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Polat Z, Elmalı M, Tanrivermis Sayit A, Kalkan C, Danacı M, Kefeli M. Comparative evaluation of shear wave elastography elasticity values in thyroid nodules with cytology results and TI-RADS scoring in differentiation of benign-malignant nodules. Eur Arch Otorhinolaryngol 2024; 281:2609-2617. [PMID: 38461420 PMCID: PMC11023991 DOI: 10.1007/s00405-024-08516-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 01/29/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE The aim of this prospective study was to investigate the diagnostic performance of shear wave elastography (SWE) in differentiating benign and malignant thyroid nodules and their correlation with the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS). METHODS This prospective study included 370 thyroid nodules in 308 patients aged 18-70 years. All the patients underwent B-mode ultrasound (US), Doppler examination, and SWE and were given an ACR TI-RADS risk score before fine needle aspiration biopsy (FNAB) and/or surgery. The correlation between SWE parameters and ACR TI-RADS categories was investigated statistically and compared with histopathologic results. Additionally, the diagnostic performance of SWE was evaluated to distinguish malignant and benign thyroid nodules. RESULTS One hundred and thirty-five of the 370 thyroid nodules were malignant, and 235 nodules were benign. The mean shear wave velocity (SWV) value of the malignant nodules (3.70 ± 0.98 m/s) was statistically higher than that of the benign nodules (2.70 ± 0.37 m/s). The best cutoff value of the mean SWV for differentiating benign and malignant nodules was found to be 2.94 m/s (sensitivity 90.4%, specificity 89.9%, positive predictive value 81.3%, negative predictive value 94.1%, p < 0.001). The average score of the nodules according to the ACR TI-RADS was 3.57 ± 1.83 in benign nodules and 7.38 ± 2.69 in malignant nodules (p ≤ 0.001). CONCLUSION This study showed that combining SWE and TI-RADS improves the specificity of TI-RADS alone in differentiating benign and malignant nodules.
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Affiliation(s)
- Zafer Polat
- Faculty of Medicine, Department of Radiology, Ondokuzmayis University, 55139, Atakum, Samsun, Turkey
| | - Muzaffer Elmalı
- Faculty of Medicine, Department of Radiology, Ondokuzmayis University, 55139, Atakum, Samsun, Turkey
| | - Asli Tanrivermis Sayit
- Faculty of Medicine, Department of Radiology, Ondokuzmayis University, 55139, Atakum, Samsun, Turkey.
| | - Cihan Kalkan
- Faculty of Medicine, Department of Radiology, Ondokuzmayis University, 55139, Atakum, Samsun, Turkey
| | - Murat Danacı
- Faculty of Medicine, Department of Radiology, Ondokuzmayis University, 55139, Atakum, Samsun, Turkey
| | - Mehmet Kefeli
- Faculty of Medicine, Department of Pathology, Ondokuzmayis University, Samsun, Turkey
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Polat Z, Elmalı M, Sayit AT, Kalkan C, Danacı M, Kefeli M. Correction: Comparative evaluation of shear wave elastography elasticity values in thyroid nodules with cytology results and TI-RADS scoring in differentiation of benign-malignant nodules. Eur Arch Otorhinolaryngol 2024; 281:2775. [PMID: 38568299 PMCID: PMC11023989 DOI: 10.1007/s00405-024-08637-6] [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: 04/18/2024]
Affiliation(s)
- Zafer Polat
- Faculty of Medicine, Department of Radiology, Ondokuzmayis University, 55139, Atakum, Samsun, Turkey
| | - Muzaffer Elmalı
- Faculty of Medicine, Department of Radiology, Ondokuzmayis University, 55139, Atakum, Samsun, Turkey
| | - Asli Tanrivermis Sayit
- Faculty of Medicine, Department of Radiology, Ondokuzmayis University, 55139, Atakum, Samsun, Turkey.
