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Öğe 99mTc-MIBI SPET in non-small cell lung cancer in relationship with Pgp and prognosis(Springer, 2002) Yüksel, M; Çermik, TF; Doganay, L; Karlikaya, C; Çakir, E; Salan, A; Berkarda, SHigher technetium-99m methoxyisobutylisonitrile (MIBI) uptake in non-small cell lung cancer (NSCLC) has been reported to be associated with a positive response to chemotherapy. It has previously been found that in tumour cells, P-glycoprotein (Pgp) expression is of importance for tracer uptake. However, some studies have indicated that Pgp expression does not play an important role in Tc-99m-MIBI uptake in NSCLC; indeed, a negative correlation between 99mTc-MIBI uptake and Pgp expression has been reported. Against the background of conflicting results, our aim was to evaluate the relationship between Tc-99m-MIBI uptake, prognosis and Pgp expression in NSCLC. A total of 37 patients with NSCLC underwent Tc-99m-MIBI single-photon emission tomography (SPET) before chemotherapy. In 19 patients both Pgp and p53 expression, and in two patients only p53 expression (due to the limited biopsy material), were measured with immunohistochemical staining. Tc-99m-MIBI uptake was significantly higher in responders than in non-responders: 3.09+/-1.14 vs 2.24+/-0.88 (P<0.03) and 3.09+/-1.08 vs 2.37+/-1.06 (P<0.05) for the early ratio (ER) and the delayed ratio (DR), respectively. The wash-out rate (WR) of responders was not significantly different from that of non-responders. We found no significant differences in ER, DR and WR among the groups positive or negative for Pgp and p53 status. There was a significant positive correlation between the survival rate and both ER and DR: r=0.49 (P=0.003) and r=0.40 (P=0.018), respectively. Patients with ER and DR values above 3 showed significantly longer survival than those with values below 3: 14.7+/-8.5 months vs 7.3+/-5.1 months (P<0.009) and 13.2+/-8.4 months vs 7.4+/-5.3 months (P<0.04) for ER and DR, respectively. However, interestingly, and in contrast to expectations, patients with a Pgp score of +2 showed significantly longer survival (12.9+/-6.7 months) than those with Pgp scores of +1 (4.4+/-3.0 months) or - (negative) (3.8+/-2.2 months) (P<0.009 and P<0.02, respectively). Our results suggest that in NSCLC, patients with higher Tc-99m-MIBI uptake tend to show a positive response to chemotherapy, and patients with ER and DR values above 3 have a significantly better prognosis. We also found that Pgp expression seems to play only a minor role in Tc-99m-MIBI uptake. Our finding that patients with ER and DR values above 3 have a better prognosis needs to be confirmed in larger series of patient.Öğe Findings of pulmonary involvement on HRCT in turkish rheumatoid arthritis patients and contributory factors(Bmj Publishing Group, 2005) Koker, IH; Pamuk, ÖN; Tuncbilek, N; Karlikaya, C; Çakir, N[Abstract Not Available]Öğe Monitoring the chemotherapeutic response in primary lung cancer using 99mTc-MIBI SPET(Springer-Verlag, 2001) Yüksel, M; Çermik, TF; Karlikaya, C; Salan, A; Çakir, E; Gültekin, A; Berkarda, FPrediction and evaluation of the response to chemotherapy (CTx) are important for the correct and cost-effective treatment of patients with primary lung cancer. Although fluorine-18 fluorodeoxyglucose. positron emission tomography (FDG-PET) is accepted as the most useful and accurate nuclear medicine technique for this purpose, its expense and limited availability restrict its use. Compared with PET agents, technetium-99m methoxyisobutylisonitrile (MIBI), which is used in nuclear oncology, is cheaper and available in any nuclear medicine clinic. With this in mind, in this study we aimed to evaluate the role of Te-99m-MIBI in monitoring the chemotherapeutic response in primary lung