Browsing by Author "Soylu, Esra"
Now showing 1 - 8 of 8
- Results Per Page
- Sort Options
Publication Dynamic contrast-enhanced T1-weighted perfusion magnetic resonance imaging identifies glioblastoma immunohistochemical biomarkers via tumoral and peritumoral approach: A pilot study(Elsevier Science, 2019-04-09) Öztürk, Kerem; Soylu, Esra; Tolunay, Şahsine; Narter, Selin; Hakyemez, Bahattin; Özturk, Kerem; Soylu, Esra; TOLUNAY, ŞAHSİNE; NARTER, SELİN; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0001-9664-2347; 0000-0002-3425-0740; AAI-2318-2021; E-1228-2018; AAI-1612-2021; DSW-1175-2022; FOL-7699-2022OBJECTIVE: We aimed to evaluate the usefulness of dynamic contrast-enhanced T1-weighted perfusion magnetic resonance imaging (DCE-pMRI) to predict certain immunohistochemical (IHC) biomarkers of glioblastoma (GB) in this pilot study.METHODS: We retrospectively reviewed 36 patients (male/female, 25:11; mean age, 53 years; age range, 29-85 years) who had pretreatment DCE-pMRI with IHC analysis of their excised GBs. Regions of interest of the enhancing tumor (ER) and nonenhancing peritumoral region (NER) were used to calculate DCE-pMRI parameters of volume transfer constant, back flux constant, volume of the extravascular extracellular space, initial area under enhancement curve, and maximum slope. IHC biomarkers including Ki-67 labeling index, epidermal growth factor receptor (EGFR), oligodendrocyte transcription factor 2 (OLIG2), isocitrate dehydrogenase 1 (IDH1), and p53 mutation status were determined. The imaging metrics of GB with IHC markers were compared using the Kruskal-Wallis test and Spearman correlation analysis.RESULTS: Among 30 patients with available IDH1 status, 14 patients (46.6%) had IDH1 mutation. EGFR amplification was present in 24/36 (66.6%) patients. Mean Ki-67 labeling index was 29% (range, 1.5%-80%). p53 mutation was present in 20/36 GBs (55%), whereas OLIG2 expression was positive in 29/36 GBs (80.5%). Various DCE-pMRI parameters gathered from the ER and NER were significantly correlated with IDH1 mutation, EGFR amplification, and OLIG2 expression (P < 0.05). Ki-67 labeling index showed a strong positive correlation with initial area under enhancement curve (r = 0.619; P < 0.001).CONCLUSIONS: DCE-pMRI could determine surrogate IHC biomarkers in GB via tumoral and peritumoral approach, potential targets for individualized treatment protocols.Publication Effect of needle-tract bleeding on pneumothorax and chest tube placement following CT guided core needle lung biopsy(Ubiquity Press, 2019-01-01) Soylu, Esra; Öztürk, Kerem; Gökalp, Gökhan; Topal, Uğur; Öztürk, Kerem; GÖKALP, GÖKHAN; Topal, Uğur; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-9664-2347; AAI-2336-2021; E-1228-2018; F-6421-2019Background: Bleeding in the biopsy tract has been studied for its ability to decrease the risk of pneumothorax with indefinite results in the previous studies.Purpose: To investigate the risk factors for needle-tract bleeding (NTB) and the possible effect of NTB on the pneumothorax and resultant chest tube placement after CT-guided cutting needle biopsy (CT-CNB) of pulmonary lesions.Methods: Predictive variables for NTB and the effect of NTB on the development of pneumothorax and consequent chest tube placement were retrospectively determined in 416 patients who had undergone an 18-gauge non-coaxial CT-CNB (338 men and 78 women; average age, 59.3 years). Patient-related parameters were age, gender, patient position, and severity of pulmonary emphysema. Lesion-related variables were size, localization, and contour characteristics of the lesion. Procedure-related variables were the presence of atelectasis, pleural tag, and fissure in the needle-tract, length of the aerated lung parenchyma crossed by needle, needle entry angle, number of pleural punctures, the experience of the operator, and procedure duration. All variables were analyzed by x(2) test and logistic regression analysis.Results: NTB was demonstrated in 142 of 421 (33.7%) procedures. The predictive variables of NTB were smaller lesion size (p = 0.011) and greater lesion depth (p = 0.002). In patients without emphysema around the lesion, the pneumothorax developed in 44/190 cases (23.1%) without NTB and in 12/95 procedures (12.6%) with NTB (p < 0.001).Conclusion: NTB may have a preventive effect on pneumothorax development, particularly in the absence of emphysema around the lesion.Item Evaluation of the ossification of the medial clavicle according to the Kellinghaus substage system in identifying the 18-year-old age limit in the estimation of forensic age-is it necessary?