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Acoustic Radiation Force Impulse (ARFI) imaging for the distinction between benign and malignant thyroid nodules
(Springer-Verlag Italia Srl, 2015) Hamidi, Cihad; Goya, Cemil; Hattapoglu, Salih; Uslukaya, Omer; Teke, Memik; Durmaz, Mehmet Sedat; Yavuz, Mehmet Siddik
The aim of the present study was to evaluate thyroid nodules using virtual touch quantification (VTQ) of force impulse acoustic radiation (ARFI) imaging and to investigate a cutoff value for the differentiation of malignant thyroid nodules. Ninety-five patients with quantitatively-assessed (VTQ) thyroid nodules were evaluated with ARFI imaging in this prospective study. ARFI imaging with VTQ was performed only on the nodules which were expected to undergo fine-needle aspiration biopsy (FNAB). All of the thyroid lesions were examined histopathologically. The mean shear wave velocity (SWV) value of the malignant nodules (3.18 +/- A 0.39 m/s) was higher than that of the benign nodules (2.11 +/- A 0.53 m/s). There was a statistically significant difference between the mean SWV values of benign and malignant nodules (p < 0.001). A SWV cutoff value of greater than 2.66 m/s yielded sensitivity and specificity values of 100 and 82.3 %, respectively, for diagnosis of malignant nodules. VTQ of ARFI imaging has high sensitivity and specificity for discriminating between benign and malignant thyroid nodules and may positively contribute to clinical evaluation of these nodules.
Adrenal bez kalınlığının multi-dedektörlü bilgisayarlı tomografi ile değerlendirilmesi
(Modestum Publishing Ltd., 2012) Hamidi, Cihad; Göya, Cemil; Hattapoğlu, Salih; Çetinçakmak, Mehmet Güli; Teke, Memik; Dusak, Abdurrahim; Kuday, Suzan
Amaç: Bu çalışmanın amacı anatomik detayın daha iyi değerlendirildiği multi-dedektörlü bilgisayarlı tomografi ile adrenal bez boyutlarını ve her iki taraftaki adrenal bezler arasında kalınlık farkının olup olmadığını araştırmaktır. Gereç ve yöntem: Adrenal bez patolojisi bulunmayan, adrenal bez dışı kitlesi olmayan 100 hasta bilateral adrenal bez kalınlıkları açısından 16 ve 64 dedektörlü bilgisayarlı tomografi ile retrospektif olarak incelendi. Bulgular: Ölçümler sonucunda her iki adrenal bez ortalama medial ve lateral bacak kalınlıkları arasında istatistiksel olarak anlamlı farklılık saptandı (p< 0.001, p=0.035). Her iki adrenal bez gövdeleri arasında ise istatistiksel olarak anlamlı farklılık saptanmadı (p=0.611). Sonuç: Sol adrenal bez sağa nazaran varyatif olarak kalın izlenmiş olup, adrenal bez kalınlıkları standardizasyonu açısından daha geniş çalışmalara ihtiyaç duyulmaktadır.
Assessment of Placental Stiffness Using Acoustic Radiation Force Impulse Elastography in Pregnant Women with Fetal Anomalies
(Korean Radiological Soc, 2016) Alan, Bircan; Goya, Cemil; Tunc, Senem; Teke, Memik; Hattapoglu, Salih
Objective: We aimed to evaluate placental stiffness measured by acoustic radiation force impulse (ARFI) elastography in pregnant women in the second trimester with a normal fetus versus those with structural anomalies and non-structural findings. Materials and Methods: Forty pregnant women carrying a fetus with structural anomalies diagnosed sonographically at 18-28 weeks of gestation comprised the study group. The control group consisted of 34 healthy pregnant women with a sonographically normal fetus at a similar gestational age. Placental shear wave velocity (SWV) was measured by ARFI elastography and compared between the two groups. Structural anomalies and non-structural findings were scored based on sonographic markers. Placental stiffness measurements were compared among fetus anomaly categories. Doppler parameters of umbilical and uterine arteries were compared with placental SWV measurements. Results: All placental SWV measurements, including minimum SWV, maximum SWV, and mean SWV were significantly higher in the study group than the control group ([0.86 +/- 0.2, 0.74 +/- 0.1; p < 0.001], [1.89 +/- 0.7, 1.59 +/- 0.5; p = 0.04], and [1.26 +/- 0.4, 1.09 +/- 0.2; p = 0.01]), respectively. Conclusion: Placental stiffness evaluated by ARFI elastography during the second trimester in pregnant women with fetuses with congenital structural anomalies is higher than that of pregnant women with normal fetuses.
