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Article: Theranostic Risk Stratification for Thyroid Cancer in the Genomic Paradigm.

Gulec, Seza A / Meneses, Evander

2024 Volume 16, Issue 8

Abstract: Theranostics define diagnostic evaluations directing patient-specific therapeutic decisions. Molecular theranostics involves genomic, transcriptomic, proteomic, metabolomic and finally phenonic definitions thyroid cancer differentiation. It is the ... ...

Abstract	Theranostics define diagnostic evaluations directing patient-specific therapeutic decisions. Molecular theranostics involves genomic, transcriptomic, proteomic, metabolomic and finally phenonic definitions thyroid cancer differentiation. It is the functional differentiation that determines the sensitivity and accuracy of RAI imaging as well as the effectiveness of RAI treatment. Total thyroidectomy is performed to empower an anticipated RAI treatment. A preoperative determination of the genomic and transcriptomic profile of the tumor is a strong predictor of response to therapeutic interventions. This article discusses the oncopathophysiologic basis of the theranostic risk stratification approach.
Language	English
Publishing date	2024-04-20
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16081585
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Article ; Online: Birth of the Beta-knife Thyroidectomy: The Radiance of Saul Hertz.

Ehrhardt, John D / Gulec, Seza A

The American surgeon

2022 Volume 89, Issue 5, Page(s) 2145–2149

Abstract: This is the story of how one man's life's work allowed for Iodine-131 (I-131) to become a therapy for hyperthyroidism and thyroid cancer. What is now a standard in our times arose from Saul Hertz's rather challenging and humble beginnings. Thyroid ... ...

Abstract	This is the story of how one man's life's work allowed for Iodine-131 (I-131) to become a therapy for hyperthyroidism and thyroid cancer. What is now a standard in our times arose from Saul Hertz's rather challenging and humble beginnings. Thyroid lobectomy and total thyroidectomy were therapeutic mainstays for thyroid disease until Hertz treated his first patient with radioactive iodine (RAI) ablation therapy at Massachusetts General Hospital (MGH) on March 31, 1941. His concepts for using beta particle emission from RAI to ablate thyroid tissue were revolutionary. Hertz's RAI therapy translated to research with thyroid cancer by the mid-1940s. The high-energy beta particles produced cytolethal effects on remnant thyroid tissue left behind by total thyroidectomy, thereby accomplishing completion thyroidectomy in some patients. Progressive surgeons from the Hertz era incorporated RAI into their practice. MGH surgery resident Francis Moore took sabbatical from clinical training to do translational research with RAI and other radioisotopes. Irving Ariel of New York became known as a nuclear surgeon in the wake of Hertz's work. George Crile Jr of Cleveland became an RAI advocate for the surgical community, implementing several paradigm-changing concepts in thyroid disease along the way. Hertz was a visionary who sparked this movement, predicting many of the molecular dilemmas with RAI-tumor avidity that clinical researchers continue to navigate today. This timely history for surgical oncologists and endocrine surgeons traces the development of RAI therapy through the life of Saul Hertz, a biographical window influenced by social stigma, political controversy, and mainstream media.
MeSH term(s)	Male ; Humans ; Thyroidectomy ; Thyroid Neoplasms/radiotherapy ; Thyroid Neoplasms/surgery ; Thyroid Neoplasms/pathology ; Iodine Radioisotopes/therapeutic use
Chemical Substances	Iodine-131 ; Iodine Radioisotopes
Language	English
Publishing date	2022-01-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348211060463
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Article ; Online: Thyroidectomy without Radioiodine in Low-Risk Thyroid Cancer.

Gulec, Seza A / McGoron, Anthony J

The New England journal of medicine

2022 Volume 386, Issue 22, Page(s) 2154–2155

MeSH term(s)	Carcinoma, Papillary/surgery ; Humans ; Iodine Radioisotopes/therapeutic use ; Risk ; Thyroid Neoplasms/radiotherapy ; Thyroid Neoplasms/surgery ; Thyroidectomy
Chemical Substances	Iodine Radioisotopes
Language	English
Publishing date	2022-06-02
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc2204553
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Article ; Online: Radiomicrosphere Dosimetry: Principles and Current State of the Art.

Gulec, Seza A / McGoron, Anthony J

Seminars in nuclear medicine

2022 Volume 52, Issue 2, Page(s) 215–228

Abstract: Radiomicrosphere Therapy (RMT) refers to a liver-directed therapeutic modality based on the intrahepatic arterial administration of radiolabeled microspheres. There is a need for standardization of the terminology of RMT. A descriptive identifier should ... ...

