Tıp Fakültesi / Faculty of Medicine

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    Diffusion-Weighted MRI and Optimal b-value For Characterization of Liver Lesions
    (2014) Kaya, Bilal; Koc, Zafer; https://orcid.org/0000-0002-8917-3375; https://orcid.org/0000-0003-0987-1980; 23982322; AAK-9366-2020; S-8384-2016
    Background: Diffusion-weighted imaging (DWI) is commonly used to distinguish between benign and malignant liver lesions. However, different b-values are recommended. Purpose: To determine the most suitable b-value in DWI for differentiation of benign and malignant liver lesions. Material and Methods: A total of 124 lesions in 89 consecutive patients (43 men, 46 women; age, mean +/- standard deviation, 58 +/- 14 years) with a pathological or radiological diagnosis of malignant or benign focal liver lesions after magnetic resonance imaging (MRI) were included in this study. Routine abdominal MRI and DWI were performed using seven b-values (0, 50, 200, 400, 600, 800, 1000 s/mm(2)). Lesions were analyzed for benignity/malignity using apparent diffusion coefficient (ADC) values with 10 b-value combinations and by measuring the lesion/normal parenchyma ADC ratio. Results: Mean ADC values were significantly different between malignant and benign lesions for all b-value combinations (P = 0.000). The best b-value combination was 0 and 800 (Az = 0.935). Using lower b-values such as 0 and 50 together with higher b-values >= 600 s/mm(2) was beneficial (Az = 0.928 and 0.927). Mean ADC values were approximately 13% (1-15%) higher in total when b = 0 and b = 50 s/mm(2) were included in multiple b-value combinations. Conclusion: In DWI, we recommend the use of b-values of 0 and 800 s/mm(2) as two b-values, or b = 0, 50, 600, 800, and 1000 s/mm(2) as multiple b-values for distinguishing between benign and malignant liver lesions. Mean ADC value is 13% higher in total by additional use of b = 0 and b = 50 s/mm(2) in multiple b-value combinations.
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    Brain Metastasis of Penile Angiosarcoma
    (2018) Kardes, Ozgur; Aydemir, Fatih; Suner, Halil Ibrahim; Durdag, Emre; Civi, Soner; Tufan, Kadir; Kayaselcuk, Fazilet; https://orcid.org/0000-0003-2854-941X; https://orcid.org/0000-0002-5957-8611; https://orcid.org/0000-0001-6939-5491; https://orcid.org/0000-0002-1055-5152; https://orcid.org/0000-0003-1509-4575; https://orcid.org/0000-0002-1180-3840; 29150829; P-5895-2018; AAJ-5381-2021; AAK-1734-2021; U-2400-2018; AAK-1686-2021; AAE-2550-2021
    Angiosarcoma is a rare malignancy originating from vascular endothelial cells. Brain metastasis of aniosarcomas are uncommon up to the literature. Penile angiosarcomas are also seldom among all anjiosarcomas. A case with penile angiosarcoma with confirmed brain metastasis is aimed to be reported and contribute to the literature for similar cases.
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    Factors associated with the involvement of lymph nodes in low-grade serous ovarian cancer
    (2021) Akilli, Huseyin; Celik, Husnu; Ayhan, Ali; 0000-0002-5240-8441; 34610148; AAX-3230-2020
    Background and Objectives Evaluating nodal metastases in low-grade serous ovarian cancer (LGSOC) patients. Methods Women with LGSOC who had undergone primary cytoreductive surgery comprising systematic pelvic-paraaortic lymphadenectomy were included. Data were obtained retrospectively from 12 oncology centers. Results One hundred and forty-eight women with LGSOC who had undergone comprehensive surgical staging were included. Seventy-one (48.0%) patients had metastatic lymph nodes. Preoperative serum CA-125 levels of >= 170 U/ml (odds ratio [OR]: 3.84; 95% confidence interval [CI]: 1.22-12.07; p = 0.021) and presence of lymphovascular space invasion (LVSI) (OR: 13.72; 95% CI: 3.36-55.93; p < 0.001) were independent predictors of nodal metastasis in LGSOC. Sixty (40.5%) patients were classified to have apparently limited disease to the ovary/ovaries. Twenty (33.3%) of them were upstaged after surgical staging. Twelve (20.0%) had metastatic lymph nodes. Presence of LVSI (OR: 12.96; 95% CI: 1.14-146.43; p = 0.038) and preoperative serum CA-125 of >= 180 U/ml (OR: 7.19; 95% CI: 1.35-38.12; p = 0.02) were independent predictors of lymph node metastases in apparent Stage I disease. Conclusions Clinicians may consider to perform a reoperation comprising systematic lymphadenectomy in patients who had apparently limited disease to the ovary/ovaries and had not undergone lymphadenectomy initially. Reoperation may be considered particularly in patients whose preoperative serum CA-125 is >= 180 U/ml and/or whose pathological assessment reported the presence of LVSI.