Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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15 results
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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 Can Breast Magnetic Resonance Imaging Prevent Biopsy or Change the Management of BI-RADS (R) Category 4 Breast Lesions?(2018) Turnaoglu, Hale; Ozturk, Emine; Yucesoy, Cuneyt; Teber, Mehmet Akif; Turan, Aynur; Ozbalci, Aysu Basak; Seker, Ebru Gaye; Onal, Binnur; Hekimoglu, Baki; 0000-0002-0781-0036; AAK-8242-2021The BI-RADS (R) category 4 includes suspicious breast lesions which requires biopsy. The aim of this study is to investigate the contribution of breast magnetic resonance imaging to the management of BI-RADS (R) category 4 breast lesions detected by mammography and/or ultrasonography. Thirty-four lesions classified as BI-RADS (R) category 4A, 4B, or 4C by conventional methods were evaluated with magnetic resonance imaging. All lesions were coded by using the American College of Radiology BI-RADS (R) lexicon. Each lesion was verified with the result of pathology. Lesions were evaluated as BI-RADS (R) category 1 in 1 patient (2.9%), category 3 (20.6%) in 7 patients, category 4 in 25 patients (73.6%), and category 5 in 1 patient (2.9%) with breast magnetic resonance imaging. Only the BI-RADS (R) 4A lesion categories were changed by breast magnetic resonance imaging, and these lesions were pathologically diagnosed as benign. The negative predictive value of breast MRI for BI-RADS (R) category 4A lesions was calculated as 100%. In all BI-RADS (R) category 4 lesions, pathologically 4 lesions found to be high risk and 3 lesions found to be malignant. The sensitivity, specificity, positive predictive, and negative predictive value of breast magnetic resonance imaging in BI-RADS (R) category 4 lesions were calculated as 100, 29.6, 26.9, and 100%, respectively. The area under the ROC curve was calculated 0.648. Breast magnetic resonance imaging is promising to be used as a problem-solving modality in BI-RADS (R) category 4A breast lesions.Item Does Renal Function Affect Gadolinium Deposition in the Brain?(2018) Rahatli, Feride Kural; Donmez, Fuldem Yildirim; Kibaroglu, Seda; Kesim, Cagri; Haberal, Kemal Murat; Turnaoglu, Hale; Agildere, Ahmet Muhtesem; 0000-0002-4226-4034; 0000-0003-4502-106X; 0000-0002-3964-268X; 0000-0002-8964-291X; 0000-0002-8211-4065; 0000-0002-0781-0036; 0000-0003-4223-7017; 29857863; AAL-9808-2021; AAE-5528-2021; AAJ-2956-2021; AAD-5996-2021; R-9398-2019; AAK-8242-2021; AAB-5802-2020Objective: Was to compare T1 signal intensity ratios of dentate nucleus to cerebellar white matter (DN/cerebellum), dentate nucleus to pons (DN/pons) and globus pallidus to thalamus (GP/thalamus) in patients with normal renal function and in patients on chronic hemodialysis. To find out if renal function affects the deposition of gadolinium in brain after administration of linear gadolinium based contrast agents (GBCA). Methods: Seventy eight contrast enhanced brain MRIs (Magnetic Resonance Imaging) with linear GBCA of 13 patients on chronic hemodialysis and 13 patients with normal renal function retrospectively evaluated. The DN/ pons, DN/cerebellum and GP/thalamus signal intensity ratios were measured from each brain MRI on unenhanced axial T1 weighted images. Results: In hemodialysis group statistically significant increase in the signal intensity ratios of DN/pons, DN/ cerebellum and GP/thalamus were found between the first and the last brain MRIs (p = .001). The increase in the signal intensity ratios of DN/pons, DN/cerebellum and GP/thalamus between the first and the last brain MRIs in control group were not significant (p > 0.05). The signal intensity increase in DN and globus pallidus were significantly higher in hemodialysis group than control group (p < 0.05). Conclusions: Patients on hemodialysis had significantly higher DN and GP signal intensity increase compared to the patients with normal renal function. Renal function affects the rate of gadolinium deposition in the brain after administration of linear GBCA.Item 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; 35938620Background 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.Item Acoustic Radiation Force Impulse Elastography and Ultrasonographic Findings of Achilles Tendon in Patients With and Without Diabetic Peripheral Neuropathy: A