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Paragangliomas (PGLs) are neuroendocrine tumors originating from the neural crest. They usually arise from the adrenal medulla and sympathetic or parasympathetic ganglions. Approximately 10% of PGLs are located in the extra-adrenal gland. Renal PGL is a rare condition. In this case report, we present the 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and 68 Ga-DOTATATE PET/CT findings of polycystic kidney-derived PGL., Competing Interests: Conflict of Interest: No conflicts of interest were declared by the authors., (Copyright© 2024 The Author. Published by Galenos Publishing House on behalf of the Turkish Society of Nuclear Medicine.)

Peliosis hepatis (PH) and sclerosing angiomatoid nodular transformation of the spleen are uncommon benign lesions. Diagnosis can be difficult in some patients. Herein, we present the case of a 28-year-old woman referred with abdominal pain who had spleen lesions. 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography revealed multiple non-FDG avid lesions in the liver and hypermetabolic lesions in the spleen. In addition, abdominal magnetic resonance imaging was performed. Histopathology revealed sclerosing angiomatoid nodular transformation in the spleen and PH in the liver., Competing Interests: Conflict of Interest: No conflicts of interest were declared by the authors., (Copyright© 2024 The Author. Published by Galenos Publishing House on behalf of the Turkish Society of Nuclear Medicine.)

Gallbladder perforation is one of the most serious complications of cholecystitis and is rarely seen in 2-11% of cases. Pericholecystic abscesses secondary to gallbladder perforation are rare. Rapid diagnosis is important because of high morbidity and mortalityrates. A subcapsular abscess secondary to gallbladder microperforation is presented on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography performed for restaging in a patient with maxillary sinus cancer., Competing Interests: Conflict of Interest: No conflicts of interest were declared by the authors., (Copyright© 2024 The Author. Published by Galenos Publishing House on behalf of the Turkish Society of Nuclear Medicine.)

Objectives: The aim of this study was to evaluate the correlation between clinical histopathologic features and micropapillary (MP) ratio with the maximum standardized uptake value (SUV max ) derived from 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) in treatment naïve breast cancer., Methods: Twenty-nine patients diagnosed with breast cancer with a MP component who underwent PET/CT imaging before any local and/or systemic treatment were included in this retrospective study. All clinical histopathological features were recorded. SUV max values were measured from 18 F-FDG PET images for primary tumors and metastatic axillary lymph nodes., Results: MP component percentage did not correlate with any clinical histopathological features except age. At early ages, the MP component ratio was significantly higher. Our results showed that there is no significant correlation between the SUV max value and MP component percentage., Conclusion: A high SUV max value is generally expected in aggressive malignancies. However, this assumption may not be valid for the MP subgroup, which has an aggressive course compared to other subgroups in breast cancer., Competing Interests: Conflict of Interest: No conflicts of interest were declared by the authors., (©Copyright 2023 by the Turkish Society of Nuclear Medicine / Molecular Imaging and Radionuclide Therapy published by Galenos Publishing House.)

A 70-year-old man with newly diagnosed rectum adenocarcinoma was referred to 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) for staging, and 68 Ga-fibroblast activation protein inhibitor (FAPI)-04 PET/CT for ongoing trial. Both 18 F-FDG PET/CT and 68 Ga-FAPI-04 PET/CT showed intense uptake in the primary rectal tumor, and also in nodular areas in the right lung. Due to intense 68 Ga-FAPI-04 and 18 F-FDG uptake, the lung lesions were considered as metastases. However the lesions were reduced in size on CT after 20 days antibiotherapy and diagnosed as pneumonia., Competing Interests: Conflict of Interest: No conflicts of interest were declared by the authors., (©Copyright 2023 by the Turkish Society of Nuclear Medicine / Molecular Imaging and Radionuclide Therapy published by Galenos Publishing House.)

