68Ga-PSMA Versus 18F-FDG PET/CT in the Evaluation of Epithelioid Hemangioendothelioma.

ABSTRACT: A 32-year-old man with epithelioid hemangioendothelioma was imaged with 68Ga-PSMA PET/CT to evaluate the potential of 177Lu-PSMA radionuclide therapy after progression findings were observed on follow-up 18F-FDG PET/CT imaging. Liver lesions showed low FDG SUVmax. The lesion-to-background ratio (TBR) was calculated as 5.1/2.9 on 18F-FDG PET/CT imaging. However, 68Ga-PSMA PET/CT showed moderate PSMA SUVmax. TBR was calculated as 4.5/1.1. In conclusion, in this case report, we demonstrated that 68Ga-PSMA with moderate TBR in epithelioid hemangioendothelioma may be promising for 177Lu-PSMA radionuclide therapy.

Should new organ involvement be included in Response Evaluation Criteria in PSMA Imaging?

PURPOSE: The current study is intended to investigate the effect of new organ involvement on overall survival (OS) and modify the Response Evaluation Criteria in PSMA Imaging (RECIP) by including new organ involvement to RECIP 1.0. MATERIALS AND METHODS: This retrospective study includes 114 patients diagnosed with metastatic castration-resistant prostate cancer (mCRPC) between September 2017 and June 2022 who had received docetaxel treatment and had baseline and post-treatment prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) images. The inclusion criteria were patients with pre- and post-treatment [18F]FDG PET/CT images and whose [18F]FDG PET images were negative. Those whose data were unavailable, who had additional malignancy, or who received abiraterone, enzalutamide, or Lutetium (Lu)-177 treatment were excluded. Age, Gleason score (GS), TPSA (total prostate-specific antigen) levels, surgical history, and OS information were recorded for each patient. RESULTS: The 114 patients herein had a median age of 72.5 (51-91) years and a median GS of 8 (7-10). New lesions were observed in 59 patients (51.7%) and new organ PSMA uptake was observed in 14 patients (12.2%). In the multivariate Cox regression analysis, volume-based treatment response (vTR)-total lesion PSMA (TLP), RECIP PSMA-VOL, modified RECIP (mRECIP) PSMA-VOL, and mRECIP TLP were independent prognostic factors for mortality (p < 0.001, p = 0.006, p = 0.003, and p = 0.003, respectively). The median OS of patients with new organ involvement and new lesion with PSMA uptake was 9.3 months (95% CI 2.1-16.5 months) and 11.8 months (95% CI 7.4-16.2 months), respectively. CONCLUSION: The study concluded that new organ involvement had a shorter OS than new lesion involvement. In the mRECIP that we developed, unlike RECIP, we demonstrated that both PSMA-VOL and TLP value were independent prognostic factors for mortality.

Phenotypic and genotypic diversity of root nodule bacteria from wild Lathyrus and Vicia species in Gaziantep, Turkey.

This study identified the phenotypic and genotypic characteristics of the bacteria that nodulate wild Lathyrus and Vicia species natural distribution in the Gaziantep province of Turkey. Principle component analysis of phenotypic features revealed that rhizobial isolates were highly resistant to stress factors such as high salt, pH and temperature. They were found to be highly sensitive to the concentrations (mg/mL) of the antibiotics neomycin 10, kanamycin, and tetracycline 5, as well as the heavy metals Ni 10, and Cu 10, and 5. As a result of REP-PCR analysis, it was determined that the rhizobial isolates were quite diverse, and 5 main groups and many subgroups being found. All of the isolates nodulating wild Vicia species were found to be related to Rhizobium sp., and these isolates were found to be in Clades II, III, IV, and V of the phylogenetic tree based on 16S rRNA. The isolates that nodulated wild Lathyrus species were in Clades I, II, IV, V, VI, VII, and VIII, and they were closely related to Rhizobium leguminasorum, Rhizobium sp., Phyllobacterium sp., Serratia sp., and Pseudomonas sp. According to the genetic analyses, the isolates could not be classified at the species level, the similarity ratio was low, they formed a distinct group that was supported by strong bootstrap values in the phylogenetic tree, and the differences discovered in the network analysis revealed the diversity among the isolates and gave important findings that these isolates may be new species.

