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Aslaner MA, Helvacı Ö, Haycock K, Kılıçaslan İ, Yaşar E, Cerit MN, Şendur HN, Güz G, Demircan A. Diagnostic accuracy of venous system ultrasound for subtypes of acute kidney injury. Emerg Med J 2024; 41:304-310. [PMID: 38355289 DOI: 10.1136/emermed-2023-213241] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 02/03/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Management of acute kidney injury (AKI) in the ED can be difficult due to uncertainty regarding the aetiology. This study investigated the diagnostic value of venous system ultrasound for determining the aetiological subtypes of AKI in the ED. METHODS This multidisciplinary prospective cohort study was conducted in a single academic ED over the course of a year. Adult patients with AKI were evaluated using the venous excess ultrasound (VExUS) score, which is a four-step ultrasound protocol. The protocol begins with the inferior vena cava (IVC) measurement and examines organ flow patterns, including portal, hepatic and renal veins in the presence of dilated IVC. The AKI subtypes (hypovolaemia, cardiorenal, systemic vasodilatation and renal) were adjudicated by nephrologists and emergency physicians, considering data that became available during the hospitalisation. We determined the diagnostic test characteristics of VExUS for identifying each of the four AKI aetiological subtypes. RESULTS 150 patients with AKI were included in the study. Hypovolaemia was the most frequent finally adjudicated cause of AKI (66%), followed by cardiorenal (18%), systemic vasodilatation (8.7%) and renal (7.3%). In diagnosing the cardiorenal subtype, the area under the curve (AUC) for VExUS grade >0 was 0.819, with 77.8% sensitivity and 80.5% specificity, and the AUC for IVC maximum diameter >20.4 mm was 0.865, with 74.1% sensitivity and 86.2% specificity. For the hypovolaemia subtype, the AUC for VExUS grade ≤0 was 0.711, with 83.8% sensitivity and 56.9% specificity, and the AUC for IVC maximum diameter ≤16.8 mm was 0.736, with 73.7% sensitivity and 68.6% specificity. None of the parameters achieved adequate test characteristics for renal and systemic vasodilatation subtypes. CONCLUSION The VExUS score has good diagnostic accuracy for cardiorenal AKI and fair accuracy for hypovolaemic AKI but cannot identify renal and systemic vasodilatation subtypes. It should not therefore be used in isolation to determine the cause of AKI in the ED. TRIAL REGISTRATION NUMBER NCT04948710.
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Affiliation(s)
- Mehmet Ali Aslaner
- Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Özant Helvacı
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Korbin Haycock
- Department of Emergency Medicine, Loma Linda University, Loma Linda, California, USA
- Emergency Medicine, Riverside University Health System, Moreno Valley, California, USA
| | - İsa Kılıçaslan
- Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Emre Yaşar
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Halit Nahit Şendur
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Galip Güz
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ahmet Demircan
- Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
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Aslaner MA, Helvacı Ö, Cerit MN, Şendur HN. The value of venous system ultrasound in predicting the need for emergency haemodialysis in haemodialysis patients. J Ultrasound 2024; 27:67-71. [PMID: 37526835 PMCID: PMC10908672 DOI: 10.1007/s40477-023-00802-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/11/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Emergency haemodialysis (HD) is a therapeutic procedure performed in serious clinical situations. This study investigated venous Doppler ultrasound parameters for predicting emergency HD in patients on routine HD treatment for end-stage renal disease in the emergency department (ED). METHOD Adult patients on a routine HD program in a tertiary care ED between April and December 2022 were enrolled in the study. Inferior vena cava, hepatic, and portal vein flow parameters and the venous excess ultrasound (VExUS) score calculated from these parameters were noted in order to predict emergency HD indications. Hyperkalaemia, hypervolemia, missing more than one session, uremic findings, and metabolic acidosis were regarded as emergency HD indications. RESULTS One hundred twenty-nine venous ultrasound examinations were performed on 43 patients with routine HD during the study period. The rate of emergency HD was 30.2%. The most common indication of it was hypervolemia (76.9%), followed by missing more than one session (23.1%). Only the portal vein had an AUC value of 0.714, with a sensitivity of 61.5% and specificity of 83.3% for predicting emergency HD. Other parameters including the IVC, hepatic vein, and VExUS score were of no diagnostic value. CONCLUSION The findings of this study show that only the portal vein Doppler flow parameter has very limited diagnostic value for emergency HD in patients on a routine HD program in the ED. This study can serve as a guide to further research.
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Affiliation(s)
- Mehmet Ali Aslaner
- Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Özant Helvacı
- Department of Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Halit Nahit Şendur
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Coskun M, Sendur HN, Cerit MN, Babayeva A, Cerit ET, Yalcin MM, Altinova AE, Akturk M, Karakoc MA, Toruner FB. Assessment of forearm muscles with ultrasound shear wave elastography in patients with acromegaly. Pituitary 2023; 26:716-724. [PMID: 37899388 DOI: 10.1007/s11102-023-01352-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 10/31/2023]
Abstract
PURPOSE The effects of acromegaly on soft tissues, bones and joints are well-documented, but information on its effects on muscle mass and quality remains limited. The primary goal of this study is to assess the sonoelastographic features of forearm muscles in patients with acromegaly. METHOD Forty-five patients with acromegaly and 45 healthy controls similar in terms of gender, age, and body mass index (BMI) were included in a single-center, multidisciplinary, cross-sectional study. The body composition was analyzed using bioelectrical impedance analysis (BIA), and height-adjusted appendicular skeletal muscle index (hSMI) was calculated. The dominant hand's grip strength was also measured. Two radiologists specialized in the musculoskeletal system employed ultrasound shear wave elastography (SWE) to assess the thickness and stiffness of brachioradialis and biceps brachii muscles. RESULTS The acromegaly group had significantly higher thickness of both the biceps brachii (p = 0.034) and brachioradialis muscle (p = 0.046) than the control group. However, the stiffness of the biceps brachii (p = 0.001) and brachioradialis muscle (p = 0.001) was lower in the acromegaly group than in the control group. Disease activity has not caused a significant difference in muscle thickness and stiffness in the acromegaly group (p > 0.05). The acromegaly group had a higher hSMI (p = 0.004) than the control group. The hand grip strength was similar between the acromegaly and control group (p = 0.594). CONCLUSION The patients with acromegaly have an increased muscle thickness but decreased muscle stiffness in the forearm muscles responsible for elbow flexion. Acromegaly can lead to a permanent deterioration of the muscular structure regardless of the disease activity.