Neuroendocrine tumors are slow-growing tumors originating from neuroendocrine cells and capable of metastasis. Most of them are found in the gastrointestinal tract; however, they can also be rarely seen in other organs. Testicular neuroendocrine tumors account for less than 1% of all testicular neoplasms. They may present as primary testicular or secondary tumors from extratesticular sources. Jejunal neuroendocrine tumor metastasis to the testis is extremely rare. We present the case of a 61-year-old man with a jejunal neuroendocrine tumor and metastases to bilateral testicles revealed on Gallium-68-DOTATATE positron emission tomography/computed tomography., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2023 by the Turkish Society of Nuclear Medicine / Molecular Imaging and Radionuclide Therapy published by Galenos Publishing House.)

Rectal neuroendocrine carcinomas constitute <1% of all neuroendocrine carcinomas and <1% of all gastrointestinal tract malignancies. Cutaneous metastases of rectal neuroendocrine carcinoma are rarer than visceral metastases. We represent a 71-year-old man who was diagnosed with neuroendocrine tumor grade 3 originating from the rectum 1 year ago. He was referred for 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography for restaging after 6 cycles of chemotherapy and radiotherapy. Intensely increased 18 F-FDG uptake in the right cutaneous inguinal region was consistent with neuroendocrine carcinoma metastasis with biopsy from the same region., Competing Interests: Conflict of Interest: No conflict of interest was declare by the authors., (©Copyright 2023 by the Turkish Society of Nuclear Medicine / Molecular Imaging and Radionuclide Therapy published by Galenos Publishing House.)

Fibroblast activation protein (FAP) is expressed as a pro-inflammatory agent from fibrous tissue in liver cirrhosis and in the tumor microenvironment. Cirrhosis is the last stage of any chronic liver disease, and the natural course of cirrhosis is the progression from the asymptomatic phase to the symptomatic decompensated phase with the development of ascites. Although various clinical features suggest cirrhosis in patients with chronic liver disease, non-invasive methods should follow the clinical approach before a definitive diagnosis. Herein, we present three cases of liver cirrhosis with fibroblast activation protein inhibitor (FAPI) uptake to demonstrate the usefulness of 68 Ga-FAPI-04 positron emission tomography/computed tomography (PET/CT) scan in cirrhosis., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2023 by the Turkish Society of Nuclear Medicine / Molecular Imaging and Radionuclide Therapy published by Galenos Publishing House.)

A 50-year-old man undergone total thyroidectomy and histopathology revealed papillary thyroid carcinoma with a tumor size of 4.5 cm. The patient was referred to a nuclear medicine clinic for radioiodine therapy. Since the thyroglobulin level before the treatment was 495 ug/L, low-dose (185 MBq) I-131 scan was performed. In addition to multiple liver metastases, bone metastases were detected in the sacrum and right 7 th rib in I-131 whole body scanning and single photon emission computed tomography/computed tomography (CT) imaging at the time of initial staging. We present a case of multiple metastatic papillary thyroid carcinoma whose radioiodine treatment response and clinical outcome were evaluated with 18 F-fluorodeoxyglucose and Gallium-68 FAPI-04 positron emission tomography/CT., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2023 by Turkish Society of Nuclear Medicine Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi.)

A 76-year-old man with metastatic prostate cancer was referred to 68 Ga prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for restaging. A consecutive 18 F-fluorodeoxyglucose (FDG) PET/CT was performed due to the history of lung cancer in the left lung treated with stereotactic radiotherapy. Intense 18 F-FDG uptake was detected in the pituitary gland despite the mild uptake of 68 Ga PSMA. Contrast-enhanced magnetic resonance imaging confirmed pituitary adenoma., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2022 by Turkish Society of Nuclear Medicine | Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi.)

