Browsing by Author "Ozturk, Funda Ulu"

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Can Strain Elastography Combined with Ultrasound Breast Imaging Reporting and Data System Be A More Effective Method in The Differentiation of Benign and Malignant Breast Lesions?
(2017) Arslan, Serdar; Uslu, Nihal; Ozturk, Funda Ulu; Akcay, Eda Yilmaz; Tezcaner, Tugan; Agildere, Ahmet Muhtesem; https://orcid.org/0000-0001-7984-4326; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0002-3641-8674; https://orcid.org/0000-0003-4223-7017; 28154989; AAH-9796-2019; ABC-5258-2020; AAK-1960-2021; AAD-9865-2021; AAB-5802-2020
To investigate whether a novel method that combines breast imaging reporting and data system (BI-RADS) with strain elastography contributes to diagnostic performance in differentiation of malignant and benign breast lesions. In 81 patients, 81 breast lesions were prospectively investigated. Breast lesions were separately evaluated with ultrasonography and strain elastography. While evaluations with ultrasonography were based on 2003 BI-RADS-US, strain elastography evaluations were based on a 5-point scale and strain ratio. Diagnostic performances of ultrasonography, strain elastography, and the combined method were compared. Among 81 lesions, 43 (53.1%) were benign and 38 (46.9%) were malignant. When a cutoff point of category 3 was used, sensitivity, specificity, positive and negative predictive values, and accuracy for BI-RADS were 100, 11.6, 50, 100, and 53%, respectively. When BI-RADS and strain ratio were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 89.5, 93, 91.9, 90.9, and 91.3%, respectively. When BI-RADS and elastography scores were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 86.8, 97.7, 97.1, 89.4, and 92.5%, respectively. The combination of strain elastography and BI-RADS was found to have better diagnostic performances to diagnose breast lesions than BI-RADS alone.
Carpal Tunnel Syndrome: Evaluation of the Effects of Low-Level Laser Therapy With Ultrasound Strain Imaging
(2019) Tezcan, Sehnaz; Ozturk, Funda Ulu; Uslu, Nihal; Nalbant, Merve; Yemisci, Oya Umit; 0000-0001-7204-3008; 29892976; ABC-5258-2020
Objectives To evaluate the efficacy of low-level laser therapy on median nerve stiffness by using strain elastography in carpal tunnel syndrome (CTS). Methods This study included 37 wrists of 34 patients with mild or moderate CTS between January 2016 and August 2016. The control group comprised 17 patients (18 wrists) with CTS who were treated with wrist splinting for 3 weeks. The low-level laser therapy group included 17 patients (19 wrists) with CTS who were treated with a combination of splinting and low-level laser therapy, which was applied 5 times per week for 3 weeks. Clinical assessment scales, including the Symptom Severity Scale (SSS) and Functional Status Score (FSS), were obtained from our database. The cross-sectional area by ultrasound and strain ratio by elastography were studied. The differences in the strain ratio, cross-sectional area, SSS, and FSS between pretreatment and posttreatment periods in the groups were compared by the paired-sample t test. The correlations between changes in the strain ratio and the cross-sectional area, SSS, and FSS were analyzed by Pearson correlation coefficients. Results The control group included 13 women and 4 men, and the therapy group included 14 women and 3 men. In the therapy group, the mean values of the strain ratio, cross-sectional area, SSS, and FSS decreased significantly after laser therapy (P < .001) in contrast to the control group. No significant correlation was observed between the decreasing degree of the strain ratio and the cross-sectional area, SSS, and FSS after laser therapy. Conclusions The strain ratio and cross-sectional area of the median nerve decrease after low-level laser therapy. These changes may be related to the therapeutic effects of low-level laser therapy, such as nerve regeneration and improvement of the vascular supply.