Cross-Sectional Study(2021) Iyidir, Ozlem Turhan; Rahatli, Feride Kural; Bozkus, Yusuf; Ramazanova, Lala; Turnaoglu, Hale; Nar, Asli; Tutuncu, Neslihan Bascil; 0000-0001-5305-6807; 0000-0002-6976-6659; 0000-0003-0998-8388; 0000-0002-1816-3903; 30786314; K-7904-2019; AAA-5419-2021; AAA-2743-2021; ABG-5027-2020Aims We aimed to evaluate the elastographic features of Achilles tendon with Acoustic Radiation Force Impulse in patients with and without diabetic neuropathy. Methods According to the presence of peripheral neuropathy, 45 patients with type 2 diabetes were divided into 2 subgroups. Those with peripheral neuropathy were defined as group I (22 patients) and those without peripheral neuropathy were defined as group II (23 patients). A total of thirty age-, gender-, and body mass index-matched healthy individuals were selected as controls. All participants underwent both ultrasonographic and Acoustic Radiation Force Impulse elastographic examination in order to evaluate Achilles Tendon thickness and stiffness. Results Achilles tendon thicknesses were similar between groups (p = 0.991). Achilles tendon thicknesses of both patient groups were significantly higher than the control group (group I vs control p = 0.01; group II vs control p = 0.006). Stiffness values of Achilles tendons were similar between the control group and group II (p = 0.993). Shear Wave Velocity was significantly lower in group I than group II and control group (p < 0.001). Conclusion Diabetic patients with neuropathy have thicker and softer Achilles tendon while the elasticity of Achilles tendon in diabetic patients without neuropathy is similar to the healthy controls. Softening of the Achilles tendon may be an early sign of diabetic foot and reveal the patients with a risk of diabetic foot.Item Use of Computed Tomography Volumetry to Assess Liver Weight in Patients With Cirrhosis During Evaluation Before Living-Donor Liver Transplant(2021) Haberal, Kemal Murat; Rahatli, Feride Kural; Turnaoglu, Hale; Ozgun, Gonca; Coskun, Mehmet; 0000-0002-8211-4065; 0000-0002-4226-4034; 0000-0002-0781-0036; 0000-0001-5630-022X; 30398100; R-9398-2019; AAL-9808-2021; AAK-8242-2021; AAM-4120-2021Objectives: Computed tomography liver volumetry has been widely used to detect total and segmental liver volume in living-donor liver transplantation. However, use of this technique to evaluate the cirrhotic liver remains unclear. In this study, we evaluated the accuracy of freehand computed tomography volumetry to assess total liver volume by comparing weights of total hepatectomy specimens in patients with cirrhosis. For our analyses, we considered the density of a cirrhotic liver to be 1.1 kg/L. Materials and Methods: Liver volume was measured using a freehand computed tomography technique in 52 patients with cirrhosis from different causes and who had no solid lesions before transplant. Measurements were made with a 16-slice multidetector computed tomography scanner (Siemens Somatom Sensation 16, Erlangen, Germany). For volumetric measurements, 10-mm-thick slices with 10-mm reconstruction intervals were preferred. Total hepatectomy weights of explant livers and computed tomography volumetry data were compared. Results: We excluded 3 cirrhotic patients with Budd-Chiari syndrome due to wide variations in scatterplot results. In the 49 patients included in the final analyses, average estimated liver volume by computed tomography was 721 +/- 398 mL and actual cirrhotic liver weight was 727.8 +/- 415 g. No significant differences were shown between these measurements. A simple regression analysis used to analyze correlations between estimated liver volume by computed tomography and real cirrhotic liver weight showed correlation of 0.957 (P < .001). When computed tomography liver volumetry as the independent variable and cirrhotic liver weight as dependent variable were considered, regression analyses showed R-2 = 0.915. Conclusions: Freehand computed tomography liver volumetry can be confidently used to evaluate liver volume in cirrhotic liver patients similar to use of this technique to estimate actual weights in normal livers. This technique can also be valuable during pretransplant and liver resection evaluations to ensure a more successful outcome.Item Liver Stiffness Measurements Using Acoustic Radiation Force Impulse in Recipients of Living-Donor and Deceased-Donor Orthotopic Liver