Browsing by Author "Ozgokce, Mesut"

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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.
Cardiovascular Evaluation and Serum Paraoxonase-1 Levels in Adolescents With Polycystic Ovary Syndrome
(Taylor & Francis inc, 2020) Cetin, Mecnun; Tuncdemir, Perihan; Karaman, Kamuran; Yel, Servet; Karaman, Erbil; Ozgokce, Mesut; Komuroglu, Ahmet Ufuk
The aim of our study was to evaluate whether cardiovascular disease risks seen in adults with polycystic ovary syndrome (PCOS) develop in adolescents with PCOS using conventional Doppler echocardiography (CDE) and tissue Doppler echocardiography (TDE) or not. The other aim was to investigate the association of paraoxonase-1 (PON-1) level with cardiovascular parameters. 30 PCOS patients and 30 control patients were included in the study. All patients were evaluated with TDE and CDE. Paraoxonase-1 levels of both groups were studied. In CDE study, myocardial performance index (MPI) was higher in the PCOS group than in the control group (0.54 +/- 0.11, 0.50 +/- 0.12, p = .049, respectively). In the TDE study, early diastolic myocardial velocity (E)'/late diastolic myocardial velocity (A ') was lower in PCOS group than in the control group (2.07 +/- 0.08, 2.44 +/- 0.10, p = .008, respectively). PON-1 was higher in PCOS group than in the control group (26.81 +/- 3.05, 18.68 +/- 1.18, p = .011, respectively). Cardiovascular disease risks, which are among the long-term complications of PCOS, seem to begin from the early stage of PCOS. The high PON-1 level was thought to increase in response to increased oxidative stress in PCOS.Impact statement What is already known on this subject? Polycystic ovary syndrome (PCOS) is one of the most commonly seen endocrinopathy in the adolescent age group. PCOS has detrimental effects on the cardiovascular system in the adult population which is reported in many studies. What the results of this study add? The result of this study showed that cardiovascular effects, which are among the long-term complications of PCOS, seem to begin from the early stage of PCOS. And also, serum paraoxonase-1 level increases in response to the oxidative stress in the adolescent with PCOS.
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.
A Comparative Evaluation of Cataract Classifications Based on Shear-Wave Elastography and B-Mode Ultrasound Findings
(Springer international Publishing Ag, 2019) Ozgokce, Mesut; Batur, Muhammed; Alpaslan, Muhammed; Yavuz, Alpaslan; Batur, Abdussamet; Seven, Erbil; Arslan, Harun
In this study, a comparison is made of the findings of B-mode ultrasound and ultrasound elastography with the Lens Opacities Classification (LOCS) grade in patients with senile cataracts. A total of 74 patients with cataracts and 32 age-matched healthy volunteers as the control group were evaluated in the departments of ophthalmology and radiology between 2016 and 2017. In the patient group, cataracts were graded according to LOCS, and B-mode sonographic appearance and elasticity measurements were recorded, after which the cataract grade and sonoelastography/B-mode ultrasound findings were compared using statistical methods. Among the 74 patients with cataracts, 38 were females (51.4%) and 36 were males (48.6%), and the mean age was 62.05 +/- 7.95 (43-78) years. A Chi-square test revealed a significant relationship between ultrasound echogenicity of cataract and grade of cataract (p < 0.005). The ultrasound elastography revealed a mean shear-wave velocity of 2.90 m/s +/- 0.371 (2.13-3.53) among patients with grade 3 cataracts, 3.1 m/s +/- 0.45 (2.26-3.98) among patients with grade 4, 3 m/s +/- 0.58 (2.35-4.60) among patients with grade 5 and 3 m/s +/- 0.528 (2.31-4.50) among patients with grade 6 cataracts, and 3 m/s +/- 0.258 (2.36-3.58) among the normal subjects. No statistically significant difference was noted in the analysis of variance (p > 0.005). While cataract grade and B mode echogenicity were directly proportional, there was no significant difference in lens elasticity.