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Affiliation(s)
- Meric Coskun
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey.
| | - Halit Nahit Sendur
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, 06100, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, 06100, Turkey
| | - Afruz Babayeva
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Ethem Turgay Cerit
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Mehmet Muhittin Yalcin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Alev Eroglu Altinova
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Mujde Akturk
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Mehmet Ayhan Karakoc
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Fusun Balos Toruner
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
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Şendur AB, Cerit MN, Şendur HN. Clinical applicability of US-based hepatic fat quantification tools may be expedited by adherence to guidelines. Radiol Med 2023; 128:1589-1590. [PMID: 37713156 DOI: 10.1007/s11547-023-01727-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Aylin Billur Şendur
- Private Radiology Clinic, Kızılırmak Mah. 1443. Cad. No:25 B Blok Daire 126, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Faculty of Medicine, Gazi University, Mevlana Bulvarı No:29, 06560, Yenimahalle, Ankara, Turkey
| | - Halit Nahit Şendur
- Department of Radiology, Faculty of Medicine, Gazi University, Mevlana Bulvarı No:29, 06560, Yenimahalle, Ankara, Turkey.
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Abstract
ChatGPT is a newly developed technology created by the OpenAI company. It is an artificial-intelligence-based large language model (LLM) and able to generate human-like text. The potential roles of ChatGPT in clinical decision support and academic writing have led to intense criticism of this technology in the scientific community. Therefore, radiologists also need to be familiar with LLMs such as ChatGPT.
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Affiliation(s)
- Halit Nahit Şendur
- Department of Radiology, Gazi University, Faculty of Medicine, Mevlana Bulvarı, Yenimahalle, Ankara, Turkey
| | - Aylin Billur Şendur
- Private Radiology Clinic, Kızılırmak Mah. 1443. Cad. No:25 1071 Plaza, Çankaya, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Gazi University, Faculty of Medicine, Mevlana Bulvarı, Yenimahalle, Ankara, Turkey
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Şendur HN, Cerit MN, Ibrahimkhanli N, Şendur AB, Özhan Oktar S. Interobserver Variability in Ultrasound-Based Liver Fat Quantification. J Ultrasound Med 2023; 42:833-841. [PMID: 35778902 DOI: 10.1002/jum.16048] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/28/2022] [Accepted: 06/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To assess interobserver variability in ultrasound-based quantitative liver fat content measurements and to determine how much time these quantitative ultrasound (QUS) techniques require. METHODS One hundred patients with known or suspected of having nonalcoholic fatty liver disease were included in this prospective study. Two observers who were blinded to each other measurements performed tissue attenuation imaging (TAI) and tissue scatter distribution imaging (TSI) techniques independently. Both observers assessed hepatic steatosis visually and obtained 5 measurements for each QUS technique and the median values of the measurements were recorded. Spearman's correlation test was used to assess the correlation between QUS measurements and visual hepatic stetaosis grades. Intraclass correlation coefficient (ICC) test was used to assess interobserver variability in QUS measurements. RESULTS The median values of TAI measurements for the observers 1 and 2 were 0.75 and 0.74 dB/cm/MHz, respectively. The median values of TSI measurements for the observers 1 and 2 were 93.53 and 92.58, respectively. The interobserver agreement in TAI (ICC: 0.970) and TSI (ICC: 0.938) measurements were excellent. The mean of the required time period for TAI technique were 55.1 ± 7.8 and 59.9 ± 6.6 seconds for the observers 1 and 2, respectively. The mean of the required time period for TSI technique were 49.1 ± 5.8 and 54.1 ± 5.4 seconds for the observers 1 and 2, respectively. CONCLUSION The current study revealed that both TAI and TSI techniques are highly reproducible and can be implemented into daily practice with little additional time requirement.
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Affiliation(s)
- Halit Nahit Şendur
- Department of Radiology, Gazi University Faculty of Medicine, Mevlana Bulvarı No:29 06560 Yenimahalle, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Gazi University Faculty of Medicine, Mevlana Bulvarı No:29 06560 Yenimahalle, Ankara, Turkey
| | - Nemat Ibrahimkhanli
- Department of Radiology, Gazi University Faculty of Medicine, Mevlana Bulvarı No:29 06560 Yenimahalle, Ankara, Turkey
| | | | - Suna Özhan Oktar
- Department of Radiology, Gazi University Faculty of Medicine, Mevlana Bulvarı No:29 06560 Yenimahalle, Ankara, Turkey
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Cavusoglu C, Sendur HN, Cerit MN, Candemir B, Ileri I, Borazan FY, Dogrul RT, Goker B. Correction to: Elasticity of leg muscles and incidence of falls in older adults: a prospective cohort analysis. Eur Geriatr Med 2023; 14:401. [PMID: 36913106 DOI: 10.1007/s41999-023-00758-1] [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] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Affiliation(s)
- Cagatay Cavusoglu
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Halit Nahit Sendur
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Burcu Candemir
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ibrahim Ileri
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Funda Yildirim Borazan
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Rana Tuna Dogrul
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Berna Goker
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
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Polattaş Solak E, Şendur HN, Cerit MN, Cindil E, Özhan Oktar S, Yücel C. The Value of Strain Elastography in the Distinction Between Benign and Malignant Thyroid Nodules in Patients with Hashimoto Thyroiditis. cjms 2023. [DOI: 10.4274/cjms.2022.2021-176] [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: 03/08/2023]
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Emekli E, Coşkun Ö, Budakoğlu Iİ, Cerit MN. Obstetric Ultrasonography in Postgraduate Radiology Training: A National Survey Study. Ultrasound Q 2022; 38:297-303. [PMID: 36441841 DOI: 10.1097/ruq.0000000000000629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
ABSTRACT There is no study in the literature that reveals the adequacy of obstetric ultrasonography (US) training in Turkey. We aimed to evaluate the adequacy of obstetric US training radiologists had received during their residency and determine how competent they considered themselves to be in this regard.A survey (27 items for residents, 21 items for specialists) was sent to all the radiology residents and specialists in Turkey through the mail list of the Turkish Society of Radiology.Ninety-one residents and 217 specialists participated in our study. Sixteen residents (17.6%) had received theoretical courses, 21 residents (23.1%) and 59 specialists (27.2%) had attended in-house obstetric US rotations, and 5 residents (5.5%) and 23 specialists (10.6%) had attended obstetric US rotations in another institution. When questioned separately for each trimester, only 11% to 36.3% of the residents stated that they took care of a sufficient number of patients. In general, 62.6% of the residents and 25.3% of the specialists did not consider themselves to be absolutely competent in obstetric US. The competency sources were specified as residency training by 44 residents (48.6%) and 55 specialists (25.3%), postgraduate training by 2 residents (2.2%) and 78 specialist (35.9%).In Turkey, current obstetric US training does not provide the experience that will allow physicians with radiology training to easily perform and interpret obstetric US. The main reasons for this situation include the limited number of patients the physicians took care of as a resident, insufficient rotation time, and lack of theoretical courses they attended.