Transplant(2021) Haberal, Kemal Murat; Turnaoglu, Hale; Ozdemir, Adnan; Uslu, Nihal; Reyhan, Asuman Nihan Haberal; Moray, Gokhan; Haberal, Mehmet; 0000-0002-8211-4065; 0000-0002-3462-7632; 28836931; R-9398-2019; AAJ-8097-2021Objectives: The aim of this study was to evaluate the diagnostic efficiency of the acoustic radiation force impulse (Siemens Medical Solutions, Erlangen, Germany) elastography in assessment of fibrosis in orthotopic liver transplant patients. Materials and Methods: We enrolled 28 orthotopic liver transplant patients (5 deceased and 23 living donors), whose biopsy decision had been prospectively given clinically. Ten acoustic radiation force impulse elastographic measurements were applied before the biopsy or within 3 days after the biopsy by 2 radiologists. After the core tissue needle biopsy, specimens of all patients were analyzed according to the modified Ishak scoring system. Measurements of acoustic radiation force impulse elastography and pathology specimen results were compared. Results: From 28 biopsies, fibrosis scores of 4 biopsies were evaluated as F0 (14.3%), 16 as F1 (57.1%), 4 as F2 (14.3%), and 4 as F3 (14.3%). Mean results of acoustic radiation force impulse measurements were calculated as 1.4 +/- 0.07 in F0, 1.74 +/- 0.57 in F1, 2.19 +/- 0.7 in F2, and 2.18 +/- 0.35 in F3. There were no significant correlations of mean acoustic radiation force impulse values between the F0 versus F1 (P =.956) and F0 versus F2 stages (P =.234). A statistically significant correlation of mean acoustic radiation force impulse values was found between the F0 and F3 fibrosis stages (P =.046). Conclusions: Acoustic radiation force impulse imaging is a promising screening test for detecting significant liver fibrosis (>= F3 in modified Ishak) in living- donor or deceased-donor orthotopic liver transplant recipients.Item Acoustic Radiation Force Impulse Elastography Findings of Achilles Tendons in Patients on Chronic Hemodialysis and in Renal Transplant Patients(2021) Rahatli, Feride Kural; Turnaoglu, Hale; Haberal, Kemal Murat; Kirnap, Mahir; Fidan, Cihan; Sayin, Cihat Burak; Uslu, Nihal; Haberal, Mehmet; 0000-0002-8211-4065; 0000-0002-9093-1524; 0000-0002-9093-1524; 30398098; R-9398-2019; F-5830-2019; F-5830-2019Objectives: The Achilles tendon, which is composed of tendinous parts of gastrocnemius and soleus muscles, is the strongest and the largest tendon in the human body. Chronic renal disease can lead to reduced physical activity and exercise capacity. Spontaneous rupture of the Achilles tendon can occur in patients with chronic renal failure, with recurrent microtraumas, hypoxia, and chronic acidosis as predisposing factors. Here, we assessed and compared the elastographic findings in the Achilles tendon using acoustic radiation force impulse elastography in patients on chronic hemodialysis, in renal transplant patients, and in healthy volunteers. Materials and Methods: Our study included 25 patients on chronic hemodialysis, 25 renal transplant patients, and 25 healthy individuals (control group). The thickness and shear wave velocity of the Achilles tendons were measured bilaterally by ultrasonography and acoustic radiation force impulse elastography. Results: The mean shear wave velocity was 3.67 m/s in the right and 3.64 m/s in the left Achilles tendon in the hemodialysis group. In the renal transplant group, the mean shear wave velocity was 4.29 and 4.25 m/s for the right and left Achilles tendon, respectively. In the control group, the mean shear wave velocity was 6.68 and 6.59 m/s, respectively for the right and left Achilles tendon. A statistically significant difference in shear wave velocities was shown among the groups (P<.05). Conclusions: Achilles tendons in patients with chronic renal failure and on hemodialysis were softer than in renal transplant patients and softer than in the control group. Chronic tendinopathy causes softening of the tendon. In the renal transplant group, stiffness of the Achilles tendon was increased versus the hemodialysis group but still softer than the control group, which could be explained as a positive clinical effect of renal transplant. Acoustic radiation force impulse elastography is an objective, easy, and noninvasive method to assess Achilles tendinopathy.Item The effect of the use of the Gail model on breast cancer diagnosis in bi-rads 4A