Browsing by Author "Goya, Cemil"

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Acoustic Radiation Force Impulse (Arfi) Elastography Quantification of Muscle Stiffness Over a Course of Gradual Isometric Contractions: a Preliminary Study
(Soc Romana Ultrasonografe Medicina Biologie-srumb, 2015) Yavuz, Alpaslan; Bora, Aydin; Bulut, Mehmet Deniz; Batur, Abdussamet; Milanlioglu, Aysel; Goya, Cemil; Andic, Cagatay
Aims: To evaluate the feasibility of quantitative analysis of muscle stiffness by Acoustic Radiation Forced Impulse (ARFI) elastography over a course of graduate isometric voluntary contractions. Material and methods: The stiffness of the bilateral biceps muscle of 13 healthy volunteers was measured in real time by ARFI elastography, while the forearm was in neutral-extended position, 90 degree self-flexed positions and 90 degree self-flexed position, with altered weights ranging from 1 to 8 kg placed on flattened palmar surfaces consecutively. The determined increases in biceps muscle stiffness were measured for both arms and correlated with the loadings weights adopted at progressive trial stages. Results: The mean shear wave velocity (SWV) values of biceps muscles in a neutral position, in 90 degree flex position and 90 degree flex position with 1 to 8 kg weights on palmar surfaces were 2.162 +/- 0.302 m/sec, 3.382 +/- 0.581 m/sec, and 3.897 +/- 0.585 to 5.562 +/- 0.587 m/sec, respectively. Significant correlations between the muscle SWV values and related palmar weights and between the SWV values of right and left sides at different trial stages were identified (r=0.951 and r=0.954, respectively). A mutual propagation path of deep regions to entire areas was described to account for the distribution of increase in stiffness with increases in palmar weights. The confidence of method regarding inter-observer difference was confirmed by the correlation analyses of the results (r=0.998). Conclusions: ARFI elastography is a feasible imaging modality for quantifying the stiffness of isometrically voluntarily contracting muscles.
Acoustic Radiation Force Impulse Imaging for Evaluation of Renal Parenchyma Elasticity in Diabetic Nephropathy
(Amer Roentgen Ray Soc, 2015) Goya, Cemil; Kilinc, Faruk; Hamidi, Cihad; Yavuz, Alpaslan; Yildirim, Yasar; Cetincakmak, Mehmet Guli; Hattapoglu, Salih
Objective: The goal of this study is to evaluate the changes in the elasticity of the renal parenchyma in diabetic nephropathy using acoustic radiation force impulse imaging. SUBJECTS AND METHODS. The study included 281 healthy volunteers and 114 patients with diabetic nephropathy. In healthy volunteers, the kidney elasticity was assessed quantitatively by measuring the shear-wave velocity using acoustic radiation force impulse imaging based on age, body mass index, and sex. The changes in the renal elasticity were compared between the different stages of diabetic nephropathy and the healthy control group. RESULTS. In healthy volunteers, there was a statistically significant correlation between the shear-wave velocity values and age and sex. The shear-wave velocity values for the kidneys were 2.87, 3.14, 2.95, 2.68, and 2.55 m/s in patients with stage 1, 2, 3, 4, and 5 diabetic nephropathy, respectively, compared with 2.35 m/s for healthy control subjects. Acoustic radiation force impulse imaging was able to distinguish between the different diabetic nephropathy stages (except for stage 5) in the kidneys. The threshold value for predicting diabetic nephropathy was 2.43 m/s (sensitivity, 84.1%; specificity, 67.3%; positive predictive value, 93.1%; negative predictive value 50.8%; accuracy, 72.1%; positive likelihood ratio, 2.5; and negative likelihood ratio, 0.23). CONCLUSION. Acoustic radiation force impulse imaging could be used for the evaluation of the renal elasticity changes that are due to secondary structural and functional changes in diabetic nephropathy.