Comparison of Computed Tomography Densitometry and Shear Wave Elastography Velocity Measurements for Evaluation of the Liver Volume in the Nonalcoholic Fatty Liver Disease
(E-century Publishing Corp, 2016) Bulut, Mehmet Deniz; Ozdemir, Hayrullah; Bora, Aydin; Yavuz, Alpaslan; Arslan, Harun; Batur, Abdussamet; Ozgokce, Mesut
Purpose: The aim of the present study is to evaluate and compare the values of velocities measured by the shear wave elastography (SWE), and those of the liver attenuation index (LAI) determined by the computerized tomography (CT) densitometry, in the nonalcoholic fatty liver disease (NAFLD). In other words, we aimed to compare the values of density measured by CT and the stiffness determined by elastography, in the liver steatosis. In addition, it is to investigate the effect of NAFLD on the liver volume. Materials and methods: Forty five cases with hepatosteatosis who had undergone abdominal CT and 50 individuals who did not exist with fatty liver clinically and radiologically, were investigated by ultrasonography (US) and SWE. The liver and spleen attenuation values were then measured in the images of non-contrast CT, and the LAI indices were calculated. Contrast images of abdomen were processed by the CT-Volume software and measurements of liver volume were performed using the interactive and automatic liver segmentation techniques together. Values of the liver volume, LAI, liver dimensions, and the shear wave velocities were determined and recorded in the patients with hepatosteatosis and controls; statistical comparisons were performed then. Results: In the nonalcoholic fatty liver, the mean value of velocity measured by SWE was found to be 1.08 (+/- 0.11) m/s, and that of LAI measured by CT densitometry was 13.68 (+/- 10.6). No correlation was observed between these two parameters (P>0.05). A high statistically significant difference between the patient and control groups in terms of the liver volume, LAI values and liver size has been observed (P<0.01). Direct correlations existed between the liver volume and LAI values, and the grades in US, and highly significant differences were determined (P<0.01). The mean values of the liver volume in the patient and control groups were determined to be 1917.4 (+/- 425.9) cm(3) and 1311.4 (+/- 241.4) cm(3), respectively. A high statistically significant difference between the groups in terms of liver volumes has been observed (P<0.01). Conclusion: In our study, we determined no correlation between the values of velocity measured by SWE, and the values of LAI measured by CT densitometry, in the NAFLD (P>0.05). This result indicates that there is no relation between the degree of stiffness evaluated by SWE, and the attenuation values measured by CT densitometry, in the non-alcoholic fatty liver. The liver volume was found to increase in NAFLD. We concluded that the CT densitometry can be used as an auxiliary technique associated with the US, in determining the degree of steatosis in NAFLD.
Comparison of Conventional Magnetic Resonance Imaging, Cine-Magnetic Resonance Imaging, and Operation Findings in Invasion Assessment of Esophageal Cancer
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2017) Ozgokce, Mesut; Alper, Fatih; Sade, Recep; Yavuz, Alpaslan; Ogul, Hayri; Aydin, Yener; Eroglu, Atilla
Background: This study aims to compare the conventional magneticresonance imaging and cine-magnetic resonance imaging findings with the operation results in terms of invasion existence in esophageal cancer. Methods: This prospective study included a total of 37 suspected cases (21 males, 16 females; mean age 63.3 years; range 28 to 81 years) with respect to whether or not invasion in esophageal masses between January 2012 and February 2016. Initially, conventional magnetic resonance imaging (T-1-weighted, T-2-weighted, short tau inversion recovery), lesion characteristics and invasion areas were evaluated in all cases. The cases with invasion were re-evaluated according to dynamic moving features of the lesion and adjacent tissue by cine-magnetic resonance imaging in three planes. The relative motion of the mass with adjacent tissues, fatty planes, and invasion status were evaluated according to size and structure. Results: The presence of invasion was detected by conventional magnetic resonance imaging in all of the cases. Invasion was not detected in 28 of 37 cases, while it was observed in nine cases by cine-magnetic resonance imaging. Twenty of 28 non-invasion cases were operated and results were compatible with the cine-magnetic resonance imaging results. The remaining eight cases were not operated due to severe comorbidities and the refusal of operation. Conclusion: Cine-magnetic resonance imaging may contribute to detect invasion accurately in esophagus cancer which is adjacent to moving tissues such as heart and main vascular structures. Based on our study results, cine-magnetic resonance imaging appears to be superior to conventional magnetic resonance imaging.
