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We investigated the psychological impact of the COVID-19 outbreak in terms of stress, anxiety, depression, sleep quality and affecting factors on healthcare workers (HWs) without secondary trauma thus far in the period between the first cases in Turkey and the arrival of the first case in ahospital. This descriptive cross-sectional study included 169 HWs. We used Impact of Event Scale (IES-R), Depression Anxiety Stress Scale and Pittsburgh Sleep Quality Index (PSQI) for assessment. The mean age of HWs was 33.9±6.9 years and 56.2% were males. Of the HWs; 20.7% were nurses, 33.7% doctors and 45.6% staff members. IES-R classified the HWs as follows: 15.4% of them were affected mildly, 4.7% moderately and 9.5% of them were affected severely. 42.6% of HWs had apoor sleep quality. This study shows that how HWs were affected when the outbreak had not yet reached the hospital in which they work. In total, 29.6% of the HWs were psychologically affected by mild to severe levels from the outbreak in this period. The most prevalent psychological impact was poor sleep quality. Psychological impact on HWs may have begun before the outbreak reached the hospitals; therefore, necessary measures should be taken as early as possible.
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COVID-19 , Adulto , Ansiedade , Estudos Transversais , Depressão , Surtos de Doenças , Pessoal de Saúde , Hospitais Universitários , Humanos , Masculino , SARS-CoV-2 , Qualidade do Sono , Turquia/epidemiologiaRESUMO
BACKGROUND: Although there are many studies discussing the etiological and pathological factors leading to both, acute and chronic tendon injuries, the pathophysiology of tendon injuries is still not clearly understood. Although most lesions are uncomplicated, treatment is long and unsatisfactory due to the poor vascularity of tendon tissue. Platelet mediator concentrate (PMC) contains many growth factors derived from platelets, which can promote wound healing. In this study we investigate the effects of PMC on tenocyte proliferation and differentiation in order to provide an experimental basis for tissue regeneration strategies and to develop new treatment concepts. METHODS: Using enzyme linked immunosorbent assay (ELISA) we were able to quantify the several growth factors and cytokines found in PMC. Tenocytes were isolated both from human and from mouse Achilles tendons and stimulated with PMC. CyQuant® and Cell Titer Blue® assays were carried out to analyze tendon growth and viability at different concentrations of PMC. Real time RT-PCR was used to analyze tenocyte gene expression with or without PMC treatment. Immunohistochemistry was carried out to detect the tenocyte-specific antibody tenomodulin (TNMD) and scleraxis (SCX). RESULTS: We were able to detect numerous mediators such as platelet derived growth factor BB (PDGF-BB), interleukin 6 (IL-6), vascular endothelial growth factor (VEGF), tumor necrosis factor (TNF-α), transforming growth factor beta 1 (TGF-ß1), and bone morphogenetic proteins 2, 4 and 7 (BMP-4, BMP-2, BMP-7) in PMC. It was possible to show a positive effect of PMC on human tendon cell growth and viability in a dose-dependent manner. Furthermore, PMC treatment led to induction of gene expression of scleraxis (SCX), type I collagen A 1 (Col1A1) and TNMD by tenocytes. CONCLUSIONS: We suggest that the use of autologous PMC may be a suitable addition to conventional tendon therapy that is capable of increasing and optimizing tendon healing and reducing the risk of recurrence.
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Indutores da Angiogênese/uso terapêutico , Plaquetas/metabolismo , Traumatismos dos Tendões/tratamento farmacológico , Tenócitos/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Tendão do Calcâneo/citologia , Adolescente , Adulto , Animais , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Becaplermina , Proteínas Morfogenéticas Ósseas , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Colágeno Tipo I/metabolismo , Cadeia alfa 1 do Colágeno Tipo I , Ensaio de Imunoadsorção Enzimática , Feminino , Perfilação da Expressão Gênica , Voluntários Saudáveis , Humanos , Imuno-Histoquímica , Masculino , Proteínas de Membrana/metabolismo , Camundongos , Pessoa de Meia-Idade , Proteínas Proto-Oncogênicas c-sis/uso terapêutico , Regeneração/efeitos dos fármacos , Tenócitos/metabolismo , Tenócitos/fisiologia , Fator A de Crescimento do Endotélio Vascular , Adulto JovemRESUMO
In this research, we aimed to determine genotoxic effects of boron (B) and zinc (Zn) on Zea mays by using total soluble protein content and random amplification of polymorphic DNA (RAPD) analyses. For the RAPD analysis, 16 RAPD primers were found to produce unique polymorphic band profiles on treated maize seedlings. With increased Zn and B concentrations, increased polymorphism rate was observed, while genomic template stability and total soluble protein content decreased. The treatment with Zn was more effective than that of B groups on the levels of total proteins. The obtained results from this study revealed that the total soluble protein levels and RAPD profiles were performed as endpoints of genotoxicity and these analyses can offer useful biomarker assays for the evaluation of genotoxic effects on Zn and B polluted plants.