Advantages of Us in Percutaneous Dilatational Tracheostomy: Randomized Controlled Trial and Review of the Literature
(Radiological Soc North America, 2014) Yavuz, Alpaslan; Yilmaz, Murat; Goya, Cemil; Alimoglu, Emel; Kabaalioglu, Adnan
Purpose: To compare procedure times and complication rates of preincisional ultrasonographic (US) evaluation and perioperative US guidance in percutaneous dilatational tracheostomy (PDT) with those of the current standard of care, PDT performed without image guidance. Materials and Methods: Between December 2007 and January 2011, 341 patients were included in this institutional review board-approved study after informed consent was obtained from the patients or their relatives. The patients were divided randomly into two groups. In group A (n = 166), the possible causes of complications, such as aberrations of tracheal, thyroidal, and vascular structures, were determined with US, and tracheal measurements were performed by using US. The clinician's initial considerations at physical examination were compared with the US findings. PDT was subsequently performed with US guidance in suitable cases. In group B (n = 175), PDT was performed solely on the basis of physical landmarks. The procedure times and complication rates were compared across groups by using the Fisher exact test. Results: In group A, the puncture sites designated at the physical examination were reconsidered in 39 (23.8%) of 164 cases. The perioperative complication rates were slightly lower in group A (7.8% [12 of 154]) than in group B (15.0% [25 of 167]); however, the difference did not achieve statistical significance (P = .054). The mean procedure times for groups A and B were 24.09 minutes +/- 8.05 (standard deviation) (range, 14-68 minutes) and 18.62 minutes +/- 6.34 (range, 12-81 minutes), respectively (P = .001), and the numbers of patients in each group who required multiple puncture attempts were six (3.9%) of 154 and 23 (13.6%) of 169 (P = .003), respectively. Conclusion: The use of US guidance before and during PDT could render the procedure easier and safer, with fewer complications but a slightly longer procedure time. (C) RSNA, 2014
Anterior Hepatic Grooves Accompanied by Chilaiditi Sign: a Retrospective Radiological Analysis of a Neglected Anatomical Fact
(Springer France, 2015) Yavuz, Alpaslan; Batur, Abdussamet; Bulut, Mehmet Deniz; Bora, Aydin; Goya, Cemil; Andic, Cagatay; Olmez, Sehmus
To evaluate anterior hepatic grooves (AHGs) associated with hepato-diaphragmatic mesocolic indentations (Chilaiditi sign) and to delineate the incidence and potential clinical significance of this association. Between November 2011 and June 2014, abdominal computed tomography examinations of 2,314 patients with varied indications were retrospectively reviewed. Patients were surveyed consecutively for the Chilaiditi sign and syndrome, and cases with grooves at the antero-inferior hepatic surface enclosing the adjacent mesocolic indents were determined. The incidence of AHGs and their predominance by gender and age were determined. The potential clinical significance of AHGs associated with Chilaiditi syndrome and their possible effect on liver volume were assessed. The incidences of AHGs were similar between genders (p = .461 and p = .646) and age (p = .113 and .621, respectively) among total cohort and patients with Chilaiditi sign, respectively. There was no significant correlation between AHGs and Chilaiditi syndrome (p = .506); no efficacies of AHGs to liver volume were assessed (p = .413). The AHGs are rare adaptive changes in shape of the liver without a significant effect on liver volume. This overlooked phenomenon is likely derived from the Chilaiditi sign, but has no significant correlation with Chilaiditi syndrome. Future studies with extended series are encouraged to reveal the possible significance of this phenomenon based on concerned surgical interventions.
The Association of Vascular Loops of Anterior Inferior Cerebellar Artery and Vestibulocochlear Symptoms
(Wolters Kluwer Medknow Publications, 2023) Dadali, Yeliz; Ozkacmaz, Sercan; Avcu, Mustafa; Alpaslan, Muhammed; Goya, Cemil; Ozgokce, Mesut; Durmaz, Fatma
Aim: The association of vascular loops of anterior inferior cerebellar artery (AICA) with vestibulocochlear symptoms including hear loss, tinnitus, and vertigo is controversial. We aimed to investigate the relationship between vestibulocochlear symptoms and AICA vascular loop syndrome on magnetic resonance imaging (MRI). Materials and Methods: The patients underwent a posterior fossa MRI examination were reviewed regarding the presence of hear loss, tinnitus, and vertigo by an experienced ear-nose-throat specialists' physical examinations. The incidences of these lesions in the patients with and without AICA vascular loop syndromes were compared. Furthermore, the correlation between the AICA vascular loop syndrome subtypes (grade 1-3) and the incidence of the symptoms were analyzed. Results: A total of 502 patients (1004 ears) were included in this study. Vascular loops were demonstrated in 150 ears (14.9%). Subtype 1 was observed in 97 (9.7%), subtype 2 in 40 (4.0%) and subtype 3 in 13 (1.3%) ears. The incidences of tinnitus, hear loss, and tinnitus + hear loss were statistically significantly higher in the patients with vascular loops than without vascular loops (p: 0.000042, p: 0.0446906, p: 0.028106, respectively). However, there was not a significant correlation between the incidence of the symptoms and the grade of the vascular loop formation (p>0.05). Vertigo incidence was very similar among the patients with no, with one-sided and with both-sided AICA vascular loops (41.5%, 39.8% and 46.2%, respectively) with no statistical difference (p>0.05). Conclusion: The AICA vascular loop is associated with either tinnitus or hear loss but there is no correlation with the degree of the vascular loops. There is no relationship between AICA vascular loops and vertigo.