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Affiliation(s)
| | - Özlem Coşkun
- Departments of Medical Education and Informatics
| | | | - Mahi Nur Cerit
- Radiology, Gazi University, Faculty of Medicine, Ankara, Turkey
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Aslaner MA, Yaşar E, Kılıçaslan İ, Cerit MN, Emren SV, Yüksek B, Karakök B, Baykuş BA, Bildik F, Güz G, Keleş A, Demircan A. Accuracy of Multi-organ Point-of-Care Ultrasound for Acute Kidney Injury Etiologies. Ultrasound Med Biol 2022; 48:2009-2018. [PMID: 35914991 DOI: 10.1016/j.ultrasmedbio.2022.05.025] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/15/2022] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
This study investigated the diagnostic performance of point-of-care ultrasound (POCUS) for acute kidney injury (AKI) etiological subgroups in emergency department (ED) patients. Multi-organ POCUS including kidney, bladder, inferior vena cava (IVC), lung and cardiac examinations were used to identify five AKI subgroups: hypovolemia, reduced cardiac output, systemic vasodilatation and renal vasomodulation, renal and post-renal. One hundred sixty-five AKI patients were included in the study. The most diagnostic parameter in the post-renal group was the presence of any hydronephrosis, with a sensitivity of 93.3% (95% confidence interval [CI]: 68.1-99.8) and specificity of 85.9% (95% CI: 79.3-91.1). For the reduced cardiac output group, the most diagnostic parameter was IVC maximum diameter >17 mm with a sensitivity of 100% (95% CI: 83.2-100) and specificity of 70.2% (95% CI: 61.6-77.7). For the hypovolemia group, the most diagnostic parameter was IVC maximum diameter ≤17.9 mm with a sensitivity of 81.2% (95% CI: 71.2-88.8) and specificity of 56.5% (95% CI: 44-68.4). For the systemic vasodilatation and renal vasomodulation group, the most diagnostic parameter was diffuse ascites with a sensitivity of 56.3% (95% CI: 29.9-80.2) and specificity of 89.9% (95% CI: 83.8-94.2). None of the parameters were significant for the renal group. We concluded that multi-organ POCUS is of diagnostic value for AKI subgroups.
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Affiliation(s)
- Mehmet Ali Aslaner
- Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Emre Yaşar
- Department of Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - İsa Kılıçaslan
- Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Sadık Volkan Emren
- Department of Cardiology, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Başak Yüksek
- Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Busegül Karakök
- Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bekir Alperen Baykuş
- Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Fikret Bildik
- Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Galip Güz
- Department of Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayfer Keleş
- Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ahmet Demircan
- Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
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Şendur HN, Özdemir Kalkan D, Cerit MN, Kalkan G, Şendur AB, Özhan Oktar S. Hepatic Fat Quantification With Novel Ultrasound Based Techniques: A Diagnostic Performance Study Using Magnetic Resonance Imaging Proton Density Fat Fraction as Reference Standard. Can Assoc Radiol J 2022; 74:362-369. [PMID: 36113064 DOI: 10.1177/08465371221123696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose: To assess the diagnostic performances of novel Tissue attenuation imaging (TAI) and Tissue scatter distribution imaging (TSI) tools in quantification of liver fat content using magnetic resonance imaging proton density fat fraction (MRI PDFF) as reference standard. Methods: Eighty consecutive patients with known or suspected non-alcoholic fatty liver disease (NAFLD) who volunteered to participate in the study comprised the study cohort. All patients underwent MRI PDFF scan and quantitative ultrasound (QUS) imaging using TAI and TSI tools. The cutoff values of ≥5%, ≥16.3% and ≥21.7% on MRI PDFF were used for mild, moderate and severe steatosis, respectively. Area under the Receiver operating characteristic (AUROC) curves were used to assess the diagnostic performance of TAI and TSI in detecting different grades of hepatic steatosis. Results: The AUROCs of TAI and TSI tools in detecting hepatosteatosis (MRI PDFF ≥5%), were 0.95 [95% Confidence Interval (CI): 0.91–0.99] ( P < 0.001) and 0.96 (95% CI: 0.93–0.99) ( P < 0.001), respectively. In distinguishing between different grades of steatosis, the values of 0.75, 0.86 and 0.96 dB/cm/MHz have 88%, 88% and 100% sensitivity, respectively, for TAI tool; and the values of 92.44, 96.64 and 99.45 have 90%, 92% and 91.7% sensitivity, respectively, for TSI tool. Conclusion: TAI and TSI tools accurately quantify liver fat content and can be used for the assessment and grading of hepatosteatosis in patients with known or suspected NAFLD.
