compared to conventional imaging. Objective: To evaluate the accuracy of Ga-68-PSMA-11 PET/CT for LNM detection in patients undergoing radical prostatectomy (RP) and extended pelvic lymph node dissection (PLND). Design, setting, and participants: Between June 2014 and November 2020, 96 patients with Ga-68-PSMA PET/CT for primary staging underwent RP and extended PLND. Outcome measurements and statistical analysis: The results from Ga-68-PSMA PET/CT were compared with histologic data from primary PLND in 96 patients. All Ga-68-PSMA PET/CT scans were centrally reviewed. Results and limitations: Of 96 patients, 15.6% (n = 15) harbored LNMs. The median prostate-specific antigen at Ga-68-PSMA PET/CT was 8.0 ng/ml (interquartile range 5.5-11.7). The majority of patients had intermediate- (52.1%) or high-risk disease (41.7%). Biopsy grade group 4 and 5 was present in 22.9% and 15.6%, respectively. The Ga-68-PSMA PET/CT scans identified eight of 15 patients (53.3%) as LN-positive (true positive). The calculated per-patient sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Ga-68-PSMA PET/CT in the detection of LNM were 53.3%, 98.8%, 88.9%, 92.0%, and 91.7%, respectively. The per-patient sensitivity and specificity in the detection of LNMs larger than 2 mm were 61.5% and 98.8%, respectively. The main limitation is the retrospective design of the study. Conclusions: Ga-68-PSMA PET/CT is accurate in lymph node staging and the results support its use for primary staging of prostate cancer. Patient summary: We compared prostate-specific membrane antigen (PSMA)-based positron emission tomography (PET)/computed tomography (CT) findings with histopathology results after extended lymph node dissection and showed that it is accurate in detecting lymph node metastases. Our results support the use of PSMA PET/CT for primary staging of prostate cancer. (C) 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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    18F-FDG PET/CT texture analysis of anthracotic lymph nodes detected with EBUS and comparison with cytological findings
    (P.Ziti and Co, 2022) N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; Çağlayan, Benan Niku; Fırat, Pınar Arıkan; Seymen, Hülya; Bulutay, Pınar; Falay, Fikri Okan; Demirtaş, Elif; Demirkol, Mehmet Onur; Meriçöz, Çisel Aydın; Faculty Member; Faculty Member; Teaching Faculty; Teaching Faculty; Teaching Faculty; Master Student; Faculty Member; Teaching Faculty; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Graduate School of Health Sciences; School of Medicine; School of Medicine; 230719; 207545; 350778; 133565; 246484; N/A; 196946; 162418
    Objective: Lymph node metastasis is the most important factor both in the selection of treatment since many alternatives have been created in recent years, and in the evaluation of prognosis in lung cancer. The most unpredictable cause of lymph node false positivity in fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is anthracosis. The aim of this study is to compare 18F-FDG PET/CT texture information of anthracotic (ALN) and metastatic (MLN) lymph nodes, after re-evaluation of the cytological samples obtained from anthracotic lymph nodes by EBUS-TBNA. Subjects and Methods: Ninety nine patients, 78 of whom had primary lung cancer were included in the study. Two hundred and three lymph nodes from 99 patients sampled by EBUS-TBNA and diagnosed cytologically as ALN or MLN were evaluated retrospectively. All ALN were classified as grades 1, 2 and 3 cytologically. Volume of interest (VOI) of 203 lymph nodes was re-drawn and maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values were recorded. Results: There was a statistically significant difference in MTV and TLG values in MLN and all ALN grades. However, only grade 1-2 ALNs could be differentiated from MLNs with SUVmax, and no statistically significant difference was found in grade 3 ALN and MLN. Metabolic tumor volume and TLG values over 4.10cm3 and 26.57 showed 60% and 59% sensitivity and 83% and 94 specificity respectively for the identification of MLN. Conclusion: The contribution of MTV and TLG values of 18F-FDG PET/CT to the differential diagnosis of ALN is much more valuable than SUVmax values, especially for grade 3 anthracosis. It was thought that cytological reporting of only grade 3 ALN could make a better contribution to the 18F-FDG PET/CT evaluation analysis.
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    PublicationOpen Access
    The clinical impact of the late imaging with 18F-fluorodeoxyglucose PET texture analysis in invasive lobular breast cancer
    (Kare Yayıncılık, 2021) Falay, Fikri Okan; Seymen, Hülya; Teaching Faculty; Teaching Faculty; School of Medicine; 246484; 350778
    Objective: breast invasive lobular cancer (ILC) is one of the most difficult malignancies to diagnose and follow-up due to its tumor morphology. Tumor heterogeneity is the most important reason for treatment failure and diagnostic limitation. Identification of heterogeneity by a non-invasive method, texture analysis that can be done from positron emission tomography (PET), MR, and CT is developed. In ILC, diagnostic sensitivity is lower with 18F-fluorodeoxyglucose ([18F] FDG) PET/CT compared to invasive ductal carcinoma (IDC). In this study, the correlation between histopathological variables and the texture analysis of [18F] FDG PET/CT standard images, and also late images whose contribution to the diagnosis of many malignancies has been investigated are researched. Methods: twenty ILC patients underwent standard and late [18F] FDG PET/CT imaging for staging between May 2007 and December 2018. T and N stages, histological and nuclear grades, estrogen receptor, progesterone receptor, human epidermal growth factor-2, and Ki-67 were recorded. Results: thirty-two textural indices with conventional and formal indices and histogram values were calculated with LIFEx software to find heterogeneity in standard and late [18F] FDG PET/CT images. Conventional and discrete indices based on GLRM and GLZM are more correlated than other texture indices. Greater number of significantly correlations was found between histopathological variables and texture analysis of late imaging (p<0.05). Conclusion: in our study, the conventional indices, especially in the 2nd degree indices, in the texture analysis performed with [18F] FDG PET/CT significantly correlated in the ILC, which has lower [18F] FDG affinity compared to IDC due to the tumoral tissue characteristics. Although the presence of more correlations with histopathological prognostic information in late images suggests a greater diagnostic contribution, further studies with more numbers are needed.