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Tunçer G, Geyiktepe-Güçlü C, Bayramlar OF, Atasoy-Bozan B, Yücel Ç, Sürme S, Çopur B, Güçlü KG, Mustafayev K, İkizceli T, Uzuner EG, Yıldırım M, Şengöz G, Pehlivanoglu F. Predictors of Significant Histological Hepatic Abnormality in Treatment-Naive Patients Infected with HBeAg-Negative Chronic Hepatitis B. Infect Dis Clin Microbiol 2024; 6:22-31. [PMID: 38633437 PMCID: PMC11019720 DOI: 10.36519/idcm.2024.311] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/14/2024] [Indexed: 04/19/2024]
Abstract
Objective This study aimed to determine the predictors for significant hepatic abnormality (SHA), a treatment indication, by assessing demographic, laboratory, and radiological results of chronic hepatitis B (CHB) patients who underwent liver biopsy. Materials and Methods In this retrospective study, individuals with untreated hepatitis B e-antigen (HBeAg)-negative CHB infection were enrolled. Multivariate analysis modeling was conducted with parameters identified as predictors for SHA in univariate analysis. Optimal threshold levels for variables to predict SHA in patients with chronic hepatitis B were determined based on receiver operating characteristic (ROC) curve analysis. Results A total of 566 patients with untreated chronic hepatitis B were included in the cohort; 61% (345/566) were male, and the median age was 41 years (interquartile range [IQR]=34-50). Notably, 36.9% (209/566) had SHA. In the multivariate analysis, utilizing different models, age, gender, HBV-DNA, LDL, ALT, and platelet count were identified as the most reliable predictors for SHA in CHB patients. For predicting SHA, the area under the ROC curve values of HBV-DNA, AST, and ALT were 0.704 (sensitivity=62.8%, specificity=76.2%; p<0.0001), 0.747 (sensitivity=51.9%, specificity=88.9%; p<0.0001), and 0.737 (sensitivity=68.6%, specificity=68.4%; p<0.0001), respectively. Conclusion In our study, age, male gender, ALT, AST, HBV-DNA, LDL cholesterol, platelet count, and FIB-4 score were independent predictors of SHA in HBeAg-negative chronic hepatitis B. The most sensitive parameters for SHA were LDL and ALT. The most specific parameters were age, AST, and APRI score. SHA may occur in patients with high HBV-DNA levels, even if ALT values are normal in HBeAg-negative patients.
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Affiliation(s)
- Gülşah Tunçer
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Ceyda Geyiktepe-Güçlü
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | | | - Burcu Atasoy-Bozan
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Çiğdem Yücel
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Serkan Sürme
- Department of Medical Microbiology, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
| | - Betül Çopur
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Kadir Görkem Güçlü
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Khalis Mustafayev
- Department of Infectious Diseases, Infection Control and Employee Health, University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Türkan İkizceli
- Department of Radiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Esen Gül Uzuner
- Department of Medical Pathology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Mustafa Yıldırım
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Gönül Şengöz
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Filiz Pehlivanoglu
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
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Oktay A, Aslan Ö, Taşkın F, Tunçbilek N, Esen İçten SG, Balcı P, Arıbal ME, Çelik L, Örgüç İŞ, Başaran Demirkazık F, Gültekin S, Aydın AM, Durmaz E, Kul S, Binokay F, Çetin M, Emlik GD, Akpınar MG, Kadıoğlu Voyvoda SN, Polat AV, Başara Akın I, Yıldız Ş, Poyraz N, Özsoy A, Öztekin PS, Elverici E, Bayrak İK, İkizceli T, Dinç F, Sezgin G, Gülşen G, Tunçbilek I, Yalçın SR, Çolakoğlu G, Ağlamış S, Yılmaz R, Rona G, Durhan G, Güner DC, Çelik Yabul F, Günbey Karabekmez L, Tutar B, Göktaş M, Buğdaycı O, Suner A, Özdemir N. Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study. Diagn Interv Radiol 2023; 29:579-587. [PMID: 36994925 PMCID: PMC10679644 DOI: 10.4274/dir.2022.221790] [Citation(s) in RCA: 1] [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: 07/25/2022] [Accepted: 08/27/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE The clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions. METHODS This retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson's chi-squared test, the Fisher-Freeman-Halton test, and Fisher's exact test were used for the statistical analyses. RESULTS The overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes. CONCLUSION ADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision.