Objectives: Renal cell carcinoma (RCC) comprises 85%-90% of primary renal malignant tumors originating from the renal tubular epithelium and has different genetic characteristics. This study aimed to investigate the potential predictive role of 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and metabolic parameters in overall survival (OS) analysis in patients with RCC., Methods: 18 F-FDG PET/CT images of 100 patients performed for initial staging before surgical or oncological treatments were analyzed retrospectively. Maximum standard uptake value (SUV max -T) of the primary tumor was calculated and its relationship to patient survival was analyzed. The median follow-up time was 5.61 years (0.01-8.7 years)., Results: SUV max -T levels in the patients ranged from 2.1 to 48.9 (median 5.9, mean 9.0±7.9). SUV max -T was significantly higher in RCC-related death more positive than in the negative cases (p<0.001). However, there was not any statistical significance for gender and pathological subtypes on the survival outcomes of patients (p=0.264 and p=0.784). The patients' 1-year, 3-year, and 5-year OS rates were 71%, 61%, and 57%, respectively. The highest action of SUV max -T for estimating OS was a cut-off level of 5.4, which maintained sensitivity and specificity of 81% and 75%, respectively. However, cancer staging remained independent significance for OS (p<0.001)., Conclusion: SUV max of primary tumor and cancer stage were demonstrated as significant prognostic factors for OS in patients with RCC. Evaluation of 18F-FDG accumulation with PET/CT may help plan treatment strategies and predict survival outcomes of these patients at diagnosis., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2022 by Turkish Society of Nuclear Medicine | Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi.)

A 67-year-old female patient with metastatic gastric adenocarcinoma was referred to 18 fluorine-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) for restaging. PET/CT revealed liver metastasis and the patient received six-cycles of chemotherapy. On control 18 F-FDG PET/CT the liver lesion disappeared but newly formed multiple foci of increased uptake in the subcutaneous adipose tissues of the abdominal wall were detected. The uptake was related to nodular lesions resulting from an idiosyncratic reaction to enoxaparin and from local trauma through repeated injections., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2022 by Turkish Society of Nuclear Medicine, Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi.)

Objectives: The important roles of integrins in tumor invasion, migration and proliferation are well known. In this study, we investigated the presence of integrin α3 and β1 receptors in tumor tissue, metastatic lymph node (LN) and normal thyroid tissue of patients diagnosed with thyroid cancer (TCa) and showed the prognostic and diagnostic value of these molecules as well as peptide-receptor., Methods: Sixty-one patients with TCa were included in this study. The presence of integrin α3 and β1 expression was investigated by immunohistochemical methods from tumor tissue after total thyroidectomy. TNM system was used in tumor staging. The relationship between prognostic properties such as tumor size, LN metastasis, capsular invasion and the presence of integrin α3 and β1 expression was investigated., Results: Classical type papillary TCa was the most common subtype in our study group with 31.1%. Integrin β1 was expressed in 4.9% (n=3) of normal tissue, 57.4% (n=35) of tumor tissue and 16.4% (n=10) of metastatic LN; integrin α3 was expressed in 50.8% (n=31) of normal tissue, 67.2% (n=41) of tumor tissue and 9.8% (n=6) metastatic LN. Integrin β1 expression was observed 21.3% (n=13), integrin α3 in 14.8% (n=9) and integrin α3 and β1 expression in 36.1% (n=22). Integrin β1 expression increased statistically significantly in the presence of LN metastasis and capsular invasion (p=0.022, 0.014, respectively). Furthermore, the expression of integrin α3 was found to be statistically significant in primary tumors of patients with LN metastasis (p=0.045)., Conclusion: Our study showed a significant increase in integrin α3 and β1 expression in LN metastasis or thyroid capsule invasion in tumor. Thus, it appears that the demonstration of the presence of integrin α3 and β1 expression in TCa is not only a prognostic biomarker but also has value as a potential theranostic target with peptide-bound radioactive agents., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2022 by Turkish Society of Nuclear Medicine, Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi.)