Diffusion-Weighted Imaging of Breast Cancer: Correlation of the Apparent Diffusion Coefficient Value with Pathologic Prognostic Factors
(2019) Tezcan, Sehnaz; Uslu, Nihal; Ozturk, Funda Ulu; Akcay, Eda Yilmaz; Tezcaner, Tugan; 31620686; ABC-5258-2020
Objective: The aim was to evaluate relationship between apparent diffusion coefficient (ADC) values with pathologic prognostic factors in breast carcinoma (BC). Materials and Methods: 83 patients were enrolled in this study. Prognostic factors included age, tumor size, expression of estrogen receptor (ER) and progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), nuclear grade (NG), lymph node involvement and histologic type. The relationship between ADC and prognostic factors was determined using Independent sample t-test, ANOVA, Pearson correlation and relative operating characteristics (ROC) analysis. Results: There was no significant difference between ADC and prognostic factors, including age, tumor size, ER, HER2 and histologic type. The PR-positive tumors (p=0.03) and axillary lymph node involvement (p=0.000) showed a significant association with lower ADC values. The ADC values were significantly lower in high-grade tumors than low-grade tumors (p=0.000). ROC analysis showed an optimal ADC threshold of 0.66 (x10-3 mm(2)/s) for differentiating low-grade tumors from high-grade tumors (sensitivity, 85.5%; specificity, 81%; area under curve, 0.90). Conclusion: The lower ADC values of BC were significantly associated with positive expression of PR, LN positivity and high-grade tumor. Especially, ADC values were valuable in predicting NG subgroups.
Doppler Ultrasonography Findings During Recovery Period of Transplanted Kidney After Infarction and Necrosis Due to Renal Vein Thrombosis: A Case Report
(2017) Ozturk, Funda Ulu; Uslu, Nihal; Akcay, Eda Yilmaz; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-6733-8669; 0000-0001-6831-9585; 28260477; AAJ-8097-2021; ABC-5258-2020; AAK-1960-2021
A 47-year-old male patient underwent living-related renal transplant. On day 3 posttransplant, without evidence of associated clinical symptoms, the patient's serum creatinine levels had increased. The patient was given immunosuppressive medication, and a follow-up Doppler ultrasonography revealed hypoechoic areas in the inferior pole of the renal parenchyma. Eventually, on day 25, there was no perfusion in the superior and inferior poles of the transplanted kidney. No venous flow was shown in the middle segment, and only arterial vascularization with a high resistive index and negative diastolic phase was observed. Renal biopsy showed acute humoral rejection. This was interpreted as venous thrombosis secondary to acute humoral rejection. Tissue plasminogen activator infusion, plasmapheresis, and hemodialysis were administered. After 1.5 months, arterial flow returned to its normal pattern and the renal allograft recovered by gaining back its full vascularity at the end of month 8.
Effect Of Meal Intake For Evaluating Hepatic Artery By Doppler Ultrasonography In Liver Transplants: Does Fasting Matter For Screening Hepatic Artery Due To Hemodynamic Changes In Splanchnic Circulation?
(2022) Ozturk, Funda Ulu; Tezcan, Sehnaz; Soy, Ebru Hatice Ayvazoglu; Uslu, Nihal; Haberal, Mehmet; https://orcid.org/0000-0003-2782-2824; https://orcid.org/0000-0001-7204-3008; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3462-7632; 35419884; AAC-5566-2019; AAJ-8097-2021
Purpose The aim of this study is to assess the utility of fasting on Doppler ultrasonography findings of hepatic artery in liver transplants. Methods Liver transplant patients without vascular abnormalities were prospectively evaluated between December 2017 and January 2020. Doppler sonography was used to describe hemodynamic changes in response to a standard meal. The diameter, peak systolic velocity, blood flow, resistive index (RI) of the main hepatic artery and portal vein peak velocity were measured. Results The mean hepatic arterial diameter of 44 patients was higher in the fasting group (4.5 mm) than in the postprandial group (3.3 mm) (p < .05). The mean hepatic arterial blood flow decreased (from .276 to .127 L/min) and hepatic arterial RI increased (from .66 to .71) following meal ingestion (p < .05). Hepatic arterial velocity was significantly lower and portal venous velocity was higher after oral intake. Conclusion Meal ingestion has an important effect on hepatic artery Doppler features in liver transplants. Therefore, Doppler ultrasound evaluation should be considered after appropriate fasting due to postprandial responses of liver transplant.