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Affiliation(s)
- Ayşenur Oktay
- Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Özge Aslan
- Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Füsun Taşkın
- Department of Radiology, Acıbadem MAA University Faculty of Medicine; Acıbadem MAA University Senology Research Institute, Acıbadem Atakent Hospital, İstanbul, Turkey
| | - Nermin Tunçbilek
- Department of Radiology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Selma Gül Esen İçten
- Department of Radiology, Acıbadem MAA University Faculty of Medicine; Acıbadem MAA University Senology Research Institute, İstanbul, Turkey
| | - Pınar Balcı
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Mustafa Erkin Arıbal
- Department of Radiology, Acıbadem MAA University Faculty of Medicine, İstanbul, Turkey
| | - Levent Çelik
- Department of Radiology, Maltepe University Faculty of Medicine; İstanbul, Turkey
| | - İhsan Şebnem Örgüç
- Department of Radiology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | | | - Serap Gültekin
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ayşe Murat Aydın
- Department of Radiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Emel Durmaz
- Department of Radiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Sibel Kul
- Department of Radiology, Karadeniz Techinal University Faculty of Medicine, Trabzon, Turkey
| | - Figen Binokay
- Department of Radiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Meltem Çetin
- Department of Radiology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Ganime Dilek Emlik
- Department of Radiology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | | | - Sadiye Nuray Kadıoğlu Voyvoda
- Department of Radiology, University of Health Sciences Turkey, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Ahmet Veysel Polat
- Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Işıl Başara Akın
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Şeyma Yıldız
- Department of Radiology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey
| | - Necdet Poyraz
- Department of Radiology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Arzu Özsoy
- Department of Radiology, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey
| | - Pelin Seher Öztekin
- Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Eda Elverici
- Department of Radiology, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey
| | - İlkay Koray Bayrak
- Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Türkan İkizceli
- Department of Radiology, University of Health Sciences Turkey, İstanbul Haseki Training and Research Hospital, İstanbul, Turkey
| | - Funda Dinç
- Department of Radiology, Muğla Sıtkı Koman University Faculty of Medicine, Muğla Turkey
| | - Gülten Sezgin
- Department of Radiology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - Gökçe Gülşen
- Department of Radiology, University of Health Sciences Turkey, İstanbul Haseki Training and Research Hospital, İstanbul, Turkey
| | - Işıl Tunçbilek
- Department of Radiology, Medsentez Private Clinic, Ankara, Turkey
| | | | - Gül Çolakoğlu
- Department of Radiology, University of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Serpil Ağlamış
- Department of Radiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Ravza Yılmaz
- Department of Radiology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Günay Rona
- Department of Radiology, University of Health Sciences Turkey, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Gamze Durhan
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Davut Can Güner
- Department of Radiology, Maltepe University Faculty of Medicine; İstanbul, Turkey
| | - Fatma Çelik Yabul
- Department of Radiology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey
| | - Leman Günbey Karabekmez
- Department of Radiology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Burçin Tutar
- Department of Radiology, Acıbadem Maslak Hospital, İstanbul, Turkey
| | - Muhammet Göktaş
- Department of Radiology, Ministry of Health Çerkezköy State Hospital, İstanbul, Turkey
| | - Onur Buğdaycı
- Department of Radiology, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Aslı Suner
- Department of Biostatistics and Medical Informatics, Ege University Faculty of Medicine, İzmir, Turkey
| | - Necmettin Özdemir
- Department of Medical Pathology, Ege University Faculty of Medicine, İzmir, Turkey
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Aras S, Tanzer IHO, Karaçavuş S, Sayir N, Erdem E, Hacımustafaoğlu F, Erdoğan CE, Sapmaz T, İkizceli T, Pençe HH, Baydili KN, Katmer T. Effect of melatonin on low and high dose radiotherapy induced thyroid injury. Biotech Histochem 2023:1-7. [PMID: 37073770 DOI: 10.1080/10520295.2023.2189752] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
We investigated the radioprotective effect of melatonin (MEL) against thyroid gland damage in rats caused by flattening filter (FF) and flattening filter free (FFF) single dose X-ray beams. We used 48 female rats divided into six groups of eight: group 1, untreated control group; group 2, MEL treated group; group 3, FF-low dose rate radiotherapy (FF-LDR) group; group 4, FF-LDR + MEL group; group 5, FFF-high dose rate radiotherapy (FFF-HDR) group; group 6, FFF-HDR + MEL group. Groups 2, 4 and 6 rats were injected intraperitoneally (i.p.) with 10 mg/kg MEL 15 min before exposure to radiation. The head and neck regions of each rat in groups 3 and 5 and groups 4 and 6 were irradiated with 16 Gy at 6 MV X-ray in FF and FFF beam modes. The histopathology of the thyroid gland and salient biochemical parameters were assessed in all rats 10 days after radiotherapy. We found increased inflammation, vacuolization, degradation, swelling and necrosis, and M30 apoptosis and M65 necrosis indicators in groups 3 and 5 compared to group 1; however, we found significant reductions in histopathological and biochemical parameters following application of MEL. MEL treatment before FF-LDR and FFF-HDR radiotherapy minimized thyroid gland injury due to irradiation.