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Affiliation(s)
- Halit Nahit Şendur
- Faculty of Medicine, Department of Radiology, Gazi University, Ankara, Turkey
| | | | - Mahi Nur Cerit
- Faculty of Medicine, Department of Radiology, Gazi University, Ankara, Turkey
| | - Gökalp Kalkan
- Medicana International Ankara Hospital, Radiology Unit, Ankara, Turkey
| | | | - Suna Özhan Oktar
- Faculty of Medicine, Department of Radiology, Gazi University, Ankara, Turkey
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Şendur HN, Cerit MN. Reliable Assessment of US Performance for Liver Fat Quantification. Radiology 2022; 305:E70. [PMID: 35972358 DOI: 10.1148/radiol.220258] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Halit Nahit Şendur
- Department of Radiology, Gazi University Faculty of Medicine, Mevlana Bulvarı No. 29, 06560 Yenimahalle, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Gazi University Faculty of Medicine, Mevlana Bulvarı No. 29, 06560 Yenimahalle, Ankara, Turkey
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Şendur HN, Cerit MN, Şendur AB. Impact of COVID-19 pandemic on radiology literature. Diagn Interv Radiol 2022; 28:185. [PMID: 35548904 DOI: 10.5152/dir.2022.21438] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Halit Nahit Şendur
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
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Cindil E, Sendur HN, Cerit MN, Erdogan N, Celebi F, Dag N, Celtikci E, Inan A, Oner Y, Tali T. Prediction of IDH Mutation Status in High-grade Gliomas Using DWI and High T1-weight DSC-MRI. Acad Radiol 2022; 29 Suppl 3:S52-S62. [PMID: 33685792 DOI: 10.1016/j.acra.2021.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 01/24/2021] [Accepted: 02/03/2021] [Indexed: 01/09/2023]
Abstract
RATIONALE AND OBJECTIVES We aimed to evaluate the diagnostic performance of diffusion-weighted imaging (DWI) and dynamic susceptibility contrast-enhanced (DSC) magnetic resonance imaging (MRI) parameters in the noninvasive prediction of the isocitrate dehydrogenase (IDH) mutation status in high-grade gliomas (HGGs). MATERIALS AND METHODS A total of 58 patients with histopathologically proved HGGs were included in this retrospective study. All patients underwent multiparametric MRI on 3-T, including DSC-MRI and DWI before surgery. The mean apparent diffusion coefficient (ADC), relative maximum cerebral blood volume (rCBV), and percentage signal recovery (PSR) of the tumor core were measured and compared depending on the IDH mutation status and tumor grade. The Mann-Whitney U test was used to detect statistically significant differences in parameters between IDH-mutant-type (IDH-m-type) and IDH-wild-type (IDH-w-type) HGGs. Receiver operating characteristic curve (ROC) analysis was performed to evaluate the diagnostic performance. RESULTS The rCBV was significantly higher, and the PSR value was significantly lower in IDH-w-type tumors than in the IDH-m group (p = 0.002 and <0.001, respectively).The ADC value in IDH-w-type tumors was significantly lower compared with the one in IDH-m types (p = 0.023), but remarkable overlaps were found between the groups. The PSR showed the best diagnostic performance with an AUC of 0.938 and with an accuracy rate of 0.87 at the optimal cutoff value of 86.85. The combination of the PSR and the rCBV for the identification of the IDH mutation status increased the discrimination ability at the AUC level of 0.955. In terms of each tumor grade, the PSR and rCBV showed significant differences between the IDH-m and IDH-w groups (p ≤0.001). CONCLUSION The rCBV and PSR from DSC-MRI may be feasible noninvasive imaging parameters for predicting the IDH mutation status in HGGs. The standardization of the imaging protocol is indispensable to the utility of DSC perfusion MRI in wider clinical usage.
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Şendur HN, Cerit MN, Şendur AB, Özhan Oktar S, Yücel C. Evaluation of Diaphragm Thickness and Stiffness Using Ultrasound and Shear-Wave Elastography. Ultrasound Q 2022; 38:89-93. [PMID: 35001026 DOI: 10.1097/ruq.0000000000000593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ABSTRACT The purposes of this study are to measure the thickness and stiffness of diaphragm in association with the respiratory cyclus and to assess the reproducibility of these measurements. Forty individuals who are volunteered for participating diaphragm evaluation were included in the study. Two radiologists with 14 and 15 years of experiences in abdominal ultrasound performed all examinations independently. Furthermore, 8 chronic obstructive pulmonary disease (COPD) patients were examined by only the first radiologist. Gray scale and shear-wave elastography imaging of only the right hemidiaphragm of all participants were performed. Thickness and stiffness of diaphragm were measured at the peak inspiration and end expiration phases. Intraclass correlation coefficients test was used to assess the interobserver agreement. The thickness and stiffness of diaphragm significantly increased with inspiration (P < 0.001). The mean ± SD stiffness of diaphragm in peak inspiration and end expiration phases was 51.84 ± 16.83 kPa and 38.49 ± 9.42 kPa, respectively, for the first radiologist and 49.61 ± 13.83 kPa and 37.52 ± 10.71 kPa, respectively, for the second radiologist. Intraclass correlation coefficient values for diaphragm stiffness were 0.667 and 0.736 in peak inspiration and end expiration phases, respectively. In COPD patients, there was no significant difference between stiffness measurements of respiratory phases. In conclusion, the current study revealed that diaphragm thickness and stiffness increase at inspiration, and these measurements are slightly more reproducible at the end of expiration. However, diaphragm stiffness changes between respiratory phases may not be valid for COPD patients, and this may be related to loss of force-generating capacity of diaphragm in COPD patients.
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Affiliation(s)
| | - Mahi Nur Cerit
- Department of Radiology, Gazi University Faculty of Medicine
| | | | | | - Cem Yücel
- Department of Radiology, Gazi University Faculty of Medicine
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16
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Yılmaz Demirci N, Uğraş Dikmen A, Taşçı C, Doğan D, Arslan Y, Öcal N, Taşar M, Bozlar U, Artuk C, Yılmaz G, Karacaer Z, Avcı İY, Tuncer Ertem G, Erdinç FŞ, Kınıklı S, Altun Demircan Ş, Ergün E, Nercis Koşar P, Karakoç AE, Gökçek A, Aloğlu M, Gülgösteren S, Atikcan Ş, Akçay Ş, Erol Ç, Hekimoğlu K, Cerit MN, Erbaş G, Özger HS, Bozdayı G, Şenol E, Yurdakul AS, Yılmaz A. Relationship between chest computed tomography findings and clinical conditions of coronavirus disease (COVID-19): A multicentre experience. Int J Clin Pract 2021; 75:e14459. [PMID: 34105857 DOI: 10.1111/ijcp.14459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/06/2021] [Indexed: 12/12/2022] Open
Abstract
AIMS This study aimed to investigate the clinical and chest computed tomography (CT) features associated with clinical parameters for coronavirus disease (COVID-19) in the capital of Turkey, Ankara. MATERIALS AND METHODS Epidemiological, clinical features, laboratory findings and radiological characteristics of 1563 hospitalised patients with COVID-19 in Ankara were collected, reviewed and analysed in this study. The risk factors associated with disease severity were investigated. RESULTS Non-severe (1214; 77.7%) and severe cases (349; 22.3%) were enrolled in the study. Compared with the non-severe group, the severe group were significantly older and had more comorbidities (ie, hypertension, diabetes mellitus, cardiovascular disease and chronic kidney disease). Smoking was more common in the severe group. Severe patients had higher respiratory rates and higher incidences of cough and dyspnoea compared with non-severe patients. Compared with the non-severe patients, the severe patients had increased C-reactive protein (CRP), procalcitonin, neutrophil to lymphocyte ratio (NLR) and CRP/albumin ratio and decreased albumin. The occurrence rates of consolidation, subpleural sparing, crazy-paving pattern, cavity, halo sign, reversed halo sign, air bronchogram, pleural thickening, micronodule, subpleural curvilinear line and multilobar and bilateral involvement in the CT finding of the severe patients were significantly higher than those of the non-severe patients. CONCLUSIONS Many factors are related to the severity of COVID-19, which can help clinicians judge the severity of the patient and evaluate the prognosis. This cohort study revealed that male sex, age (≥55 years), patients with any comorbidities, especially those with cardiovascular disease, dyspnoea, increased CRP, D-dimer and NLR, and decreased lymphocyte count and CT findings of consolidation and multilobar involvement were predictors of severe COVID-19.