Efficacy of the Sonoelastography Method for Diagnosis of Fibrosis in Renal Transplant Patients
(2022) Soudmand, Arash; Ozturk, Funda Ulu; Uslu, Nihal; Haberal, Nihan; Boyvat, Fatih; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-3462-7632; 29993356; AAJ-8097-2021
Objectives: Although biopsy is the most important method for diagnosing the cause of renal allograft dysfunction, sonoelastography, a new ultrasonography method, can be used to distinguish between the soft or hard nature of lesions. In this study, our aim was to investigate whether sonoelastography could diagnose fibrosis in renal transplant patients. Materials and Methods: In this prospective study, we included patients over 18 years old who were recommended for clinical biopsy. Sonoelastographic evaluation was made by conducting acoustic radiation force impulse measurements for each patient after they were admitted to the clinic for biopsy. Measurements were performed just before the biopsy procedure. All results were examined by 2 experienced radiologists using the Siemens S3000 Ultrasound Machine (Erlangen, Germany). Comparisons of ultrasonographic values with biopsy results were made with SPSS software (SPSS: An IBM Company, version 20, IBM Corporation, Armonk, NY, USA). Results: Of the 65 patients included in this study, pathology showed acute T-cell-mediated rejection in 37 patients. There was a significant correlation between the pathologic Banff scores and the sonographic acoustic radiation force impulse values (P = .002), where the degree of Banff increased as the mean acoustic radiation force impulse values elevated. A rise in mean impulse values correlated with increased degree of interstitial fibrosis in renal allografts. Renal parenchymal echogenicity of patients significantly differed by sex (P = .009), with an average renal echogenicity of grade 1 in women and grade 0 in men. Also, a statistically significant difference was found between age of the renal transplant recipient and resistive index values. Conclusions: Our study showed a significant correlation between Banff degree and the acoustic radiation force impulse values of renal transplant patients. In addition to biopsy, sonoelastography can be beneficial for the diagnosis of fibrosis in renal transplant patients.
Hepatic Artery Doppler Flow Changes During Cholangitis in Liver Transplantation Patients
(2018) Ozturk, Funda Ulu; Tezcan, Sehnaz; Soy, Ebru H. Ayvazoglu; Uslu, Nihal; Haberal, Mehmet; 0000-0002-0993-9917; 0000-0002-6733-8669; 0000-0002-3462-7632; AAC-5566-2019; ABC-5258-2020; AAJ-8097-2021
Importance of Regular Ultrasound Imaging in Renal Allografts for Early Diagnosis of De Novo Renal Cell Carcinoma: A report of Two Rare Cases
(2018) Ozturk, Funda Ulu; Uslu, Nihal; Kirnap, Mahir; Haberal, Mehmet; 0000-0002-6733-8669; 0000-0002-3462-7632; ABC-5258-2020; AAH-9198-2019; AAJ-8097-2021
Preferred Music Lowers Anxiety Levels and Pain Perception While Promoting Patient Satisfaction in Women Undergoing Ultrasound-guided Breast Biopsy: Randomized Controlled Study
(2023) Ozturk, Funda Ulu; Turnaoglu, Hale; Uslu, Nihal; 0000-0003-2782-2824; 35938620
Background Image-guided breast biopsies are well accepted, yet stressful procedures for patients in radiology clinics. Purpose To investigate the effect of music on anxiety, pain, and patient satisfaction related to a breast biopsy session. Material and Methods After approval of institutional review board and giving informed consent, 93 women scheduled for ultrasound-guided breast biopsy or stereotactic wire localization were prospectively enrolled in this randomized controlled study. Patients were referred into two groups either listening to music of their own choice from three options of genre list during the procedure or not. Immediately before and after the biopsy session, participants were asked to complete questionnaires for measuring anxiety (State-Trait Anxiety Inventory, Beck Anxiety Inventory), pain, and patient satisfaction (visual analog scale). Sociodemographic data were described, and the duration was noted at the end. Statistical analysis was made using paired samples t-test, chi-square test, independent samples t-test, and Mann-Whitney U test. Results Except for the duration, demographic characteristics were statistically similar between the two groups. Trait and preprocedural state anxiety scores did not have significant difference between the groups. Both groups showed lowered state anxiety values after the biopsy (P < 0.05) and there was statistically significant reduction in state anxiety levels of music group (10.35 +/- 7.5 music vs. 7 +/- 7.98 control; P = 0.024). Pain perception was fewer (P < 0.05) and patient satisfaction was greater (P < 0.05) through the implementation of music. Conclusion Music intervention reduces anxiety and pain and thereby increases patient satisfaction during ultrasound-guided breast biopsies.