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Affiliation(s)
- Serhat Aras
- Medical Imaging Techniques Program, University of Health Sciences Turkey, Istanbul, Turkey
- Department of Radiation Oncology, Haydarpasa Numune Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - I Hsan Oğuz Tanzer
- Department of Neuroscience and Biomedical Engineering, Aalto University, Finland
- Biomedical Technology Program, University of Health Sciences Turkey, Istanbul, Turkey
| | - Seyhan Karaçavuş
- Department of Nuclear Medicine, Kayseri City Training and Research Hospital, University of Health Sciences Turkey, Kayseri, Turkey
| | - Neslihan Sayir
- Pathology Laboratory Techniques Program, University of Health Sciences Turkey, Istanbul, Turkey
| | - Esra Erdem
- Pathology Laboratory Techniques Program, University of Health Sciences Turkey, Istanbul, Turkey
| | - Fatih Hacımustafaoğlu
- Medical Laboratory Techniques Program, University of Health Sciences Turkey, Istanbul, Turkey
| | - Ceren Ezgi Erdoğan
- Department of Radiation Oncology, Haydarpasa Numune Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Tansel Sapmaz
- Department of Histology and Embryology, University of Health Sciences Turkey, Istanbul, Turkey
| | - Türkan İkizceli
- Department of Radiology, Haseki Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Halime Hanım Pençe
- Department of Biochemistry, University of Health Sciences Turkey, Istanbul, Turkey
| | - Kürşad Nuri Baydili
- Management and Organization Program, University of Health Sciences Turkey, Istanbul, Turkey
| | - Tolga Katmer
- Department of General Surgery, Haydarpasa Numune Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
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Yılmaz BK, Türkay R, Özdemir S, İkizceli T, Selçuk Can T, Göçgün N, Atasoy B. Prevalence and radiologic features of elastofibroma dorsi: a CT study. Curr Thorac Surg 2023. [DOI: 10.26663/cts.2023.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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Abstract
Breast cancer is the most common cancer that progresses from cells in the breast tissue among women. Early-stage detection could reduce death rates significantly, and the detection-stage determines the treatment process. Mammography is utilized to discover breast cancer at an early stage prior to any physical sign. However, mammography might return false-negative, in which case, if it is suspected that lesions might have cancer of chance greater than two percent, a biopsy is recommended. About 30 percent of biopsies result in malignancy that means the rate of unnecessary biopsies is high. So to reduce unnecessary biopsies, recently, due to its excellent capability in soft tissue imaging, Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) has been utilized to detect breast cancer. Nowadays, DCE-MRI is a highly recommended method not only to identify breast cancer but also to monitor its development, and to interpret tumorous regions. However, in addition to being a time-consuming process, the accuracy depends on radiologists’ experience. Radiomic data, on the other hand, are used in medical imaging and have the potential to extract disease characteristics that can not be seen by the naked eye. Radiomics are hard-coded features and provide crucial information about the disease where it is imaged. Conversely, deep learning methods like convolutional neural networks(CNNs) learn features automatically from the dataset. Especially in medical imaging, CNNs’ performance is better than compared to hard-coded features-based methods. However, combining the power of these two types of features increases accuracy significantly, which is especially critical in medicine. Herein, a stacked ensemble of gradient boosting and deep learning models were developed to classify breast tumors using DCE-MRI images. The model makes use of radiomics acquired from pixel information in breast DCE-MRI images. Prior to train the model, radiomics had been applied to the factor analysis to refine the feature set and eliminate unuseful features. The performance metrics, as well as the comparisons to some well-known machine learning methods, state the ensemble model outperforms its counterparts. The ensembled model’s accuracy is 94.87% and its AUC value is 0.9728. The recall and precision are 1.0 and 0.9130, respectively, whereas F1-score is 0.9545.