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Affiliation(s)
| | - Asiye Uğraş Dikmen
- Department of Public Health, Gazi University Medical Faculty, Ankara, Turkey
| | - Cantürk Taşçı
- Department of Chest Diseases, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Deniz Doğan
- Department of Chest Diseases, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Yakup Arslan
- Department of Chest Diseases, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Nesrin Öcal
- Department of Chest Diseases, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Mustafa Taşar
- Department of Radiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Uğur Bozlar
- Department of Radiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Cumhur Artuk
- Department of Infectious Diseases and Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Gülden Yılmaz
- Department of Infectious Diseases and Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Zehra Karacaer
- Department of Infectious Diseases and Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - İsmail Yaşar Avcı
- Department of Infectious Diseases and Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Günay Tuncer Ertem
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Fatma Şebnem Erdinç
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Sami Kınıklı
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Şerife Altun Demircan
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Elif Ergün
- Department of Radiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Pınar Nercis Koşar
- Department of Radiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Ayşe Esra Karakoç
- Department of Medical Microbiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Atila Gökçek
- Department of Radiology, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Melike Aloğlu
- Department of Chest Diseases, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Sevtap Gülgösteren
- Department of Chest Diseases, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Şükran Atikcan
- Department of Chest Diseases, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Şule Akçay
- Department of Chest Diseases, Baskent University Medical Faculty, Ankara, Turkey
| | - Çiğdem Erol
- Department of Infectious Diseases and Clinical Microbiology, Baskent University Medical Faculty, Ankara, Turkey
| | - Koray Hekimoğlu
- Department of Radiology, Baskent University Medical Faculty, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Gazi University Medical Faculty, Ankara, Turkey
| | - Gonca Erbaş
- Department of Radiology, Gazi University Medical Faculty, Ankara, Turkey
| | - Hasan Selçuk Özger
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Medical Faculty, Ankara, Turkey
| | - Gülendam Bozdayı
- Department of Medical Microbiology, Division of Medical Virology, Gazi University Medical Faculty, Ankara, Turkey
| | - Esin Şenol
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Medical Faculty, Ankara, Turkey
| | | | - Aydın Yılmaz
- Department of Chest Diseases, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
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Avdan Aslan A, Erbaş G, Erdal ZS, Şendur HN, Cerit MN, Öncü F, Cindil E, Şahinarslan A, Kiliç K, Araç M. Prevalence and associated risk factors of coronary artery disease in patients with a zero coronary calcium score. Clin Imaging 2021; 77:207-212. [PMID: 33991927 DOI: 10.1016/j.clinimag.2021.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/03/2021] [Revised: 04/26/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE A zero coronary calcium score (CCS) is not able to provide a definite exclusion for coronary artery disease (CAD). The goal of this study was to determine the prevalence and associated cardiovascular risk factors of CAD in patients with zero CCS. METHODS Six hundred thirteen patients with zero CCS referred to coronary calcium score analysis (CCSA) and coronary computed tomography angiography (CCTA) with suspicion of CAD were included. The descriptive, univariate, and multivariate analyses were used to determine the prevalence and predictors of CAD presence. RESULTS Among 613 patients, 17 patients (2.7%) have NCCP, and obstructive CAD was found in 3 patients (0.48%). Multivariate analysis revealed that male gender and older age (≥50 years) were significantly associated with the presence of noncalcified coronary plaques (NCCP) (p < 0.05). The receiver operating characteristic (ROC) curve analysis showed that the male gender and older age (≥50 years) model had 70.6% sensitivity and 84.2% specificity for predicting NCCP. CONCLUSION A non-negligible portion of patients with zero CCS had CAD. Male gender and older age (≥50 years) were independently associated with NCCP. Due to the high specificity value (84.2%) and negative predictive value (99.0%) of the male gender and older age (≥50 years) model, selective use of CCTA is recommended in <50 years old female patients to avoid unnecessary radiation exposure.
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Affiliation(s)
- Aydan Avdan Aslan
- Department of Radiology, Faculty of Medicine, Gazi University, Emniyet, Mevlana Blv. No:29, 06560 Yenimahalle, Ankara, Türkiye.