Clinical Impacts of Juxtapapillary Duodenal Diverticulum Detected on Computed Tomography
(Bentham Science Publ Ltd, 2022) Dundar, Ilyas; Goya, Cemil; Hattapoglu, Salih; Ozkacmaz, Sercan; Ozgokce, Mesut; Turkoglu, Saim; Turko, Ensar
Background: Diverticula are commonly observed in the duodenum. Duodenal Diverticulum (DD) usually does not give symptoms throughout life and is diagnosed by coincidence. However, it may present with different symptoms in patients. Objective: This study aims to evaluate the prevalence of DD and Juxtapapillary Duodenal Diverticilium (JDD) and its association with other possible pathologies and to determine its clinical impact by using Computed Tomography (CT). Methods: This retrospective observational study, which was taken consecutively between the years of 2013-2020, was evaluated in the Radiology Department. The total number of cases was 4850 (male-2440; female-2410). CT images were evaluated by two experienced radiologists at the workstation. DD and JDD prevalence and clinical findings in the hospital registry system were examined. Results: The age of the patients included in the study ranged from 17 to 92 years (mean age 46.94 +/- 16.42). In patients with DD (female-130; male-101), mean age was 62.24 +/- 12.69 (21-92). The prevalence of DD was 4.76% (n=231). The prevalence of JDD was 4.02% (n=195) and increased with age (p<0.01). The average diameter of the JDD was measured as 23.29 +/- 8.22 (9.5-55.3) mm. A significant positive correlation was found between age and DD diameter (p=0.039). DDs were found most commonly 84.42% (n=195) in the second segment of the duodenum as JDD. In patients with JDD, the mean diameter of choledochus and wirsung canal were 6.7 +/- 2.4 (3-15.3) mm and 0.31 +/- 0.1 (0.1-6.5) mm respectively. The choledochal diameter was correlated with the JDD size (p - 0.004). Cholelithiasis (n 56), choledocholithiasis (n 20), cholecystitis (n=52), diverticulitis (n=15), duodenitis (n=37), pancreatitis (n=5) and hiatal hernia (n=60) with JDD were observed. Periampullary carcinoma was detected in one patient. Conclusion: Our study shows that cholelithiasis, choledocholithiasis, cholecystitis, diverticulitis, duodenitis, pancreatitis may be associated with JDD. Therefore, in contrast-enhanced abdominal CT scans taken for various reasons, investigation of the presence and characteristics of JDD and detection of pathologies that may be associated with JDD are important for patients to benefit from early diagnosis and treatment opportunities and to take precautions against possible complications.
Comparison of Computed Tomography Findings Between Adult and Pediatric Covid-19 Patients
(Bentham Science Publ Ltd, 2024) Dadali, Yeliz; Ozkacmaz, Sercan; Unlu, Erdal; Ozkacmaz, Ayse; Alparslan, Muhammed; Dundar, Ilyas; Goya, Cemil
Purpose: This study aims to compare chest computed tomography (CT) findings between adult and pediatric patients with coronavirus disease-19 (COVID-19) pneumonia. Materials and Methods: This study included 30 pediatric patients aged 1 to 17 years and 30 adult patients over 18 years of age with COVID-19 pneumonia confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR) who have findings related to COVID-19 on Chest Computed Tomography. The CT findings of adult and pediatric patients were compared with a z-test. Results: Bilateral involvement (p:0.00056), involvement in all five lobes (p<0.00001), and central and peripheral involvement (p:0.01928) were significantly higher in the adult group compared to the pediatric group. In the pediatric group, the frequency of unilateral involvement (p:0.00056), involvement of solitary lobe (p:0.00132), and peripheral involvement (p: 0.01928) were significantly higher than in the adult group. The most common parenchymal finding in adults and pediatric patients was ground-glass opacities (100% and 83%, respectively). Among the parenchymal findings in adults, ground-glass opacities with consolidation (63%) were the second most common finding, followed by air bronchogram (60%) in adults, while in pediatric patients, halo sign (27%) and nodule (27%) were the second most common, followed by the ground-glass opacities with consolidation (23%). Conclusion: The CT findings of pediatric COVID-19 patients must be well-known as the course of the disease is usually less severe, and the radiological findings are uncertain when compared with adults.