First report of Ascochyta rabiei infections on endemic Turkish populations of Cicer bijugum and C. turcicum.

Ascochyta rabiei causes Ascochyta blight disease on C. arietinum as well as on annual C. reticulatum, C. pinnatifidum and C. judaicum and perennial C. montbretii, C. isauricum, C. ervoides species (Can et al. 2007; Frenkel et al. 2007; Ozkilinc et al. 2019; Peever et al. 2007; Tekin et al. 2018). During field survey studies carried out on annual Cicer spp. in June 2022, concentric ring-shaped lesions were observed on the stems and leaves of C. bijugum in Mardin province and C. turcicum in Elazig province. Cicer reticulatum and C. arietinum plants were also found in the location where C. bijugum was found. No disease symptoms were observed in other Cicer species, while C. bijugum had 32% disease incidence. The disease incidence among the C. turcicum population was 37.3 %, and no chickpea cultivation area was found near it. Diseased plant parts were surface sterilized, placed on ½ potato dextrose agar (PDA) and incubated at 24±2 oC in 12 hours light/dark photoperiod. Each symptomatic plant was considered as one isolate. Monosporic isolates were obtained and the same colony morphology developed from all plant parts of C. turcicum and C. bijugum. Spores were oblong and spore sizes were 10.73±0.62 µm (n=15) in length and 3.60±0.25 (n=15) µm in width, 10.64±0.98 (n=15) µm in length and 3.00±0.26 (n=15) µm in width for isolates obtained from C. turcicum and C. bijugum, respectively. Amplicons for all 40 isolates were generated with mating type (MAT) primers, and the ITS region was amplified and sequenced by using the ITS4 and ITS5 primers (Peever et al. 2007). For the MAT primers, a 700 bp amplicon was observed for all the 20 isolates obtained from C. bijugum conferring to MAT1.1 idiomorph. In contrast, for the isolates obtained from C. turcicum 14 isolates had a 700 bp amplicon for MAT1.1 and 6 isolates had a 500 bp amplicon for MAT1.2, thus representing both idiomorphs in a ~2:1 ratio. BLAST analysis of the ITS sequences showed 100% homology with the reference ITS sequences for A. rabiei except for 23 SVRC CT 09/22 and 23 SVRC CT 22/22 isolates showing 99.81 % similarity. All sequences were submitted to GenBank (OP967923, OP967924, OP967925, OP967926 and OP967927 for A. rabiei isolates from C. turcicum; OP981072, OP981073 and OP981074 for A. rabiei isolates from C. bijugum). A phylogenetic tree was constructed using MEGAX software and the Neighbor-Joining method, using the ITS sequences of A. rabiei, other Ascochyta spp. and Colletotrichum gloeosporioides. The A. rabiei isolates from C. turcicum and C. bijugum clustered together with A. rabiei sequences from the NCBI (Kumar et al. 2018). Twelve-day-old C. bijugum and C. turcicum seedlings were inoculated with 5 x 105 spore/mL concentration of spores from 5 C. turcicum and 3 C. bijugum isolates and put in plastic bags for 24 hours (Can et al. 2007). Pathogenicity tests were carried out in triplicate pots with four plants each for each isolate in a controlled climate chamber at 24±2 oC, 70% humidity under 12 hours light/dark conditions. The first symptoms were observed within 7 days after inoculation (dai) and severe Ascochyta blight symptoms developed on all plants by 21 dai. Cicer bijugum and C. turcicum are endemic Cicer species exhibiting narrow distribution in the Southeastern region of Republic of Türkiye. As a major biotic stress source, A. rabiei could be an important threat to Cicer spp (Abbo et al. 2003). To our knowledge, this is the first report of A. rabiei from C. bijugum and C. turcicum species.

The Role of 68Ga FAPI-04 and 18F-FDG PET/CT in Detecting Liver Metastases in Different Types of Cancer.