Combination of Virtual Touch Tissue Imaging and Virtual Touch Tissue Quantification for Differential Diagnosis of Breast Lesions
(Amer Inst Ultrasound Medicine, 2015) Teke, Memik; Goya, Cemil; Teke, Fatma; Uslukaya, Omer; Hamidi, Cihad; Cetincakmak, Mehmet Guli; Hattapoglu, Salih
Objectives-Breast cancer is the second leading cause of death from cancer in women, and early detection is the key to successful treatment. Unfortunately, even with technological advances, the specificity of imaging modalities is still low. Therefore, we evaluated the value of a newly developed noninvasive technique, acoustic radiation force impulse imaging, for differentiating benign versus malignant breast lesions. Methods We prospectively examined 141 breast lesions in 122 patients. All lesions were classified according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) for mammography, BI-RADS for sonography, and Virtual Touch tissue imaging (VTI; Siemens Medical Solutions, Mountain View, CA) pattern. Internal and marginal shear wave velocity (SWV) values for the lesions were noted. The sensitivity, specificity, accuracy, and positive and negative predictive values for VTI and Virtual Touch tissue quantification (VTQ Siemens Medical Solutions) were calculated. Results The marginal SWV values were statistically higher in malignant lesions (mean +/- SD, 5.41 +/- 1.37 m/s) than benign lesions (2.91 +/- 0.88 m/s; P < .001). When the SWV cutoff level was set at 4.07 m/s, and the higher of the internal and marginal values was adopted, the combination of VTI and VTQ showed 95.1% sensitivity, 99.0% specificity, and 97.8% accuracy. Conclusions Breast Imaging Reporting and Data System category 4 lesions are the main focus of research for early detection of breast cancer. Unfortunately, BI-RADS category 4 assessment covers a-wide range of likelihood of malignancy (2%-95%). This wide range reflects the necessity for a more specific imaging modality. The combination of. VTI and VTQ could increase the diagnostic performance of conventional sonography.
Diagnosis of Bride Ileus By Multidetector CT andSurgical Correlation
(2014) Oğuz, Abdullah; Hamidi, Cihad; Yavuz, Alparslan; Çetinçakmak, Mehmet Güli; Teke, Memik; Göya, Cemil; Hattapoğlu, Salih
Amaç: Amacımız brid ileus ön tanılı hastaların cerrahi bilgileri ve patoloji sonuçları ışığında çok kesitli bilgisayarlı tomografi bulgularını retrospektif olarak değerlendirmektir. Yöntem: Çalışmamıza Ocak 2010 ve Ocak 2014 dönemleri arasında genel cerrahi servisine başvurmuş ve operasyon sonrasında brid ileus kesin tanısı alan yaşları 13-87 arasında değişen 35'i kadın, 30'u erkek toplam 65 olgu dâhil edildi. Hastalarımızın tüm abdomen BT çekimleri 64 kesitli çok kesitli BT cihazıyla; ksifoid proçesten başlayarak simfizis pubise kadar inguinal kanal orifislerini de içine alacak şekilde nefes tutturularak yapıldı. Radyolojik bulgular cerrahi ve patoloji verileriyle beraber istatistiksel olarak karşılaştırıldı. Bulgular: Brid ileusu tesbit etmede çok kesitli bilgisayarlı tomografi'nin sensitivitesi %91, spesifitesi 44 olarak saptandı. Vakalarımızın %72'sinde ince barsak tipi, %28'inde ise kalın barsak tipi obstrüksiyon saptandı. İleuslu olgularımıza eşlik eden mezenterik kirlenme, batında serbest mayi, "inci dizisi" bulgusu ve geçiş zonu ile barsak obstrüksiyonu arasında istatistiksel olarak anlamlı ilişki saptandı (p<0.05). Sonuç: Çok kesitli bilgisayarlı tomografi brid ileuslu hastalarda obstrüksiyonun varlığı, seviyesi ve ikincil olarak oluşan bulguların değerlendirilmesinde etkili görüntüleme yöntemidir.
