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Öğe Assessment of Duodenal Diverticula: Computed Tomography Findings(Bentham Science Publ Ltd, 2019) Yilmaz, Erdem; Kostek, Osman; Hereklioglu, Savas; Goktas, Muhammet; Tuncbilek, NerminAims: To demonstrate the prevalence, accompanying pathologies, imaging and follow up findings of Duodenal Diverticula (DD) with Multidetector Computed Tomography (MDCT). Materials and Methods: Consecutive 2910 abdominal MDCTs were retrospectively reviewed on axial, coronal and sagittal planes. DD were evaluated for prevalence, location, number, size, contents, diverticular neck, accompanying pancreaticobiliary pathologies, jejunal and colonic diverticula, respectively. Results: DD were diagnosed in 157 cases (5.4%) and found mostly in the second part of the duodenum. Juxta-ampullary DD was the most common type (78.3%) and mostly located ventral (n:86, 69.9%) to the ampulla of Vater. DD was solitary in 123 patients (78.3%) and more than one in 34 patients (21.7%). The median diameter of DD was 2.5 cm (range 1.5-3.6 cm) in the long-axis. The lumen of DD contains air and contrast agent (n:96, 61.1%); air, contrast agent and debris (n:42, 26.7%) in most cases. Colonic diverticula (n:36, 22.9%), cholelithiasis (n:32, 20.4%), choledocholithiasis (n:7, 4.4%), and biliary dilatation (n:8, 5.1%) were the most common additional findings. Median follow-up time was 23 months (range 11 to 41 months). In three cases, new findings (cholelithiasis, n:3, choledocholithiasis, n:1) were detected. Conclusion: Accompanying pathologies with DD diagnosis are valuable for physicians in order to manage the patients. Following clinical and radiological features of well-diagnosed DD might reduce the possible complications.Öğe Diffusion tensor imaging: survival analysis prediction in breast cancer patients(Springer Heidelberg, 2024) Urut, Devrim Ulas; Karabulut, Derya; Hereklioglu, Savas; Oezdemir, Gulsah; Cicin, Berkin Anil; Hacioglu, Bekir; Suet, NecetPurpose We aimed to explore the performance of diffusion-tensor imaging (DTI) and apparent diffusion coefficient (ADC) parameters in evaluating disease-free survival (DFS) and overall survival (OS) in patients with invasive breast cancer. Material and methods A total of 49 women with invasive breast cancer who were diagnosed between 2017 and 2022 were included. All patients underwent breast magnetic resonance imaging (MRI) with DTI and diffusion-weighted imaging (DWI) features, with examiners blinded to the clinical data. Volume anisotropy (VA), fractional anisotropy (FA), and ADC values were measured to assess intratumoral measured heterogeneity. Correlations and differences in diffusion metrics according to OS and DFS status of the cases were analyzed. The discriminative ability of the quantitative findings was assessed by receiver operating characteristic (ROC) curve analyses and validated in the independent cohort. Results We evaluated patients with metastases (n = 13, 36.5%) and those without metastases (n = 36, 73.5%). Differences in the ADC, FA, and VA values were observed. The results of Cox regression survival analysis for all the patients included in the survival analysis revealed that DTI metrics contributed to the prediction of overall survival (OS) in the emerging models (p < 0.05). Both FA and VA were associated with OS (p = 0.037 and p = 0.038, respectively). However, ADC was not associated with OS (p = 0.177) or DFS (p = 0.252). Conclusion To the best of our knowledge, this is the first study to assess the prognostic value of DTI-MRI in breast cancer with statistical survival analysis techniques. We believe that DTI measurements can be used as a biomarker for OS analysis in breast cancer given the available data.Öğe Giant Pulmonary Herniation: A Late and Rare Complication of Minimally Invasive Lung Biopsy for Interstitial Lung Disease(Marmara Univ, Inst Health Sciences, 2023) Edis, Ebru cakir; Yanik, Fazli; Karabulut, Derya; Hereklioglu, SavasPulmonary herniation is the protrusion of the lung parenchyma beyond the normal limits of the thoracic cavity. It is a rare entity. In general, the defect in the chest wall is accompanied by increased intrathoracic pressures in the formation mechanism. Usually the cause is blunt-penetrating thoracic trauma, violent cough or previous thoracic surgery with insufficient closure of the chest wall. We report a case with giant pulmonary herniation that developed four years after biopsy in a patient diagnosed with usual interstitial pneumonia by VATS. Although this is a very rare condition in the literature, one of the late and rare complications of diagnostic pulmonary resections with awake VATS may be caused giant pulmonary herniationÖğe Prognostic Role of Tumor Percentage in Multiparametric MRI for Upgrade Prediction Before Radical Prostatectomy(Galenos Publ House, 2024) Arikan, Mehmet Guerkan; Ecer, Goekhan; Sahin, Mehmet Fatih; Hereklioglu, Savas; Goekalp, Fatih; Arda, Ersan; Akguel, BurakObjective: To determine the parameters that can predict upgrade with multiparametric magnetic resonance imaging (mpMRI) findings before radical prostatectomy Materials and Methods: The study included 69 patients who were diagnosed with prostate cancer (PCa) between January 2017-December 2020 and subsequently underwent RP. Patients were divided into two groups by comparing prostate biopsies and RP specimens as patients with upgrade (group 1) and patients without upgrade (group 2). Of the 69 patients, 26 were in group 1 and 43 in group 2. The images were evaluated by a single radiologist experienced in mpMRI using the Prostate Imaging Reporting and Data System v2.1 scoring system. Biopsy and RP pathology specimens were evaluated by an experienced neuropathologist. Results: The median prostate-specific antigen (PSA) levels were higher in patients with upgraded pathology [8.60 (5.90-14.00) ng/dL vs. 7.70 (5.20-10.00) ng/dL, respectively; p=0.040]. The prostate volume [31.88 (23.40-51.48) vs. 48.06 (23.40-87.35); p=0.009] and PSA density [3.72 (2.17-5.62) vs. 5.75 (3.35-9.6), respectively; p=0.007] were lower in patients with upgraded pathology. The tumor percentage on mpMRI was not different between the groups [3.70 (1.80-16.20 Conclusions: Although the percentage of tumors on multiparametric mpMRI is an inadequate pattern to predict upgrade in PCa patients, prospective studies