cancer. Twenty patients with primary lung cancer underwent Tc-99m-MIBI single-photon emission tomography (SPET) at 15 min (early) and 3-4 h (delayed) after injection of the tracer. All patients underwent 99mTc-MIBI SPET study twice: before and after the 3rd cycle of CTx. Patients were divided into two groups, responders [R(+), n=10] and nonresponders [R(-), n=10], according to the change in tumour size on CT scan taken 2 weeks after the last cycle of the CTx. From the SPET images early and delayed tumour/lung ratios (ER and DR) were obtained before and after CTx. In the R(+) group, ER and DR decreased significantly after CTx, from 3.28 +/-1.55 to 1.78 +/-0.72 (P <0.04) and from 3.23 +/-1.55 to 2.0 +/-0.88 (P <0.05), respectively. However, in the R(-) group, while ER showed a slight and statistically insignificant increase after CTx (from 2.51 +/-1.23 to 2.65 +/-1.86), DR increased significantly, from 2.74 +/-1.37 to 3.27 +/-2.31 (P <0.03). The percentage decreases in ER and DR in the R(+) group after CTx was significantly higher than that in the R(-) group: 34.36%+/- 26.7% vs -13.78%+/- 27.58% (P <0.0002) and 29.45%+/- 25.23% vs -18.58%+/- 20.51% (P <0.0005), respectively. Using a decrease of greater than or equal to 10% as a threshold for monitoring the chemotherapeutic response, Te-99m-MIBI had a sensitivity of 90% and a specificity of 100%. We found a positive correlation in 14 patients between ER and DR and survival: r=0.6754 and P=0.008, and r=0.5755 and P=0.031, respectively. Our results suggest that Te-99m-MIBI might be used in routine practice to monitor the chemotherapeutic response in patients with primary lung cancer, especially when PET is not available.Öğe The relationship between Tc-99m MIBI uptake and chemotherapeutic response, metastasis, Pgp, p53, and prognosis in lung cancer(Springer-Verlag, 2001) Yüksel, M; Çermik, TF; Doganay, L; Karlikaya, C; Salan, A; Çakir, E; Ture, M[Abstract Not Available]Öğe Thallium-201 SPECT in advanced non-small cell lung cancer(Japanese Society Nuclear Medicine, 2003) Çermik, TF; Yüksel, M; Karlikaya, C; Doganay, L; Türe, M; Berkarda, SPurpose: The aim of this study was to evaluate the relationship between Tl-201 tumor uptake, chemotherapeutic response, metastasis, p53 status and survival in non-small cell lung cancer (NSCLC). Methods: A total of 23 patients underwent Tl-201 SPECT. In 9 patients, 2nd Tl-201 SPECT study were performed 1 week after the 3rd cycle of chemotherapy (ChT), and early (ER) and delayed (DR) tumor/normal lung ratios and retention indices (RI) were obtained. In 15 patients p53 status was assayed with immuno-histochemical staining. The patients were divided into subgroups after the 3rd cycle of ChT; responders [R(+) (n = 10)] and non-responders [R(-) (n = 13)], distant metastasis [(M-1) n =11] and [(M-0) n = 12], and mutant p53 status [p(+) n = 7, p53(-) n = 8]. Results: The differences for ER, DR and RI values between all of the subgroups were not statistically significant. ER and DR of responders decreased significantly after ChT; from to 2.46 to 1.36 (p = 0.04) and 2.29 to 1.53 (p = 0.04), respectively. In the non-responder group, both ER and DR slightly increased after ChT (p > 0.05). Conclusion: Our results suggest that in NSCLC, there was a weak correlation between higher Tl-201 ratios and positive response to chemotherapy, absence of distant metastasis, and p53(-) status. Significant Tl-201 uptake decrease after chemotherapy indicates that delayed Tl-201 uptake can be used in evaluating the chemotherapeutic response.Öğe Tl-201 uptake and its relationship with chemotherapeutic response, metastasis, p53 status, and survival in primary lung cancer(Springer-Verlag, 2001) Çermik, TF; Yüksel, M; Karlikaya, C; Doganay, L; Çakir, E; Salan, A; Ture, M[Abstract Not Available]Öğe