Abstract	Radiomicrosphere Therapy (RMT) refers to a liver-directed therapeutic modality based on the intrahepatic arterial administration of radiolabeled microspheres. There is a need for standardization of the terminology of RMT. A descriptive identifier should first name the radioisotope, then the chemical formulation of the microsphere, and lastly add the term RMT that indicates the therapeutic modality. At present, clinically available options include \|Y-90\| \|Resin\| \|RMT\|, \|Y-90\| \|Glass\| \|RMT\| and \|Ho-166\| \|PLLA\| \|RMT\|. The latter is available in Europe and is being considered for clearance by the FDA in the United States. Preclinical studies with \|Re-188\| \|PLLA\| \|RMT\| are underway. Dosimetric considerations are strongly tied to both the type of the radioisotope and the chemical composition of the microsphere type. This review will focus on Y-90 resin and glass RMT, the history, dosimetry, clinical use, and controversies.
MeSH term(s)	Embolization, Therapeutic ; Humans ; Liver Neoplasms/drug therapy ; Microspheres ; Radioisotopes ; Radiometry ; Rhenium ; Yttrium Radioisotopes/therapeutic use
Chemical Substances	Radioisotopes ; Yttrium Radioisotopes ; Yttrium-90 (1K8M7UR6O1) ; Rhenium-188 (229C124H5I) ; Rhenium (7440-15-5)
Language	English
Publishing date	2022-02-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	120248-0
ISSN	1558-4623 ; 0001-2998
ISSN (online)	1558-4623
ISSN	0001-2998
DOI	10.1053/j.semnuclmed.2021.12.009
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Article ; Online: Y-90 Radiomicrosphere Therapy for Colorectal Cancer Liver Metastases.

Gulec, Seza A

Seminars in nuclear medicine

2016 Volume 46, Issue 2, Page(s) 126–134

Abstract: At present, the systemic treatment of unresectable colorectal cancer liver metastases involves oxaliplatin and irinotecan-based chemotherapy regimens combined with targeted therapies such as bevacizumab (Avastin) and cetuximab (Erbitux). Radiation ... ...

Abstract	At present, the systemic treatment of unresectable colorectal cancer liver metastases involves oxaliplatin and irinotecan-based chemotherapy regimens combined with targeted therapies such as bevacizumab (Avastin) and cetuximab (Erbitux). Radiation therapy, traditionally, is not considered a viable treatment modality owing to its unacceptably high hepatic toxicity, and still steering traditional wisdom or dogma that chemoradiation cannot be an oncological strategy for a stage IV disease. Selective internal radiation treatment with yttrium-90 (Y-90) radiomicrospheres has emerged as an effective liver-directed therapy with a favorable therapeutic ratio. Since its early clinical trials, it has demonstrated improved response rates when used in conjunction with systemic or regional chemotherapy. This article reviews the clinical role for Y-90 radiomicrosphere therapy in the contemporary management of colorectal cancer liver metastases. All the structured clinical trials, to date, are summarized, including those that studied the value of combined Y-90 radiomicrosphere therapy and current chemotherapy protocols.
MeSH term(s)	Animals ; Colorectal Neoplasms/pathology ; Humans ; Liver Neoplasms/diagnosis ; Liver Neoplasms/physiopathology ; Liver Neoplasms/radiotherapy ; Liver Neoplasms/secondary ; Microspheres ; Yttrium Radioisotopes/chemistry ; Yttrium Radioisotopes/therapeutic use
Chemical Substances	Yttrium Radioisotopes
Language	English
Publishing date	2016-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	120248-0
ISSN	1558-4623 ; 0001-2998
ISSN (online)	1558-4623
ISSN	0001-2998
DOI	10.1053/j.semnuclmed.2015.10.008
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Article ; Online: 18F-FLT Positron Emission Tomography/Computed Tomography Imaging in Pancreatic Cancer

Senait Aknaw Debebe / Mohammed Goryawala / Seza A. Güleç

Molecular Imaging and Radionuclide Therapy, Vol 25, Iss 1, Pp 32-

Determination of Tumor Proliferative Activity and Comparison with Glycolytic Activity as Measured by 18F-FDG Positron Emission Tomography/Computed Tomography Imaging

2016 Volume 38

Abstract: Objective: This phase-I imaging study examined the imaging characteristic of 3’-deoxy-3’-(18F)-fluorothymidine (18F-FLT) positron emission tomography (PET) in patients with pancreatic cancer and comparisons were made with (18F)-fluorodeoxyglucose (18F- ... ...