Comparison of Efficiencies Between Shear Wave Elastography, Fine-Needle Aspiration Biopsy and American College of Radiology Thyroid Imaging Reporting and Data System Scoring System in Determining the Malignity Potential of Solid Thyroid Nodules
(Lippincott Williams & Wilkins, 2021) Yavuz, Alpaslan; Akbudak, Ibrahim; Ucler, Rifki; Ozgokce, Mesut; Arslan, Harun; Batur, Abdussamed
We aimed to evaluate the efficiencies of quantitative shear-wave elastography, fine-needle aspiration (FNA) biopsy and American College of Radiology (ACR)-thyroid imaging reporting and data system (TIRADS) scoring system in determining the malignity potential of solid thyroid nodules. In period between September 2014 and January 2016, 191 solid thyroid nodules of 189 patients were enrolled in this study. The mean shear wave velocities of the nodules were recorded by acoustic radiation force impulse method. All nodules were classified according to ACR-TIRADS scoring system and underwent FNA procedure. The cytopathologic results (after FNA) were benign in nature, atypical-cytology/suspiciously malign and highly suspicious of malignity in 117, 28, and 21 nodules, respectively. The specimen from FNA was insufficient in 25 nodules. Thirty-four nodules of 33 enrolled patients were operated, and the efficiencies of shear wave elastography, FNA, and ACR-TIRADS procedures were statistically analyzed; relying on the histopathologic results, the shear-wave elastography had 83.3% sensitivity, 93.7% specificity (with a cutoff value of 2,74 m/s), the FNA had 94.4% sensitivity, 87.5% specificity, and ACR-TIRADS had 88.2% sensitivity, 94.1 specificity in determining malignant tyroid nodules (P < 0.005). Quantitative shear wave elastography is concluded to be an effective, noninvasive, and practical imaging modality with a lesser sensitivity and specificity values than TIRADS unless a lower sensitivity but a higher specificity values than FNA (93.7% vs 87.5%) in considering the malignity potential of solid thyroid nodules.
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.
A Comprehensive Exploration of Deep Learning Approaches for Pulmonary Nodule Classification and Segmentation in Chest Ct Images
(Springer London Ltd, 2024) Canayaz, Murat; Sehribanoglu, Sanem; Ozgokce, Mesut; Akinci, M. Bilal
Accurately determining whether nodules on CT images of the lung are benign or malignant plays an important role in the early diagnosis and treatment of tumors. In this study, the classification and segmentation of benign and malignant nodules on CT images of the lung were performed using deep learning models. A new approach, C+EffxNet, is used for classification. With this approach, the features are extracted from CT images and then classified with different classifiers. In other phases of the study, a segmentation between benign and malignant was performed and, for the first time, a comparison of nodes was made during segmentation. The deep learning models InceptionV3, DenseNet121, and SeResNet101 were used as backbone models for feature extraction in the segmentation phase. In the classification phase, an accuracy of 0.9798, a precision of 0.9802, a recognition of 0.9798, an F1 score of 0.9798, and a kappa value of 0.9690 were achieved. During segmentation, the highest values of 0.8026 Jacard index and 0.8877 Dice coefficient were achieved.
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.