We present 2 cases of acrometastases that manifest as the first signs of underlying lung cancer. The first case is 37 year-old-man misdiagnosed and treated as having a traumatic fracture at the left thumb. The second case is a 77 year-old-man who received treatment for soft tissue infection at left hand for 4 weeks. In both cases 18 fluorine-fluorodeoxyglucose positron emission tomography/computed tomography demonstrated primary malignant lesions in the lungs consistent with primary lung cancer with acrometastases., (©Copyright 2022 by Turkish Society of Nuclear Medicine, Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi.)

Extranodal-multiorgan involvement is rarely presented in diffuse large B-cell non-Hodgkin lymphoma. 18 Fluorine-fluorodeoxyglucose positron emission tomography/computed tomography findings of a 22-year-old female patient with supra/infra-diaphragmatic nodal and skeletal involvements and thyroid, pancreas, right breast, bilateral renal, and ovarian involvements were presented.

A 34-year-old male patient who had left orchiectomy and received three cycles of chemotherapy for testicular mix germ cell carcinoma was referred for 18 fluorine-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) for complaints of weight loss and fever. PET/CT showed multiple and progressive 18 F-FDG uptakes in supra and infra diaphragmatic lymphatic regions, and multiple abnormal 18 F-FDG uptakes were noted in the lytic formed skeletal lesions. Clinicians remain in doubt regarding the multiple metastatic lesions without elevated serum tumor marker levels (alpha-fetoprotein, beta-human chorionic gonadotrophin, CA19-9, and carcinoembryonic antigen). Biopsy of the lytic lesion in the iliac bone revealed granulomatous inflammation suggestive of sarcoidosis. Systemic prednisone at 20-40 mg/daily was started. 18 F-FDG PET/CT images showed complete metabolic response to prednisone 8 months following the start of treatment.

Objectives: This study aimed to compare the metabolic parameters obtained from 18 fluorine-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) and gallium-68 ( 68 Ga)-prostate-specific membrane antigen (PSMA) PET/CT and investigate the relationship between serum alpha-fetoprotein and PET scan parameters in patients with hepatocellular carcinoma., Methods: Fourteen patients were recruited after dynamic magnetic resonance imaging (MRI) of the upper abdomen, and 18 F-FDG and 68 Ga-PSMA PET/CT imaging studies were conducted. Regions of interest (ROIs) were drawn from lesion-free liver tissue, abdominal aorta (A), and right medial gluteal muscle (G) for the background activity. Maximum standard uptake value (SUV max ) of these regions were compared with the SUV max of primary tumor (T)., Results: On visual assessment, five patients (36%) experienced low 18 F-FDG uptake in the primary lesion, three patients (21%) experienced moderate uptake, and six patients (43%) experienced high uptake. However, only one patient (7%) showed low 68 Ga-PSMA uptake, two patients (14%) showed moderate uptake, and 11 patients (79%) showed high uptake. Four patients with a low 18 F-FDG uptake showed high 68 Ga-PSMA uptake, while one patient exhibited low uptake with both 18 F-FDG and 68 Ga-PSMA. The number of lesions on 68 Ga-PSMA PET/CT and MRI was significantly higher than 18 F-FDG PET/CT (p=0.042 and 0.026, respectively). T/A and T/G values were significantly higher in 68 Ga-PSMA than 18 F-FDG (p=0.002 and 0.002, respectively)., Conclusion: 68 Ga-PSMA PET/CT is superior to 18 F-FDG PET/CT in the staging of hepatocellular carcinoma. High 68 Ga-PSMA uptake could be promising for PSMA-targeted radionuclide treatments.

A 67-year-old male patient had undergone total gastrectomy and Roux-en-Y eso-jejunostomy 3 years ago for the treatment of tubular adenocarcinoma located at the corpus of the stomach. The patient was diagnosed with Gleason score 8 (4+4) metastatic prostate cancer during the follow-up period and received hormone therapy. Owing to his elevated prostate-specific antigen levels (77 ng/mL), his clinician referred him gallium-68 ( 68 Ga) prostate-specific membrane antigen 11 (PSMA) positron emission tomography/computed tomography (PET/CT) for restaging. PET/CT showed multiple 68 Ga PSMA receptor-positive skeletal lesions and linear PSMA activity at the eso-jejunostomy junction. He was then referred to undergo 18 fluorine-fluorodeoxyglucose ( 18 F-FDG) PET/CT to screen for gastric carcinoma recurrence. PET/CT images demonstrated no 18 F-FDG avid lesion. However, endoscopy and biopsy performed with samples from the eso-jejunostomy junction revealed superficial benign squamous epithelial fragments.