Comparison of Medical Treatment Efficiency With Shear Wave Elastography Values of Thrombus in Patients With Lower Extremity Deep Vein Thrombosis
(Lippincott Williams & Wilkins, 2023) Ince, Suat; Ozgokce, Mesut; Ozkacmaz, Sercan; Dundar, Ilyas; Turko, Ensar; Ayyildiz, Veysel A.; Goya, Cemil
In lower-extremity deep vein thrombosis (DVT), thrombus age is essential for successful treatment. The aim of our study was to compare the shear wave elastography (SWE) values measured before treatment and achieved lumen patency after treatment in lower-extremity DVT patients with total occlusion. Patients diagnosed with DVT in the acute-subacute stage (<4 week) with total thrombosis in lower extremity were included in this prospective study. Shear wave elastography measurements were performed where the thrombus was most prominent and homogeneous. To evaluate patient response to treatment, lumen patency (partial [>25%] or total recanalization) was examined using color Doppler imaging in the first and third months posttreatment. Shear wave elastography values with and without patency were compared using an independent t test. Among 75 patients in this study, at the first-month color Doppler imaging examination, the SWE values were 1.77 +/- 0.49 (1.09-3.03) m/s in patients who achieved lumen patency (n = 42) and 2.21 +/- 0.54 (1.24-3.36) m/s in those who did not show lumen patency (n = 33). The difference between the groups' mean elastography value was statistically significant (P < 0.001). At the third-month examination, the SWE values were 1.76 +/- 0.46 (1.09-3.03) m/s in patients with lumen patency (n = 55) and 2.52 +/- 0.48 (1.74-3.36) in patients without lumen patency (n = 20). The difference between the 2 groups' mean elastography value was statistically significant (P < 0.001). We concluded that it is more difficult to achieve lumen patency in veins occluded by thrombus with higher elasto values, and endovascular interventional procedures should be considered during the initial treatment of high SWE value thrombosis.
The Comparison of Wall Thickness of Esophagus and Gastroesophageal Junction Using Computed Tomography With Endoscopy and Biopsy Results
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2020) Durmaz, Fatma; Ozgokce, Mesut; Toprak, Nursen; Oguzlar, Furkan Cangin; Goya, Cemil
Background: This study aims to establish a cut-off value for increases in the esophageal wall thickness measured using computed tomography to differentiate between benign and malignant pathologies. Methods: A total of 144 patients (61 males, 83 females; mean age 57.2 +/- 12.4 years; range, 24 to 86 years) who underwent thoracic and/or abdominal computed tomography in the radiology clinic between January 2015 and June 2018 for any reason and who were found to have a thickening of the esophageal wall or gastroesophageal junction were retrospectively analyzed. Tomography images were examined by two radiologists who reached consensus on the wall morphology and thickness, anatomic localization, and any accompanying findings regardless of the endoscopy results. Benign and malignant patients were identified from the endoscopy and/or biopsy results. The receiver operating characteristic analysis was carried out to establish a cut-off value for the lesion wall thickness to differentiate between benign and malignant pathologies and to determine a cut-off value for the lesion-level thickness-normal segment thickness ratio. Results: A statistically significant difference was found in the wall thicknesses of patients with esophageal cancer and those with benign lesions. According to a cut-off value for wall thickness of 13.5 mm, sensitivity and specificity were found to be 94.3% and 100%, respectively. The lesion-level thickness-normal segment thickness ratio was found to be statistically significant in malignant-benign differentiation, and a significant correlation was found between the asymmetric thickening and malignancy. Conclusion: Increases in the esophageal wall thickness and asymmetry detected on computed tomography can contribute to the early diagnosis of esophageal cancers, particularly in regions endemic to esophageal cancer as in Van province in eastern anatolia region of Turkey. Asymmetric wall thicknesses over 13.5 mm would be highly significant in terms of malignancy in tomographic examinations.
