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 Cranial MRI Abnormalities and Long-term Follow-up of the Lesions in 770 Girls With Central Precocious Puberty(ENDOCRINE SOC, 2021-01-01) Helvacioglu, Didem; Turan, Serap Demircioglu; Guran, Tulay; Atay, Zeynep; Dagcinar, Adnan; Bezen, Digdem; Ozturan, Esin Karakilic; Darendeliler, Feyza; Yuksel, Aysegul; Dursun, Fatma; Kilinc, Suna; Semiz, Serap; Abali, Saygin; Yildiz, Metin; Onder, Asan; Bereket, AbdullahContext: Central precocious puberty (CPP) may arise from central nervous system (CNS) lesions in a few affected girls. Recently, the incidence of girls with CPP has increased mostly in 6-8 year olds, in whom the necessity of magnetic resonance imaging (MRI) is debated. Objective: To investigate the frequency, long-term outcome and potential predictors of CNS lesions in a large cohort of girls with CPP. Methods: A multicenter cohort of 770 Turkish girls with CPP who had systematic cranial MRI between 2005 and 2017. Age at puberty onset was <6 years in 116 and 6-8 years in 654. CNS lesions were followed until final decision(6.2 +/- 3.1 years). Potential predictors of CNS lesions were evaluated by univariate analyses. Results: A total of 104/770 (13.5\%) girls had abnormal brain MRI. Of these, 2.8\% were previously known CNS lesions, 3.8\% had newly detected and causally related CNS lesions, 3.1 \% were possibly, related and 3.8\% were incidental. Only 2 (0.25\%) neoplastic lesions (1 low grade glioma and 1 meningioma) were identifiedItem Olfactory Bulb MRI and Paranasal Sinus CT Findings in Persistent COVID-19 Anosmia(ELSEVIER SCIENCE INC, 2021-01-01) Kandemirli, Sedat Giray; Altundag, Aytug; Yildirim, Duzgun; Sanli, Deniz Esin Tekcan; Saatci, OzlemBackground and purpose: There is limited literature consisting of case reports or series on olfactory bulb imaging in COVID-19 olfactory dysfunction. An imaging study with objective clinical correlation is needed in COVID-19 anosmia in order to better understand underlying pathogenesis. Material and methods: We evaluated 23 patients with persistent COVID-19 olfactory dysfunction. Patients included in this study had a minimum 1-month duration between onset of olfactory dysfunction and evaluation. Olfactory functions were evaluated with Sniffin' Sticks Test. Paranasal sinus CTs and MRI dedicated to olfactory nerves were acquired. On MRI, quantitative measurements of olfactory bulb volumes and olfactory sulcus depth and qualitative assessment of olfactory bulb morphology, signal intensity, and olfactory nerve filia architecture were performed. Results: All patients were anosmic at the time of imaging based on olfactory test results. On CT, Olfactory cleft opacification was seen in 73.9\% of cases with a mid and posterior segment dominance. 43.5\% of cases had below normal olfactory bulb volumes and 60.9\% of cases had shallow olfactory sulci. Of all, 54.2\% of cases had changes in normal inverted J shape of the bulb. 91.3\% of cases had abnormality in olfactory bulb signal intensity in the forms of diffusely increased signal intensity, scattered hyperintense foci or microhemorrhages. Evident clumping of olfactory filia was seen in 34.8\% of cases and thinning with scarcity of filia in 17.4\%. Primary olfactory cortical signal abnormality was seen in 21.7\% of cases. Conclusion: Our findings indicate olfactory cleft and olfactory bulb abnormalities are seen in COVID-19 anosmia. There was a relatively high percentage of olfactory bulb degeneration. Further longitudinal imaging studies could shed light on the mechanism of olfactory neuronal pathway injury in COVID-19 anosmia.Item Metachromatic Leukodystrophy Diagnosed after Traumatic Brain Injury: A Case Report(GALENOS YAYINCILIK, 2011-01-01) Guzel, Selcuk; Atalay, Ayce; Turhan, Nur; Benli, Ulku Sibel; Tore, Huseyin GurkanMetachromatic leukodystrophy (MLD) is a rare inherited neurodegenerative disorder caused by a deficiency of a lysosomal enzyme arylsulphatase A. Herein, we report the case of a patient with late-onset MLD who presented with symptoms inconsistent with traumatic brain injury. The diagnosis of MLD was based only on MRI findings and low levels