cases(2021) Karakaya, Emre; Erken, Murathan; Turnaoglu, Hale; Sirinoglu, Tugce; Akdur, Aydincan; Kavasoglu, Lara; 0000-0002-0664-5147; 0000-0002-8726-3369; 0000-0002-3592-5092; 0000-0002-3592-5092; 35677495; AAJ-8219-2021; AAA-3068-2021; ABI-7217-2020; CAA-2756-2022Objective: The BI-RADS classification system and the Gail Model are the scoring systems that contribute to the diagnosis of breast cancer. The aim of the study was to determine the contribution of Gail Model to the diagnosis of breast lesions that were radiologically categorized as BI-RADS 4A. Material and Methods: We retrospectively examined the medical records of 320 patients between January 2011 and December 2020 whose lesions had been categorized as BI-RADS 4A. Radiological parameters of breast lesions and clinical parameters according to the Gail Model were collected. The relationship between malignant BI-RADS 4A lesions and radiological and clinical parameters was evaluated. In addition, the effect of the Gail Model on diagnosis in malignant BI-RADS 4A lesions was evaluated. Results: Among radiological features, there were significant differences between lesion size, contour, microcalcification content, echogenicity, and presence of ectasia with respect to the pathological diagnosis (p< 0.05). No significant difference was found between the lesions' pathological diagnosis and the patients' Gail score (p> 0.05). An analysis of the features of the Gail model revealed that there was no significant difference between the age of menarche, age at first live birth, presence of a first-degree relative with breast cancer, and a history of breast biopsy and the pathological diagnosis (p> 0.05). Conclusion: As a conclusion Gail Model does not contribute to the diagnosis of BC, especially in patients with BI-RADS 4A lesions.Item Evaluation of Neuroimaging Findings of Central Nervous System Complications in Heart Transplant Recipients(2020) Turnaoglu, Hale; Agildere, Ahmet Muhtesem; Rahatli, Feride Kural; Donmez, FuldemYildirim; Ocal, Ruhsen; Sezer, Taner; Can, Ufuk; Sezgin, Atilla; Aslamaci, Sait; 0000-0002-2278-1827; 0000-0001-8689-417X; 0000-0003-4223-7017; 29790456; AAJ-5931-2021; AAJ-2999-2021; AAB-5802-2020Objectives: In this study, we presented neuroradiologic findings and diagnoses of neurologic complications in a series of heart transplant recipients. Materials and Methods: A retrospective review was conducted at Baskent University Hospital. We searched the hospital and radiology databases and identified 109 heart transplant recipients. Thirty-one of these recipients had neuroradiologic evaluations secondary to presentation of neurologic symptoms after heart transplant, with 18 patients evaluated with computed tomography and 22 patients evaluated with magnetic resonance imaging (overlap of imaging-defined groups occurred in 9 recipients). Computed tomography and magnetic resonance imaging studies were retrieved from the Picture Archiving and Communication System, with each type of imaging retrospectively evaluated on consensus by 2 radiologists. Results: Radiopathologic findings related to symptoms were detected in 12 of the 31 study patients. The most common abnormality was posterior reversible leuko-encephalopathy syndrome (5 patients, 4.6%). The other abnormalities were ischemic stroke (3 patients, 2.8%), hemorrhagic stroke (1 patient, 0.9%), intracranial abscess (2 patients, 1.8%), and intracranial dissemination of sinusoidal fungal infection and related hemorrhagic infarct (1 patient, 0.9%). The other 19 heart transplant recipients who underwent computed tomography and/or magnetic resonance imaging for neurologic complaints showed no neuroradiologic findings related to neurologic symptoms. Conclusions: Posterior reversible leukoencephalopathy syndrome and ischemic stroke were the most common neurologic complications in our heart transplant recipients. The other complications were hemorrhagic stroke, intracranial abscess, and intracranial dissemination of sinusoidal fungal infection. Neurologic complications are common in heart transplant recipients and should be identified promptly for early treatment. For the recognition of these complications, computed tomography should be performed for initial evaluation to rule out edema or hemorrhage. However, in the presence of serious neurologic symptoms that cannot be explained by computed tomography, magnetic resonance imaging should be indicated.