The diagnostic efficacy of low-dose cervical and thoracic CT in multiple trauma patients
(Dicle Üniversitesi Tıp Fakültesi, 2013) Göya, Cemil; Yavuz, Alpaslan; Hamidi, Cihad; Andiç, Çağatay; Çetinçakmak, Mehmet Guli; Teke, Memik; Özkaynak, Can
Objective: The aim of this study was to evaluate the initial diagnostic efficacy of low-dose computed tomography (CT) in multi-trauma patients. Methods: 74 patients (44 male, 30 female; average age: 36.9 years) accepted to the emergency unit with the reason of multiple trauma which is included in this study. Cervical and thoracic injury sites were initially evaluated with portable X-Ray and low-dose CT. The Patients’ progress, surgical findings and additional radiologic examination results were recorded until the patients were discharged. Results: The sensitivity and specificity of X-Ray graphies were 50% and 95% for thoracic traumatic pathologies; 0-40% and 95-100% for cervical injuries respectively. CT examination sensitivity and specificity values were 95-100% and 80-100% for thoracic injuries; 95-100% and 96-100% for cervical injuries respectively. Conclusion: Low-dose CT examination is more sensitive than X-Ray graphs for the evaluation of cervicothoracic traumatic injuries. We recommend to prefer low-dose CT as an initial radiologic examination for managing cervicothoracic trauma cases because of its higher diagnostic capability than X-Ray graphy.
Differential diagnosis of idiopathic granulomatous mastitis and breast cancer using acoustic radiation force impulse imaging
(Springer Japan Kk, 2017) Teke, Memik; Teke, Fatma; Alan, Bircan; Turkoglu, Ahmet; Hamidi, Cihad; Goya, Cemil; Hattapoglu, Salih
Purpose Differentiation of idiopathic granulomatous mastitis (IGM) from carcinoma with routine imaging methods, such as ultrasonography (US) and mammography, is difficult. Therefore, we evaluated the value of a newly developed noninvasive technique called acoustic radiation force impulse imaging in differentiating IGM versus malignant lesions in the breast. Methods Four hundred and eighty-six patients, who were referred to us with a presumptive diagnosis of a mass, underwent Virtual Touch tissue imaging (VTI; Siemens) and Virtual Touch tissue quantification (VTQ; Siemens) after conventional gray-scale US. US-guided percutaneous needle biopsy was then performed on 276 lesions with clinically and radiologically suspicious features. Malignant lesions (n = 122) and IGM (n = 48) were included in the final study group. Results There was a statistically significant difference in shear wave velocity marginal and internal values between the IGM and malignant lesions. The median marginal velocity for IGM and malignant lesions was 3.19 m/s (minimum-maximum 2.49-5.82) and 5.05 m/s (minimum-maximum 2.09-8.46), respectively (p < 0.001). The median internal velocity for IGM and malignant lesions was 2.76 m/s (minimum-maximum 1.14-4.12) and 4.79 m/s (minimum-maximum 2.12-8.02), respectively (p < 0.001). Conclusion The combination of VTI and VTQ as a complement to conventional US provides viscoelastic properties of tissues, and thus has the potential to increase the specificity of US.