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Boro/toxicidade , Dano ao DNA/efeitos dos fármacos , Técnica de Amplificação ao Acaso de DNA Polimórfico/métodos , Zea mays/efeitos dos fármacos , Zinco/toxicidade , DNA de Plantas/genética , Instabilidade Genômica/efeitos dos fármacos , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Plântula/efeitos dos fármacosRESUMO
ß-Thalassemia (ß-thal) is the most common monogenic disorder in Turkey. The aim of this study was to investigate the spectrum of ß-thal mutations in the Aegean region of Turkey. The data was derived from 1171 unrelated ß-thal subjects, detected in a regional reference hospital between November 2004 and December 2013. Screening for the 22 common mutations was performed using the polymerase chain reaction (PCR)-reverse dot-blot method, and direct automated DNA sequencing for the unknown samples. Thirty-one different ß-thal alleles were identified. Seven mutations, namely IVS-I-110 (G > A) (41.7%), IVS-I-1 (G > A) (8.9%), IVS-II-745 (C > G) (8.6%), codon 8 (-AA) (7.7%), IVS-II-1 (G > A) (7.2%), IVS-I-6 (T > C) (6.6%), codon 39 (C > T) (4.6%) accounted for 85.3% of the mutated alleles. Frequencies of the remaining 24 ß-thal mutations were less than 2.2%; these included one novel mutation [HBB: c.206_212del (p.Leu69Profs*19)], and four others [-56 (G > C), codon 16 (-C), IVS-I (-3) (C > T) (codon 29), codon 76 (-C)] found in Turkey for the first time. The results will help to prevent severe ß-thal through genetic counseling and prenatal diagnosis (PND) in the Aegean region of Turkey.
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Deleção de Sequência , Globinas beta/genética , Talassemia beta/genética , Alelos , Análise Mutacional de DNA , Índices de Eritrócitos , Frequência do Gene , Genótipo , Geografia , Humanos , Turquia , Talassemia beta/sangue , Talassemia beta/diagnósticoRESUMO
ABSTRACT: Prostate-specific membrane antigen (PSMA) is a transmembrane protein physiologically expressed in nonprostatic tissues. Inflammation and infectious diseases could show false-positive PSMA uptake. Herein, we present a 55-year-old patient's findings of inflammation in the lower respiratory tract due to inhaler use in 68 Ga-PSMA PET/CT in a patient with prostate cancer.
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Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Próstata , Masculino , Humanos , Pessoa de Meia-Idade , Isótopos de Gálio , Radioisótopos de Gálio , Neoplasias da Próstata/metabolismo , Inflamação/diagnóstico por imagem , Sistema Respiratório , Ácido Edético/metabolismoRESUMO
ABSTRACT: Medication-related osteonecrosis of the jaw (ONJ) is rare adverse effect of zoledronic acid. We present ONJ detected in a 65-year-old man with prostate cancer who underwent 18 F-FDG PET/CT for metabolic characterization and to exclude a second primary malignancy of the liver lesion observed in 68 Ga-PSMA PET/CT. ONJ has high metabolic activity on 18 F-FDG PET/CT and no PSMA receptor activation on the 68 Ga-PSMA PET/CT. In this case, we wanted to underline the importance of 18 F-FDG PET/CT imaging of medication-related ONJ in patients receiving zoledronic acid therapy and to emphasize that rapid and appropriate treatment can be provided.
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Osteonecrose , Neoplasias da Próstata , Masculino , Humanos , Idoso , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Fluordesoxiglucose F18 , Ácido Zoledrônico , Compostos Radiofarmacêuticos , Radioisótopos de Gálio , Neoplasias da Próstata/complicações , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologiaRESUMO
Gallbladder perforation is one of the most serious complications of cholecystitis and is rarely seen in 2-11% of cases. Pericholecystic abscesses secondary to gallbladder perforation are rare. Rapid diagnosis is important because of high morbidity and mortalityrates. A subcapsular abscess secondary to gallbladder microperforation is presented on 18F-fluorodeoxyglucose positron emission tomography/computed tomography performed for restaging in a patient with maxillary sinus cancer.