| | - Gonca Erbaş
- Department of Radiology, Faculty of Medicine, Gazi University, Emniyet, Mevlana Blv. No:29, 06560 Yenimahalle, Ankara, Türkiye
| | - Zeynep Sezgi Erdal
- Department of Radiology, Faculty of Medicine, Gazi University, Emniyet, Mevlana Blv. No:29, 06560 Yenimahalle, Ankara, Türkiye
| | - Halit Nahit Şendur
- Department of Radiology, Faculty of Medicine, Gazi University, Emniyet, Mevlana Blv. No:29, 06560 Yenimahalle, Ankara, Türkiye
| | - Mahi Nur Cerit
- Department of Radiology, Faculty of Medicine, Gazi University, Emniyet, Mevlana Blv. No:29, 06560 Yenimahalle, Ankara, Türkiye
| | - Fatih Öncü
- Department of Radiology, Faculty of Medicine, Gazi University, Emniyet, Mevlana Blv. No:29, 06560 Yenimahalle, Ankara, Türkiye
| | - Emetullah Cindil
- Department of Radiology, Faculty of Medicine, Gazi University, Emniyet, Mevlana Blv. No:29, 06560 Yenimahalle, Ankara, Türkiye
| | - Asife Şahinarslan
- Department of Cardiology, Faculty of Medicine, Gazi University, Emniyet, Mevlana Blv. No:29, 06560 Yenimahalle, Ankara, Türkiye
| | - Koray Kiliç
- Department of Radiology, Faculty of Medicine, Gazi University, Emniyet, Mevlana Blv. No:29, 06560 Yenimahalle, Ankara, Türkiye
| | - Mehmet Araç
- Department of Radiology, Faculty of Medicine, Gazi University, Emniyet, Mevlana Blv. No:29, 06560 Yenimahalle, Ankara, Türkiye
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Cerit MN, Sendur HN, Bolayır B, Cerit ET, Cindil E, Yaşım Aktürk M, Baloş Törüner F, Özhan Oktar S. Evaluation of common carotid artery in type 1 diabetes mellitus patients through speckle tracking carotid strain ultrasonography. Diagn Interv Radiol 2021; 27:195-205. [PMID: 33599210 DOI: 10.5152/dir.2021.20025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE We aimed to evaluate the effectiveness of speckle tracking carotid strain (STCS) technique, which enables measurement of arterial stiffness and strain parameters, in the detection of early atherosclerotic findings in type 1 diabetes mellitus (T1DM). METHODS We prospectively enrolled 30 T1DM patients and 30 age- and sex-matched control participants with no history of cardiovascular disease. All study population underwent carotid ultrasonography. Radial and circumferential movement of the common carotid artery (CCA) in the transverse plane as the well as the radial movement of the CCA in the longitudinal plane were calculated automatically by using the STCS method. In addition, the strain (%), strain rate (per second), and peak circumferential and radial displacements (mm) were calculated. Arterial stiffness parameters, such as elastic modulus, distensibility, arterial compliance, and β-stiffness index, were calculated using the radial measurements. The mean value of the carotid intima media thickness (CIMT) was calculated semi-automatically for each CCA, in the longitudinal plane. We also analyzed the patients' overall body composition. RESULTS T1DM and control groups were compared in terms of strain and stiffness parameters and no statistically significant difference was found (p > 0.05). CIMT was higher in diabetic patients than in the control group (p = 0.039). In both groups, age was correlated with all arterial stiffness and strain parameters (p < 0.05). The duration of diabetes was also correlated with β-stiffness index, distensibility, and elastic modulus in the longitudinal plane (p < 0.05). In the diabetic group, abdominal fat ratio, whole body fat ratio, and fat mass were correlated with radial and circumferential displacement and strain parameters in transverse plane, and radial displacement in longitudinal plane (p < 0.05, for each). Diabetic patients were divided into subgroups according to the presence of nephropathy and dyslipidemia. Although no significant difference was found between the groups in terms of CIMT, patients with nephropathy had higher values for transverse and longitudinal elastic modulus, pulse-wave velocity, and longitudinal β-stiffness index, as well as lower values for longitudinal arterial compliance and distensibility, compared with patients without nephropathy (p < 0.05). Also, patients with dyslipidemia had higher longitudinal β-stiffness and elastic modulus values compared with patients without dyslipidemia (p < 0.05). CONCLUSION STCS ultrasonography is an effective, easy, and noninvasive method for evaluating the arterial elasticity. It may provide an early assessment of atherosclerosis in patients with T1DM, especially in the presence of nephropathy and dyslipidemia; thus, together with CIMT measurement, it may be used more frequently to detect subclinical damage and stratify atherosclerosis.
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Affiliation(s)
- Mahi Nur Cerit
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Halit Nahit Sendur
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Başak Bolayır
- Department of Endocrinology, Gazi University Faculty of Medicine, Ankara, Turkey
| | | | - Emetullah Cindil
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Müjde Yaşım Aktürk
- Department of Endocrinology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Füsun Baloş Törüner
- Department of Endocrinology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Suna Özhan Oktar
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
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19
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Şendur HN, Cerit MN, Cindil E. More information for the biopsies of calcifications under digital breast tomosynthesis guidance may be helpful. Clin Imaging 2020; 71:180. [PMID: 33309184 DOI: 10.1016/j.clinimag.2020.12.002] [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] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/01/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Halit Nahit Şendur
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, 06560 Yenimahalle, Ankara, Turkey.
| | - Mahi Nur Cerit
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, 06560 Yenimahalle, Ankara, Turkey
| | - Emetullah Cindil
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, 06560 Yenimahalle, Ankara, Turkey
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20
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Cindil E, Sendur HN, Cerit MN, Dag N, Erdogan N, Celebi FE, Oner Y, Tali T. Validation of combined use of DWI and percentage signal recovery-optimized protocol of DSC-MRI in differentiation of high-grade glioma, metastasis, and lymphoma. Neuroradiology 2020; 63:331-342. [PMID: 32821962 DOI: 10.1007/s00234-020-02522-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 06/02/2020] [Accepted: 08/13/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE With conventional MRI, it is often difficult to effectively differentiate between contrast-enhancing brain tumors, including primary central nervous system lymphoma (PCNSL), high-grade glioma (HGG), and metastasis. This study aimed to assess the discrimination ability of the parameters obtained from DWI and the percentage signal recovery- (PSR-) optimized protocol of DSC-MRI between these three tumor types at an initial step. METHODS DSC-MRI using a PSR-optimized protocol (TR/TE = 1500/30 ms, flip angle = 90°, no preload) and DWI of 99 solitary enhancing tumors (60 HGGs, 24 metastases, 15 PCNSLs) were retrospectively assessed before treatment. rCBV, PSR, ADC in the tumor core and rCBV, and ADC in peritumoral edema were measured. The differences were evaluated using one-way ANOVA, and the diagnostic performance was evaluated using ROC curve analysis. RESULTS PSR in the tumor core showed the best discriminating performance in differentiating these three tumor types with AUC values of 0.979 for PCNSL vs. others and 0.947 for HGG vs. metastasis. The ADC was only helpful in the tumor core and distinguishing PCNSLs from others (AUC = 0.897). CONCLUSION Different from CBV-optimized protocols (preload, intermediate FA), PSR derived from the PSR-optimized protocol seems to be the most important parameter in the differentiation of HGGs, metastases, and PCNSLs at initial diagnosis. This property makes PSR remarkable and carries the need for comprehensive DSC-MRI protocols, which provides PSR sensitivity and CBV accuracy together, such as the preload use of the PSR-optimized protocol before the CBV-optimized protocol.