| | - Cihan Kalkan
- Faculty of Medicine, Department of Radiology, Ondokuzmayis University, 55139, Atakum, Samsun, Turkey
| | - Murat Danacı
- Faculty of Medicine, Department of Radiology, Ondokuzmayis University, 55139, Atakum, Samsun, Turkey
| | - Mehmet Kefeli
- Faculty of Medicine, Department of Pathology, Ondokuzmayis University, Samsun, Turkey
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Çamlıdağ İ, Nural MS, Kalkan C, Danacı M. Discrimination of papillary renal cell carcinoma from benign proteinaceous cyst based on iodine and water content on rapid kV-switching dual-energy CT. ACTA ACUST UNITED AC 2020; 26:390-395. [PMID: 32755880 DOI: 10.5152/dir.2020.19483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to evaluate whether rapid kV-switching dual energy CT (rsDECT) can discriminate between papillary renal cell carcinoma (RCC) and benign proteinaceous cysts (BPCs) based on iodine and water content. METHODS Twenty-four patients with histopathologically proven papillary RCC and 38 patients with 41 BPCs were retrospectively included. Patients with BPCs were eligible for inclusion when the cysts were stable in size and appearance for at least 2 years or proved to be a cyst on ultrasound or MRI. All patients underwent delayed phase (70-90 s) rsDECT. Iodine and water content of each lesion was measured on the workstation. RESULTS Of papillary RCC patients, 4 (16%) were female and 20 (84%) were male. Mean tumor size was 39±20 mm. Mean iodine and water content was 2.08±0.7 mg/mL and 1021±14 mg/mL, respectively. Of BPC patients, 9 were female and 29 were male. Mean cyst size was 20±7 mm. Mean iodine and water content was 0.82±0.4 mg/mL and 1012±14 mg/mL, respectively. There were significant differences between iodine and water contents of papillary RCCs and BPCs (P < 0.001). The best cutoff of iodine content for differentiating papillary RCC from BPC was 1.21 mg/mL (area under the curve [AUC]=0.97, P < 0.001, sensitivity 96%, specificity 88%, positive predictive value [PPV] 82%, negative predictive value [NPV] 97%, accuracy 91%,); the best cutoff of water content was 1015.5 mg/mL (AUC=0.68, P = 0.016, sensitivity 83%, specificity 56%, PPV 52%, NPV 85%, accuracy 66%). CONCLUSION An iodine content threshold of 1.21 mg/mL accurately differentiates papillary RCC from BPCs on a single postcontrast rsDECT. Despite having a high sensitivity, water content has inferior diagnostic accuracy.
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Affiliation(s)
- İlkay Çamlıdağ
- Department of Radiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Mehmet Selim Nural
- Department of Radiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Cihan Kalkan
- Department of Radiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Murat Danacı
- Department of Urology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
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Abstract
PURPOSE To investigate whether iodine content can discriminate between benign or malignant renal tumors, malign tumor subtypes, low-grade and high-grade tumors on rapid kv-switching dual-energy CT (rsDECT). METHODS This prospective study enrolled 95 patients with renal tumors who underwent rsDECT for tumor characterization between 2016 and 2018. Attenuation on true and virtual unenhanced images, absolute enhancement and enhancement ratio and iodine content of each lesion on nephrographic phase iodine density images were measured. Histopathological diagnosis was obtained following either surgery or core biopsy. RESULTS Eighty-five tumors were renal cell carcinoma (RCC) (56 clear cell, 20 papillary, 9 chromophobe) and 10 were benign (6 angiomyolipoma,4 oncocytoma). 46 tumors were low-grade and 23 high-grade. There was significant difference between iodine content of clear cell and non-clear cell (papillary + chromophobe) RCC (p < 0.001). However, no significant iodine content differences were found between papillary and chromophobe RCC, benign and malignant tumors, low-grade and high-grade tumors. The best cut-off iodine content for differentiating clear cell from non-clear cell RCC was 3.2 mg/ml and clear cell from papillary RCC was 2.9 mg/ml with a high sensitivity and specificity. Also, significant difference was found between attenuation values of true and virtual unenhanced images (p = 0.007). Mean iodine content, absolute enhancement and enhancement ratio were highly correlated. CONCLUSION rsDECT contributes to renal tumor characterization by showing higher iodine content in clear cell RCCs compared with non-clear cell RCCs.
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Akın IB, Altay C, Güler E, Çamlıdağ İ, Harman M, Danacı M, Tuna B, Yörükoğlu K, Seçil M. Discrimination of oncocytoma and chromophobe renal cell carcinoma using MRI. ACTA ACUST UNITED AC 2019; 25:5-13. [PMID: 30644365 DOI: 10.5152/dir.2018.18013] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE We aimed to evaluate magnetic resonance imaging (MRI) features, including signal intensities, enhancement patterns and T2 signal intensity ratios to differentiate oncocytoma from chromophobe renal cell carcinoma (RCC). METHODS This retrospective study included 17 patients with oncocytoma and 33 patients with chromophobe RCC who underwent dynamic MRI. Two radiologists independently reviewed images blinded to pathology. Morphologic characteristics, T1 and T2 signal intensities were reviewed. T2 signal intensities, wash-in, wash-out values, T2 signal intensity ratios were calculated. Sensitivity and specificity analyses were performed. RESULTS Mean ages of patients with oncocytoma and chromophobe RCC were 61.0±11.6 and 58.5±14.0 years, respectively. Mean tumor size was 60.6±47.3 mm for oncocytoma, 61.7±45.9 mm for chromophobe RCC. Qualitative imaging findings in conventional MRI have no distinctive feature in discrimination of two tumors. Regarding signal intensity ratios, oncocytomas were higher than chromophobe RCCs. Renal oncocytomas showed higher signal intensity ratios and wash-in values than chromophobe RCCs in all phases. Fast spin-echo T2 signal intensities were higher in oncocytomas than chromophobe RCCs. CONCLUSION Signal intensity ratios, fast spin-echo T2 signal intensities and wash-in values constitute diagnostic parameters for discriminating between oncoytomas and chromophobes. In the excretory phase of dynamic enhanced images, oncocytomas have higher signal intensity ratio than chromophobe RCC and high wash-in values strongly imply a diagnosis of renal oncocytoma.
