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Öğe Comparison of pinhole/high resolution parallel hole and early/late Tc99m-MIBI images in parathyroid imaging(Springer-Verlag, 2001) Yararbas, U; Erinc, R; Karapolat, I; Kumanlioglu, KÖğe Correlation of Tc-99m-sestamibi uptake with blood-pool and osseous phase Tc-99m-MDP uptake in malignant bone and soft tissue tumors(Springer Verlag, 1999) Ozcan, Z; Burak, Z; Erinc, R; Dirlik, A; Basdemir, G; Sabah, D; Ozkilic, HÖğe Correlation of Tc-99m-sestamibi uptake with blood-pool and osseous phase Tc-99m-MDP uptake in malignant bone and soft-tissue tumours(Lippincott Williams & Wilkins, 2001) Ozcan, Z; Burak, Z; Erinc, R; Dirlik, A; Basdemir, G; Sabah, D; Ozkilic, HTechnetium-99m-sestamibi (Tc-99m-MIBI) imaging is a well-established modality in oncologic investigations. The current study aimed to investigate whether any relationship could be found between Tc-99m-MIBI uptake and local perfusion in malignant bone and soft-tissue tumours. It also aimed to compare Tc-99m-MIBI images with those of technetium-99m-methylene diphosphonate (Tc-99m-MDP) bone scintigraphy with regard to the activity distribution pattern, intensity and lesion extension. The study group included 24 patients with various bone and soft-tissue tumours. Three-phase bone scintigraphy and Tc-99m-MIBI studies were performed within the same week before any surgical and therapeutic intervention. Images were evaluated visually and quantitatively using regions of interest (ROIs) over the lesion and adjacent normal tissue. The Tc-99m-MIBI study was positive with varying degrees of uptake (range, 1.4-5.3). The mean Tc-99m-MIBI uptake and Tc-99m-MDP blood-pool and osseous phase activity ratios were 2.5 +/- 0.5, 2.8 +/- 1.0 and 5.5 +/- 4.0, respectively. The correlation between the Tc-99m-MIBI uptake and blood-pool ratios was 0.70 (P<0.05). While activity distribution patterns were in agreement in Tc-99m-MIBI and blood-pool images in the majority of cases, Tc-99m-MIBI better delineated tumour viability and extension in five cases. In conclusion, Tc-99m-MIBI accumulation shows a reasonable correlation with blood-pool uptake assuming the presence of multifactorial mechanisms in addition to local hyperaemia. Better delineation of tumour outlines and cellular activity seems to be an advantage of Tc-99m-MIBI scintigraphy which may be helpful in the evaluation of musculoskeletal tumours. ((C) 2001 Lippincott Williams & Wilkins).Öğe The effect of surgical dissection method in callus formation: Experimental study in rabbits.(Springer, 1999) Bilkay, U; Bilkay, U; Erinc, R; Celik, N; Songur, E; Kumanlioglu, KÖğe The role of Tc-99m MIBI imaging in the assessment of drug resistance in musculo-skeletal tumors.(Springer Verlag, 1999) Burak, Z; Erinc, R; Ozcan, Z; Ersoy, O; Basdemir, G; Dirlik, A; Sabah, D; Moretti, JLÖğe The role of Tc-99m sestamibi imaging in predicting clinical response to chemotherapy in lung cancer(Japanese Society Nuclear Medicine, 2002) Dirlik, A; Burak, Z; Goksel, T; Erinc, R; Karakus, H; Ozcan, Z; Veral, A; Ozhan, MMultidrug resistance (MDR) is a major problem in lung cancer. Tc-99m methoxyisobutyl isonitrile (MIBI) has been demonstrated to be a non-invasive marker to diagnose MDR1 related P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP) expression in various solid tumors. The aim of this study was to evaluate the relationship between the degree of Tc-99m MIBI uptake and its retention on delayed images and the response to chemotherapy in lung cancer. Twenty-three patients (I woman and 22 men, age range 40-67 years) with lung cancer (9 small cell and 14 non-small cell) were examined with Tc-99m MIBI imaging before chemotherapy. After i.v. administration of 740 MBq Tc-99m MIBI, planar and SPECT imaging at 30 minutes and 2 hours was performed. Tumor to normal