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Peliosis hepatis (PH) and sclerosing angiomatoid nodular transformation of the spleen are uncommon benign lesions. Diagnosis can be difficult in some patients. Herein, we present the case of a 28-year-old woman referred with abdominal pain who had spleen lesions. 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography revealed multiple non-FDG avid lesions in the liver and hypermetabolic lesions in the spleen. In addition, abdominal magnetic resonance imaging was performed. Histopathology revealed sclerosing angiomatoid nodular transformation in the spleen and PH in the liver.
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ABSTRACT: A 76-year-old woman was diagnosed breast carcinoma and treated with breast-conserving surgery and chemoradiotherapy. A year after the treatment completion, restaging 18 F-FDG PET/CT scan detected no any pathological finding. However, due to a lesion detected during physical examination on the right thoracic wall adjacent to the primary tumor bed, 18 F-FDG PET/CT imaging was performed 9 months later for restaging. Highly intense FDG uptake was detected in an approximately 1-cm nodular lesion, and metastasis was reported as suspicious, and histopathological confirmation was recommended. Excision was performed and pathological examination diagnosed benign cellular fibrous histiocytoma.
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Neoplasias da Mama , Fluordesoxiglucose F18 , Recidiva Local de Neoplasia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Humanos , Feminino , Idoso , Neoplasias da Mama/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Diagnóstico Diferencial , Histiocitoma Fibroso Benigno/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Imagem Multimodal , Neoplasias Induzidas por Radiação/diagnóstico por imagemRESUMO
Objective: This study aimed to compare the effects of three different kinesio taping (KT) techniques in individuals with myofascial pain syndrome (MPS) who have a trigger point in the trapezius muscle. Methods: The individuals included in our study were randomly divided into four groups: Group 1: Functional correlation technique, group 2: Fascia correlation technique, group 3: Star taping technique (STT), and group 4: Sham group. The visual analog scale was used to assess pain, cervical joint range of motion (ROM) with a universal goniometer, grip strength with a hand dynamometer, number of active trigger points by palpation, pressure-pain threshold with an algometer, quality of life with the Nottingham Health Profile and functional level with the Neck Disability index were evaluated before and after treatment. Results: There was no difference between the groups in terms of demographic data and pre-treatment outcome measures (p>0.05). There was a significant difference in the pain score between the groups after treatment (p<0.05). A statistically significant difference was found in the cervical flexion ROM of all groups after treatment (p<0.05). In pairwise comparisons, these differences were found due to group 3 (p<0.05). Conclusions: The three KT techniques are effective in reducing pain, increasing ROM, reducing the number of active trigger points, and increasing grip strength. Among these techniques, STT was found to be more effective in reducing pain and increasing cervical flexion ROM. KT is a method that can be used in the clinic for patients with MPS.
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AIM: This study aimed to compare the diagnostic capabilities of 18F-FDG PET/CT and 68Ga-FAPI-04 PET/CT imaging in staging gastric carcinoma, exploring the impact of 68Ga-FAPI-04 PET/CT on treatment planning and its prognostic significance. METHODS: The research included 31 patients undergoing staging for gastric cancer, who received both 18F-FDG PET/CT and 68Ga-FAPI-04 PET/CT scans. We compared the SUVmax and SUVmean of the primary tumor and lymph nodes, the count of organ metastases, tumor-to-background ratios, and overall staging accuracy. Additionally, the study evaluated radiological progression-free survival and overall survival rates. RESULTS: The 68Ga-FAPI-04 PET/CT demonstrated superior efficacy in identifying the primary tumor compared with 18F-FDG PET/CT, particularly in cases of poorly cohesive, signet-ring cell, and mucinous subtypes, with detection rates of 96.7% versus 77.4% (P = 0.006 and P = 0.008, respectively). Analysis of lymph nodes showed a significantly higher detection of positive nodes with 68Ga-FAPI-04 (P = 0.026), although no significant differences were observed in SUVmax and tumor-to-background ratio on a patient basis (P > 0.05). SUVmax and tumor-to-background ratios for peritoneal involvement were notably higher with 68Ga-FAPI-04 PET/CT compared with 18F-FDG PET/CT (P = 0.04 for both). No significant differences were found in the detection of organ metastases and disease stage between the 2 imaging modalities (P > 0.05). Primary tumor uptake did not significantly impact radiological progression-free survival or overall survival in either modality. CONCLUSION: 68Ga-FAPI-04 PET/CT imaging surpasses 18F-FDG PET/CT in detecting the primary tumor, especially in poorly cohesive and signet-ring cell gastric cancer types, and offers improved accuracy in disease staging. This indicates its potential to enhance treatment management and prognostic assessment in gastric cancer patients.