OBJECTIVE: We compared the diagnostic accuracies of 68Ga FAPI-04 PET/CT and 18F-FDG PET/CT for detecting liver metastases (LMs) in patients with different cancer types. MATERIALS AND METHODS: This retrospective study included 63 patients with liver lesions who underwent 18F-FDG PET/CT and 68Ga-FAPI-04 PET/CT between May 2020 and May 2022. Patients with histopathologically confirmed primary diagnoses, data that could be accessed retrospectively, liver lesions confirmed by biopsy over at least 3-6 months of follow-up (via ultrasonography, CT, magnetic resonance imaging, PET/CT, or laboratory tests) were included. Patients with secondary malignancies or primary liver malignancies, and/or who could not be followed-up, were excluded. RESULTS: Of the 63 total patients, 34 (54%) were female, and the mean age was 61 (30-92) years. There were 582 LMs in 51 patients and 35 benign liver lesions in 20 (12 patients had only benign and 8 both benign and malignant lesions). Of the 582 LMs, 472 (81.1%) evidenced 18F-FDG uptake and 572 (98.2%) 68Ga-FAPI uptake. The diagnostic accuracies of 68Ga-FAPI PET/CT and 18F-FDG PET/CT were 98% and 82%, respectively (p < 0.001; McNemar test). When the LMs were compared, the maximum standardized uptake (SUVmax) value was significantly higher on 18F-FDG PET/CT than 68Ga-FAPI PET/CT (median: 6.0 vs. 5.4; p = 0.016). However, the LM-to-background ratio (TBR) was significantly higher on 68Ga-FAPI PET/CT than 18F-FDG PET/CT (median: 4.1 vs. 2.1; p < 0.001). CONCLUSION: 68Ga-FAPI PET/CT detected more LMs than did 18F-FDG PET/CT, and TBR was significantly higher on 68Ga-FAPI PET/CT than 18F-FDG PET/CT.

Genome wide association study of genes controlling resistance to Didymella rabiei Pathotype IV through genotyping by sequencing in chickpeas (Cicer arietinum).

Ascochyta blight (AB) is a major disease in chickpeas (Cicer arietinum L.) that can cause a yield loss of up to 100%. Chickpea germplasm collections at the center of origin offer great potential to discover novel sources of resistance to pests and diseases. Herein, 189 Cicer arietinum samples were genotyped via genotyping by sequencing. This chickpea collection was phenotyped for resistance to an aggressive Turkish Didymella rabiei Pathotype IV isolate. Genome-wide association studies based on different models revealed 19 single nucleotide polymorphism (SNP) associations on chromosomes 1, 2, 3, 4, 7, and 8. Although eight of these SNPs have been previously reported, to the best of our knowledge, the remaining ten were associated with AB resistance for the first time. The regions identified in this study can be addressed in future studies to reveal the genetic mechanism underlying AB resistance and can also be utilized in chickpea breeding programs to improve AB resistance in new chickpea varieties.

Role of volumetric parameters obtained from 68 Ga-PSMA PET/CT and 18F-FDG PET/CT in predicting overall survival in patients with mCRPC receiving taxane therapy.

OBJECTIVE: The aim of this study was to determine the prognostic role of volumetric parameters and Pro-PET scores obtained from 68 Ga-prostate-specific membrane antigen (PSMA) PET/CT and 18F-FDG PET/CT in patients with metastatic castration-resistant prostate cancer (mCRPC) receiving taxane therapy. MATERIALS AND METHODS: The study included 71 patients who underwent simultaneous PSMA and 18F-FDG PET/CT imaging between January 2019 and January 2022, had a Pro-PET score of 3-5 and had received taxane therapy after imaging. 18F-FDG tumor volume (TV-F) and PSMA tumor volume (TV-P) values of the lesions and total lesion glycolysis (TL-G) and total lesion PSMA (TL-P) values of the lesions were calculated on both imaging studies and the effects of these parameters on overall survival (OS) were investigated. RESULTS: The median age of the patients included herein was 71 years (56-89) and the median prostate-specific antigen (PSA) level was 16.4 (0.01-1852 ng/dL). According to the Kaplan-Meier survival analysis, TTV-P ≥ 78.5, TTL-P ≥ 278.8, TTV-F ≥ 94.98, TTL-G ≥ 458.3, TTV-P + F ≥ 195.45, TTL-G + P ≥ 855.78, lymph node (L)TV-FDG ≥ 3.4, LFDG-SUVmax ≥ 3.2, LFDG-SUVmean ≥ 2.25, LFDG-SUVpeak ≥ 2.55, and bone (B)TV-F ≥ 51.15 values were found to be prognostic factors in predicting short OS. Multivariate Cox regression analysis showed that a Vscore ≥ 3 (95% confidence interval [CI]: 7.069-98.251, p < 0.001) and TTL-G + P ≥ 855.78 (95% CI: 4.878-1037.860, p = 0.006) were found to be independent prognostic factors in predicting short OS. CONCLUSION: Volumetric parameters and Pro-PET scores obtained from 68 Ga-PSMA PET/CT and 18F-FDG PET/CT imaging have been shown to have an impact on OS in patients with mCRPC receiving taxane therapy.