Evaluation of changes in myelination in the brain during infancy and childhood using ADC maps
(Fatih BAŞAK, 2019) Özkan, Mustafa; Taşkent, İsmail; Teke, Memik
Aim: Myelinization has a critical role in achieving rapid synchronization between the neural system and high-grade cognitive functions. Because of this critical role, it is important to quantitatively determine the degree of myelination. Today, structural changes due to myelination can be evaluated quantitatively by diffusion magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) measurements. The aim of this study was to evaluate myelination-related changes in different regions of the brain during infancy and childhood in the normal population by measuring ADC values in routine MRI examinations.Methods: In this cross-sectional study, 109 patients aged 0-17 years who underwent brain MRI examination with 3.0T device and whose myelination and maturation were interpreted as normal in conventional sequences were evaluated. In all examinations, ADC maps from 30 different locations were evaluated and measured in the workstation based on T2-weighted images.Results: There is a functional relationship between ADC values and the myelination process during infancy and childhood in the normal population. ADC values decrease in all localizations with increasing age, especially during the first 2 years. During the postnatal period, ADC values, which are higher in the white matter, decrease as maturation of white matter is completed and increase in the cortical gray matter. No significant difference was found between bilateral structures except the thalamus, caudate nucleus or centrum semiovale regions. There was no gender-dependent significant difference in the patients aged between zero and 2 years. Conclusion: ADC values for each localization can be easily obtained by diffusion weighted imaging and ADC maps, which are frequently used in routine MRI examinations. The relationship between ADC values and myelination process can be revealed in the whole brain and normative values can be obtained for multiple regions in the brain.
Evaluation of outcome and prognostic factors in 739 patients with uterine cervix carcinoma: a single institution experience
(Termedia Publishing House Ltd, 2015) Teke, Fatma; Yoney, Adnan; Teke, Memik; Adanas, Gultekin; Urakci, Zuhat; Tukcu, Gu; Eren, Bekir
Aim of the study: The aim of this retrospective chart review was to determine the long-term outcomes and identify prognostic factors that impact the survival of patients with cervical cancer. Material and methods: A retrospective chart review of 739 patients with International Federation of Gynaecology and Obstetrics (FIGO) stage I-IV cervical cancer treated with surgery, radiation or chemoradiation was performed. Patient charts were evaluated in terms of demographics, clinical outcomes, and survival. Disease-free survival (DFS) and overall survival (OS) were calculated with the Kaplan-Meier method, and differences in survival were compared with the log-rank test. Multivariate analysis was performed with a Cox proportional hazards model to determine the estimated hazard ratios (HR) with 95% confidence intervals (CI) for each prognostic factor. Results: The Cox proportional hazards model demonstrated that pelvic nodal metastasis (p = 0.018), parametrial invasion (p = 0.015), and presence of disease in the surgical margin (p = = 0.011) were all independent prognostic factors for OS. The 5-year OS rate of patients with negative pelvic lymph nodes was 67.1%, which was higher than the rate for those with positive nodes at 49.0% (p < 0.05). The 5-year OS rate was 54.3% for patients with metastasis to the parametrium, 79.2% with a cancer-free parametrium, 60.9% with a cancer-positive surgical margin, 85.4% with a cancer-negative surgical margin, and 64.3% with a 1-3 mm close surgical margin (p < 0.05). Conclusions: Assessing pelvic lymph nodes, the parametrium, and surgical margins is important for survival and may aid in better identifying patients who would derive greater benefits from receiving adjuvant therapies and more aggressive treatments.