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Affiliation(s)
- Ahmet Haşim Yurttakal
- Computer Engineering Department, EngineeringFaculty, Afyon Kocatepe University, Afyon-Turkey
| | - Hasan Erbay
- Computer Engineering Department, EngineeringFaculty, University of Turkish Aeronautical Association, 06790Etimesgut Ankara-Turkey
| | - Türkan İkizceli
- Haseki Training and Research Hospital, Departmentof Radiology, University of Health Sciences, İstanbul-Turkey
| | - Seyhan Karaçavuş
- Kayseri Training and Research Hospital, Departmentof Nuclear Medicine, University of Health Sciences, Kayseri-Turkey
| | - Cenker Biçer
- Statistcs Department, Arts & Science Faculty, Kırıkkale University, Kırıkkale-Turkey
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Ağbaş A, Bay ED, Başaran MK, İkizceli T, Kayhan GK, Özlük Y. Nephrotic range proteinuria in an adolescent with a diagnosis of Wilson's disease: Answers. Pediatr Nephrol 2021; 36:2103-2106. [PMID: 33528637 DOI: 10.1007/s00467-021-04961-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/12/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Ayşe Ağbaş
- Department of Pediatric Nephrology, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey. .,Çocuk Kliniği, Çocuk Nefroloji Bölümü, S.B.Ü Haseki Eğitim ve Araştırma Hastanesi, 34130, Fatih Istanbul, Turkey.
| | - Eda Dilara Bay
- Department of Pediatrics, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Meryem Keçeli Başaran
- Department of Pediatric Gastroenterology, Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey
| | - Türkan İkizceli
- Department of Radiology, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gözde Kılıç Kayhan
- Istanbul Faculty of Medicine, Department of Pathology, Istanbul University, Istanbul, Turkey
| | - Yasemin Özlük
- Istanbul Faculty of Medicine, Department of Pathology, Istanbul University, Istanbul, Turkey
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Ağbaş A, Bay ED, Başaran MK, İkizceli T, Kayhan GK, Özlük Y. Nephrotic range proteinuria in an adolescent with a diagnosis of Wilson's disease: Questions. Pediatr Nephrol 2021; 36:2101-2102. [PMID: 33528634 DOI: 10.1007/s00467-021-04947-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Ayşe Ağbaş
- Department of Pediatric Nephrology, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey. .,Çocuk Kliniği, Çocuk Nefroloji Bölümü, S.B.Ü Haseki Eğitim ve Araştırma Hastanesi, Fatih, 34130, Istanbul, Turkey.
| | - Eda Dilara Bay
- Department of Pediatrics, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Meryem Keçeli Başaran
- Department of Pediatric Gastroenterology, Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey
| | - Türkan İkizceli
- Department of Radiology, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gözde Kılıç Kayhan
- Istanbul Faculty of Medicine, Department of Pathology, Istanbul University, Istanbul, Turkey
| | - Yasemin Özlük
- Istanbul Faculty of Medicine, Department of Pathology, Istanbul University, Istanbul, Turkey
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Aras S, Tanzer İO, İkizceli T. Dosimetric Comparison of Superflab and Specially Prepared Bolus Materials Used in Radiotherapy Practice. Eur J Breast Health 2020; 16:167-170. [PMID: 32656515 PMCID: PMC7337918 DOI: 10.5152/ejbh.2020.5041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/31/2019] [Accepted: 11/18/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study compares standard commercial bolus material (Superflab) to custom prepared silicone dental impression material (CDIM) and play dough material (PDM) with respect to dosimetric properties and applicability by using ion chamber measurement and calculated dose values. MATERIALS AND METHODS The CDIM bolus was prepared by mixing dental impression silicone material with enough water to maintain a density of about 1.0 g/cm3. The prepared bolus material is applied on an RW3 solid phantom by covering 10x10 cm2 area with 0.5-1 cm thickness. Ion chamber measurements were performed separately with and without bolus material application. The setup was scanned in CT and the same procedure was repeated in the TPS using the scan data, in which the Pencil Beam Convolution dose calculation algorithm was used. To compare the effect of bolus material on tissue, the Superflab bolus and CDIM bolus were applied with 1 cm of thickness on postmastectomy scar and dose calculations on TPS were performed. RESULTS After comparison of the dosimetric values for Superflab, CDIM and PDM, we obtained statistically meaningful results between superflab and CDIM. For PDM, the results obtained with TPS and ion chamber measurements indicated that, it is not suitable to use in radiotherapy application due to its material properties. For the simulated skin dose values obtained at five random points on the scar tissue, the comparison of Superflab and CDIM TPS calculation results were not statistically significant. CONCLUSION The CDIM is easy to prepare and apply on irregular mastectomy scar tissue and it prevents formation of air gaps in the application surface. Especially for curved anatomical regions such as scar tissue, inclusion of the bolus material in treatment planning protocol will reduce dose uncertainty in application. It is safe to use CDIM as an alternative to Superflab in radiotherapy application, whereas PDM is not useful in clinical practice due to its material properties.