of arylsulphatase A. Although there was an underlying serious neurodegenerative disorderItem Predictive value of preoperative MRI using the \#ENZIAN classification score in patients with deep infiltrating endometriosis(SPRINGER HEIDELBERG, 2023-01-01) Tunca, Aysun Fendal; Iliman, Derya Ece; Gemici, Aysegul Akdogan; Kaya, CihanPurpose The aim of this study is to investigate the correlation between the magnetic resonance imaging (MRI) and intraoperative findings of deep infiltrating endometriosis using the \#ENZIAN score. Methods This retrospective study included 64 patients who underwent surgery for deep infiltrating endometriosis between January 2017 and August 2020. Preoperative abdominopelvic MRI assessment was evaluated and scored using the \#ENZIAN classification. Operative scores were considered the gold standard, and the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of MRI for each category were calculated. Results MRI has higher sensitivity and specificity in showing the lesions of the compartments O (ovarian lesions), A (rectovaginal septum and posterior vaginal fornix), and B (uterosacral ligaments and parametrium) (100-100\%, 100-100\%, and 97-100\%, respectively, p < 0.001) compared to the other compartments. The lowest sensitivity, specificity, accuracy, and PPV of the MRI was found in compartment P (14\%, 76\%, 70\%, and 7\%, respectively). Conclusion We demonstrated that the \#ENZIAN classification in MRI reports has significant sensitivity and specificity in compartments A, B (uterosacral ligaments and parametrium), and O. Furthermore, the determination of peritoneal lesions via MRI is inadequate.Item The role of PET and MRI in evaluating the feasibility of skin-sparing mastectomy following neoadjuvant therapy(SAGE PUBLICATIONS LTD, 2018-01-01) Malya, Fatma Umit; Kadioglu, Huseyin; Bektasoglu, Huseyin Kazim; Gucin, Zuhal; Yildiz, Seyma; Guzel, Mehmet; Erdogan, Ezgi Basak; Yucel, Serap; Ersoy, Yeliz EmineObjective To investigate the role of positron emission tomography (PET) and magnetic resonance imaging (MRI) in evaluating the feasibility of skin-sparing mastectomy in patients with locally-advanced breast cancer (LABC) who will undergo neoadjuvant chemotherapy (NAC) by evaluating the sensitivity and specificity of PET and MRI compared with skin biopsy results before and after NAC treatment. Methods Patients with LABC who were treated with NAC between November 2013 and November 2015 were included in this study. Demographic, clinical, radiological and histopathological features of the patients were recorded. Results A total of 30 patients were included in the study with a mean age of 52.6 years (range, 35-70 years). Sensitivity and specificity for detecting skin involvement in LABC was 100\%/10\% (62\%/85\%) with MRI and 60\%/80\% (12\%/92\%) with PET before (after) NAC, respectively. When radiological skin involvement was assessed in relation to the final histopathological results, the preNAC PET results and histopathological skin involvement were not significantly differentItem Stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of liver metastases in oligometastatic patients: initial clinical experience(KOREAN SOC THERAPEUTIC RADIOLOGY \& ONCOLOGY, 2021-01-01) Ugurluer, Gamze; Mustafayev, Teuta Zoto; Gungor, Gorkem; Atalar, Banu; Abacioglu, Ufuk; Sengoz, Meric; Agaoglu, Fulya; Demir, Gokhan; Ozyar, EnisPurpose: We aimed to present our initial clinical experience on the implementation of a stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of liver metastases in oligometastatic disease. Materials and Methods: Twenty-one patients (24 lesions) with liver metastasis treated with SMART were included in this retrospective study. Step-and-shoot intensity-modulated radiotherapy technique was used with daily plan adaptation. During delivery, real-time imaging was used by acquiring planar magnetic resonance images in sagittal plane for monitoring and gating. Acute and late toxicities were recorded both during treatment and follow-up visits. Results: The median follow-up time was 11.6 months (range, 2.2 to 24.6 months). The median delivered total dose was 50 Gy (range, 40 to 60 Gy)