lung uptake ratio (T/N) and percent retention were measured, Response to chemotherapy was evaluated according to follow-up CT and grouped as complete responders (CR), partial responders (PR) and non-responders (NR). Clinical follow-up and CT evaluation revealed that 12 patients had partial remission, 4 patients had complete remission and 7 patients had no-remission after chemotherapy. Statistically, there was no significant correlation between early (30 min), delayed (2 hr) T/N ratios and percent retention of Tc-99m MIBI with chemotherapeutic response of the lung cancer among the three groups (p > 0.05). Results of the cur-rent study imply that Tc-99m MIBI uptake and the retention index may not correlate with chemotherapy response in lung cancer, so that the accuracy of this method needs to be verified in a larger series with additional investigation at the molecular level.Öğe The role of Tc-99m-MIBI scintigraphy in the assessment of MDR1 overexpression in patients with musculoskeletal sarcomas: comparison with therapy response(Springer-Verlag, 2001) Burak, Z; Ersoy, O; Moretti, JL; Erinc, R; Ozcan, Z; Dirlik, A; Sabah, D; Basdemir, GThe occurrence of multidrug resistance (MDR), which is in part due to the overexpression of P-glycoprotein (Pgp), is a major problem in neoadjuvant therapy of malignant musculoskeletal tumours. The aim of this study was to investigate the role of technetium-99m hexakis-2-methoxyisobutylisonitrile (Tc-99m-MIBI) scintigraphy for functional imaging of the MDR1 phenotype in patients with musculoskeletal sarcomas. We aimed to compare Tc-99m-MIBI uptake and washout kinetics with the expression of Pgp and with chemotherapy response. Twenty-five patients (16 males and 9 females, aged between 8 and 65 years) with malignant musculoskeletal tumours were studied. After injection of 555-740 MBq Tc-99m-MIBI, dynamic flow images of the involved area were obtained for 3 min, and planar images were acquired at 10 min and I h. From the dynamic images, a tumour perfusion index (TPI) was obtained using Patlak-Rutland analysis. Tumour to background (T/B) ratios of both early and delayed images and percent wash-out rate (WR%) of Tc-99m-MIBI were calculated. Immunohistochemical analysis of Pgp was performed on biopsy specimens and the degree of expression was graded according to a semiquantitative scoring system, from 0 to 6. After neoadjuvant therapy, tumour response was assessed by examining the ratio of viable cells and by detecting percent necrosis. Scintigraphic results were compared with Pgp status and therapy response. Irrespective of the Pgp status, all patients showed significant perfusion and Tc-99m-MIBI uptake in early images. There was not a significant correlation between T/B ratios of early and delayed images and Pgp expression. We observed a positive correlation between WR% and Pgp status (r=0.61, P <0.01), and the wash-out rate of Tc-99m-MIBI was significantly higher in patients with high Pgp expression than in those with a low Pgp score (33%+/-9% vs 17%+/-9%). Therapy response was determined in 21 of 25 patients, and in only 5 of 21 cases was the percent necrosis more than 90%. Neither Pgp expression rate nor WR% was found to show a significant correlation with percent necrosis in the bulk tumour specimens. In conclusion, the initial uptake of Tc-99m-MIBI in bone and soft tissue sarcomas did not correlate with Pgp expression. A relationship was found between the wash-out rate of Tc-99m-MIBI and the Pgp score, with a significant difference in WR% being observed between patients with high and patients with low Pgp expression.