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PURPOSE: Prostate-specific membrane antigen (PSMA)-targeted PET/CT is a well-established imaging method in prostate cancer (PC) for both staging and restaging, and also for theranostic applications. An alternative imaging method is crucial for 15% PSMA-negative cases. We aimed to investigate the contribution of 68 Ga-DOTA-FAPI-04 PET/CT to PC imaging. PATIENTS AND METHODS: Thirty-six patients diagnosed with PC were included. Patients underwent both 68 Ga-PSMA PET/CT and 68 Ga-DOTA-FAPI-04 PET/CT imaging within 1 week. In staging group, primary tumor uptake values were compared, and also correlations were done with histopathological findings, MRI findings, and total PSA levels. In biochemical recurrence group, the uptake values in prostatic region and metastases were evaluated to define the local recurrence or metastatic disease. RESULTS: In staging group, PSMA PET showed increased uptake in the primary lesion area in 14/27 (52%) patients, whereas 20/27 (74%) patients were positive in FAPI-04 PET. FAPI-04 positivity was found to be quite high, such as 54%, in PSMA-negative patients. A significant difference was observed between ISUP grade 1-3 patients and ISUP grade 4-5 patients in FAPI-04 PET ( P = 0.03). Local recurrence was detected in 3 patients, pelvic lymph node metastasis in 1 patient, and sacrum metastasis in 1 patient in biochemical recurrence group, and all of the lesions had more intense uptake in PSMA PET than FAPI-04 PET. CONCLUSIONS: FAPI PET imaging seems to have a potential to contribute PSMA PET imaging with FAPI positivity in more than half of PSMA-negative cases. Also, FAPI-targeted radionuclide therapy may be a promising method in patients resistant to PSMA-targeted therapy.
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Compostos Heterocíclicos com 1 Anel , Próstata , Neoplasias da Próstata , Quinolinas , Masculino , Humanos , Próstata/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Isótopos de Gálio , Radioisótopos de Gálio , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologiaRESUMO
OBJECTIVE: Patients with residual disease after neoadjuvant chemotherapy have a relative risk of developing recurrence. This study investigates the risk factors for recurrence in locally advanced breast cancer patients with residual disease and evaluates survival analysis. METHODS: This is a retrospective, single-center study. Breast cancer patients who failed to achieve a pathological complete response after neoadjuvant chemotherapy were included. Demographic, clinicopathological, and treatment characteristics were evaluated to identify predictive factors of recurrence and survival analysis. RESULTS: We included 205 patients in this study. After a median of 31 months of follow-up, 10 patients died, and 20 developed distant metastasis. Disease-free survival and disease-specific survival were 73.8% and 83.1%, respectively. Lymphovascular invasion and non-luminal subtype were independent predictors of locoregional recurrence. In situ carcinoma, lymphovascular invasion, ypTIII stage, and non-luminal molecular subtypes were independent predictors of disease-free survival. The only independent factor affecting disease-specific survival was cNII-III. The number of involved lymph nodes was an independent predictor of disease-free survival in patients without complete axillary response. CONCLUSION: Factors affecting disease-specific survival and disease-free survival were cNII-III and the number of involved lymph nodes, respectively. Patients with non-luminal, large residual tumors with in situ carcinoma, lymphovascular invasion, clinically positive axilla, and residual nodal involvement have a high relative risk for recurrence and may benefit from additional treatments.