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Affiliation(s)
- Emetullah Cindil
- School of Medicine, Department of Radiology, Gazi University, Ankara, Turkey.
| | - Halit Nahit Sendur
- School of Medicine, Department of Radiology, Gazi University, Ankara, Turkey
| | - Mahi Nur Cerit
- School of Medicine, Department of Radiology, Gazi University, Ankara, Turkey
| | - Nurullah Dag
- School of Medicine, Department of Radiology, Gazi University, Ankara, Turkey
| | - Nesrin Erdogan
- School of Medicine, Department of Radiology, Gazi University, Ankara, Turkey
| | - Filiz Elbuken Celebi
- School of Medicine, Department of Radiology, Yeditepe University, Istanbul, Turkey
| | - Yusuf Oner
- School of Medicine, Department of Radiology, Gazi University, Ankara, Turkey
| | - Turgut Tali
- School of Medicine, Department of Radiology, Gazi University, Ankara, Turkey
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Şendur HN, Cerit MN, Gültekin S, Cindil E, Avdan Aslan A, Erdal ZS, Gültekin Iİ, Teke F. Accuracy in tumor size measurements: Comparison of digital mammography, digital breast tomosynthesis and synthetic mammography. Clin Imaging 2020; 69:115-119. [PMID: 32717538 DOI: 10.1016/j.clinimag.2020.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/07/2020] [Revised: 06/16/2020] [Accepted: 07/13/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The aim of this study was to assess the accuracy of digital mammography (DM), digital breast tomosynthesis (DBT) and synthetic mammography (SM) in tumor size measurements compared with histological tumor sizes. MATERIALS AND METHODS 71 breast cancer patients who underwent DM and DBT acquisitions simultaneously were included in this study. One radiologist with 8 years of experience in breast imaging measured tumor sizes independently in three separate sessions which include DM, DBT and SM images, respectively. The correlations between the measured tumor sizes on each imaging technique and histological sizes were analyzed using Spearman correlation test. The patients were categorized into two subgroups according to assigned breast density categories (dense and non-dense), and histological tumor sizes (≤2 cm and > 2 cm). To assess the agreement levels between the measured tumor sizes and histological sizes Bland-Altman analyses were performed for each imaging technique. RESULTS The mean of histological size of tumors was 23.85 ± 16.57 mm (median: 20). The means of measured tumor sizes were 21.21 ± 13.59 mm (median: 19), 21.52 ± 13.42 mm (median: 19) and 18.97 ± 11.21 mm (median: 17) in DM, DBT and SM, respectively. The Spearman correlation values with histologic sizes were 0.814 (P < 0.001), 0.887 (P < 0.001), and 0.852 (P < 0.001) for DM, DBT and SM, respectively. In subgroup analyses, the correlation values showed decrement for tumors >2 cm in size compared to tumors ≤2 cm in size. CONCLUSION DBT provides the most accurate tumor size measurements among mammographic imaging techniques and if mammography will be used in tumor size measurements, DBT should be preferred.
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Affiliation(s)
- Halit Nahit Şendur
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, 06560 Yenimahalle, Ankara, Turkey.
| | - Mahi Nur Cerit
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, 06560 Yenimahalle, Ankara, Turkey
| | - Serap Gültekin
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, 06560 Yenimahalle, Ankara, Turkey
| | - Emetullah Cindil
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, 06560 Yenimahalle, Ankara, Turkey
| | - Aydan Avdan Aslan
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, 06560 Yenimahalle, Ankara, Turkey
| | - Zeynep Sezgi Erdal
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, 06560 Yenimahalle, Ankara, Turkey
| | - Işıl İmge Gültekin
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, 06560 Yenimahalle, Ankara, Turkey
| | - Furkan Teke
- Gazi University Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, 06560 Yenimahalle, Ankara, Turkey
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Şendur HN, Cerit MN, Gültekin S, Cindil E, Kılıç P. Comparison of Mass Size Measurements: Synthesized Mammography Versus Full-Field Digital Mammography. Acad Radiol 2020; 27:766-773. [PMID: 31537507 DOI: 10.1016/j.acra.2019.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/14/2019] [Accepted: 08/15/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare mass size measurements between synthesized mammography (SM) and full-field digital mammography (FFDM), and to assess interobserver agreement for those measurements. MATERIALS AND METHODS One hundred and forty-three patients who underwent FFDM and digital breast tomosynthesis acquisitions during the same compression session were included in the study. Two observers with four-and 1-year experience with digital breast tomosynthesis and SM images, respectively, measured mass sizes independently in two different sessions that were 2 weeks apart, and were blinded to each other. The first session included only FFDM images, and the second session included only SM images. Largest dimension of masses was measured in millimeters. Paired t test was used to compare differences in size measurements between FFDM and SM images. Intraclass correlation coefficient test was used to analyze interobserver agreement. Bland-Altman analyses were performed to evaluate agreements between the imaging techniques and between the observers. RESULTS The mean mass sizes on FFDM and SM images were 20.27 ± 14.10 and 18.50 ± 13.05 mm, respectively, for the first observer and 21.56 ± 14.84 and 19.89 ± 13.68 mm, respectively, for the second observer. The mass size measurements were significantly different between FFDM and SM for both observers (p < 0.001). Range of measurement errors, defined as 95% limits of agreements between two imaging techniques for observers 1 and 2 were ±1.96*1.36 mm, and ±1.96*1.53 mm, respectively. Range of measurement errors, defined as 95% limits of agreements between two observers for SM and FFDM were ±1.96*3.68 mm, and ±1.96*3.35 mm, respectively. CONCLUSION The measured mass sizes were significantly smaller on SM than FFDM images, and the interobserver differences for both of the imaging techniques were greater than the differences measured between FFDM and SM images.
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Şendur HN, Cindil E, Cerit MN, Kılıç P, Gültekin Iİ, Oktar SÖ. Evaluation of effects of aging on skeletal muscle elasticity using shear wave elastography. Eur J Radiol 2020; 128:109038. [PMID: 32422550 DOI: 10.1016/j.ejrad.2020.109038] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 11/29/2019] [Revised: 04/07/2020] [Accepted: 04/27/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the effects of aging on skeletal muscle stiffness in relaxed and contracted status using shear wave elastography (SWE). MATERIALS AND METHODS A total of 57 participants were enrolled to this institutional review board approved prospective study. Medial head of the gastrocnemius muscle (GM) of all participants were examined bilaterally by a single radiologist in prone position. Muscle thickness, stiffness values in both relaxed and contracted status were measured. Stiffness increase rate (SIR) was calculated for all muscles. The Spearman's correlation test was used for correlation analyses. Mann-Whitney U test was used to compare subgroups. RESULTS The mean age of the participants was 41.15 ± 16.19 (range, 18-74). The means of stiffness values of medial head of GM were 12.51 ± 2.56 kPa and 81.74 ± 15.77 kPa in relaxed and contracted status, respectively. The mean of SIR values was 5.62 ± 1.05 (range, 3.18-8.66). The stiffness values of relaxed and contracted medial head of GM had moderate to strong inverse correlations with age for both dominant and non-dominant extremities (r range: -0.703 to -0.590). Age subgroup analyses revealed significant differences in muscle thickness and stiffness values, whereas no significant difference was found in SIR values. CONCLUSION In conclusion, despite the decrease in stiffness of skeletal muscle with advancing age, SIR remained similar. Any improvement in stiffness values of skeletal muscle in relaxed status may play pivotal role in the management of sarcopenia.
