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    A New Perspective on the Effectiveness of FDG PET/CT in Predicting KRAS Mutation in Colon Cancer Cases
    (Mary Ann Liebert, Inc, 2024) Tamer, Fatih; Yararbas, Ulkem
    Aim: The main aim of this study was to evaluate the effectiveness of 18F-fluorodeoxyglucose (18FDG) positron emission tomography/computerized tomography (PET/CT) parameters in predicting the Kristen rat sarcoma viral oncogene(KRAS) mutation status of patients with colon cancer.Materials and Methods: Between April 2013 and December 2020, 79 patients who were diagnosed with colon cancer by colonoscopy underwent staging 18FDG PET/CT with this diagnosis and met all the inclusion criteria were included in this study. Clinical and prognostic features and also imaging (18FDG PET/CT and magnetic resonance imaging) reports of the patients were collected and analyzed retrospectively.Results: KRAS mutation was seen in 32 of patients (40.5%). No significant difference was observed between KRAS mutant and wild-type patients in terms of clinical features (tumor location, findings regarding metastasis, T stage, and tumor differentiation grade in patients who underwent surgery) and overall survival. Progression-free survival was significantly shorter in KRAS mutant patients (p = 0.018). Primary tumor standardized uptake value (SUVmean) was significantly higher in KRAS mutant cases in the whole group (p = 0.024) and in patients in whom KRAS analysis was performed only in the primary lesion (p = 0.036). The cutoff value for predicting KRAS mutation status was 7.01 g/mL (area under the curve [AUC]: 0.650, confidence interval [CI] 95%, 0.56-0.74).Conclusions: When colon and rectal cancer cases were evaluated separately, the primary tumor SUVmean value was significantly higher in KRAS mutant colon cancer cases. However, its effectiveness in predicting KRAS mutation status was low, similar to other parameters in the literature.
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    Alterations in 18F-FDG Uptake Patterns may Limit Cross-sectional Evaluation of Adrenal Adenomas Using Single 18F-FDG PET/CT Imaging
    (Galenos Publ House, 2023) Tamer, Fatih; Yararbas, Ulkem
    Adrenal adenomas are observed in up to 7% of the population and are predominantly non-functional, increased 18F-fluorodeoxyglucose (FDG) uptake is seen in only a small portion of them on F-18-FDG positron emission tomography/computed tomography (PET/CT) imaging. In this report, we present the sequential(18)F-FDG PET/CT imaging findings of 2 patients with radiologically or pathologically confirmed adrenal adenomas who had severely altered F-18-FDG uptake patterns in adrenal lesions in different imaging studies of the same patient. In light of these findings, we wanted to highlight that evaluating adrenal adenomas as cross-sectional with semi-quantitative PET/CT parameters obtained from single imaging may cause misinterpretation.