Browsing by Author "Vural, Metin"

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Comparison of the trifecta outcomes of robotic and open nephron-sparing surgeries performed in the robotic era of a single institution
(SPRINGER INTERNATIONAL PUBLISHING AG, 2015-01-01) Acar, Omer; Isik, Esin Ozturk; Mut, Tuna; Saglican, Yesim; Onay, Aslihan; Vural, Metin; Musaoglu, Ahmet; Esen, Tarik
Purpose: In this study we aimed to report a comparative analysis between open and robotic nephron sparing surgeries (NSS) from a single institutional database. Methods: Patients who have undergone NSS during the robotic era of our institution were included in this study. Open (n = 74) and robotic (n = 59) groups were compared regarding trifecta outcome. Trifecta was defined as
Comparison of the trifecta outcomes of robotic and open nephron-sparing surgeries performed in the robotic era of a single institution (vol 4, 472, 2015)
(SPRINGER INTERNATIONAL PUBLISHING AG, 2015-01-01) Acar, Omer; Ozturk-Isik, Esin; Mut, Tuna; Saglican, Yesim; Onay, Aslihan; Vural, Metin; Musaoglu, Ahmet; Esen, Tarik
Conspicuity of Peripheral Zone Prostate Cancer on Computed Diffusion-Weighted Imaging: Comparison of cDWI(1500), cDWI(2000), and cDWI(3000)
(HINDAWI LTD, 2014-01-01) Vural, Metin; Ertas, Gokhan; Onay, Aslihan; Acar, Omer; Esen, Tarik; Saglican, Yesim; Zengingonul, Hale Pinar; Akpek, Sergin
Introduction and Objective. Disadvantages associated with direct high b-value measurements may be avoided with use of computed diffusion-weighted imaging (cDWI). The purpose of this study is to assess the diagnostic performance of cDWI image sets calculated for high b-values of 1500, 2000, and 3000 s/mm(2). Materials and Methods. Twenty-eight patients who underwent multiparametric MRI of the prostate and radical prostatectomy consecutively were enrolled in this retrospective study. Using a software developed at our institute, cDWI 1500, cDWI 2000, and cDWI 3000 image sets were generated by fitting a monoexponential model. Index lesions on cDWI image sets were scored by two radiologists in consensus considering lesion conspicuity, suppression of background prostate tissue, distortion, image set preferability, and contrast ratio measurements were performed. Results. Lesion detection rates are the same for computed b-values of 2000 and 3000 s/ mm 2 and are better than b-values of 1500 s/ mm(2). Best lesion conspicuity and best background prostate tissue suppression are provided by cDWI(3000) image set. cDWI(2000) image set provides the best zonal anatomical delineation and less distortion and was chosen as the most preferred image set. Average contrast ratio measured on these image sets shows almost a linear relation with the b-values. Conclusion. cDWI 2000 image set with similar conspicuity and the same lesion detection rate, but better zonal anatomical delineation, and less distortion, was chosen as the preferable image set.
Evaluation of Peripheral Zone Prostate Cancer Aggressiveness Using the Ratio of Diffusion Tensor Imaging Measures
(WILEY-HINDAWI, 2017-01-01) Onay, Aslihan; Ertas, Gokhan; Vural, Metin; Acar, Omer; Saglican, Yesim; Coskun, Bilgen; Akpek, Sergin
Purpose. To evaluate the aggressiveness of peripheral zone prostate cancer by correlating the Gleason score (GS) with the ratio of the diffusion tensor imaging (DTI) measures. Materials and Methods. Forty-two peripheral zone prostate tumors were imaged using DTI. Regions of interest focusing on the center of tumor foci and noncancerous tissue were used to extract statistical measures of mean diffusivity (MD) and fractional anisotroy (FA). Measure ratio was calculated by dividing tumor measure by noncancerous tissue measure. Results. Strong correlations are observable between GS and MD measures while weak correlations are present between GS and FA measures. Minimum tumor MD (MDmin) and the ratio of minimum MD (rMD(min)) show the same highest correlation with GS (both rho = -0.73). Between GS <= 7 (3 + 4) and GS >= 7 (4 + 3), differences are significant for all MD measures but for some FA measures. MD measures perform better than FA measures in discriminating GS >= 7 (4 + 3). Conclusion. Ratios of MD measures can be used in evaluation of peripheral zone prostate cancer aggressiveness
Multiparametric MRI guidance in first-time prostate biopsies: what is the real benefit?
(TURKISH SOC RADIOLOGY, 2015-01-01) Acar, Omer; Esen, Tarik; Colakoglu, Bulent; Vural, Metin; Onay, Aslihan; Saglican, Yesim; Tuerkbey, Baris; Rozanes, Izzet
PURPOSE With the increased recognition of the capabilities of prostate multiparametric (mp) magnetic resonance imaging (MRI), attempts are being made to incorporate MRI into routine prostate biopsies. In this study, we aimed to analyze the diagnostic yield via cognitive fusion, transrectal ultrasound (TRUS)-guided, and in-bore MRI-guided biopsies in biopsy-naive patients with positive findings for prostate cancer screening. METHODS Charts of 140 patients, who underwent transrectal prostate biopsy after the adaptation of mp-MRI into our routine clinical practice, were reviewed retrospectively. Patients with previous negative biopsies (n=24) and digital rectal examination findings suspicious for >= cT3 prostate cancer (n=16) were excluded. T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced imaging were included in mp-MRI. Cognitive fusion biopsies were performed after a review of mp-MRI data, whereas TRUS-guided biopsies were performed blinded to MRI information. In-bore biopsies were conducted by means of real-time targeting under MRI guidance. RESULTS Between January 2012 and February 2014, a total of 100 patients fulfilling the inclusion criteria underwent TRUS-guided (n=37), cognitive fusion (n=49), and in-bore (n=14) biopsies. Mean age, serum prostate specific antigen level, and prostate size did not differ significantly among the study groups. In TRUS-guided biopsy group, 51.3\% were diagnosed with prostate cancer, while the same ratio was 55.1\% and 71.4\% in cognitive fusion and in-bore biopsy groups, respectively (P = 0.429). Clinically significant prostate cancer detection rate was 69.1\%, 70.3\%, and 90\% in TRUS-guided, cognitive fusion, and in-bore biopsy groups, respectively (P = 0.31). According to histopathologic variables in the prostatectomy specimen, significant prostate cancer was detected in 85.7\%, 93.3\%, and 100\% of patients in TRUS-guided, cognitive fusion, and in-bore biopsy groups, respectively. CONCLUSION In the first set of transrectal prostate biopsies, mp-MRI guidance did not increase the diagnostic yield significantly.