Contribution of Sonoelastography To Diagnosis in Distinguishing Benign and Malignant Breast Masses
(Wiley, 2020) Yildiz, Mehmet Siddik; Goya, Cemil; Adin, Mehmet Emin
Objectives The purpose of this study was to investigate the contribution of strain index measurements and a 5-point scoring method to diagnostic accuracy in differential diagnosis of benign and malignant solid breast masses and to compare the diagnostic performances of both methods. Methods Eighty female patients were included in this study. Before biopsy, all patients underwent ultrasound (US) and sonoelastographic examinations. The elastographic images of lesions were assessed according to the 5-point scoring method, and then elasticity scores were determined. Strain values of the masses and subcutaneous adipose tissue were measured. The diagnostic efficacies of B-mode US, sonoelastographic 5-point scoring, and strain index methods were compared with histopathologic findings. Results The mean age of the patients +/- SD was 42 +/- 13 years (range, 14-81 years). In histopathologic evaluations, 59 (74%) lesions were diagnosed as benign, and 21 (26%) were diagnosed as malignant. The mean strain index values were 10.45 +/- 7.04 (range, 3.4-25.1) in malignant lesions and 2.88 +/- 2.5 (range, 0.5-19.81) in benign lesions. The mean strain index for malignant lesions was significantly higher than that for benign lesions (P < .05). The highest sensitivity was found for B-mode US, and the highest specificity was found for the strain index. The diagnostic performance of the strain index was higher than that of the 5-point scoring method. Conclusions The addition of a sonoelastographic examination to B-mode US prevents unnecessary biopsies. The strain index was found to be superior to the 5-point scoring method to a limited extent.
Deep Learning in Distinguishing Pulmonary Nodules as Benign and Malignant
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2024) Akinci, Muhammed Bilal; Ozgokce, Mesut; Canayaz, Murat; Durmaz, Fatma; Ozkacmaz, Sercan; Dundar, Ilyas; Goya, Cemil
Background: Due to the high mortality of lung cancer, the aim was to find convolutional neural network models that can distinguish benign and malignant cases with high accuracy, which can help in early diagnosis with diagnostic imaging. Methods: Patients who underwent tomography in our clinic and who were found to have lung nodules were retrospectively screened between January 2015 and December 2020. The patients were divided into two groups: benign (n=68; 38 males, 30 females; mean age: 59 +/- 12.2 years; range, 27 to 81 years) and malignant (n=29; 19 males, 10 females; mean age: 65 +/- 10.4 years; range, 43 to 88 years). In addition, a control group (n=67; 38 males, 29 females; mean age: 56.9 +/- 14.1 years; range, 26 to 81 years) consisting of healthy patients with no pathology in their sections was formed. Deep neural networks were trained with 80% of the three-class dataset we created and tested with 20% of the data. After the training of deep neural networks, feature extraction was done for these networks. The features extracted from the dataset were classified by machine learning algorithms. Performance results were obtained using confusion matrix analysis. Results: After training deep neural networks, the highest accuracy rate of 80% was achieved with the AlexNET model among the models used. In the second stage results, obtained after feature extraction and using the classifier, the highest accuracy rate was achieved with the support vector machine classifier in the VGG19 model with 93.5%. In addition, increases in accuracy were noted in all models with the use of the support vector machine classifier. Conclusion: Differentiation of benign and malignant lung nodules using deep learning models and feature extraction will provide important advantages for early diagnosis in radiology practice. The results obtained in our study support this view.
The Diagnostic Value of Bladder-Wall Thickness and Arfi Elastography of Bladder Wall Amongst Patients With Bph
(Duzce Univ, Fac Medicine, 2022) Alan, Bircan; Goya, Cemil; Utangac, Mazhar; Dusak, Abdurrahim
Objective: The present study identified bladder-wall thickness and, through the use of ARFI elastography, bladder-wall elasticity values amongst patients with benign prostate hyperplasia (BPH), then examined their relationship with the disease diagnosis and progression. Methods: The study included 60 patients with BPH (patient group) and 50 healthy volunteers (control group). All members of the patient and control groups were measured for bladder-wall thickness (BWT) and bladder-wall mean shear-wave velocity (BW mean SWV) values, as well as for uroflowmetry parameters. The patient group was divided into the sub-groups of mild-medium and severe BPH, according to the International Prostate Symptom Score (IPSS). The patient and control groups and their sub-groups were compared amongst themselves. Results: Whilst the BPH group indicated a mean wall thickness of 6.3 +/- 2 mm (range: 3-12 mm), the control group yielded a result of 2.8 +/- 0.7 mm (range: 2-5 mm), which led to the conclusion that there was a significant difference between these groups (p<0.01). The BWmeanSWV value was 1.39 +/- 0.5 m/s (range: 0.60-2.65 m/s) for the BPH group and 1.01 +/- 0.2 m/s (range: 0.60-1.50 m/s) for the control group, and this also indicated the presence of a significant difference between the groups (p<0.01). According to the IPSS, BWT was observed to be significantly higher in the severe sub-group when compared to the mild-medium BPH group [(5.07 +/- 1 mm; range: 3-7 mm), (6.8 +/- 2 mm; range: 4-12 mm), p<0.01). Conclusions: When compared to the control group, patients with BPH showed significantly higher BWT and BWmeanSWV values; these two parameters may provide an additional method in the diagnosis of bladder outlet obstruction secondary to BPH. BWT, increasing in parallel with the severity of BPH, may be utilised in the follow-up for BPH progression.