Öğe The role of Tc99m sestamibi imaging in predicting clinical response to chemotherapy in lung cancer(Springer Verlag, 1999) Dirlik, A; Erinc, R; Goksel, T; Argon, M; Karakus, H; Ozhan, M; Burak, ZÖğe Scintigraphy in the detection of gastrooesophageal reflux in children with caustic oesophageal burns: a comparative study with radiography and 24-h pH monitoring(Springer-Verlag, 2001) Ozcan, Z; Ozcan, C; Erinc, R; Dirlik, AE; Mutaf, OBackground. Caustic injury of the oesophagus not only causes luminal narrowing but is also responsible for longitudinal contraction, resulting in gastro-oesophageal reflux (GOR), which leads to failure of conventional therapy. Therefore, the development of GOR should be investigated periodically to direct appropriate management of these patients. Purpose. To determine the ability of scintigraphy to detect GOR in children with caustic oesophageal strictures in comparison with barium study and 24-h pH monitoring. Materials and methods. Seventeen children with caustic oesophageal injury underwent scintigraphy, an upper GI barium study and 24-h pH monitoring within the same week. Five patients were also investigated post-operatively for the assessment of surgical outcome after antireflux surgery. Results. On the whole, there was good correlation (r = 0.78, P < 0.001) between scintigraphy and 24-h oesophageal pH monitoring. Scintigraphy detected all but one (9/10) refluxing patients and also correctly identified all (7/7) non-refluxing patients. Barium studies demonstrated 6 out of 10 refluxing patients. There were no false-positive barium studies in non-refluxing patients. Post-operative studies demonstrated no evidence of GOR in surgically treated patients. Conclusions. Our results indicate that, by comparison with barium studies, scintigraphy is useful in the detection of GOR in cases with caustic oesophageal strictures and may be used as a screening modality for those under clinical follow-up.Öğe Technetium-99m-DTPA aerosol scintigraphy in amiodarone induced pulmonary toxicity in comparison with Ga-67 scintigraphy(Japanese Society Nuclear Medicine, 2002) Dirlik, A; Erinc, R; Ozcan, Z; Atasever, A; Bacakoglu, F; Nalbantgil, S; Ozhan, M; Burak, ZAmiodarone hydrochloride, which is used in life-threatening cardiac tachyarrhythmia, has been known to cause amiodarone induced pulmonary toxicity (AIPT) as a complication. In this study we aimed to investigate the clinical value of technetium-99m diethylene triamine penta-acetic acid (DTPA) aerosol lung scintigraphy in patients with AIPT in comparison with gallium-67 (Ga-67) scan. The study group included 26 cases, 7 patients with diagnosis of AIPT (Group A), 8 patients receiving amiodarone therapy but without AIPT (Group B) and I I healthy subjects as a control group (Group Q. All patients underwent Ga-67 and Tc-99m-DTPA aerosol scintigraphy in addition to various laboratory tests, Ga-67 scintigraphy was positive in 4 of 7 AIPT patients but quite normal in Group B. A positive correlation was found (r = 0.52, p < 0.05) between kep values determined by Tc-99m-DTPA aerosol scintigraphy and the cumulative dose of amiodarone. The mean kep values were 2.04% +/- 0.85%/min, 1.30% +/- 0.42%/min and 0.86% +/- 0.19%/min for groups A, B and C, respectively. ne mean clearance rate of group A was significantly faster than that of normals (p < 0.0005) and group B (p = 0.028). In addition, there was a significant difference between groups B and C (p = 0.015). In conclusion, Ga-67 lung scintigraphy is a useful method for the detection of AIPT but Tc-99m-DTPA aerosol scintigraphy offers better results than Ga-67 scintigraphy. Early changes in Tc-99m-DTPA clearance may be observed in patients receiving amiodarone. The kep value in patients with AIPT is noticeably increased with respect to the control group. With its favorable physical properties, low cost, lower radiation burden and its ability to be used as an objective measure for the pulmonary clearance rate, Tc-99m-DTPA aerosol scintigraphy appears to be promising in patients receiving amiodarone therapy.