Delftia Acidovorans Pneumonia With Lung Cavities Formation
(Corporacion Editora Medica Valle, 2019) Yildiz, Hanifi; Sunnetcioglu, Aysel; Ekin, Selami; Baran, Irfan; Ozgokce, Mesut; Asker, Selvi; Akyuz, Sumeyye
Case Description: A 52-year-old female patient was admitted to our clinic with complaints of cough, sputum, fever and fatigue. The patient has been receiving immunosuppressive therapy for thrombocytopenic purpura for 5 years. Clinical Finding: Inspiratory crackles were heard on both hemithorax. Oxygen saturation measured with the pulse oximeter was 97%. Chest X-ray showed diffuse reticular opacities that were more prominent in the upper zones of both lungs. WBC counts were 17,600 mm(3) and Platelet counts were 29,000 mm3. Thorax CT showed that there were many thin-walled cavities and millimetric nodules accompanied by ground-glass infiltrates in the upper and middle lobes. Gram staining of bronchial fluid, taken by bronchoscopy, revealed Gram-negative bacilli and intense polymorphonuclear leukocytes. The bacteria were defined as Delftia acidovorans by BD Phoenix automated system. Treatment and outcomes: The patient was hospitalized with suspicion of opportunistic pulmonary infections and cavitary lung disease. After the empirical treatment of intravenous piperacillintazobactam and oral clarithromycin, her clinical and radiological findings significantly regressed, and she was discharged with outpatient follow-up. Clinical Relevance: This is the first example of cavitary pneumonia due to Delftia acidovorans in an immunocompromised patient. We would like to emphasize that Delftia pneumonia should be considered in the differential diagnosis of pulmonary cavitary involvement in such patients.
Dev Duodenum Divertikülü: Radyolojik Bulgular
(2016) Yokuş, Adem; Durmaz, Fatma; Ozgokce, Mesut; Batur, Abdussamet
Duodenum divertikülü az bilinen bir patolojidir.Divertiküller genellikle semptom vermezler, sıklıklagastrointestinal görüntüleme yöntemlerinde tesadüfensaptanmaktadırlar. Bu yazımızda, duodenum 1.segmentte yerleşmiş, yaklaşık 5x3 cm boyutunda dev birduodenum divertikülü olgusunu sunuyoruz
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] .
Doubling Time in Pulmonary and Hepatic Hydatid Cysts
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2024) Aydin, Yener; Ozgokce, Mesut; Ulas, Ali Bilal; Durmaz, Fatma; Kasali, Kamber; Eren, Suat; Eroglu, Atilla
Background: This study aims to investigate whether the concept of doubling time in hydatid cysts differs according to different parameters such as age, sex, and whether the cyst is located in the lung or liver. Methods: Between January 2012 and August 2023, a total of 138 hydatid cysts were retrospectively analyzed. There were 55 pulmonary (32 males, 23 females; mean age: 25.6 +/- 23.8 years; range, 2 to 77 years) and 83 hepatic hydatid cyst patients (32 males, 51 females; mean age: 31.1 +/- 22.8 years; range, 3 to 75 years). Results: The mean doubling times for pulmonary and hepatic hydatid cysts were 73.4 +/- 41.8 and 172.6 +/- 108.8 days, respectively (p<0.001). When children (<= 18 years old) and adult cases were compared for pulmonary hydatid cysts, the mean doubling times were 61.1 +/- 17.6 and 87.1 +/- 55.3 days, respectively (p=0.119), and for hepatic hydatid cysts, 110.6 +/- 48.4 and 215.6 +/- 118.3 days, respectively (p<0.001). While comparing male and female cases, the mean doubling time for pulmonary hydatid cysts was 77.6 +/- 32.2 and 67.6 +/- 52.6 days, respectively (p=0.018), while for hepatic hydatid cysts, it was 192.0 +/- 111.7 and 160.4 +/- 106.2 days, respectively (p=0.250). Conclusion: The doubling time seems to be approximately 10 weeks in the lung and approximately 25 weeks in the liver. Hydatid cysts grow faster in children than adults in both the lungs and liver.