Evaluation of Parathyroid Lesions With Point Shear Wave Elastography
(Amer Inst Ultrasound Medicine, 2016) Hattapoglu, Salih; Goya, Cemil; Hamidi, Cihad; Tasdemir, Bekir; Alan, Bircan; Durmaz, Mehmet Sedat; Teke, Memik
Objectives-The aim of our study was to evaluate the shear wave velocity (SWV) of parathyroid lesions by point shear wave elastography (SWE) and to compare their stiffness with that of thyroid nodules and normal thyroid parenchyma quantitatively. Methods-Thirty-six patients considered to have parathyroid disorders by clinical and laboratory tests and scintigraphy were enrolled in the study between January 2012 and February 2015. Conventional sonography, Doppler sonography, and the Virtual Touch tissue quantification (VTQ) method of point SWE (Siemens Medical Solutions, Mountain View, CA) were conducted with a linear transducer (4-9 MHz) while the patients were in the supine position. Then we compared our VTQ measurements with pathologic results. Results-The 36 patients included 31 female and 5 male patients with a mean age +/- SD of 49 +/- 15.7 years (range, 15-79 years). The mean SWV of parathyroid hyperplasia lesions (n = 4) was 1.46 +/- 0.23 m/s, whereas the mean SWV of parathyroid adenomas (n = 32) was 2.28 +/- 0.50 m/s. The mean SWV of normal thyroid parenchyma (n = 36) was 1.62 +/- 0.20 m/s, and the mean SWV of benign thyroid nodules (n = 21) was 2.25 +/- 0.51 m/s. A significant difference was found between SWV values of normal thyroid parenchyma and parathyroid adenoma (P<.001). A cutoff value of 1.73 m/s for adenomas led to 90.0% sensitivity and 80.6% specificity. Conclusions-The VTQ method of point SWE may contribute to the discrimination of parathyroid adenomas from the thyroid gland. However, more comprehensive studies are needed.
Evaluation of pulmonary function after radiotherapy using helical tomotherapy for breast cancer treatment: Prospective study
(KARE yayıncılık, 2016) Teke, Fatma; Demir, Melike; Bucaktepe, Pakize Gamze Erten; Kaya, Mehmet Ali; Doğan, Mehmet Hakan; Küçüköner, Mehmet; Zincircioğlu, Seyit Burhanedtin; Teke, Memik
Purpose of the present study was to investigate acute pulmonary changes using pulmonary function tests (PFTs) after breast cancer irradiation with helical tomotherapy (HT). METHODS Forty patients were included in this study. Pretreatment and 3 months after completion of radiotherapy (RT), values of forced vital capacity (FVC), forced expiratory volume in first second (FEV1), and FEV1/ FVC ratio were measured and recorded. RESULTS Restrictive pattern was seen in 4 patients in baseline PFTs and moderate deterioration was observed in their measurements of PFT at 3 months after RT. Obstructive pattern was defined in only 1 patient in baseline PFTs and it remained unchanged after RT. Mild obstructive pattern in 4 patients and mild restrictive pattern in 3 patients had developed at 3 months after RT. CONCLUSION Minimal changes that result in mild restrictive and obstructive pattern in PFTs can be seen in acute phase after RT with HT.
Evaluation of Retrobulbar Blood Flow with Color Doppler Ultrasonography in Patients with Central Serous Chorioretinopathy
(WILEY-BLACKWELL, 111 RIVER ST, HOBOKEN 07030-5774, NJ USA, 2014) Hamidi, Cihad; Türkçü, Fatih Mehmet; Goya, Cemil; Çetinçakmak, Mehmet Güli; Yüksel, Harun; Teke, Memik; Hattapoğlu, Salih; Bilici, Aslan
Background. To compare retrobulbar blood flow in patients with central serous chorioretinopathy (CSC) and healthy subjects using color Doppler ultrasonography. Methods. Thirty patients (age 23-54 years) with a first episode of acute CSC and 30 healthy controls (age 30-44 years) were evaluated. The peak systolic blood flow velocity, end-diastolic velocity (EDV), resistance index (RI), and pulsatility index (PI) were measured in the ophthalmic, posterior ciliary, and central retinal arteries. Results. The posterior ciliary and central retinal artery EDV were lower in the patient group than in the control group, whereas RI and PI values were significantly higher (p < .05). The ophthalmic artery peak systolic blood flow velocity and EDV were lower in the CSC than in the control group (p < .05) without significant difference in RI and PI. Conclusions. Color Doppler ultrasonography provides additional insights into the pathophysiology of CSC and may support the vasospasm hypothesis. (C) 2014 Wiley Periodicals, Inc.
