Araştırma Çıktıları
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Item Multicenter Multireader Evaluation of an Artificial Intelligence-Based Attention Mapping System for the Detection of Prostate Cancer With Multiparametric MRI(AMER ROENTGEN RAY SOC, 2020-01-01) Mehralivand, Sherif; Harmon, Stephanie A.; Shih, Joanna H.; Smith, Clayton P.; Lay, Nathan; Argun, Burak; Bednarova, Sandra; Baroni, Ronaldo Hueb; Canda, Abdullah Erdem; Ercan, Karabekir; Girometti, Rossano; Karaarslan, Ercan; Kural, Ali Riza; Pursyko, Andrei S.; Rais-Bahrami, Soroush; Tonso, Victor Martins; Magi-Galluzzi, Cristina; Gordetsky, Jennifer B.; Silvestre e Silva Macarenco, Ricardo; Merino, Maria J.; Gumuskaya, Berrak; Saglican, Yesim; Sioletic, Stefano; Warren, Anne Y.; Barrett, Tristan; Bittencourt, Leonardo; Coskun, Mehmet; Knauss, Chris; Law, Yan Mee; Malayeri, Ashkan A.; Margolis, Daniel J.; Marko, Jamie; Yakar, Derya; Wood, Bradford J.; Pinto, Peter A.; Choyke, Peter L.; Summers, Ronald M.; Turkbey, BarisOBJECTIVE. The purpose of this study was to evaluate in a multicenter dataset the performance of an artificial intelligence (AI) detection system with attention mapping compared with multiparametric MRI (mpMRI) interpretation in the detection of prostate cancer. MATERIALS AND METHODS. MRI examinations from five institutions were included in this study and were evaluated by nine readers. In the first round, readers evaluated mpMRI studies using the Prostate Imaging Reporting and Data System version 2. After 4 weeks, images were again presented to readers along with the AI-based detection system output. Readers accepted or rejected lesions within four AI-generated attention map boxes. Additional lesions outside of boxes were excluded from detection and categorization. The performances of readers using the mpMRI-only and AI-assisted approaches were compared. RESULTS. The study population included 152 case patients and 84 control patients with 274 pathologically proven cancer lesions. The lesion-based AUC was 74.9\% for MRI and 77.5\% for AI with no significant difference (p = 0.095). The sensitivity for overall detection of cancer lesions was higher for AI than for mpMRI but did not reach statistical significance (57.4\% vs 53.6\%, p = 0.073). However, for transition zone lesions, sensitivity was higher for AI than for MRI (61.8\% vs 50.8\%, p = 0.001). Reading time was longer for AI than for MRI (4.66 vs 4.03 minutes, p < 0.001). There was moderate interreader agreement for AI and MRI with no significant difference (58.7\% vs 58.5\%, p = 0.966). CONCLUSION. Overall sensitivity was only minimally improved by use of the AI system. Significant improvement was achieved, however, in the detection of transition zone lesions with use of the AI system at the cost of a mean of 40 seconds of additional reading time.Item 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, IzzetPURPOSE 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.Item 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, SerginPurpose. 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 aggressivenessItem 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, TarikItem 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, TarikPurpose: 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 asItem Association of B7-H4 gene polymorphisms in urothelial bladder cancer(TUBITAK SCIENTIFIC \& TECHNICAL RESEARCH COUNCIL TURKEY, 2017-01-01) Ozgoz, Asuman; Samli, Murat; Dincel, Deniz; Sahin, Ahmet; Ince, Umit; Saglican, Yesim; Balci, Faruk; Samli, HaleBackground/aim: We aimed to study polymorphisms of the B7-H4 gene in order to evaluate a possible association in urothelial carcinoma, as it is highly expressed in cancer tissues. Materials and methods: In this study B7-H4 gene rs10754339, rs10801935, and rs3738414 SNPs were studied by PCR-RFLP method in paraffin-embedded tumor specimens from 62 urothelial carcinoma patients and in a control group including 30 patients without bladder cancer. Results: We detected that the rs10754339 polymorphism was more frequent in the cancer patients when compared with the control group (P < 0.05). Only the rs3738414 polymorphism showed a statistically significant difference in frequency between pathologic diagnostic groups. Conclusion: The rs10754339 AA genotype distribution was found to have a higher frequency whereas the rs3738414 AG genotype distribution was lower in the bladder cancer group (P < 0.05). None of the genotype distributions showed a significant difference from the control group for the rs10801935 polymorphism. We conclude that B7-H4 has the potential to be a useful prognostic marker in urothelial carcinoma.Item BRAF(V600E) Mutation: Has It a Role in Cervical Lymph Node Metastasis of Papillary Thyroid Cancer?(KARGER, 2016-01-01) Kurtulmus, Neslihan; Ertas, Burak; Saglican, Yesim; Kaya, Hakan; Ince, Umit; Duren, MeteBackground: The BRAF(V600E) mutation is common in papillary thyroid cancer (PTC). Lymph node metastasis (LNM) may be associated with poor prognosis. However, the LNM mechanism remains unclear. Objectives: Our aim was to evaluate the prevalence of the BRAF(V600E) mutation in primary tumors and accompanying LNM at the time of diagnosis. Methods: This retrospective study included 51 PTC patients (40 women, 11 menItem A Comparative Study of Multiparametric MRI Sequences in Measuring Prostate Cancer Index Lesion Volume(UBIQUITY PRESS LTD, 2022-01-01) Bagcilar, Omer; Alis, Deniz; Seker, Mustafa; Erdemli, Servet; Karaarslan, Umut; Kus, Aylin; Kayhan, Cavit; Saglican, Yesim; Kural, Ali; Karaarslan, ErcanObjectives: To compare the effectiveness of individual multiparametric prostate MRI (mpMRI) sequences-T2W, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), and dynamic contrast-enhanced (DCE)-in assessing prostate cancer (PCa) index lesion volume using whole-mount pathology as the ground-truthItem HER2/neu Status in Breast Cancer Specimens: Comparison of Immunohistochemistry (IHC) and Fluorescence in situ Hybridization (FISH) Methods(SOC CHILENA ANATOMIA, 2015-01-01) Saglican, Yesim; Ince, UmitHER2 amplification or overexpression is considered as disease outcome and a predictive marker of response to treatment in breast cancer. The present study aimed to compare the results of IHC and FISH for determining HER2 and to search the interpretational differences. Samples (n= 169), of which 31 were the paraffin blocks sent from outer centers, that underwent FISH analysis for HER-2 were included. Samples were re-reviewed by IHC in our laboratory. FISH test was negative in 131 (77.5\%) and positive in 38 (22.5\%). When those with previous IHC 0-1+ were re-reviewed, the results were found again 0-1+ and none of them was FISH positive. Inconsistency between re-reviewed IHC and previous IHC results was 25\% for those with 2+ score and 11\% for those with 3+ score. Consistency between IHC and FISH was 17\% and 67\% for previous IHC 2+ and 3+, respectively, whereas it was 23\% and \%75 for re-reviewed IHC 2+ and 3+, respectively. Whilst 79\% of the samples evaluated as 2+ by the inexperienced pathologist were found to be 0-1+ on the re-review, all of them were FISH negative. According to our results, we suggest that samples with IHC 2+ should be re-reviewed by consulting with an experienced pathologist.