Objectives: Several studies demonstrate the relationship between coronary artery disease and inflammatory parameters. Nevertheless, there is paucity of data regarding the role of high sensitivity (hs)-C-reactive protein (CRP) to albumin ratio (CAR) in patients with ischemia on gated single photon emission tomography (SPECT) myocardial perfusion imaging (MPI). This study was aimed at demonstrating the relationship between CAR and the occurrence of ischemia on gated SPECT MPI., Methods: We retrospectively evaluated 2.048 referred patients for gated SPECT MPI from a cardiology outpatient clinic between October 2017 and June 2019. After applying exclusion criteria and measuring serum CRP and albumin levels, we included 126 patients in the study. We then classified subjects into different groups according to the absence or presence of ischemia on gated SPECT MPI., Results: According to laboratory findings, hs-CRP and CAR were significantly higher in the ischemia group, while the serum albumin was significantly lower in ischemia group (p<0.05 for each). The independent predictors of presence of ischemia in multivariate analysis were hypertension and CAR (CAR; odds ratio: 5.720, 95% confidence interval: 2.697-12.133, p<0.001). The optimal value of CAR for presence of ischemia was 0.96 with 76% sensitivity and 71% specificity., Conclusion: We found CAR values as a predictor for ischemia before MPI.

Objectives: The aim of this study was to evaluate the impact of maximum standard uptake value (SUV max ) of the primary tumor and locoregional metastatic lymph node in predicting survival in patients with the preoperative rectal adenocarcinoma., Methods: One hundred and fifteen patients [mean age ± standard deviation (SD): 58.7±11.4 years] with biopsy-proven rectal adenocarcinoma underwent 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging for the staging were included in this study. All patients were followed-up for a minimum of 12 months (mean ± SD: 29.7±13.5 months). Tumor-node-metastasis 2017 clinical staging, SUV max of the primary rectal tumor and locoregional lymph nodes on the PET/CT studies were evaluated., Results: All patients had increased FDG activity of the primary tumor. The mean ± SD SUV max of the primary tumor and locoregional metastatic lymph node were 21.0±9.1 and 4.6±2.8, respectively. Primary tumor SUV max did not have an effect on predicting survival (p=0.525) however locoregional metastatic lymph node SUV max had an effect (p<0.05) on predicting survival. Clinical stage of the disease was a factor predicting survival (p<0.001)., Conclusion: 18 F-FDG PET/CT is an effective imaging modality for detecting primary tumors and metastases in rectal adenocarcinoma and clinical stage assessment with PET/CT had an effect on predicting survival. Furthermore, in our study locoregional lymph node SUV max was defined as a factor in predicting survival.