(Springer, 2016-12-02) Gürses, Murat Serdar; İnanır, Nursel Türkmen; Soylu, Esra; Gökalp, Gökhan; Kır, Elif; Fedakar, Recep; Uludağ Üniversitesi/Tıp Fakültesi/Adli Tıp Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; AAI-2336-2021; AAH-6287-2021; 56712925300; 57200888554; 8312505100; 57192388153; 8725968900The evaluation of the ossification of the medial clavicular epiphysis being part of an assigned expert approach according to standard plays an important role within civil and criminal proceedings in assessing whether a person has reached her/his 19th or 22nd year of age. Evaluation of the medial clavicular epiphysis with thin-section CT is one of the methods recommended by the Study Group on Forensic Age Diagnostics of the German Association of Forensic Medicine. In this retrospective study, we evaluated the thin-section CT (section thickness of 0.6 and 1 mm) images of 254 patients (146 male, 108 female) with an age range of 13-28 years according to the Kellinghaus substage system. The mean values of female patients were observed to be about 10 months lower for stage 2a than the mean values of the male patients, about 13 months lower for stage 2b, and about 18 months lower for stage 2c. The earliest appearance for stage 3c was at 19 years in both sexes. Our data from this study were consistent with both our previous studies and the data of other studies. We think that stage 3c is important in determining whether a person has reached the age of 18 or not and, therefore, that the Kellinghaus substage system is a requirement in the assessment of forensic age.Publication Linear atelectasis around the hilum on chest radiography: A novel sign of early lung cancer(Wolters Kluwer Medknow Publications, 2018-07-20) Soylu, Esra; Öztürk, Kerem; Topal, Uğur; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.Background: Linear atelectasis is a focal area of subsegmental atelectasis with a linear shape. Linear atelectasis may occur as a consequence of subsegmental bronchial obstruction. Aims: We propose an early roentgen sign of obstructing lung tumors, namely perihilar linear atelectasis, and ascertain whether this phenomenon could be used as a sign to detect radiographically occult primary lung cancer. Materials and Methods: We performed a retrospective review of 45,000 posteroanterior chest radiographs to determine the frequency of appearance and characteristics of perihilar linear atelectasis. The perihilar region of chest radiographs was evaluated for the presence of linear atelectasis. When linear atelectasis was found, the total thickness was measured. Student's t-test was used to evaluate statistical significance, correlating the thickness of atelectasis and the presence of obstructing central primary lung cancer. Results: Perihilar linear atelectasis was demonstrated in 58 patients. Atelectasis was caused by an obstructing tumor in 21 (36%) cases and a variety of other conditions in 37 (64%) patients. A statistically significant relationship (P < 0.001) was observed between the dimension of perihilar linear atelectasis and primary lung cancer, with 16 of 19 patients with thick (>5.5 mm) perihilar linear atelectasis found to have primary lung cancer. Conclusion: Thick perihilar linear atelectasis is a new diagnostic roentgen sign that suggests subsegmental bronchial obstruction. In this patient subgroup, who are otherwise asymptomatic, a persistent linear atelectasis can be due to primary lung cancer.Publication Neuroimaging of first seizure in the adult emergency patients(Springer Heidelberg, 2020-08-01) Öztürk, Kerem; Soylu, Esra; Bilgin, Cem; Hakyemez, Bahattin; Parlak, Müfit; Öztürk, Kerem; BİLGİN, CEM; HAKYEMEZ, BAHATTİN; PARLAK, MÜFİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-9664-2347; 