Evaluation of the surgical anatomy of sphenoid ostium with 3D computed tomography
(Springer Verlag, 2014) Göçmez, Cüneyt; Goya, Cemil; Hamidi, Cihad; Teke, Memik; Hattapoğlu, Salih; Kamasak, Kağan
To evaluate the anatomy of the sphenoid ostium (SO), which has so far only been investigated with the aid of two-dimensional computed tomography (CT) or using a cadaver, from a new point of view through the use of 3D CT for the first time. We have evaluated 50 patients who had CT angiography done for different reasons. The sphenoid sinus types and the SO were evaluated three dimensionally. The average diameters of the sphenoid ostia, and their distances to the midline, as well as to each other and the choana have been measured. In addition, the SO were categorized according to their shapes. The average age of the patients was 48.5. No SO was found in seven cases (14 %). The average distance of the SO to the midline was 2.78 mm on the right side and 2.77 on the left. Four different shapes of SO were determined; round, oval, irregular and linear. The average distance of the right and left SO to the choana was 15.22 +/- A 0.95 and 14.87 +/- A 1.11 mm, respectively. No statistically significant difference was found between the male and female sexes with regard to the calculated diameters and shapes of the SO (p > 0.05). The anatomy of the sphenoid sinus and the SO varies widely from individual to individual. We have demonstrated in our study that these anatomic variations could be evaluated pre-operatively. Using this imaging technique, surgeons can make a pre-operative 3D evaluation of the sphenoid ostium, encountered in the surgery and thus achieve better orientation
Gallstone obstruction in anastomotic stricture: A very rare case
(Modestum Ltd., 2014) Ülger, Burak Veli; Uslukaya, Ömer; Oğuz, Abdullah; Gündüz, Ercan; Teke, Memik; Baç, Bilsel
Gallstone ileus is a rare but serious complication of cholelithiasis. It is a rare cause of small bowel obstruction but it accounts up to 25% of non-strangulated small bowel obstructions in elderly. Obstruction usually occurs in the terminal ileum. Although the most frequent mechanism of gallstone ileus is migration of the gallstone through a gallbladder-duodenal fistula, there have been cases of bowel obstruction caused by gallstones without any findings of bilio-enteric fistula during the operation. The diagnosis is usually delayed due to nonspecific clinical signs and symptoms. Abdominal computerized tomography (CT) scan is the optimal way to diagnose the gallstone ileus. It can identify the site and nature of the obstruction. The optimal surgical approach is a matter of debate. Enterolithotomy is the most performed operation. One stage operation should be performed in selected low risk patients. In this study, we report a 55 years old male patient who underwent surgical intervention due to gallstone ileus. During the operation, we observed that two individual gallstones lead to obstruction in anastomotic stricture which was due to the patient's prior small bowel resection. Also, no fistula was found during the operation between the gall bladder and the gastrointestinal tract of patient. The gallstones were removed by enterolithotomy. Because there was no gallstone in the gallbladder, we did not perform cholecystectomy. J Clin Exp Invest 2015; 6 (1): 72-74.
Hidrosefali ile birlikte seyreden bilateral konjenital perisilviyan sendrom
(2012) Teke, Memik; Hamidi, Cihad; Göya, Cemil; Çetinçakmak, Mehmet Güli; Hattapoğlu, Salih
Konjenital bilateral slyvian sendrom (KBPS) mental retardasyon, epilepsi, konuşma bozukluğu, psödobulbar palsi gibi bulgularla kendini gösteren, genetik ve genetik dışı nedenlerle ortaya çıkan konjenital bir hastalıktır. Klinik bulgularla birlikte, MR görüntüleme ile karakteristik bulguların (polimikrogiri gibi) ortaya konması, tanı konulmasında katkı sağlamaktadır. Yazımızda hidrosefali bulgusu bulunan KBPS tanısı konulan 18 aylık kız çocuğu olgusu-nu sunmayı amaçladık.
