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Kul M, Akkaya S, Kul S. Diagnostic value of qualitative and quantitative enhancement parameters on contrast-enhanced mammography. Diagn Interv Radiol 2024; 0:0-0. [PMID: 38619006 DOI: 10.4274/dir.2024.232472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
PURPOSE To determine whether qualitative and quantitative enhancement parameters obtained from contrast-enhanced mammography (CEM) can be used in predicting malignancy. METHODS After review board approval, consecutive 136 suspicious lesions with definite diagnosis were retrospectively analyzed on CEM. Acquisition was routinely started with craniocaudal view and ended with mediolateral oblique view of the affected breast. Lesion conspicuity (low, moderate, high), internal enhancement pattern (homogeneous, heterogeneous, rim), contrast-to-noise ratio (CNR), percentage of signal difference (PSD) and relative enhancement from early to late view were analyzed. PSD and relative enhancements were used to determine patterns of descending, steady or ascending enhancements. Receiver operating characteristic analysis, Cohen's kappa statistics and Spearman correlation tests were used. RESULTS There were 29 benign and 107 malignant lesions. 64% of the malignant lesions exhibited high conspicuity compared to 14% of the benign lesions (P < 0.001). CNR values were higher in malignant lesions compared to benign ones (P ≤ 0.004). CNR from early view yielded 82% sensitivity, 72% specificity and PSD yielded 79% sensitivity, 65% specificity. Descending pattern and rim enhancement observed in 44% and 21% of breast cancers, respectively, and both provided 96% positive predictive value for malignancy. CONCLUSION Diagnostic accuracy of quantitative parameters was higher than that of qualitative parameters. High CNR, rim enhancement, and descending pattern were features commonly seen in malignant lesions, while low CNR, homogeneous enhancement, and ascending pattern were commonly seen in benign lesions.
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Affiliation(s)
- Musa Kul
- University of Health Sciences, Trabzon Faculty of Medicine, Kanuni Health Research Center, Department of Radiology, Trabzon, Türkiye
| | - Selçuk Akkaya
- Karadeniz Technical University, Faculty of Medicine, Department of Radiology, Trabzon, Türkiye
| | - Sibel Kul
- Karadeniz Technical University, Faculty of Medicine, Department of Radiology, Trabzon, Türkiye
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Senses Dinc G, Cak T, Cengel Kultur E, Bilginer Y, Kul M, Topaloglu R. Psychiatric morbidity and different treatment modalities in children with chronic kidney disease. Arch Pediatr 2019; 26:263-267. [PMID: 31278026 DOI: 10.1016/j.arcped.2019.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 01/15/2019] [Accepted: 05/30/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Chronic kidney disease (CKD) is a potentially life-threatening condition leading to various psychosocial problems associated with different treatment modalities in addition to their medical advantages and disadvantages. The aim of this study was to evaluate the psychiatric morbidity in children with CKD in terms of different treatment modalities in comparison to healthy peers. In addition, parental attitudes and psychiatric symptoms in this group of mothers were examined. POPULATION AND METHODS A matched cohort study including 66 children with CKD (21 renal transplantation, 27 dialysis, 18 conservative treatment) and 37 healthy age- and sex-matched controls were evaluated. Children filled out the Children's Depression Inventory, the State-Trait Anxiety Inventory, and the Parental Attitude Scale, and the mothers filled out the Symptom Checklist-90-R. The Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version was used for psychiatric diagnosis. RESULTS The overall depression scores in children and the mothers' overall symptom severity index were significantly higher in the CKD group: 40.9% of children in the CKD group were diagnosed with a psychiatric disorder, while the corresponding figure for the control group was 16.2%. The in-group comparison of the CKD group failed to detect any significant difference between the three treatment modalities. CONCLUSION The results support the findings of research showing that CKD has high psychiatric morbidity. It is important to include psychosocial and psychiatric assessments in the evaluation processes of different treatment modalities in CKD.