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Affiliation(s)
- Serhat Aras
- Medical Imaging Programme, University of Health Sciences, İstanbul, Turkey
| | - İhsan Oğuz Tanzer
- Biomedical Technology Programme, University of Health Sciences, İstanbul, Turkey
| | - Türkan İkizceli
- Department of Radiology, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey
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Ağbaş A, Aksu B, Doğan G, İkizceli T, Selçuk HND, Elevli M. Correction to: A child with bilateral multiple renal cysts presenting with ascites and pleural effusion: answers. Pediatr Nephrol 2020; 35:717. [PMID: 31468146 DOI: 10.1007/s00467-019-04340-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The original version of this article unfortunately contained a mistake. The answer to question 3 was presented incorrectly. The correct answer is given below.
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Affiliation(s)
- Ayşe Ağbaş
- Department of Pediatric Nephrology, Haseki Education and Research Hospital, University of Health Sciences, 34140, Istanbul, Turkey.
| | - Bağdagül Aksu
- Department of Pediatric Nephrology, Haseki Education and Research Hospital, University of Health Sciences, 34140, Istanbul, Turkey
| | - Güzide Doğan
- Department of Pediatric Gastroenterology, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Türkan İkizceli
- Department of Radiology, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Hatice Nilgün Duru Selçuk
- Department of Pediatrics, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Murat Elevli
- Department of Pediatrics, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Ağbaş A, Aksu B, Doğan G, İkizceli T, Selçuk HND, Elevli M. A child with bilateral multiple renal cysts presenting with ascites and pleural effusion: Questions. Pediatr Nephrol 2019; 34:1541-1542. [PMID: 30790040 DOI: 10.1007/s00467-019-4196-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Ayşe Ağbaş
- Department of Pediatric Nephrology, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, 34140, Turkey.
| | - Bağdagül Aksu
- Department of Pediatric Nephrology, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, 34140, Turkey
| | - Güzide Doğan
- Department of Pediatric Gastroenterology, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Türkan İkizceli
- Department of Radiology, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Hatice Nilgün Duru Selçuk
- Department of Pediatrics, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Murat Elevli
- Department of Pediatrics, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
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11
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Çakmak F, Kanbakan A, Akdeniz YS, İpekçi A, İkizceli T. Tacrolimus-Induced Vision Loss in a Renal Transplant Patient: Posterior Reversible Encephalopathy Syndrome. EXP CLIN TRANSPLANT 2019. [PMID: 31104625 DOI: 10.6002/ect.2018.0193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Posterior reversible encephalopathy syndrome is a rare and serious neurologic adverse effect of calcineurin inhibitors. The pathophysiology of this clinical entity is still unclear. Impaired cerebral autoregulation and endothelial dysfunction are thought to be the main pathologic processes. Imaging shows the syndrome to be characterized by vasogenic edema or cytotoxic edema in parietal and occipital areas of the brain. With regard to clinic presentation, headache, diminished visual acuity, cortical blindness, altered consciousness, seizures, and hallucinations can be seen. It is known that the clinical presentation is improved when calcineurin inhibitors are stopped early. Here, we present and evaluate a case of a cortical blindness that developed in a 36-year-old patient who had been using tacrolimus after renal transplant and who returned to health after 1 week of hospitalization.