Imaging features of cerebral and spinal cystic echinococcosis
(Springer-Verlag Italia Srl, 2015) Teke, Memik; Gocmez, Cuneyt; Hamidi, Cihad; Gunduz, Ercan; Goya, Cemil; Cetincakmak, Mehmet Guli; Hattapoglu, Salih
The main objective of this study was to describe the characteristic imaging features of cerebral and spinal hydatid disease (HD) in magnetic resonance imaging (MRI) and computed tomography (CT) in order to provide more effective differential diagnoses in endemic regions. We also aimed to use MRI and CT to evaluate whether the World Health Organization's (WHO) new classification of hepatic cystic echinococcosis (CE) could be used in the classification of cerebral HD. We retrospectively reviewed the CT and MR images of 30 patients who were diagnosed with cerebral and spinal HD between 1990 and 2014. The imaging findings were noted. All hydatid cysts were classified according to the WHO classification of hepatic CE, consisting of six types. The study group consisted of 49 CEs in 27 patients with cerebral HD and 12 CEs in three patients with spinal HD. Of the cysts, 14 were type CL (cystic lesion), 29 were type CE1, 11 were type CE2 and seven were type CE3. In other words, 54 cysts were in the active group and seven were in the transition group. Most of the cysts were type CL and CE1. Even though characteristic imaging features could be used in the differential diagnosis of HD, sometimes the differentiation of HD from other cystic lesions may be difficult. The use of WHO classification will provide standardisation of uniform treatment modality, as the treatment of HD, according to the stage of the disease, may be surgical or medical.
Imaging of anterior cruciate ligament graft reconstruction imaging of anterior cruciate ligament graft reconstruction
(Akdeniz Üniversitesi Tıp Fakültesi, 2018) Durmaz, Mehmet Serdar; Göya, Cemil; Hamidi, Cihad; Hattapoğlu, Salih; Teke, Memik
Amaç: Ön çapraz bağ (ÖÇB) greft rekonstrüksiyonunun postoperatif direkt grafi , manyetik rezonans görüntüleme(MRG) normal bulgularını tanımlamak, operasyon sonrası gelişebilecek potansiyel komplikasyonlarının MRG bulgularını sunmaktır.Gereç ve Yöntemler: Çalışmaya ÖÇB rekonstrüksiyon cerrahisi geçirmiş 52 hasta alındı. Hastaların direkt grafi , manyetik rezonans görüntüleri ÖÇB greft bütünlüğü ve eşlik edebilecek komplikasyonlar açısından retrospektif olarak değerlendirildi.Bulgular: Çalışmaya alınan 52 hastanın 18'inde postoperatif patolojik bulgular saptandı. Dört hastada total greft rüptürü, bir hastada parsiyel greft rüptürü, iki hastada gevşek greft, 10 hastada anterior yerleşimli tibial tünel, sekiz hastada tepe impigement, iki hastada yan duvar impigement, dört hastada tünelde kistik genişleme, bir hastada patellar fraktür, iki hastada operasyon materyaline bağlı iliotibial band sürtünme sendromu ve dört hastada artrofi brozis saptandı.Sonuç: MRG, ÖÇB greftinin, tünellerin ve fi ksasyon materyallerinin pozisyonunu değerlendirmede, operasyon sonrası ağrı ve fonksiyon kaybının nedenini araştırmada kullanılabilen etkili bir görüntüleme yöntemidir.
The impact of the stage and tumor size on brain metastasis of cervical cancer.