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Affiliation(s)
- G Senses Dinc
- Clinics of Child and Adolescent Psychiatry, Ministry of Health Ankara Children's Health and Pediatric Hematology- Oncology Training and Research Hospital, Ankara, Turkey.
| | - T Cak
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - E Cengel Kultur
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Y Bilginer
- Division of Pediatric Nephrology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - M Kul
- Mersin Child Hospital, Clinic of Child and Adolescent Psychiatry, Mersin, Turkey
| | - R Topaloglu
- Division of Pediatric Nephrology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Kul S, Metin Y, Kul M, Metin N, Eyuboglu I, Ozdemir O. Assessment of breast mass morphology with diffusion-weighted MRI: Beyond apparent diffusion coefficient. J Magn Reson Imaging 2018; 48:1668-1677. [PMID: 29734493 DOI: 10.1002/jmri.26175] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 04/12/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) is a noncontrast-enhanced MRI technique. There are new promising studies on the use of DWI as a part of the enhanced or unenhanced abbreviated breast MRI protocols. PURPOSE To evaluate the ability of breast DWI in the assessment of mass morphology and determine the contribution of this morphologic evaluation in their characterization. STUDY TYPE Retrospective. POPULATION In all, 213 consecutive women were breast MR imaged and had a later confirmed diagnosis. FIELD STRENGTH/SEQUENCE Breast dynamic contrast-enhanced-MRI (DCE-MRI) and DWI at 1.5T. ASSESSMENT After Institutional Review Board approval, two radiologists first independently, and later in consensus, evaluated the visibility and morphology of the 143 malignant, 70 benign masses on DWI and DCE-MRI in separate sessions, blindly. Shape, margin, and internal pattern of the masses were evaluated according to BI-RADS lexicon. Apparent diffusion coefficient (ADC) and tumor size were measured by one radiologist. STATISTICAL TESTS Consistency between imaging methods and readers was evaluated with Cohen's kappa statistics. Multivariate analysis was applied to find the best predictors of malignancy. RESULTS Tumor visibility on DWI was high to moderate in at least 88% of cases. Consistency between DWI and DCE-MRI was substantial (kappa ≥0.757) for shape and margin and moderate (kappa = 0.505) for internal pattern. Interobserver agreement was substantial to moderate for all morphologic parameters (kappa ≥0.596). Morphology evaluated on DWI provided 83-84% accuracy in discriminating malignant from benign masses. ADC alone provided 90-91% accuracy. Both morphologic parameters and ADC were significantly associated with malignancy on multivariate analysis and provided 91-93% accuracy. DATA CONCLUSION DWI might be used not only for ADC evaluation but also for the morphological evaluation of breast masses to characterize them. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:1668-1677.
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Affiliation(s)
- Sibel Kul
- Karadeniz Technical University, School of Medicine, Department of Radiology, Trabzon, Turkey
| | - Yavuz Metin
- Recep Tayyib Erdoğan University, Faculty of Medicine, Department of Radiology, Rize, Turkey
| | - Musa Kul
- Trabzon Kanuni Training and Research Hospital, Department of Radiology, Trabzon, Turkey
| | - Nurgul Metin
- Recep Tayyib Erdoğan University, Faculty of Medicine, Department of Radiology, Rize, Turkey
| | - Ilker Eyuboglu
- Karadeniz Technical University, School of Medicine, Department of Radiology, Trabzon, Turkey
| | - Oguzhan Ozdemir
- Recep Tayyib Erdoğan University, Faculty of Medicine, Department of Radiology, Rize, Turkey
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Çekmez F, Aydemir G, Yildirim S, Bulut Ö, Tunç T, Kul M, İnce E, Çoban A. Diagnostic Value of 25-Hydroxyvitamin D Level and New Cytokines in Neonatal Sepsis. EUR J INFLAMM 2014. [DOI: 10.1177/1721727x1401200209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to evaluate diagnostic value of 25-hydroxyvitamin D level, Upar, IL-33 and ST2 in comparison with C-reactive protein, TNF-α and Interleukin-6 in neonatal sepsis. A total of 106 term babies were included 20 of whom were the control group. We used only data of high probable sepsis with blood culture positive infants, therefore 46 infants were excluded. Blood was collected from infants from the first day of sepsis (1.value) and 48–72 hours later (2.value). There were significant differences between the controls and sepsis (1.value) for 25-hydroxyvitamin D levels (35±19ng/ml and 69±7.5ng/ml, p=0.01), for IL-33 levels (90±34 ng/ml and 412±170 ng/ml, p=0.01), for sST2 levels (453±44 ng/ml and 4120±2720ng/ml, p=0.01), for sUpar levels (2.1±1.3 ng/ml and 11.4 ± 5.2 ng/ml, p=0.01), respectively. There were significant differences between sepsis (1.value) and sepsis (2.value.) with reference to 25-hydroxyvitamin D, IL-33, sST2, and suPAR levels, respectively. In the light of these results, it may be suggested that 25-hydroxyvitamin D level, upar, IL-33 and ST2 can be used as an acute phase reactant like C-reactive protein, TNF-α and Interleukin-6 in diagnosis of neonatal sepsis.