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Affiliation(s)
- Halit Nahit Şendur
- Gazi University, Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, Yenimahalle, 06560, Ankara, Turkey.
| | - Emetullah Cindil
- Gazi University, Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, Yenimahalle, 06560, Ankara, Turkey
| | - Mahi Nur Cerit
- Gazi University, Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, Yenimahalle, 06560, Ankara, Turkey
| | - Pınar Kılıç
- Gazi University, Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, Yenimahalle, 06560, Ankara, Turkey
| | - Işıl İmge Gültekin
- Gazi University, Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, Yenimahalle, 06560, Ankara, Turkey
| | - Suna Özhan Oktar
- Gazi University, Faculty of Medicine, Department of Radiology, Mevlana Bulvarı No: 29, Yenimahalle, 06560, Ankara, Turkey
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Cerit MN, Öner AY, Yıldız A, Cindil E, Şendur HN, Leventoğlu S. Perianal fistula mapping at 3 T: volumetric versus conventional MRI sequences. Clin Radiol 2020; 75:563.e1-563.e9. [PMID: 32334811 DOI: 10.1016/j.crad.2020.03.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 03/23/2020] [Indexed: 01/06/2023]
Abstract
AIM To evaluate volumetric contrast-enhanced three-dimensional T1-weighted (CE 3D T1) turbo spin-echo (TSE) with variable flip angle (SPACE), CE 3D T1 volumetric interpolated breath-hold examination (VIBE) sequences with conventional CE-two-dimensional (2D)-T1 and 2D-T2-weighted imaging (WI) sequences in assessing perianal fistulas. METHODS AND MATERIALS Twenty-three patients with perianal fistula were included in this prospective study and underwent pelvic magnetic resonance imaging (MRI) at 3 T including fat-supressed CE 3D T1 SPACE, CE 3D T1 VIBE, axial and coronal 2D-T1WI together with 2D-T2WI sequences in the axial and coronal planes. Acquisition times were recorded. Performance of each sequence was evaluated in terms of image quality, presence of artefacts, lesion conspicuity, fistula type, presence of abscess, visibility of internal orifice, and number of internal orifices. Results were compared with post-surgical findings defined as the reference standard. RESULTS Both CE 3D T1 VIBE and CE 3D T1 SPACE were the best sequences to determine fistula type and in terms of image quality, artefacts, and determining locations of internal orifices. The number of internal orifices was detected correctly in 23 (100%) patients for CE 3D T1 SPACE and CE 3D T1 VIBE sequences, in 17 (73.9%) patients on CE-T1WI, and in seven (30.4%) patients on 2D-T2WI. Lesion conspicuity was higher for CE 3D T1 SPACE and CE 3D T1 VIBE sequences compared to the 2D sequences (p<0.05). The overall acquisition time for each 3D sequence was shorter compared to the 2D sequences combined. CONCLUSION CE 3D T1 SPACE and CE 3D T1 VIBE sequences may outperform conventional 2D sequences in the evaluation of perianal fistulas in terms of visibility and number of internal orifices with a shorter scanning time.
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Affiliation(s)
- M N Cerit
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey.
| | - A Y Öner
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - A Yıldız
- Department of General Surgery, Yıldırım Beyazıt University, Yenimahalle Research and Training Hospital, Ankara, Turkey
| | - E Cindil
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - H N Şendur
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - S Leventoğlu
- Department of General Surgery, Gazi University Faculty of Medicine, Ankara, Turkey
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Cindil E, Oner Y, Sendur HN, Ozdemir H, Gazel E, Tunc L, Cerit MN. The Utility of Diffusion-Weighted Imaging and Perfusion Magnetic Resonance Imaging Parameters for Detecting Clinically Significant Prostate Cancer. Can Assoc Radiol J 2020; 70:441-451. [DOI: 10.1016/j.carj.2019.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/30/2019] [Accepted: 07/10/2019] [Indexed: 01/26/2023] Open
Abstract
Introduction To establish the diagnostic performance of the parameters obtained from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging at 3T in discriminating between non-clinically significant prostate cancers (ncsPCa, Gleason score [GS] < 7) and clinically significant prostate cancers (csPCa, GS ≥ 7) in the peripheral zone. Materials and Methods Twenty-six male patients with peripheral zone prostate cancer (PCa) who had undergone 3T multiparametric magnetic resonance imaging (MRI) scan prior to biopsy were included in the study and evaluated retrospectively. The GS was obtained by both standard 12-core transrectal ultrasound guided biopsy and targeted MRI-US fusion biopsy and then confirmed by prostatectomy, if available. For each confirmed tumour focus, DCE-derived quantitative perfusion metrics (Ktrans, Kep, Ve, initial area under the curve [AUC]), the apparent diffusion coefficient (ADC) value, and normalized versions of quantitative metrics were measured and correlated with the GS. Results Ktrans had the highest diagnostic accuracy value of 82% among the DCE-MRI parameters (AUC 0.90), and ADC had the strongest diagnostic accuracy value of 87% among the overall parameters (AUC 0.92). The combination of ADC and Ktrans have higher diagnostic performance with the area under the receiver operating characteristic curve being 0.98 (sensitivity 0.94; specificity 0.89; accuracy 0.92) compared to the individual evaluation of each parameter alone. The GS showed strong negative correlations with ADC (r = −0.72) and normalized ADC (r = −0.69) as well as a significant positive correlation with Ktrans (r = 0.69). Conclusion The combination of Ktrans and ADC and their normalized versions may help differentiate between ncsPCa from csPCa in the peripheral zone.
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Affiliation(s)
- Emetullah Cindil
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Yusuf Oner
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Halit Nahit Sendur
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Hakan Ozdemir
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Eymen Gazel
- Department of Urology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Lutfi Tunc
- Department of Urology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
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