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Affiliation(s)
- Fatih Çakmak
- From the Cerrahpasa Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey
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12
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Aras S, İkizceli T, Aktan M. Dosimetric Comparison of Three-Dimensional Conformal Radiotherapy (3D-CRT) and Intensity Modulated Radiotherapy Techniques (IMRT) with Radiotherapy Dose Simulations for Left-Sided Mastectomy Patients. Eur J Breast Health 2019; 15:85-89. [PMID: 31001609 DOI: 10.5152/ejbh.2019.4619] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 12/13/2018] [Accepted: 02/07/2019] [Indexed: 12/25/2022]
Abstract
Objective To compare 3-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiotherapy (IMRT) techniques on the target tissue and critical organ doses in terms of dosimetry, during treatment planning of patient's post-mastectomy radiotherapy (PMRT) to the left chest wall. Materials and Methods Twenty breast cancer patients with left-sided post-mastectomy have selected for PMRT both 3D-CRT and IMRT techniques. Dosimetric calculation of dose simulation in Eclipse treatment planning system have been performed. Organs at risk with the maximum dose, minimum dose, mean dose, D95, conformity and homogeneity indexes and total monitor unit for the Planning Target Volume were compared in terms of the critical organ doses. Results There was no significant difference between the two treatment planning techniques in terms of maximum, minimum, mean dose and heterogeneity index (p>0.05). At low doses, the dose received at the heart was significantly lower with the 3D-CRT technique, but there was no statistically significant difference between the two techniques at the maximum and average doses in the high dose regions. Conclusion For PMRT to the left chest wall, IMRT significantly improves the conformity of plan and reduce the high-dose volumes of ipsilateral lung and heart compared to 3D-CRT, but 3D-CRT is superior in terms of low-dose volume.
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Affiliation(s)
- Serhat Aras
- Department of Medical Imaging Techniques, University of Health Sciences, İstanbul, Turkey
| | - Türkan İkizceli
- Department of Radiology, University of Health Sciences, İstanbul, Turkey
| | - Meryem Aktan
- Department of Radiation Oncology, Necmettin Erbakan University School of Medicine, Konya, Turkey
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13
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İkizceli T, Gülşen G, İnsan A, Savaş Y, Erözgen F. Male Breast Cancer Associated with Paget’s Disease: A Case Report. Haseki 2018. [DOI: 10.4274/haseki.3967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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14
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İkizceli T, Gülşen G, Akın İ. Silicone Granuloma Associated with Pectoral Muscle Involvement after Ruptured Breast Implant: a Novel case report. Eur J Breast Health 2018; 14:54-57. [PMID: 29322121 DOI: 10.5152/ejbh.2017.3499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 03/04/2017] [Accepted: 11/07/2017] [Indexed: 11/22/2022]
Abstract
In this study, an unusual case of a patient who was previously operated on a ruptured breast implant following silicone granuloma associated with pectoral muscle involvement is reported. A 72-year-old woman had undergone breast augmentation surgery when she was 52-year-old and silicone implant rupture 10 years later. After 10 years of ruptured silicone implant, her mammography showed diffuse, multiple high-density nodules in the left breast. The pectoral muscle was significantly hypertrophic. The magnetic resonance imaging showed that the pectoral muscle was quite hypertrophic and had heterogeneous enhancement. In clinical consideration and the presence of the suspected malignancy, a biopsy was performed. The histological analysis identified pectoral muscle and breast tissue, which had been mainly replaced by giant cells, along with an apparent foreign body response. Silicone granuloma can present itself as a soft tissue mass. Malignancy is the most important differential diagnosis. Meticulous follow-up is recommended for these patients.
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Affiliation(s)
- Türkan İkizceli
- Department of Radiology, İstanbul Health Sciences University, Haseki Training and Research Hospital, İstanbul, Turkey
| | - Gökçe Gülşen
- Department of Radiology, Haseki Training and Research Hospital, İstanbul, Turkey
| | - İlker Akın
- Department of Pathology, Haseki Training and Research Hospital, İstanbul, Turkey
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15
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İçer S, Coşkun A, İkizceli T. Quantitative Grading Using Grey Relational Analysis on Ultrasonographic Images of a Fatty Liver. J Med Syst 2011; 36:2521-8. [DOI: 10.1007/s10916-011-9724-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 04/18/2011] [Indexed: 10/18/2022]
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