1.The efficacy of 18F-FDG PET/CT in the preoperative evaluation of pancreatic lesions
Atilgan Tolga AKCAM ; Zafer TEKE ; Ahmet Gokhan SARITAS ; Abdullah ULKU ; Isa Burak GUNEY ; Ahmet RENCUZOGULLARI
Annals of Surgical Treatment and Research 2020;98(4):184-189
Purpose:
Since the treatment strategy for benign and malignant pancreatic lesions differ, we aimed to evaluate the clinical value of PET/CT in the diagnosis and management of pancreatic lesions.
Methods:
Ninety patients who had a histologically confirmed pancreatic lesion were studied. Receiver operating characteristic (ROC) curve analysis was used to investigate the ability of PET/CT to differentiate malignant lesions from benign tumors.
Results:
The malignant and benign groups comprised 64 and 26 patients, respectively. Despite the similarity in the size of primary tumors (P = 0.588), the mean maximum standardized uptake values (SUVmax) obtained from PET/CT imaging were significantly higher in malignant lesions (9.36 ± 5.9) than those of benign tumors (1.04 ± 2.6, P < 0.001). ROC analysis showed that the optimal SUVmax cutoff value for differentiating malignant lesions (to an accuracy of 91%; 95% confidence interval, 83%–98%) from benign tumors was 3.9 (sensitivity, 92.2%; specificity, 84.6%).
Conclusion
PET/CT evaluation of pancreatic lesions confers advantages including fine assessment of malignant potential with high sensitivity and accuracy using a threshold SUVmax value of 3.9.
2.Xanthogranulomatous cholecystitis: a rare gallbladder pathology from a single-center perspective
Ahmet Gokhan SARITAS ; Mehmet Onur GUL ; Zafer TEKE ; Abdullah ULKU ; Ahmet RENCUZOGULLARI ; Ishak AYDIN ; Atilgan Tolga AKCAM
Annals of Surgical Treatment and Research 2020;99(4):230-237
Purpose:
The aim of this study was to review patients with xanthogranulomatous cholecystitis (XGC).
Methods:
A total of 79 patients diagnosed with XGC were included in the study. The criteria for XGC in the pathology specimens were the presence of histiocytes, cholesterol deposits, lipids, and focal or widespread wall enlargement.
Results:
Patients were diagnosed with XGC, of which 52 (65.8%) were male and 27 (34.2%) were female, creating a male-to-female ratio of 2:1. The mean age was 65.8 ± 14.3 years (range, 36–97 years). The most common presenting symptom was abdominal pain (63.3%), and the least common presenting symptom was jaundice (8.9%). Of the total, 25 patients were found to have pathological conditions with the potential to obstruct the bile duct or to slow bile flow.A frozen section examination was performed on 20 patients due to suspicion of a tumor by intraoperative macroscopic examination. However, no malignancy was detected in the cases who underwent a frozen section examination. An increase in wall thickness of the gallbladder was observed in 81.6% (n = 31) of the patients on computed tomography scans and in 81.8% (n = 18) of the patients on magnetic resonance imaging scans in which possible tumor lesions were reported, but no tumor was detected.
Conclusion
It is difficult to diagnose XGC either preoperatively or intraoperatively, and further imaging methods are needed in the preoperative period other than ultrasonography. However, a definitive diagnosis depends exclusively on pathologic examination.