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Neoplasias da Mama , Terapia Neoadjuvante , Recidiva Local de Neoplasia , Neoplasia Residual , Humanos , Feminino , Neoplasias da Mama/patologia , Neoplasias da Mama/mortalidade , Recidiva Local de Neoplasia/patologia , Estudos Retrospectivos , Pessoa de Meia-Idade , Fatores de Risco , Adulto , Neoplasia Residual/patologia , Intervalo Livre de Doença , Idoso , Estadiamento de Neoplasias , Metástase Linfática , Quimioterapia AdjuvanteRESUMO
Otofaciocervical syndrome (OFCS) is an autosomal recessively inherited disorder characterized by facial dysmorphism, external ear anomalies with preauricular pits and hearing impairment, branchial cysts or fistulas, anomalies of the vertebrae and the shoulder girdle, and mild intellectual disability. In a large consanguineous family with OFCS from Turkey, we performed whole-exome sequencing (WES) of a single pooled DNA sample of four affected individuals. Filtering for variants with a percentage of alternate reads ≥ 90 % and a coverage of at least five reads identified only a single novel homozygous variant, c.497G>T, located in PAX1 that co-segregated with the disease in the family. PAX1 encodes a transcription factor with a critical role in pattern formation during embryogenesis in vertebrates. The mutation is predicted to substitute the glycine at position 166 to valine (p.G166V) within the highly conserved paired-box domain of the PAX1 protein. We performed a dual luciferase reporter assay to examine the transactivation of a regulatory sequence in the Nkx3-2 promoter region, which is a direct target of mouse Pax1 transcriptional regulation. We observed a significantly reduced transactivation in HEK293T cells overexpressing Pax1(G157V) in comparison to Pax1(WT) expressing cells, indicating a reduced DNA-binding affinity of the mutant protein. Taken together, our results show that the strategy of pooling DNA is a powerful, cost-effective application for WES in consanguineous families and establish PAX1 as a new disease-causing gene for OFCS and as part of the EYA-DACH-SIX-PAX network, important in early embryogenesis.
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Síndrome Brânquio-Otorrenal/genética , Fatores de Transcrição Box Pareados/genética , Sequência de Aminoácidos , Animais , Feminino , Regulação da Expressão Gênica no Desenvolvimento , Células HEK293 , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , Humanos , Masculino , Camundongos , Dados de Sequência Molecular , Mutação , Fatores de Transcrição Box Pareados/metabolismo , Linhagem , Regiões Promotoras Genéticas , Análise de Sequência de DNA , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , TurquiaRESUMO
ABSTRACT: A 58-year-old man who underwent surgery for a well-differentiated neuroendocrine tumor of pancreatic origin was evaluated with 68Ga-DOTATATE PET/CT imaging in the follow-up period. After PET/CT findings consistent with disease remission, the patient was started on leflunomide treatment with the diagnosis of rheumatoid arthritis. The patient received leflunomide for 6 months. Then, 68Ga-DOTATATE PET/CT scan was repeated to evaluate the primary disease outcome. Besides the disease remission, we also observed alterations in DOTATATE uptakes of some tissues and organs. In this case, we present the changes in 68Ga-DOTATATE PET/CT scan findings after leflunomide use.
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Tumores Neuroendócrinos , Compostos Organometálicos , Masculino , Humanos , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tumores Neuroendócrinos/patologia , Leflunomida/uso terapêutico , Distribuição Tecidual , Compostos Organometálicos/uso terapêuticoRESUMO
ABSTRACT: A 79-year-old man with prostate cancer was evaluated with 68Ga-prostate-specific membrane antigen (PSMA), 68Ga-FAPI-04, and 18F-FDG PET/CT scans since a rise in prostate-specific antigen was seen at last control while receiving chemotherapy. Abnormal FDG uptakes were observed in the tumoral areas of the left half of the prostate and walls of the bladder, although PSMA and FAPI activity were absent or lower in the relevant tumoral areas. Restaging 68Ga-PSMA and 18F-FDG PET/CT scans were obtained on the patient whose progression continued after transurethral tumor resection. Herein, we present a case proving intraindividual tumor heterogeneity in prostate cancer underwent PET/CT imaging with 3 different radiopharmaceuticals.
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Fluordesoxiglucose F18 , Neoplasias da Próstata , Masculino , Humanos , Idoso , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Radioisótopos de Gálio , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologiaRESUMO
ABSTRACT: A 47-year-old woman had complaint of palpable swelling in the left breast for the last 3 weeks. 18F-FDG PET/CT for staging of concomitant invasive carcinoma in the right breast and 68Ga-labeled fibroblast activation protein inhibitor 04 PET/CT imaging in an ongoing study were performed. Increased radiopharmaceutical uptake was observed in both PET/CT imaging in complex fibroadenoma located in the left breast.