Comparison of the role of 18 F-fluorodeoxyglucose PET/computed tomography and 68 Ga-labeled FAP inhibitor-04 PET/CT in patients with malignant mesothelioma.

OBJECTIVE: In this study, we aimed to compare the role of 68 Ga-labeled FAP inhibitor ( 68 Ga-FAPI)-04 PET/computed tomography (CT) and 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT in the evaluation of primary tumor and metastases in patients diagnosed with malignant mesothelioma. MATERIALS AND METHODS: Our prospective study included 21 patients with histopathological diagnosis of malignant mesothelioma who underwent both 68 Ga-FAPI-04 PET/CT and 18 F-FDG PET/CT imaging between April 2022 and September 2022. Maximum standardized uptake value (SUVmax), metabolic tumor volume, total lesion glycolysis, tumor-to-background ratio (TBR) and highest SUVpeak (HPeak) values and lesion numbers were calculated from primary and metastatic lesions on FDG and FAPI PET/CT images. Findings obtained from FAPI and FDG PET/CT were compared. RESULTS: More lesions were detected in 68 Ga-FAPI-04 PET/CT compared to 18 F-FDG PET/CT in primary tumor and lymph node metastases. Statistically significantly higher SUVmax and TBR values were found with FAPI PET/CT (primary lesion SUVmax and TBR, P  = 0.001 and P  < 0.001, respectively; lymph node SUVmax and TBR, P  = 0.016 and P  = 0.005, respectively). With FAPI PET/CT, upstage was observed according to tumor-node-metastasis staging in a total of seven patients including three patients with pleural origin, three patients with peritoneal origin and one patient with pericardial origin. CONCLUSION: In addition to the stage change with 68 Ga-FAPI-04 PET/CT in malignant mesothelioma patients, a statistically significant superiority was observed in SUVmax, TBR and volumetric parameters in primary tumors and metastases.

The prognostic role of whole-body volumetric 68 GA-DOTATATE PET/computed tomography parameters in patients with gastroenteropancreatic neuroendocrine tumor treated with 177 LU-DOTATATE.

OBJECTIVE: The aim of this study is to evaluate the prognostic role of Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and quantitative 68 Ga-DOTATATE PET/computed tomography parameters such as maximum standardized uptake value (SUVmax), mean SUV (SUVmean), DOTATATE tumor volume (DTV), total lesion DOTATATE (TLD) in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) treated with 177 Lu-DOTATATE. MATERIAL AND METHOD: Our retrospective study included 21 patients with GEP-NETs treated with 177 Lu-DOTATATE between January 2017 and January 2022. SUVmax, SUVmean, SUVmax/spleenSUVmax (SUVmax/Sx), DTV, TLD, SUVmean/spleenSUVmean (SUVmean/Sm), TLD/Sm values were calculated and recorded for all patients before and after 177 Lu-DOTATATE treatment. RESULTS: A total of 319 metastases were detected in the patients included in the study, and a total of 68 target lesions were selected. In univariant Cox regression analysis, TLD/Sm percent change (∆TLD/Sm) was found to be statistically significant on overall survival (OS) ( P  = 0.044). The 3-year survival in nonresponders was 50% ( P  = 0.034) based on ∆SUVmax/Sx values, 50% ( P  = 0.002) based on RECIST values, 50% based on ∆TDTV + new lesion values ( P  = 0.033), and according to ∆TTLD + new lesion values, it was 66% ( P  = 0.030). CONCLUSION: In our study, we showed that SUVmax/Sx, RECIST, ∆TDTV + new lesion, and ∆TTLD + new lesion parameters can predict OS in the evaluation of response to treatment.