Direct X-Ray and Ct Findings of Gallstone Ileus
(Springer india, 2020) Turkoglu, Saim; Goya, Cemil; Kalayci, Tolga
Gallstone ileus is a complication of biliary tree stones and was first described by Bartholin in 1654. In any localization, one or more gallstones may occlude as a result of access to the gastrointestinal tract via the bilioenteric fistula. In this article, we aimed to present a rare and operate with gallstone ileus cases of radiological and surgical imaging findings. A 74-year-old male patient presented with complaints of right upper quadrant pain, nausea, vomiting, and constipation in the last few days of the emergency department. Radiographical and computed tomography examination was done. The patient was urgently operated with gallstones. The ileal stone was removed in addition to cholecystectomy in the operation, and the cholecystododenal fistula detected during the operation was repaired. Gallstone ileus is an uncommon cause of a mechanical small bowel obstruction. Gallstone ileus should also be kept in mind in the elderly patients who have recurrent abdominal operation history with abdominal obesity findings of the omentum. In our case, we wanted to emphasize the importance of the radiological approach in diagnosing gallstone ileus disease in elderly patients with diabetes mellitus.
Does Contrast-Enhanced Computed Tomography Raise Awareness in the Diagnosis of the Invisible Side of Celiac Disease in Adults
(Springer, 2022) Goya, Cemil; Dundar, Ilyas; Ozgokce, Mesut; Turko, Ensar; Ozkacmaz, Sercan; Durmaz, Fatma; Hattapoglu, Salih
Purpose This study aimed to evaluate the diagnosis and determine major and minor criteria of celiac disease (CD) with the malabsorption patterns (MABP) in the small intestine and colon on computed tomography (CT) and additional CT findings. Methods This retrospective study was conducted with 116 patients diagnosed with CD, 14 CD patients recovering with treatment, and 35 control patients with non-CD. All patients had CT examinations and histopathological diagnoses. The sensitivity, specificity, PPV, NPV, and accuracy values of each CT finding defined in the literature were statistically evaluated. According to the patient and control groups, the numerical values of the findings and the sensitivity and specificity values were measured according to this cut-off value. The distribution of CT findings according to pathological Marsh data was evaluated in CD patients. Results Sensitivity and specificity were found to be higher in small bowel MABP findings, mesenteric hypervascularity, and increased SMV/aorta diameter. There was a numerically significant difference in MDCT findings between the control and pathological Marsh groups. In the ROC analysis performed in terms of the total numerical values of each MDCT finding observed between the groups, it was found that there were more than 7 MDCT findings, 100% sensitivity, and 92% specificity. The presence of four major and three minor criteria or three major and four minor criteria were considered significant. Conclusions Being aware of CT findings below the iceberg that may suggest CD in abdominal CT examinations performed in patients with atypical clinical and malabsorption findings or other nonspecific findings may prevent diagnostic delay and unnecessary procedures. [GRAPHICS] .
The Effect of Computed Tomography on Oxidative Stress Level and Some Antioxidant Parameters
(Sage Publications Ltd, 2021) Gunduz, Ali Mahir; Demir, Halit; Toprak, Nursen; Akdeniz, Huseyin; Demir, Canan; Arslan, Ayse; Goya, Cemil
Background X-rays are defined as ionizing radiation and hydrolyze the water, causing free radical formation. Oxidative stress is the damage that occurs in cells due to the lack of antioxidants, which detoxifies them, with the increased production of free radicals that occur during normal cellular metabolism. Purpose To examine the acute effects of computed tomography (CT), i.e. ionizing radiation, on oxidative stress and antioxidant defense mechanisms. Material and Methods The study included a total of 53 patients that were selected among the patients that underwent non-contrast full-body CT. Malondialdehyde (MDA) and reduced glutathione (GSH) levels and superoxide dismutase (SOD) and catalase (CAT) activities were investigated in blood samples taken from patients. Results The post-scan levels of MDA increased significantly while the post-scan levels of GSH, SOD, and CAT decreased significantly compared to their pre-scan levels. Conclusion CT, which is a widely used X-ray imaging technique and has numerous known side effects, was found to increase the levels of MDA, which is an indicator of oxidative stress, and to decrease the levels of some antioxidants including GSH, SOD, and CAT.