0000-0002-3425-0740; HHS-7433-2022; E-1228-2018; AAI-2318-2021; AAG-8521-2021The aim is to establish the role of head computed tomography (CT) and magnetic resonance imaging (MRI) in adults presenting to the emergency department (ED) with first-time seizure (FS) and to analyze the potential predictor variables for the adverse imaging outcome. We retrospectively reviewed the medical records of all adults who underwent cranial CT or MRI between January 1, 2011, and December 1, 2016, to an academic ED for FS. Patients were excluded if were under 18 years of age, had known recent intracranial pathology, known brain tumor or having a history of trauma. Important predictive variables to indicate pathology in either CT or MR scan in patients with FS were evaluated with logistic regression analysis. A total of 546 FS (293 men and 253 women; range, 18-81 years; mean, 47 years) were identified in patients receiving either cranial CT or MR scan. Of them, abnormal findings were observed in 22/451 (4.8%) patients on CT and 18/95 (18.9%) patients on MRI. Predictor variables of age greater than 50 years, focal neurologic deficit, hypoglycemia, and history of malignancy were identified on CT, whereas a history of malignancy, age greater than 50 years and focal neurological deficit were determined on MRI. Limiting neuroimaging to this population would potentially reduce head CT scans by 67% and would potentially reduce head MRI scans by 47%. Clinical suspicion should be heightened and the neuroimaging should be considered for advanced age, history of malignancy, hypoglycemia or focal neurological deficits in patients with FS.Item Opacification of nondilated bile ducts through the gallbladder as an aid to percutaneous transhepatic biliary drainage(Elsevier, 2018-04) Soylu, Esra; Hacıkurt, Kadir; Öztürk, Kerem; Nas, Ömer Fatih; Erdoǧan, Cüneyt; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-9664-2347; E-1228-2018; AAG-8561-2021; 57193199579; 51864050100; 8293835700Purpose: The purpose of this study was to retrospectively assess the potential of percutaneous transhepatic biliary drainage (PTBD) in patients with nondilated bile ducts (NDBD) using a transgallbladder opacification of the bile ducts. Patients and methods: Eight patients with NDBD (7 men, 1 women; median age, 65 years; Q1-Q3, 35-69 years; range, 22-77 years) who underwent PTBD after opacification of the bile ducts through the gallbladder were evaluated. Opacification of NDBD was performed using a retrograde injection of contrast material through the gallbladder. The opacified peripheral NDBD was punctured percutaneously and a drainage catheter was introduced under fluoroscopy guidance. The success and safety of the procedure were assessed. Results: PTBD could be achieved in 6/8 patients (75%) and no significant complications were observed. The biliary tree opacification was attempted but could not be achieved due to biliary sludge that obstructed the cystic duct in 2/8 patients (25%). Two minor complications in two different patients were observed consisting of transient hemobilia and chills. Conclusion: Opacification of the bile ducts using a transgallbladder approach appears to be a safe and successful procedure for PTBD in patients with NDBD. (C) 2017 Editions francaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.Publication Risk factors of pneumothorax and chest tube placement after computed tomography-guided core needle biopsy of lung lesions: A single-centre experience with 822 biopsies(Int Scientific Information Inc, 2018-09-03) Soylu, Esra; Öztürk, Kerem; Gökalp, Gökhan; Topal, Uğur; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0001-9664-2347; E-1228-2018; AAI-2336-2021Purpose: To determine the risk factors of pneumothorax and chest tube placement after computed tomography-guided core needle lung biopsy (CT-CNB).Material and methods: Variables that could increase the risk of pnewnothorax and chest tube placement were retrospectively analysed in 822 CT-CNBs conducted with 18-gauge non-coaxial CT-CNB in 813 patients (646 men and 167 women; range: 18-90 years; mean: 59.8 years). Predictor variables were