Abstract	Objective: This phase-I imaging study examined the imaging characteristic of 3’-deoxy-3’-(18F)-fluorothymidine (18F-FLT) positron emission tomography (PET) in patients with pancreatic cancer and comparisons were made with (18F)-fluorodeoxyglucose (18F-FDG). The ultimate aim was to develop a molecular imaging tool that could better define the biologic characteristics of pancreas cancer, and to identify the patients who could potentially benefit from surgical resection who were deemed inoperable by conventional means of staging. Methods: Six patients with newly diagnosed pancreatic cancer underwent a combined FLT and FDG computed tomography (CT) PET/CT imaging protocol. The FLT PET/CT scan was performed within 1 week of FDG PET/CT imaging. Tumor uptake of a tracer was determined and compared using various techniques; statistical thresholding (z score=2.5), and fixed standardized uptake value (SUV) thresholds of 1.4 and 2.5, and applying a threshold of 40% of maximum SUV (SUVmax) and mean SUV (SUVmean). The correlation of functional tumor volumes (FTV) between 18F-FDG and 18F-FLT was assessed using linear regression analysis. Results: It was found that there is a correlation in FTV due to metabolic and proliferation activity when using a threshold of SUV 2.5 for FDG and 1.4 for FLT (r=0.698, p=ns), but a better correlation was obtained when using SUV of 2.5 for both tracers (r=0.698, p=ns). The z score thresholding (z=2.5) method showed lower correlation between the FTVs (r=0.698, p=ns) of FDG and FLT PET. Conclusion: Different tumor segmentation techniques yielded varying degrees of correlation in FTV between FLT and FDGPET images. FLT imaging may have a different meaning in determining tumor biology and prognosis.
Keywords	F-fluorothymidine ; 18F-fluorodeoxyglucose ; positron emission tomography/computed tomography ; pancreatic cancer imaging ; image processing ; tumor proliferative activity ; tumor glycolytic activity ; Medicine ; R ; Medicine (General) ; R5-920 ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
Subject code	610
Language	English
Publishing date	2016-02-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: A surgical perspective on positron emission tomography.

Gulec, Seza A

Journal of surgical oncology

2007 Volume 95, Issue 6, Page(s) 443–446

MeSH term(s)	Breast Neoplasms/diagnostic imaging ; Colorectal Neoplasms/diagnostic imaging ; Female ; Fluorodeoxyglucose F18 ; Glucose Transporter Type 1/biosynthesis ; Humans ; Image Enhancement ; Melanoma/diagnostic imaging ; Neoplasm Staging ; Neoplasms/diagnostic imaging ; Neoplasms/metabolism ; Neoplasms/pathology ; Neoplasms/surgery ; Positron-Emission Tomography ; Radiopharmaceuticals ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy ; Thyroid Neoplasms/diagnostic imaging ; Tomography, X-Ray Computed
Chemical Substances	Glucose Transporter Type 1 ; Radiopharmaceuticals ; Fluorodeoxyglucose F18 (0Z5B2CJX4D)
Language	English
Publishing date	2007-05-01
Publishing country	United States
Document type	Editorial
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.20667
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Article ; Online: 90

Debebe, Senait Aknaw / Adjouadi, Malek / Gulec, Seza A / Franquiz, Juan / McGoron, Anthony J

Journal of applied clinical medical physics

2019 Volume 20, Issue 2, Page(s) 30–42

Abstract: Introduction: Yttrium-90 (: Methods: Pre and post-treatment SPECT/CT data of patients who underwent RMT for primary or metastatic liver cancer were acquired. A Jasczak phantom with eight spherical inserts of various sizes was used to obtain optimal ... ...

Abstract	Introduction: Yttrium-90 ( Methods: Pre and post-treatment SPECT/CT data of patients who underwent RMT for primary or metastatic liver cancer were acquired. A Jasczak phantom with eight spherical inserts of various sizes was used to obtain optimal iteration number for the contrast recovery algorithm for improving Results: Improvement in CNR and contrast recovery coefficients on patient and phantom Conclusions: This study demonstrated correlation in mean TLR between
MeSH term(s)	Embolization, Therapeutic ; Humans ; Liver Neoplasms/radiotherapy ; Microspheres ; Phantoms, Imaging ; Prognosis ; Radiopharmaceuticals ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Intensity-Modulated/methods ; Retrospective Studies ; Technetium Tc 99m Aggregated Albumin/therapeutic use ; Tomography, Emission-Computed, Single-Photon/methods ; Tomography, X-Ray Computed/methods ; Yttrium Radioisotopes/therapeutic use
Chemical Substances	Radiopharmaceuticals ; Technetium Tc 99m Aggregated Albumin ; Yttrium Radioisotopes ; Yttrium-90 (1K8M7UR6O1)
Language	English
Publishing date	2019-01-09
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	2010347-5
ISSN	1526-9914 ; 1526-9914
ISSN (online)	1526-9914
ISSN	1526-9914
DOI	10.1002/acm2.12512
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Article ; Online: Isotretinoin induced achilles tendinopathy: Histopathological and biomechanical evaluation on rats.