Efficacy of Shear Wave Elastography in Malignity Assessment of Thyroid Nodules With Atypia of Undetermined Significance and Comparison With Ti-Rads
(Bayrakol Medical Publisher, 2022) Durmaz, Fatma; Ozgokce, Mesut; Ozkacmaz, Sercan; Dundar, Ilyas; Alay, Murat; Goya, Cemil; Kotan, Mehmet Cetin
Aim: The aim of this study is to investigate the effectiveness of shear wave elastography (SWE) in the differentiation of benign-malignant thyroid nodules diagnosed with atypia of undetermined significance (AUS) and to compare with the American College of Radiology (ACR)-thyroid imaging reporting and data system (TIRADS). Material and Methods: This monocentric study comprised 52 patients (9 males; 43 females) who were diagnosed with AUS by thyroid FNAB. All patients included in the study had gray scale ultrasound (US) and SWE images. The mean SWE value was calculated for each nodule, and TIRADS scores were determined based on the US. The obtained data were compared based on the histopathological result in patients who had undergone surgical treatment, and based on the cytology result in patients followed-up by FNAB, for the differentiation of benign and malignant nodules. Results: Nineteen patients were found to have malignant nodules and 33 had benign nodules. The mean SWE was 2.89 +/- 0.51 (2.30-3.92) and 2.91 +/- 0.48 (2.16- 3.79) in the malignant and benign cases, respectively. The results of independent T-tests between the two groups were insignificant (p=0.89). TIRADS 2-3 (total 29 patients) nodules were considered possibly benign, and TIRADS 4-5 (total 23 patients) possibly malign, the sensitivity, specificity, positive predictive and negative predictive value of TIRADS were identified 100%, 87.9%, 82.6% and 100%, respectively, when compared with the pathology results. Discussion: There was no significant difference in SWE values in the differentiation of malignant-benign thyroid nodules with AUS. However, the ACR-TIRADS criteria still maintain their importance.
The Efficiency of Diffusion-Weighted Magnetic Resonance Imaging in the Differentiation of Malign and Benign Cavitary Lung Lesions
(Lippincott Williams & Wilkins, 2023) Durmaz, Fatma; Ozgokce, Mesut; Aydin, Yener; Yildiz, Hanifi; Ozkacmaz, Sercan; Dundar, Ilyas; Goya, Cemil
Purpose:The present study investigates the diagnostic efficiency of apparent diffusion coefficient (ADC) values in differentiating between malignant and benign cavitary lesions on diffusion-weighted magnetic resonance imaging (DWI). Materials and Methods:This prospective study included 45 consecutive patients identified with a cavitary lung lesion with a wall thickness of >= 5 mm on thoracic computed tomography in our clinic between 2020 and 2022, and who underwent thoracic DWI within 1 week of their original computed tomography. ADC measurements were made on DWI by drawing a region of interest manually from the cavity wall, away from the lung parenchyma in the axial section where the lesion was best demonstrated. The patients were then classified into benign and malignant groups based on the pathology or clinico-radiologic follow-up. Results:The sample included 29 (64.4%) male and 16 (35.6%) female patients, with a mean age of 59.06 +/- 17.3 years. Included in the study were 1 patient with 3 and 3 patients with 2 cavitary lesions each, with a total for the sample of 50 cavitary lesions. There were 23 (46%) malignant and 27 (54%) benign cavitary lung lesions. The mean ADC value (x10(-3) mm(2)/s) of the malignant and benign cavitary lesions was 0.977 +/- 0.522 (0.511 to 2.872) and 1.383 +/- 0.370 (0.930 to 2.213), respectively. The findings were statistically significant using an independent samples t test (P=0.002). The mean wall thickness of the malignant and benign lesions was 12.47 +/- 5.51 mm (5 to 25 mm) and 10.11 +/- 4.65 mm (5 to 22 mm), respectively. Although malignant cavities had a higher mean wall thickness than benign cavities, the difference was statistically insignificant (P=0.104). Conclusion:A significant difference was identified between the ADC values measured in DWI of the malignant and benign cavitary lung lesions. DWI, a noninvasive and rapid imaging method, can provide useful information for the differential diagnosis of cavitary lesions and can minimize unnecessary biopsies.