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Affiliation(s)
- F. Çekmez
- Department of Pediatrics, Division of Neonatology, GATA Medical Faculty, Istanbul, Turkey
| | - G. Aydemir
- Department of Pediatrics, Division of Neonatology, GATA Medical Faculty, Istanbul, Turkey
| | - S. Yildirim
- Department of Pediatrics, Division of Neonatology, Istanbul Medical Faculty, Turkey
| | - Ö. Bulut
- Department of Pediatrics, Division of Neonatology, Istanbul Medical Faculty, Turkey
| | - T. Tunç
- Department of Pediatrics, Division of Neonatology, GATA Medical Faculty, Ankara, Turkey
| | - M. Kul
- Department of Pediatrics, Division of Neonatology, GATA Medical Faculty, Istanbul, Turkey
| | - E.Z. İnce
- Department of Pediatrics, Division of Neonatology, Istanbul Medical Faculty, Turkey
| | - A. Çoban
- Department of Pediatrics, Division of Neonatology, Istanbul Medical Faculty, Turkey
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Affiliation(s)
- M. Kul
- Gaziantep Children's Hospital, Gaziantep, Turkey
| | | | - M. Yumru
- Gaziantep Children's Hospital, Gaziantep, Turkey
| | - H. Kandemir
- Gaziantep Children's Hospital, Gaziantep, Turkey
| | - H. Adaletli
- Gaziantep Children's Hospital, Gaziantep, Turkey
| | - M.F. Ceylan
- Gaziantep Children's Hospital, Gaziantep, Turkey
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Köseoğlu V, Kürekçi AE, Kul M, Oztürk H, Günhan O, Ozcan O. Malignant fibrous histiocytoma in a child. A case report and review of the literature. Turk J Pediatr 2000; 42:72-5. [PMID: 10731876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma of late adult file. It is extremely rare in children, though, and its existence in the pediatric population remains controversial. Although the most common site of tumor in children is the extremities, which is similar to findings of adults' series, different sites have been reported in children. Because of the rarity of this tumor in childhood, the approach to treatment of MFH is based primarily on the experience with adults. We present the clinical and pathologic features of an eight-year-old boy with MFH located on his left retroperitoneum and also review the literature.
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Affiliation(s)
- V Köseoğlu
- Department of Pediatrics, Gülhane Military Medical Academy, Ankara, Turkey
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Abstract
PURPOSE To perform Doppler US in patients with insulin-dependent diabetes mellitus (IDDM) as a predictive method in diabetic nephropathy (DN). MATERIAL AND METHODS Twenty-five patients with type I diabetes mellitus underwent renal Doppler US examination. Children were divided into three age groups: group I, 3-7 years; group II, 8-10 years; and group III, 11-18 years. The age-matched control group consisted of 56 healthy children who underwent renal Doppler US only. RESULTS The mean values of the resistive index (RI) were, respectively, 0.64+/-0.03, 0.59+/-0.04, 0.59+/-0.02 in age groups I, II, and III for healthy children and 0.68+/-0.03, 0.62+/-0.04, 0.59+/-0.04 in age groups I, II, and III of the diabetic patients. There were no significant differences between the diabetic and healthy subjects. The mean RI value was not different in the patients with glomerular hyperfiltration compared to patients with normal filtration rate. Additionally, there were no significant differences between the mean RI value in patients with or without microalbuminuria. CONCLUSION Renal Doppler US is not useful for prediction or for early diagnosis of DN.
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Affiliation(s)
- A Okten
- Department of Pediatrics, KTU Medical School, Trabzon, Turkey
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