Molecular identification of LAB and yeasts from traditional sourdoughs and their impacts on the sourdough bread quality characteristics.

In this research, the LAB and yeast isolations and identifications of homemade traditional sourdoughs were investigated. Both LAB and yeasts were identified by the PCR method and used in the production of sourdough bread (SDB). Twelve types of SDB were produced from combinations of isolated LAB and yeasts. Eleven LAB and yests were identified from 36 sourdoughs. The most frequently isolated LAB species were Lactobacillus brevis (45.0%), Pediococcus acidilactici (20.0%) and Lactobacillus plantarum (18.3%) while other LAB species were isolated by only 1.7-3.5%. On the other hand, 27.5% of the isolates were Saccharomyces cerevisiae, which was followed by Pichia kudriavzevii (25.0%) and Kluyveromyces marxianus (12.5%). The total titratable acidity and pH of the sourdough ranged from 3.10 to 34.45% and from 4.05 to 4.80 respectively. High acceptable loaf height (7.2 cm), moisture (30.05%), dry matter (69.95%), volume (1370 cm3), specific volume (4.35 cm3 g -1 ) and sensory value (62 scores) were determined for SDB12. Isolated LAB is mainly composed of heterofermentative species (75%). Among the bread produced with the combination of LAB and yeasts, the SDB12 was the most preferred SDB in terms of sensory analysis and other quality characteristics. The use of homofermentative and heterofermentative LAB and yeast combinations provided high-quality SDB. This would be due to the symbiotic growth of these microorganisms. The use of L. plantarum by L. brevis and by other species resulted in high-quality SDB.

Superiority of 18 F-FDG PET/CT to 68 GA-FAPI PET/CT in Adrenocortical Tumor Imaging.

ABSTRACT: 18 F-FDG PET/CT was performed to evaluate the response to treatment in a 62-year-old female patient who was operated for adrenocortical carcinoma. High FDG uptake was observed in recurrent lesion in the left adrenal gland site and metastatic lesions. In the 68 Ga-FAPI-04 PET/CT study, low FAPI uptake was observed in both recurrences and metastases. In this case, we demonstrated the superiority of 18 F-FDG PET/CT over 68 Ga-FAPI-04 PET/CT in the evaluation of adrenocortical carcinoma.

68 GA-FAPI-04 PET/CT Versus 18 F-FDG PET/CT in Imaging of Malignant Mixed Germ Cell Testicular Tumor.

ABSTRACT: 18 F-FDG PET/CT imaging was performed for restaging in in a 16-year-old boy who was operated on for right testicular tumor and was diagnosed with malignant mixed germ cell tumor. Mild FDG uptake was observed in 2 nodules in both lungs and retroperitoneal lymph node in the abdomen. 68 Ga-FAPI (fibroblast activation protein inhibitor) 04 PET/CT showed moderate uptake of FAPI in lung nodules and retroperitoneal lymph node. In this case, 68 Ga-FAPI-04 PET/CT was shown to be superior to 18 F-FDG PET/CT in the evaluation of malignant mixed germ cell testicular tumor metastases.

18 F-FDG PET/CT parameters for prediction of response to neoadjuvant therapy and prognosis in rectal cancer.

OBJECTIVE: This study aims to investigate the role of F-18 fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) parameters in the prediction of treatment response and the prognosis in locally advanced rectal cancer. METHODS: We investigated the relationship of 18F-FDG PET/CT parameters [rectal metabolic tumor volume (MTV), rectal total lesion glycolysis (TLG), rectal standard uptake value (SUV) max, rectal highest peak SUV, lymph node MTV, lymph node TLG, lymph node highest peak SUV] with the pathological response and disease-free survival (DFS) in 60 patients who received neoadjuvant therapy for a diagnosis of locally advanced rectal cancer. Patients with a total score of 0 were assigned to the low-risk group, patients with a score of 1 were assigned to the intermediate-risk group and patients with a score of 2 were assigned to the high-risk group. RESULTS: The multivariate analysis revealed that, from baseline PET CT parameters, lymph node highest peak SUV strongly predicted the pathological response at a cutoff value of 2.23. DFS was predicted by the lymph node highest peak SUV at a cutoff value of 3.13 and by the MTV value at a cutoff value of 27 cm 3 . The risk scoring performed with regard to rectal MTV and lymph node highest peak SUV values determined a median DFS of 19 months in patients with a risk score of 2, whereas the median DFS was not reached in patients with risk scores of 0 and 1 (P < 0.001). CONCLUSION: This study determined that rectal MTV and lymph node highest peak SUV predicted the response to neoadjuvant therapy and DFS.