Efficiency of Diffusion-Weighted Mri for Differentiating Radiologically Similar Simple and Type I Hydatid Cysts of the Liver
(Sage Publications Ltd, 2022) Dundar, Ilyas; Ozgokce, Mesut; Durmaz, Fatma; Ozkacmaz, Sercan; Turkoglu, Saim; Goya, Cemil
Background Determining the nature of purely cystic hepatic lesions is essential because different kinds have different follow-ups, treatment options, and complications. Purpose To explore the potential of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) for the differentiation of type I hydatid cysts (HC) and simple liver cysts (SLC), which have similar radiological appearances. Material and Methods This single-center prospective study was conducted during 2016-2019. Round, homogenous, anechoic liver cysts >1 cm were classified according to at least two years of imaging follow-up, radiological features, serology, as well as puncture aspiration injection reaspiration procedure and pathology results. ADC values of 95 cysts (50 type I HCs and 45 SLCs) were calculated on DWI. The differences in ADC values were analyzed by independent t-test. Results Of 51 patients, 28 were female, 23 were male (mean age 32.07 +/- 22.95 years; age range 5-82 years). Mean diameter of 45 SLCs was 2.59 +/- 1.23 cm (range 1.2-7.6 cm) and ADC(mean) value was 3.03 +/- 0.47 (range 2.64-5.85) while mean diameter of 50 type I HCs was 7.49 +/- 2.95 cm (range 2.8-14 cm) and ADC(mean) value was 2.99 +/- 0.29 (range 2.36-3.83). There was no statistically significant difference in ADC values between type I HCs and SLCs Conclusion Some studies report that ADC values of type I HCs are statistically significantly lower than those of SLCs. Others suggest no significant difference. In our study with a higher number of cases, using ADC parameters similar to those in previous studies, we did not find any statistically significant difference.
Evaluation of Celiac Disease With Uniphasic and Multiphasic Dynamic Mdct Imaging
(Springer, 2021) Goya, Cemil; Dundar, Ilyas; Ozgokce, Mesut; Turkoglu, Saim; Turko, Ensar; Ozkacmaz, Sercan; Almali, Necat
Purpose An analysis of dynamic contrast MRI has been shown to provide valuable information about disease activity in Crohn's disease and Celiac disease (CD). However, there are no reports of dynamic multi-detector computer tomography use in patients with CD. The aim of this study is to determine and compare the perfusion dynamics of the patients treated with control subjects and the perfusion dynamics in patients with untreated CD, using dynamic contrast in MDCT and compare studying contrast dynamics in Marsh types as well. Methods In this retrospective study, uniphasic and multiphasic MDCT, untreated, treated, incompatible CD patients and healthy control group duodenum wall thickness and HU values were compared in terms of patient groups and modified Marsh types. Result In dynamic CT, the highest contrast curve was observed in the untreated group and Marsh type 1. While the contrast curve of the untreated and non-compliant patients increased rapidly and showed wash out, the type 4 contrast curve was observed, whereas the treated and control group slowly increased type 5 contrast curve. In the contrast-enhanced CT in the venous phase, in the ROC analysis between Marsh 1-2 and Marsh 3a-c, the sensitivity was 97% and the specificity was 87% when the cut off was taken as 4.45 mm for wall thickness (p: 0.005). Conclusion Contrast-enhanced single-phase and dynamic MDCT imaging in CD patients may be useful in evaluating the inflammatory and pathological process in the small intestine. [GRAPHICS] .
Ewing's Sarcoma of the Lung: a Rare Case
(Turkish Assoc Tuberculosis & Thorax, 2019) Ekin, Selami; Cobanoglu, Ufuk; Goya, Cemil; Erten, Remzi; Yildiz, Hanifi
The Ewing's sarcoma family of tumors (ESFT) incorporates both the well-recognized primary bone and the extraskeletal soft tissue sarcomas. Primitive neuroectodermal tumors (PNET) and ESFT have a similar neural phenotype and can be considered in the same entity. Here, we will present 28 years old patient with Ewing Sarcoma. Patient was admited chest pain. Chest radiograph showed a suspicious lesion in the left paracardiac area. Computed tomography (CT) scan and positron emission tomography (PET)/CT result were compatible with malignant tumor. The patient was underwent surgical resection as the bronchoscopic result couldn't a malignant finding and pathological finding was detected as Ewing's sarcoma. Ewing's sarcoma should be considered in patients who are very fast growing in the lungs, are properly confined and suspected of malignancy in FDG-PET/CT.