Beytemür, Ozan / Yüksel, Serdar / Tetikkurt, Ümit Seza / Genç, Erdinç / Olcay, Ercan / Güleç, Akif

Acta orthopaedica et traumatologica turcica

2018 Volume 52, Issue 5, Page(s) 387–391

Abstract: Objective: The aim of the present study was to evaluate histopathological and biomechanical effects of isotretinoin on Achilles tendon.: Materials & methods: Sixteen rats were divided into two groups including the control group (n = 8) and ... ...

Abstract	Objective: The aim of the present study was to evaluate histopathological and biomechanical effects of isotretinoin on Achilles tendon. Materials & methods: Sixteen rats were divided into two groups including the control group (n = 8) and isotretinoin group (n = 8). The control group received 1.42 ml/kg soy oil per day whereas the isotretinoin group received 15 mg/kg/day (gavage dose 1.42 ml/kg) isotretinoin dissolved in soy oil through gavage method for 6 weeks. Achilles tendons were excised at the end of week 6. The tendon samples were evaluated by hematoxylin-eosin under a light microscope. Quantitative evaluation was performed via Movin and Bonar scoring. A computer-monitored tensile testing machine was utilised for biomechanical testing. Biomechanical characteristics of the tendon samples (elastic modulus, yield force, ultimate tensile force) were measured. Results: Histopathological evaluation revealed a significantly higher Movin and Bonar scores in histopathological evaluation. Movin score in isotretinoin group was 4.1 ± 2.5 and it was 2.3 ± 1.0 in control group (p = 0.032). Bonar score in isotretinoin group was 2.9 ± 1.4 and it was 1.6 ± 0.7 in control group (p = 0.022). In line with histopathological evaluation, biomechanical measurements in isotretinoin group (elastic modulus, yield force, ultimate tensile force) were significantly lower than the control group. Elastic modulus in isotretinoin group was 227 ± 27.7 N/mm Conclusion: The present study detected histopathological and biomechanical negative effect of isotretinoin on Achilles tendon. Therefore, isotretinoin should be questioned in medical history of patients with tendinopathy.
MeSH term(s)	Achilles Tendon/drug effects ; Achilles Tendon/pathology ; Animals ; Biomechanical Phenomena ; Dermatologic Agents/pharmacology ; Isotretinoin/pharmacology ; Rats ; Tendinopathy/chemically induced ; Tendinopathy/pathology ; Tendinopathy/physiopathology
Chemical Substances	Dermatologic Agents ; Isotretinoin (EH28UP18IF)
Language	English
Publishing date	2018-07-13
Publishing country	Turkey
Document type	Journal Article
ISSN	2589-1294
ISSN (online)	2589-1294
DOI	10.1016/j.aott.2018.06.006
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Article: PET probe-guided surgery.

Gulec, Seza A

Journal of surgical oncology

2007 Volume 96, Issue 4, Page(s) 353–357

Abstract: Intraoperative localization of PET-positive recurrent/metastatic lesions can be facilitated using a hand-held PET probe. PET probe is a high-energy gamma probe designed to process the 511 keV photons of PET tracers. Intraoperative gamma probe performance ...

Abstract	Intraoperative localization of PET-positive recurrent/metastatic lesions can be facilitated using a hand-held PET probe. PET probe is a high-energy gamma probe designed to process the 511 keV photons of PET tracers. Intraoperative gamma probe performance is a function of radiopharmaceutical uptake, clearance kinetics, and probe engineering, all determining the target to background ratio (TBR) and detection threshold. A minimum TBR of 1.5:1 is needed in the operative field for the operating surgeon to be comfortable the differences between tumor tissue and normal adjacent tissue are real. Due to high-energy photon fluxes, achieving a satisfactory TBR intraoperatively is challenging and requires development of a clinically feasible PET-probe guided surgery protocol.
MeSH term(s)	Clinical Trials as Topic ; Fluorodeoxyglucose F18 ; Gamma Cameras ; Humans ; Iodine Radioisotopes ; Neoplasms/diagnostic imaging ; Neoplasms/surgery ; Positron-Emission Tomography ; Radioimmunodetection ; Radiopharmaceuticals ; Sensitivity and Specificity ; Surgery, Computer-Assisted
Chemical Substances	Iodine Radioisotopes ; Radiopharmaceuticals ; Fluorodeoxyglucose F18 (0Z5B2CJX4D)
Language	English
Publishing date	2007-09-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.20862
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