The Role of Combined Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced MRI for Differentiating Malignant From Benign Breast Lesions Presenting Washout Curve
(2021) Tezcan, Sehnaz; Ozturk, Funda Ulu; Uslu, Nihal; Akcay, Eda Yilmaz; 32157892
Purpose: The aim of this study is to evaluate the diagnostic performance of combined breast magnetic resonance imaging (MRI) protocol including dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with enhancing lesions that demonstrated washout curve and to determine whether applying apparent diffusion coefficient (ADC) cutoff value could improve the diagnostic value of breast MRI. Methods: The retrospective study included 116 patients with 116 suspicious breast lesions, which showed washout curve on DCE-MRI, who underwent subsequent biopsy. Morphologic characteristics on DCE-MRI and ADC values on DWI were evaluated. Apparent diffusion coefficient values and morphologic features of benign and malignant lesions were compared. Diagnostic values of DCE-MRI and combined MRI, including DCE-MRI and DWI (applying an ADC cutoff value) for distinguishing malignancy from benign lesions, were calculated. Results: Of the 116 breast lesions, 79 were malignant and 37 were benign. The ADC value of malignant tumors (median ADC, 0.72 x 10(-3) mm(2)/s) was significantly lower than that of benign lesions (median ADC, 1.03 x 10(-3) mm(2)/s; P < .000). The sensitivity and specificity of an ADC cutoff value of 0.89 x 10(-3) mm(2)/s were 92% and 95%, respectively. Dynamic contrast-enhanced MRI alone presented 100% sensitivity and 59.4% specificity. Adding an ADC cutoff value of 0.89 x 10(-3) mm(2)/s provided 100% sensitivity and 81% specificity, which would have prevented biopsy for 21.6% of benign lesions without missing any malignancies. Conclusion: Applying an ADC cutoff value to DCE-MRI provides an improvement in the diagnostic value of breast MRI for differentiating among lesions presenting washout curve.
Stones Hounsfield Unit Value And Predictors Of Urinary Leakage After PCNL
(2022) Ozturk, Erdem; Yikilmaz, Taha Numan; Hamidi, Nurullah; Ozturk, Funda Ulu; Selvi, Ismail; Basar, Halil; Resorlu, Berkan
Background To evaluate the predictive factors of urinary leakage (UL) following percutaneous nephrolithotomy (PNL) and to investigate the relationship between Hounsfield unit (HU) of stone and UL. Methods We retrospectively reviewed the data of 728 patients who underwent PNL between January 2012 and January 2017. In total, 396 patients were eligible for the study. Patient demographics, renal factors, stone properties and operative details were collected. The association between UL and these variables were assessed by univariate and multivariate analysis. Results There was no statistically significant correlation considering age, body mass index and the presence of hypertension. The presence of diabetes mellitus (DM) was significantly correlated with UL (p < 0.001). Kidney related factors such as parenchymal thickness, hydronephrosis grade (HN), previous stone treatment, and stone related factors, such as stone surface area, stone burden, stone localization and HU value of stone, were found to affect UL status significantly (p < 0.001). Operation time, fluoroscopy time, treatment outcome, j stent use, percutenous nephrostomy (PCN) catheter stay time and the hospitalization time also had significant effect on UL (p < 0.001). Multivariable logistic analysis showed that presence of DM, parenchymal thickness, HU values, HN, operation time, j stent use, and PCN catheter stay time are independently related with UL following PCNL. Moreover, we determined a HU cut-off value of 933 with ROC analysis, which demostrated 84.9% sensitivity and 67.1% specificity for predicting UL. Conclusion This study has shown that we are more likely to encounter postoperative UL in stones with higher HU values. Therefore, we suggest clinicians to inform patients with this type of kidney stones about the probable complication of UL.