age, gender, patient position, severity of pulmonary emphysema, lesion size and localisation, contour characteristics, presence of atelectasis, pleural tag and fissure in the needle-tract, length of the aerated lung parenchyma crossed by the needle, needle entry angle, number of pleural punctures, experience of the operator, and procedure duration. All variables were investigated by x2 test and logistic regression analysis.Results: The overall incidence of pneumothorax was 15.4% (127/822). Chest tube placement was required for 22.8% (29/127) of pneumothoraxes. The significant independent variables for pneumothorax were lesions smaller than 3 cm (p = 0.009), supine and lateral decubitus position during the procedure (p < 0.001), greater lesion depth (p = 0.001), severity of pulmonary emphysema (p < 0.001), needle path crossing the fissure (p < 0.001), and a path that skips the atelectasis (p < 0.001) or pleural tag (p < 0.001); those for chest tube placement were prone position (p < 0.001), less experienced operator (p = 0.001), severity of pulmonary emphysema (p < 0.001), and greater lesion depth (p = 0.008).Conclusions: The supine and lateral decubitus position, a needle path that crosses the fissure, and a path that skips the atelectasis or a pleural tag are novel predictors for the development of pneumothorax.Item Signal changes in the dentate nucleus and globus pallidus on unenhanced T1-weighted magnetic resonance images after intrathecal administration of macrocyclic gadolinium contrast agent(Lippincott Williams and Wilkins, 2018-09-01) Soylu, Esra; Öztürk, Kerem; Nas, Ömer Fatih; Hakyemez, Bahattin; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-9664-2347; 0000-0002-3425-0740; E-1228-2018; AAG-8561-2021; AAI-2318-2021; 57193199579; 51864050100; 6602527239Objectives: The aim of this study was to evaluate signal changes in the dentate nucleus and globus pallidus (GP) on unenhanced T1-weighted magnetic resonance (MR) images (T1 WI) in a cohort of patients who have received intrathecal macrocyclic ionic gadolinium-based contrast agent (GBCA) gadoterate meglumine. Materials and Methods: A group of 20 patients (male/female ratio, 8:12; mean age, 39.5 +/- 15.5 years) who had not received intravenous GBCA but had received an intrathecal macrocyclic ionic GBCA (plus baseline and an additional final magnetic resonance imaging [MRI] for reference) from 2012 to 2017 were retrospectively included in this institutional review board-approved study. Two radiologists inspected T1-weighted 2-dimensional spin echo (n = 7) and 3-dimensional isotropic turbo field echo (n = 13) images on a 3 T MRI system to conduct visual evaluation and quantitative analysis. Baseline and final examination signal intensity (SI) ratios were assessed across time by using the same pulse sequences. For visual analysis, SI changes on the GP, thalamus (Th), cerebellar peduncle (CP), and dentate nucleus (DN) were graded as a 3-point scale. For quantitative analysis, SI ratio differences between the baseline and final MR examinations were estimated for the DN-to-CP and GP-to-Th ratios. One-sample t tests were used to investigate whether they differed from 0. In addition, to investigate significant differences between the SI ratios for various pulse sequences, t tests were performed. The regression analysis was additionally used to find any correlation between SI ratio differences and various confounding variables including age, sex, or the mean interval between the baseline and final MR examinations. Results: The SI ratio differences did not deviate significantly from 0, neither for the DN/CP ratio (0.013 +/- 0.0584, P = 0.287) nor the GP/Th ratio (-0.0113 +/- 0.0546, P = 0.366). The DN-to-CP and GP-to-Th SI ratio differences did not significantly deviate from 0 in the patient groups in either of the imaging sequences (P > 0.05) as well. Age, sex, and the mean interval between examinations did not influence SI ratio differences between examinations (P > 0.05). Conclusions: Intrathecal macrocyclic GBCA administration was not associated with measurable T1 SI changes in the GP and DN as an indicator of brain gadolinium deposition detectable by MRI.