Effectiveness of Extracorporeal Shock Wave Therapy To Treat Primary Medial Knee Osteoarthritis With and Without Bone Marrow Edema in Elderly Patients
(Gunes Kitabevi Ltd Sti, 2018) Ediz, Levent; Ozgokce, Mesut
Introduction: This study aimed to evaluate the clinical and radiographic effectiveness of extracorporeal shock wave therapy to treat primary medial knee osteoarthritis with and without bone marrow edema in elderly patients. Materials and Method: Elderly patients with right knee osteoarthritis and bone marrow edema confirmed by magnetic resonance imaging were allocated to the first group (n=40), whereas patients without bone marrow edema were randomly allocated to either the second (n=40) or third (n=40) groups. The patients were treated twice weekly with a total of 10 sessions of extracorporeal shock wave therapy (Groups 1 and 2) or were left untreated with sham extracorporeal shock wave (Group 3). Results: The comparison of the patients' Visual Analogue Scale, Western Ontario and McMaster Universities Osteoarthritis Index and Lequesne scores before treatment and at 6 months and 1 year after treatment revealed significant score reductions in the first and second groups (p<0.05). One year after treatment, the medial joint space was preserved in Groups 1 and 2 (p<0.05), whereas the medial joint width protection was more prominent in Group 1 (p<0.05) than in Groups 2 and 3. Conclusion: In elderly patients with knee osteoarthritis, extracorporeal shock wave therapy led to functional and radiologic improvements and pain relief without substantial complications. The improvement remained at the 1 year follow-up and was higher in patients with bone marrow edema. Further studies are required to investigate its potential as a diseasemodifying physical agent, particularly for treating elderly patients with knee osteoarthritis with bone marrow edema.
Effectiveness of Twin-Beam Dual-Energy Computed Tomography in Characterization of Solitary Pulmonary Nodules Larger Than 5 Mm
(Brieflands, 2024) Turkoglu, Saim; Ozgokce, Mesut
Background: Advancements in technology have significantly improved the diagnosis of solitary pulmonary nodules in thelungs. Various computed tomography (CT) imaging techniques, including modern dual-energy computed tomography (DECT),have enhanced the ability to accurately classify pulmonary nodules as benign or malignant. In this study, three different dual-energy parameters - iodine load, contrast load, and visual assessment - were evaluated for their potential in characterizingpulmonary nodules. Objectives: The aim of this study was to assess the reliability and effectiveness of DECT in distinguishing benign frommalignant pulmonary nodules using different parameters, including visual assessment, iodine concentration, and contrastload. Patients and Methods: This prospective study included patients who underwent contrast-enhanced thoracic DECT forsolitary pulmonary nodules, had histopathological examination results, or had at least a two-year follow-up CT scan. Patientswith nodules smaller than 6 mm or completely calcified nodules were excluded. Patients diagnosed with a suspicious solitarypulmonary nodule on chest radiography and subsequently underwent contrast-enhanced DECT, or those diagnosed with a lungnodule on routine non-contrast CT scans and later evaluated using DECT, were included in the study. Benign and malignantnodules were compared based on gender, age, contrast load, iodine load, and color map assessment. Nodule images wereobtained 40 seconds after intravenous contrast administration using single-source DECT (120 kV split filter) with twin-beamtechnology. The visual enhancement and color map evaluation, including contrast and iodine load measurements, wereseparately calculated and recorded for each lung nodule. Results: A total of 59 patients [30 males (50.8%) and 29 females (49.2%)] with a solitary pulmonary nodule met the inclusioncriteria. Among the 59 pulmonary nodules, 16 (27.1%) were malignant, and 43 (72.9%) were benign. Of the benign lesions, 23(53.5%) were found in males and 20 (46.5%) in females. The mean age of patients with benign nodules was 53.5 +/- 12 years (range:25 - 73 years), while for those with malignant nodules, it was 69.2 +/- 5.59 years (range: 57 - 75 years). There was no statisticallysignificant difference in age between the two groups (P = 0.506). The median contrast load was 0.0 Hounsfield units (HU)[interquartile range (IQR: 64)] in benign nodules and 63 HU (IQR: 154) in malignant nodules. Malignant nodules had asignificantly higher contrast load than benign nodules (P = 0.003). Using a cut-off value of 22 HU for contrast load in malignancydiagnosis, the sensitivity was 100%, specificity was 58.14%, positive predictive value (PPV) was 47.06%, and negative predictivevalue (NPV) was 100%. The area under the curve (AUC) was 0.746. The median iodine load was 0.0 mg/dL (IQR: 4.5) in benignnodules and 4.5 mg/dL (IQR: 11.8) in malignant nodules. Malignant nodules had a significantly higher iodine load than benignnodules (P < 0.001). Using a cut-off value of 1 mg/mL for malignancy diagnosis, the sensitivity was 100%, specificity was 62.79%,PPV was 50%, and NPV was 100% (AUC: 0.768). Conclusion: Dual-energy computed tomography provides valuable contributions in differentiating benign and malignantpulmonary nodules. In this study, the diagnostic value of three different approaches - visual iodine coverage color map, iodineconcentration, and contrast load - was demonstrated in distinguishing these lesions.
