Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Interobserver and Intermethod Variability in Data Interpretation of Breast Strain Elastography in Suspicious Breast Lesions(2021) Turnaoglu, Hale; Haberal, Kemal Murat; Arslan, Serdar; Yavuz Colak, Meric; Ulu Ozturk, Funda; Uslu, Nihal; https://orcid.org/0000-0002-0781-0036; https://orcid.org/0000-0002-8211-4065; https://orcid.org/0000-0001-7984-4326; https://orcid.org/0000-0002-0294-6874; https://orcid.org/0000-0003-2782-2824; 32950046; AAK-8242-2021; R-9398-2019; AAA-4360-2021; JCP-5266-2023Background/aim: Strain elastography has the disadvantage of being operator-dependent. Interobserver variability is observed during image acquisition and interpretation. This study aimed to analyze the interobserver and intermethod variability of strain elastography in image interpretation and evaluate the diagnostic performance combining elasticity score and strain ratio with ultrasonography. Materials and methods: A retrospective study was conducted on 70 breast lesions evaluated with B-mode ultrasonography and strain elastography. B-mode ultrasonography findings, elasticity scores, and strain ratio values were evaluated using static images by two radiologists. BI-RADS assessment of the lesions and the decision of both observers as to whether the biopsy was required using B-mode ultrasonography, and the combined ultrasonography+elasticity score, and the combined ultrasonography+elasticity score+strain ratio were compared with the histopathological results. Also, the interobserver agreement was analyzed for all the combinations. Results: There was very good agreement (weighted kappa = 0.865) between the observers for the elasticity scores. Very good agreement was observed between the observers for BI-RADS assessments using the combined ultrasonography+elasticity score and the combined ultrasonography+elasticity score+strain ratio (weighted kappa = 0.848, and 0.902, respectively). Area under the curve of B-mode ultrasonography, the combined B-mode ultrasonography+elasticity score, and the combined B-mode ultrasonography+elasticity score+strain ratio, were calculated as 0.859, 0.866, and 0.916 for observer 1, and 0.851, 0.829, and 0.916 for observer 2, respectively. There were no statistically significant differences between the observers' diagnostic performances in any of the combinations (P = 0.703, 0.067, and 0.972, respectively). Conclusion: In the evaluation and further assessment of breast lesions, semiquantitative strain ratio calculation may help improve diagnostic accuracy by reducing interpretational variety, when used together with B-mode ultrasonography and elasticity scoring, especially for inexperienced individuals.Item Value of diffusion-weighted imaging in hypoglycemic encephalopathy(2015) Donmez, Fuldem Y.; Arslan, Serdar; Agildere, Ahmed M.; Ecevit, Ayse; 26166602Item Malign ve benign meme lezyonlarının ayırımında sonoelastografinin tanıya katkısı(Başkent Üniversitesi Tıp Fakültesi, 2015) Arslan, Serdar; Uslu, NihalMeme kanserinde tarama ve tanıda altın standart olarak mamografi ve ultrasonografi tetkikleri kullanılmaktadır. Bununla birlikte meme lezyonlarında istenilen duyarlılık ve özgüllük verilerine henüz ulaşılamamıştır ve gereksiz girişimler sorun olmaya devam etmektedir. Bu çalışmada B-mod ultrasonografide tespit edilen meme lezyonların malign ve benign ayırımında ultrasonografik elastografinin etkinliğinin araştırılması amaçlanmıştır. Bu çalışmaya B-mod ultrasonografi ile memesinde lezyon saptanan 81 hasta dahil edildi. Elastografi yöntemi ile elde edilen renkli kodlanmış haritalar değerlendirildi. Kompresyondan önce ve sonra elde edilen sinyaller sonucunda oluşan renk skalası Tsukuba skorlamasına göre değerlendirilerek 5 skora ayrıldı. Tüm lezyonların strain ratio değerleri hesap edildi. Strain ratio değeri incelenen dokunun çevresindeki esneklik değerlerinin incelenen lezyonun esneklik değerlerine oranı olarak kabul edildi. Elastisite skorları ve strain ratio ölçümleri histopatoloji sonuçları ile karşılaştırıldı. Hastaların yaş ortalaması 51,3±13,1 yıl ve lezyonun ortalama boyutu 16,3±11,9 mm idi. 38 hastanın histopatolojik tanısı malign iken 43 tanesi benign özellikte idi. Benign ve malign meme hastalığı olanlar arasında strain ratio değerleri bakımından istatistiksel olarak anlamlı fark vardı (p<0.05). Strain ratio değeri ortalaması benign lezyonlarda 1,8±0,9, malign lezyonlarda ise 4,3±1,5 idi. Histopatolojisi benign olan 43 hastanın sadece 1 tanesinde elastografi skoru 5 olarak değerlendirildi. Histopatolojisi malign olan 38 hastadan 7 tanesinin elastografi skoru 4, 20 tanesinin elastografi skoru 5 olarak değerlendirildi. Duyarlılık, özgüllük ve eşik değerleri sırasıyla %78,9, %90,7 ve 2.84 olarak bulunmuştur. Strain ratio eşik değerine göre malign olduğu şüphelenilen hastaların %88,2’sinin histopatolojisi malign, benign şüphesi olan hastaların da %82,9’unun histopatolojisi benign idi. Sonuç olarak pratik bir şekilde uygulanabilen strain elastografinin şüpheli meme lezyonlarının benign ve malign ayırımında diğer yöntemleri tamamlayıcı bir teknik olduğunu ve bu lezyonlar için yapılması planlanan biyopsi ihtiyacını azaltabileceğini düşünmekteyiz. Mammography and ultrasonography is the gold standard examination for scanning and diagnosis of breast cancer. However, these examinations have not reached the ideal specificity and sensitivity values and so the redundant invasive procedures are still continued to be problematic. In this study we aimed to evaluate the effectiveness of ultrasonic elastography in differential diagnosis of malign and benign breast lesions. In this study we enrolled 81 patients (80 female, 1 male) breast lesions detected by B-mode ultrasonography. Colored coded maps obtained by elastography. Color scale of signals obtained before and after compressions was divided into 5 scores according to Tsukuba score. Strain ratio values defined as the elasticity ratio between the peripheral and inspected tissue were calculated in all lesions. Both elasticity scores and strain ratio measurements were compared with histopathology results. The mean age of the patients were 51.3±13.1 years and the mean size of the lesions were 16.3±11.9 mm. Of the lesions 38 were malign and 43 were benign. Strain ratio values were statistically significantly different between benign and malign lesions. The mean strain ratio values for benign and malign lesions were 1.8±0.9 and 4.3±1.5, respectively. Only one of 43 histopathologically benign patients had 5 elastrography score while seven had 4 and twenty had 5 elastrography score among 38 histopathologically malign patients). Sensitivity, specificity and cut-off values were 78.9% , 90.7% and 2.84, respectively. According to strain ratio cut-off level, 88.2% of malign suspected patients were confirmed as malign and 82.9% of benign suspected patients were confirmed as benign. In conclusion ultrasonic elastography seems to be a practical and alternative technique to distinguish the benign and malign breast lesions and decrease the number of unnecessary biopsies.