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Affiliation(s)
- Işıl Başara Akın
- Department of Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Canan Altay
- Department of Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Ezgi Güler
- Department of Radiology, Ege University School of Medicine, İzmir, Turkey
| | - İlkay Çamlıdağ
- Department of Radiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Mustafa Harman
- Department of Radiology, Ege University School of Medicine, İzmir, Turkey
| | - Murat Danacı
- Department of Radiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Burçin Tuna
- Department of Pathology, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Kutsal Yörükoğlu
- Department of Pathology, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Mustafa Seçil
- Department of Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
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Kalkan C, Aslan S, Çamlıdağ İ, Nural MS, Danacı M, Öztürk M, Kefeli M. A Rare Mimicker of an Adrenal Carcinoma: Co-occurrence of Hemorrhagic Pseudocyst and Myelolipoma. jus 2018. [DOI: 10.4274/jus.1976] [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: 12/01/2022] Open
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Danacı M. Re: MRI Evaluation of Complex Renal Cysts Using the Bosniak Classification: A Comparison to CT. jus 2017. [DOI: 10.4274/jus.2017.04.010] [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: 12/01/2022] Open
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Çamlıdağ İ, Danacı M, Nural MS. Penile Metastasis as the First Manifestation of Sarcomatoid Renal Cell Carcinoma. jus 2016. [DOI: 10.4274/jus.2016.875] [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: 12/01/2022] Open
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Kececi I, Nural M, Aslan K, Danacı M, Kefeli M, Tosun M. Efficacy of diffusion-weighted magnetic resonance imaging in the diagnosis and staging of endometrial tumors. Diagn Interv Imaging 2016; 97:177-86. [DOI: 10.1016/j.diii.2015.06.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 06/15/2015] [Accepted: 06/30/2015] [Indexed: 11/25/2022]
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Bekci T, Özdemir M, Mehmet Selim N, Danacı M. Chemoresponsive liver hemangioma in a patient with metastatic malignant teratoma. Clin Res Hepatol Gastroenterol 2015; 39:1-2. [PMID: 25168798 DOI: 10.1016/j.clinre.2014.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 05/27/2014] [Accepted: 06/08/2014] [Indexed: 02/04/2023]
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Karlı A, Belet N, Danacı M, Avcu G, Paksu Ş, Köken Ö, Şensoy G. Iliopsoas abscess in children: report on five patients with a literature review. Turk J Pediatr 2014; 56:69-74. [PMID: 24827950] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We aimed in this study to present the clinical findings in children with iliopsoas abscess (IPA) and to discuss the diagnosis and treatment. The files of five patients, hospitalized between August 2011 and June 2013 and monitored with a diagnosis of IPA, were reviewed retrospectively. Demographic characteristics, symptoms and signs, laboratory examinations, and diagnostic and treatment methods of the cases were evaluated. Two of the cases were females and three were males, and their ages ranged from 10 to 15 years. Before the diagnosis, the duration of symptoms in patients ranged from five days to one year. The primary symptoms included fever and difficulty in walking. One patient presented with septic shock and had a history of trauma as a predisposing factor. All patients except one had a higher erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) value. Psoas abscess was demonstrated by ultrasonography (USG), except in one patient. Four patients underwent percutaneous drainage of the abscess. The isolated microorganisms included Staphylococcus aureus, Mycobacterium tuberculosis, and Enterococcus faecalis. All the cases recovered without sequelae. Diagnosis of IPA in children is difficult, and many physicians are usually consulted before any diagnosis is made. IPA should be considered in the differential diagnosis in patients presenting with complaints of lower back, hip, groin and leg pain and difficulty in walking.
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Affiliation(s)
- Arzu Karlı
- Division of Pediatric Infectious Diseases, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
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