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Neoplasias da Mama , Fibroadenoma , Fibroma , Feminino , Humanos , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Mama/diagnóstico por imagem , Fluordesoxiglucose F18 , Fibroadenoma/diagnóstico por imagemRESUMO
Objectives: The aim of this study were to determine the relationship of pseudoangiomatous stromal hyperplasia (PASH)-like appearance in invasive breast carcinomas (IBCs) with PASH foci in the non-tumoral breast parenchyma as well as axillary lymph node involvement. Methods: In this study, 200 consecutive cases with IBC were re-examined. Cases with and without PASH-like appearance in IBC were determined. Each case was assessed regarding the presence of accompanying PASH foci (CD34+, CD31-) in the non-tumoral areas in addition to other clinicopathological parameters. Results: PASH-like appearance within the IBC was present in 22 of the 200 cases (11%) and absent in 178 (89%). The presence of PASH foci in the non-tumoral breast parenchyma was significantly more common in IBC with PASH-like appearance compared to the group without such areas. However, there was no significant difference between the groups regarding other clinicopathological parameters (age, tumor size, nuclear and histological grade, Estrogen receptor/Progesterone receptor status, HER2 status, and Ki-67 proliferation index), lymphovascular invasion (LVI), and axillary lymph node involvement. There was no significant difference between the two groups regarding the histopathological findings observed in the non-tumoral areas. Conclusion: PASH-like appearance within IBC was found to be associated with higher rate of PASH foci in the non-tumoral breast parenchyma. However, such cases do not show a difference as regards LVI and axillary lymph node metastasis.
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ABSTRACT: We present a case of bilateral Phyllodes tumor located in both breasts in a 41-year-old woman who was detected with increased uptake on 68 Ga-FAPI-04 (fibroblast activation protein inhibitor) and 18 F-FDG PET/CT imaging. The tumor filling up the right breast was identified as borderline Phyllodes. The tumor with mild uptake in the left breast was reported as a benign Phyllodes tumor.
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Neoplasias da Mama , Tumor Filoide , Feminino , Humanos , Adulto , Tumor Filoide/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Mama/diagnóstico por imagem , Fluordesoxiglucose F18RESUMO
PURPOSE: In this prospective study, PET findings of 18 F-FDG PET/CT in breast cancer staging were compared with 68 Ga-FAP inhibitor (FAPI) 04 PET/CT findings in selected cases with relatively low 18 F-FDG uptake in the primary tumor or with suspected nodal or distant metastases. PATIENTS AND METHODS: Twenty-four women with a median age of 45 years (range, 36-67 years) who underwent initial staging 18 F-FDG PET/CT for breast cancer underwent 68 Ga-FAPI-04 PET/CT imaging within the same week. SUV max and quantities of primary tumors and locoregional and distant metastatic lesions were recorded from both images, and these data were compared statistically. RESULTS: The histological subtypes of primary tumors were 11 invasive lobular, 8 invasive ductal, and 5 mucinous subtypes. More intense 68 Ga-FAPI-04 uptake (mean, 17.1 ± 7.9; 7.4-38.5) was detected in all primary tumoral lesions compared with 18 F-FDG (mean, 6.3 ± 3.9; 1.5-20.5) ( P = <0.001, Z = 4.107). Additional lesions showing 68 Ga-FAPI-04 uptake in the breast were detected in 29.2% (n = 7) of patients. In 8.3% (n = 2) of the patients, the primary lesion showed only 68 Ga-FAPI-04 uptake. In 68 Ga-FAPI-04 PET/CT, 25% (n = 6) of the patients showed more lymph node involvement and more intense uptake in the ipsilateral axilla. In addition, infraclavicular (level 3) lymph nodes in 4 patients (16.7%), supraclavicular lymph nodes in 1 patient, and internal mammary lymph nodes in 1 patient were detected only on 68 Ga-FAPI-04 PET/CT. In a patient with lung and bone metastases, 68 Ga-FAPI-04 uptake was higher, and the lung nodule showed only 68 Ga-FAPI-04 uptake. CONCLUSIONS: In selected low-FDG-affinity breast cancer patients, 68 Ga-FAPI-04 PET/CT showed the primary tumor with higher sensitivity and higher SUV max values compared with 18 F-FDG PET/CT. In addition, it is believed that this method may contribute to the management of patients' treatment by increasing the nodal stage.