Incidental Detection of a Type B3 Thymoma on 68Ga-FAPI-04 PET/CT Imaging.

ABSTRACT: 18F-FDG PET/CT performed for staging of colon cancer in a 60-year-old woman revealed a thymic neoplasm with increased radiopharmaceutical uptake in the anterior mediastinum. 68Ga-FAPI PET/CT showed low FAPI uptake in the anterior mediastinal mass. The patient was diagnosed with type B3 thymoma by histopathologic evaluation. In this case, thymoma demonstrated lower uptake with FAPI than FDG. Larger studies are required for the differentiation of malignant and benign mediastinal masses with FAPI.

The role of basal metabolic and volumetric 18F-FDG PET/CT parameters and their changes in predicting pathological complete response in breast cancer patients receiving neoadjuvant chemotherapy.

OBJECTIVE: The aim of this study is to investigate the roles of pre- and post- treatment quantitative fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) parameters including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) and their rate of change in predicting pathological complete response (pCR) in patients with local and locally advanced invasive breast cancer receiving neoadjuvant chemotherapy (NAC). SUBJECTS AND METHODS: Ninety-eight patients who received NAC after being diagnosed with local and locally advanced invasive breast cancer between January 2017 and September 2021 were retrospectively included in our study. Molecular subtypes of all patients were determined. Maximum SUV, MTV, TLG, percent change in SUVmax (ΔSUVmax), ΔMTV, and ΔTLG obtained from PET/CT scans performed before and after NAC were calculated. The cut-off, AUC, sensitivity, and specificity values of these parameters in predicting pCR were calculated using receiver operating characteristic (ROC) curves. RESULTS: ΔTMTV (cut-off 94.01%, AUC: 0.846), ΔTTLG (cut-off 97.36%, AUC: 0.870), B2MTV (cut-off<1.75, AUC: 0.764), B2TLG (cut-off<2.11, AUC: 0.764), B2SUVmax (cut-off<1.58, AUC: 0.767), ΔBMTV (cut-off 93.67%, AUC: 0.851), ΔBTLG (cut-off 97.22%, AUC: 0.870), ΔBSUVmax (cut-off 84.99%, AUC: 0.846) calculated using ROC curves were found to significantly predict pCR with high sensitivity and specificity. CONCLUSION: We concluded that metabolic and volumetric PET/CT parameters, the rates of their change, and metabolic response during NAC may be important variables in predicting pCR in patients with breast cancer.

Comparison of 18 F-FDG PET/CT and 68 Ga-FAPI-04 PET/CT in patients with non-small cell lung cancer.

AIM: In this study, we aimed to compare the diagnostic accuracy of 18 F-fluorodeoxyglucose ( 18 F-FDG) and Gallium-68 labeled fibroblast activator protein inhibitor ( 68 Ga-FAPI)-04 PET/CT in the tumor-node-metastasis (TNM) staging of patients with nonsmall cell lung cancer (NSCLC) and investigate whether adenocarcinoma (ADC) and squamous cell cancer (SCC) exhibit different uptake patterns on 68 Ga-FAPI-04 PET/CT. MATERIALS AND METHOD: Twenty-nine patients with a histopathologically-confirmed diagnosis of NSCLC, who had no history of previous radiation therapy or chemotherapy and underwent 18 F-FDG PET/CT and 68 Ga-FAPI-04 PET/CT imaging between January 2021 and December 2021 were included in this retrospective study. Staging was performed using the 8th edition of the TNM staging system on both 18 F-FDG PET/CT and 68 Ga-FAPI-04 PET/CT images. Standardized uptake value (SUV) max and tumor-to-background ratios (TBR) were calculated on primary lesions and metastases. RESULTS: There was no statistically significant difference in primary lesions in terms of SUV max and TBR values. However, 68 Ga-FAPI-04 PET/CT was significantly superior to 18 F-FDG PET/CT in terms of the number of lymph nodes and bone metastases revealed. The SUV max and TBR values of lymph nodes, hepatic lesions and bone lesions were significantly higher on 68 Ga-FAPI-04 PET/CT than on 18 F-FDG PET/CT. 68 Ga-FAPI-04 PET/CT changed the disease stage of three patients (10.9%). The diagnostic accuracy of 68 Ga-FAPI-04 PET/CT was 100%, whereas the diagnostic accuracy of 18 F-FDG PET/CT was 89.6% ( P = 0.250). CONCLUSION: Although 68 Ga-FAPI-04 PET/CT detected more lesions and higher diagnostic accuracy than 18 F-FDG PET/CT in NSCLC, neither method was statistically superior to each other in terms of diagnostic accuracy in TNM staging.