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 Acoustic Radiation Force Impulse (Arfi) Elastography in the Diagnosis and Staging of Carpal Tunnel Syndrome
(Springer Japan Kk, 2018) Arslan, Harun; Yavuz, Alpaslan; Ilgen, Ferda; Aycan, Abdurrahman; Ozgokce, Mesut; Akdeniz, Huseyin; Batur, Abdussamet
The aim of the present study was to quantify the stiffness of the median nerve (MN) at the carpal tunnel inlet by acoustic radiation force impulse (ARFI) elastography and to evaluate whether ARFI can be used in diagnosis and staging of carpal tunnel syndrome (CTS). Sonographic examinations of 96 wrists in 50 patients were included in the study. The cross-sectional area and stiffness of the MN were quantitatively measured by B-mode ultrasonography (USG) and ARFI. The findings of CTS were assigned to four groups: (I) normal (n = 21), (II) mild (n = 39), (III) moderate (n = 38), and (IV) severe (n = 19). The differences between CTS patients and controls and the differences in electrodiagnostic tests among subgroups were statistically compared. ROC analysis was performed to determine the cut-off values between subgroups. Bilateral CTS was present in 46 patients (92 wrists) and unilateral CTS in four patients. Of the 96 nerves in the 50 symptomatic "idiopathic CTS" patients (48 women, 2 men; mean age 45.9 years, range 23-73 years), 39 (40.4%) were mild, 38 (39.8%) were moderate, and 19 (19.8%) were severely affected. When compared to controls, MN stiffness was significantly higher in the CTS group (P < 0.001); furthermore, it was higher in the severe or extreme severity group than the mild or moderate severity group (P < 0.001). A 3.250 m/s cut-off value on ARFI revealed sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 81, 82, 95.1, 50, and 82%, respectively. The MN stiffness measured by ARFI elastography is significantly higher in patients with CTS then in controls. ARFI elastography appears to be a highly efficient imaging modality for the diagnosis and staging of these patients.
The Efficiency of Acoustic Radiation Force Impulse (Arfi) Elastography in the Differentiation of Renal Cell Carcinoma and Oncocytoma
(Bentham Science Publ Ltd, 2024) Ozgokce, Mesut; Dundar, Ilyas; Durmaz, Fatma; Ozkacmaz, Sercan; Kankilic, Nazim A.; Aslan, Rahmi; Akinci, M. Bilal
Purpose This study is to investigate the effectiveness of Acoustic Radiation Force Impulse (ARFI) elastography in differentiating radiologically similar renal cell carcinoma (RCC) and oncocytoma in solid masses of the kidney. Methods The patients with solid renal mass histopathological diagnosed after excision or tru-cat biopsy who underwent a preoperative ARFI elastography of the lesion during a 4-year period were included in this study. Preoperative shear wave velocity (SWV) values were measured in all the lesions. SWV results of RCCs and oncocytomas were compared by an independent t-test, and cut-off, sensitivity and specificity values were calculated. Results Forty-two of the 60 patients included in the study were men (70%) and, 18 were women (30%), and the mean age was 59.7 +/- 14 (27-94) years. Among 46 RCCs (76.6%), 23 and 14 oncocytomas, 5 (23.4%) were located in the right kidney (p:0.34722). Mean SWV values were found to be significantly higher in RCCs (2.87 +/- 0.74 (0.96-4.14) m/s) than oncocytomas (1.83 +/- 0.78 (0.80-3.76) m/s) (p <0.001). In the ROC analysis, a cut-off value of 2.29 m/s was found to havean 80.4% sensitivity and a 78.6% specificity for the discrimination of RCCs from oncocytomas. Conclusion ARFI elastography measurements may be useful in distinguishing RCC and oncocytomas that may have similar solid radiological imaging features.