Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-8384-2016Background: 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.Item 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-2550-2021Angiosarcoma 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.Item Pituitary Gland Metastasis of Endometrial Cancer: A Case Report(2022) Farzaliyeva, Aydan; Iyidir, Ozlem Turhan; Altay, Feride Pinar; Tutuncu, Neslihan BascilTumor metastasis to the pituitary gland is very rare. Breast and lung cancers are the most common neoplasms reported to metastasize to the pituitary gland. Pituitary metastasis of endometrial carcinoma is extremely rare. Most of the pituitary metastasis are asymptomatic and therefore can be easily overlooked in imaging studies. Polyuria and polydipsia due to diabetes insipidus are the most common symptoms in these patients. Patients may also present with visual impairment and symptoms of panhypopituitarism. In this case report, we share a case presented with sudden onset of diabetes insipidus, as well as ophthalmoplegia, and diagnosed as pituitary metastasis of endometrium adenocarcinoma in imaging studies.Item 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-3230-2020Background 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.Item The Role of PET-CT in Evaluation of Cervical Lymph Node Metastases in Oral Cavity Squamous Cell Carcinomas(2015) Caylakli, Fatma; Yilmaz, Serkan; Ozer, Cem; Reyhan, Mehmet; 29391983Objective: The aim of this study is to determine the sensitivity and specificity of positron emission tomography-computed tomography (PET-CT) in the evaluation of cervical lymph node metastasis in oral cavity squamous cell cancers (SCCs) and to determine the SUV-max values in differentiating reactive and metastatic lymph nodes as a supportive parameter. Methods: In this study, 23 patients were included who were diagnosed with oral cavity SCC and treated with surgery between 2006 and 2013 in our department. All the patients were scanned with PET-CT during the pretreatment evaluation. Detailed pretreatment PET-CT (retention sites and SUV-max values) and histopathological examination results were obtained. SPSS 17.0 software package was used for statistical analysis of the data. Categorical measurement was summarized as number and percentage and continuous measurements as mean and standard deviation (median and minimum-maximum where necessary). Chi-square test or Fisher's test were used in the comparison of categorical variables. Compliance of methods was assessed by Kappa coefficient analysis. In this study, the advantages of PET-CT were determined by the calculation of sensitivity and specificity values with histopathological examination results considered as the gold standard, and SUV-max value was assessed by examining the area under the ROC curve. In all tests, the level of statistical significance was accepted as 0.05. Results: The threshold value for SUV-max depending on the data of the histopathological examination and results of PET-CT of the 23 patients was 2.50. The reliability of this threshold was determined as AUC=0.819. In demonstrating neck metastasis in patients with cancer of the oral cavity, PET-CT has a sensitivity of 89% and specificity of 98%. Compliance between the histopathological examination and PET-CT for metastatic cervical lymph nodes was determined to be 0.416 by kappa coefficient analysis. Conclusion: There was FDG uptake on PET-CT in the cervical lymph node regions of all patients with metastatic cervical lymph nodes. There were no metastases in any of the patients with no FDG retention. The sensitivity and specificity of PET-CT in determining cervical lymph node metastasis were 89% and 98%, respectively, with a threshold SUV-max value considered as 2.50 in patients with FDG retention.Item Sarcoidosis mimicking metastatic breast cancer in a patient with early-stage breast cancer(2016) Altinkaya, Metin; Altinkaya, Naime; Hazar, Burhan; 26985162Sarcoidosis is a systemic granulomatous disorder of unknown origin that affects the lungs and mediastinal lymph nodes in most patients. The coexistence of sarcoidosis and breast cancer has been reported. An unfortunate consequence of the presence of both entities in the same patient is the risk of misdiagnosis. We report the case of a 70-year-old female with T1N0 cancer of the right breast that was initially diagnosed as stage IV because of mediastinal positron-emission tomography - positive lymphadenopathy. Biopsy of a mediastinal lymph node allowed us to diagnose sarcoidosis and correctly stage her disease as stage I breast cancer.