Comparison of [68 Ga]Ga-DOTA-FAPI-04 PET/CT and [18F]FDG PET/CT in colorectal cancer.

AIM: In this study, we aimed to evaluate the diagnostic sensitivity of [68 Ga]Ga-DOTA-FAPI-04 PET/CT in the evaluation of primary or recurrent tumor, and nodal, peritoneal, and distant organ metastases in patients with newly diagnosed or relapsed colorectal cancer (CRC) in comparison with [18F]FDG PET/CT. MATERIALS AND METHOD: Thirty-nine patients with histopathologically confirmed primary or relapsed CRC were included in our study. All patients underwent both [18F]FDG and [68 Ga]Ga-DOTA-FAPI-04 PET/CT imaging in the same week. Primary lesions, lymph nodes, and metastatic lesions were recorded on both scans. SUVmax and background values were measured from the primary and metastatic lesions; tumor-to-background ratio (TBR) was calculated and compared. The results of the operation were compared with PET findings in patients who underwent surgical treatment without neoadjuvant chemotherapy (NAC). RESULTS: The sensitivity and specificity of [68 Ga]Ga-DOTA-FAPI-04 PET/CT in the evaluation of primary tumors were 100%, while the sensitivity of [18F]FDG PET/CT was 100% and its specificity was 85.3%. When evaluated with surgical results in the detection of lymph nodes, [68 Ga]Ga-DOTA-FAPI-04 PET/CT had a sensitivity of 90% and a specificity of 100%, whereas [18F]FDG PET/CT had a sensitivity of 80% and a specificity of 81.8%. The sensitivity and specificity of [68 Ga]Ga-DOTA-FAPI PET/CT for peritoneal implants were 100%, and the sensitivity of [18F]FDG PET/CT was 55%. The SUVmax of primary lesions was higher with [18F]FDG (p < 0.001), while TBR was higher in [68 Ga]Ga-DOTA-FAPI PET/CT than [18F]FDG PET/CT (p: 0.008). SUVmax and TBR of the lymph nodes were significantly higher in [68 Ga]Ga-DOTA-FAPI PET/CT than [18F]FDG PET/CT (p < 0.001 for both). CONCLUSION: [68 Ga]Ga-DOTA-FAPI-04 PET/CT achieved much higher sensitivity and specificity in the detection of primary lesions, and especially the lymph nodes and peritoneal metastases, suggesting that it can be employed in the assessment of primary tumor and metastases in patients with CRC in routine clinical practice.

The relationship between CEA and CA 15-3 positivity and metabolic and volumetric 18F-FDG PET/CT parameters in preoperative evaluation of breast cancer.

OBJECTIVE: We aimed to examine the relationship between tumor marker (Cancer Antigen 15-3 [CA15-3] and Carcinoembryonic Antigen [CEA]) positivity and metabolic (standardized uptake value [SUV]) and volume-based (metabolic tumor volume [MTV] and total lesion glycolysis [TLG]) 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) parameters of the primary tumor and lymph node. MATERIAL AND METHODS: Our study group consisted of 91 female patients, who underwent PET/CT between January 2018 and December 2019 in our clinic with a diagnosis of breast cancer. These patients had no distant metastasis or supraclavicular and internal mammarian lymph node metastasis. MTV, TLG, and SUVmax values were obtained from the primary breast lesion and axillary lymph nodes. RESULTS: The mean age of the patients, who participated in the study, was 52,19±14,57, and the median values of the primary tumor MTV, TLG, and total MTV values were found to be statistically significantly higher in those who were CEA positive compared to those who were CEA negative. The median SUVmax value of the axillary lymph node was found to be statistically significantly higher in those who were CEA positive compared to those who were CEA negative (p: 0.004). There was no statistically significant difference between the other parameters. CONCLUSION: There was a statistically significant correlation between CEA positivity in preoperative primary breast cancer and primary tumor volume MTV, TLG, and total MTV values, which are volume-based PET parameters. CEA positivity evaluation may indicate increased tumor load in preoperative. KEY WORDS: Breast Cancer, CEA, CA 15-3, MTV, TLG, FDG PET/CT.