Objective: Prognostic effect of KRAS mutation and side of tumor in colorectal cancer is a highly controversial subject. Therefore, we evaluated the association between FDG uptake pattern in 18 F-fluoro-2-deoxy-glucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) imaging and KRAS mutation and tumor localization in patients with a diagnosis of colon cancer and assessed the effects of these three factors on prognosis and survival., Methods: Eighty-three patients with colorectal cancer were retrospectively included in this study. 18 F-FDG PET/CT study was performed for pretreatment staging. The maximum standardized uptake value (SUV max ) of the primary tumor and survival data of patients were compared between groups. KRAS mutations were detected with the help of real-time Polymerase Chain Reaction technique through genomic DNA extracted from paraffin-embedded tumor tissue blocks. Tumor lesions with potential KRAS mutations were classified as mutant KRAS and wild type., Results: Twenty five patients were female while 58 were male. The mean age of the patients was 59.8±11.3 years. Mean follow-up was 35.5±18.9 months. Primary tumor was localized in the left colon in 83.1% of patients and in the right colon in 16.9%. KRAS mutation was detected in 54.2% (n=45) of patients. Mean SUV max of patients with primary tumor was estimated to be 21.1±9.1 (range= 6.0-47.5). Mean tumor SUV max of patients with a KRAS mutation (24.0±9.0) was found to be significantly higher than those without KRAS mutation (17.7±8.2) (p=0.001). Mean survival was significantly shorter in patients with locoregional nodal metastasis than in patients without locoregional nodal metastasis as well as in patients with distant nodal metastasis than in patients without distant nodal metastasis and in patients with organ metastasis in initial PET/CT than in patients without organ metastasis. Also, mean survival was nearly statistically-significantly shorter in patients with tumors located in left colon (34.2±19.4) than in right colon (43.2±14.6) (p=0.059). However, we found no significant impact of KRAS mutation on survival., Conclusion: In our study, we found that tumor localization had no significant effect on prognosis in patients with colon cancer. On the other hand, FDG uptake was observed to be higher in the presence of KRAS mutation and it was concluded that coexistence of KRAS mutation with higher SUV max is a negative prognostic factor.

Objectives: The aim of this study was to evaluate 18 F-fluoro-2-deoxy-glucose (FDG) uptake patterns in primary tumors and metastatic lesions, and also to assess the diagnostic contribution of positron emission tomography/computed tomography (PET/CT) in the initial staging of gastric cancer (GC)., Methods: The total number of 341 patients with GC were included in this study. All 18 F-FDG PET/CT imagings were performed for initial staging. The maximum standardized uptake value (SUV max ) of primary tumor, obtained from 18 F-FDG PET/CT imaging was compared between subtypes of GC., Results: Mean SUV max of 339 patients’ primary tumor was 12.9±8.6. The highest mean SUV max was detected in patients with medullary subtype GC (17.8±9.9) while the lowest mean SUV max (9.7±7.6) was seen in signet ring cell carcinoma (SRCC). The primary mean SUV max was found statistically higher in tubular adenocarcinoma (TAC) group than SRCC group (p<0.001). Higher SUV max values were found statistically significantly correlated with advanced age (aged ≥60) and increased tumor size (>3 cm) in patients with TAC (p=0.03). Primary tumor SUV max was found statistically higher in regional lymph node (RLN) positive patients than in RLN negative patients in TAC and SRCC groups (p<0.001 and p=0.012, respectivelly). Also, in patients with SRCC, SUV max was significantly higher in the distant metastatic group than in the group without metastasis (p=0.025)., Conclusion: Increased primary tumor SUV max was associated with some of clinical parameters such as age and RLN metastasis in patients with TAC. However, there was no relationship between distant metastatic state and primary tumor 18 F-FDG uptake in TAC. However, high SUV max of primary tumor in SRCC was associated with regional and distant metastasis, and primary tumor 18 F-FDG uptake may be a prognostic value for this subgroup.

Dystrophic epidermolysis bullosa (DEB) is a rare, inherited skin fragility disorder characterized by blister formation in the sublamina densa. DEB is associated with aggressive squamous cell carcinoma (SCC) that has increased risk of metastases and poor prognosis. A 41-year-old woman with DEB underwent 18 F-fluoro-2-deoxy-glucose positron emission tomography/computed tomography ( 18 F-FDG PET/BT). PET/CT showed increased 18 F-FDG uptakes in multifocal cutaneous lesions in both lower extremities. The patient was diagnosed with SCC via skin biopsy from the left lateral lower thigh. Ten months later, PET/CT showed increased FDG uptakes in the primary tumor area as well as the left inguinal and left supraclavicular lymph node regions. 18 F-FDG PET/CT seems to be useful for re-staging and planning appropriate therapeutic strategy in DEB-patients with SCC.