The prognostic role of baseline 18F-FDG PET/CT SUVmax and SUVmax change in patients with node-positive breast cancer receiving neoadjuvant chemotherapy.

OBJECTIVE: This study aimed to determine the prognostic role of baseline maximum standardized uptake value (SUVmax) obtained by pretreatment PET/CT and the change in SUVmax (ΔSUVmax [%]) in patients with axillary lymph node-positive breast cancer receiving neoadjuvant chemotherapy (NAC). METHODS: One hundred and eighty patients with baseline SUVmax and 121 patients with SUVmax measurement after treatment were evaluated in the study. The baseline SUVmax value of the breast (SUVmaxBI) and axilla (SUVmaxAI) and the change in the SUVmax of the breast (ΔSUVmaxB) and axilla (ΔSUVmaxA) were measured. The optimal cut-off value of SUVmax and ΔSUVmax were determined by ROC curve analysis. Disease-free survival (DFS) and overall survival (OS) were calculated using Kaplan-Meier curves. RESULTS: ΔSUVmaxB, pCRB, pCRA, and pCR parameters were found to be associated with relapse (P < .001, P = .033, P = .016, and P = .013, respectively). ΔSUVmaxB and SUVmaxAI were associated with mortality (P = .001 and P = .006, respectively). Multiple Cox regression analyses revealed that ΔSUVmaxB value was an independent prognostic factor for relapse and mortality (P = .013 and P = .010, respectively). CONCLUSION: The results showed that ΔSUVmaxB was an independent prognostic factor for relapse and mortality in patients with axillary lymph node-positive breast cancer who received NAC.

Comparison of 18F-FDG PET/CT and 68Ga-FAPI-04 PET/CT in the staging and restaging of gastric adenocarcinoma.

OBJECTIVE: In this study, we aimed to evaluate the diagnostic sensitivities of 68Ga-FAPI-04 PET/CT and 18F-FDG PET/CT in the primary tumor, and nodal, peritoneal and distant organ metastases of primary and recurrent gastric adenocarcinoma (GAc) with patient and lesion-based comparison. MATERIALS AND METHOD: Twenty-one patients with histopathologically proven newly diagnosed or recurrent GAc who underwent 18F-FDG and 68Ga-FAPI-04 imaging were included in the study. Both imaging techniques were evaluated visually according to the intensity of organ-based uptake. SUVmax and tumor-to-background ratio (TBR) values obtained from primary tumor/relapse and metastatic organs were compared statistically. RESULTS: 68Ga-FAPI-04 uptake was positive in all 15 newly diagnosed patients, while two patients among them who had mucinous and signet ring cell carcinoma did not exhibit 18F-FDG uptake. The sensitivity and specificity of 68Ga-FAPI-04 PET/CT in detecting primary gastric were 100%, while the sensitivity and specificity of 18F-FDG were 86.6 and 100%, respectively. 68Ga-FAPI-04 imaging revealed diffuse stomach uptake in seven patients, while 18F-FDG could only show two of them. The sensitivity and specificity of in-patient-based detection of lymph node metastases were 100 and 95.2%, respectively, while these values were 71.4 and 93.7%, respectively, for 18F-FDG. For peritoneal involvement 68Ga-FAPI-04 had a sensitivity and specificity of 100%, whereas 18F-FDG had a sensitivity of 40% and a specificity of 100%. CONCLUSION: 68Ga-FAPI-04 PET/CT is an imaging modality with the potential of yielding more sensitive and specific findings 18F-FDG PET/CT. This modality may help avoid invasive diagnostic procedures that may be frequently required in GAc.