(Amer Soc Clinical Oncology, 2015) Teke, Fatma; Tunc, Senem Yaman; Teke, Memik; Turan, Yahya; Urakci, Zuhat; Altin, Suleyman; Eren, Bekir
[Abstract Not Available]
The impact of the stage and tumor size on rare brain metastasis of cervical cancer
(Turkish Neurosurgical Soc, 2016) Teke, Fatma; Tunç, Senem Yaman; Teke, Memik; Turan, Yahya; Urakçı, Zuhat; Eren, Bekir; Altın, Süleyman
AIM: To investigate the clinical features, prognostic factors and survival times of cervical cancer patients with brain metastasis. MATERIAL and METHODS: We retrospectively reviewed the medical records of 820 patients with cervical cancer. Data were analyzed using SPSS version 12.0 statistical software (SPSS, Chicago, IL, USA). Overall survival, time interval from diagnosis of cervical cancer to identification of brain metastasis, and median survival time after diagnosis of brain metastasis were calculated using Kaplan-Meier curve analysis. The log-rank test was used to compare differences in survival. Differences were assumed statistically significant when p-values were <0.05. RESULTS: The incidence of brain metastases from cervical cancer in our institution was 1.82% (15/820) over a ten-year period. The median time interval from diagnosis of cervical cancer to detection of brain metastasis was 12.5 months (range: 2.9-91.9 months). Stage and tumor diameter were found to be significant relating to the interval from diagnosis of cervical cancer to detection of brain metastasis (p=0.001 for both). CONCLUSION: This study provides much information about the prognosis of patients with brain metastases from cervical cancer and highlights the importance of initial stage and tumor diameter when determining the time interval until development of brain metastasis.
Kaposi sarkomu nedeniyle radyoterapi uygulanan 14 hastanın değerlendirilmesi
(Dicle Üniversitesi Tıp Fakültesi, 2015) Teke, Fatma; Akkurt, Zeynep Meltem; Yıldırım, Özgür; Teke, Memik; Zincircioğlu, Seyit Burhanedtin
Amaç: Çalışmamızda Kaposi sarkomu (KS) tanısı nedeniyle radyoterapi (RT) uygulanan hastaların klinik özelliklerini ve tedavi sonuçlarını değerlendirdik. Yöntemler: Çalışmaya Dicle Üniversitesi Hastanesi Radyasyon Onkolojisi Kliniği’nde 2005-2012 yılları arasında RT uygulanan KS tanılı hastalar dahil edildi. Tüm hastalara semptomların palyasyonu ve yaşam kalitesini arttırmak için farklı doz-fraksiyonasyon şemaları ile RT uygulandı. Birden çok bölgesinde lezyonu olan hastalara aynı veya farklı tarihlerde RT uygulandı. Hastaların radyoterapiye cevapları tam veya kısmi yanıt olarak kaydedildi. Bulgular: KS nedeniyle radyoterapi uygulanan 14 hasta retrospektif olarak değerlendirildi. On dört hastanın toplam 22 farklı bölgesine RT uygulandı. Altı hastada (%27,3) iki ayrı bölge ışınlanırken, yalnız bir hastada (%4,5) üçüncü bölge olarak glans penisteki lezyona RT uygulandı. Işınlamalarda 6 MV ve 10 MV foton enerjileri ile 6 MeV, 9 MeV ve 12 MeV elektron enerjileri kullanıldı. Foton ışınlamalarında homojen doz dağılımı elde etmek için su fantomu veya bolus materyali kullanıldı. Uygulanan RT dozu toplam 22 farklı bölge için medyan 800 cGy (800-3000 cGy) idi. RT fraksiyon sayısı medyan 1’di (1-10). Tedavi yanıtları değerlendirildiğinde 4 (%18,1) bölgede stabil hastalık mevcuttu. Sekiz (%36,4) tedavi bölgesinde kısmi cevap sağlanırken, 10 (%45,5) bölgede de tam cevap elde edildi. Dört (%57,3) tedavi bölgesinde RT’ ye bağlı ayaklarda ve bacaklarda akut dönemde yaygın lenfödem gözlendi. İki (%28,7) bölgede ise ağrı komplikasyonu mevcuttu. Sonuç: RT, KS lezyonlarının palyatif tedavisinde uygun ve etkili bir tedavi rejimidir. RT ile cilt lezyonlarında mükemmel cevap oranları elde edilebilir. RT sonrası lezyonlar ve kaşıntı gibi şikayetler kaybolabilir. Ağrı, ödem gibi yan etkiler destek tedavi ile giderilebilir.

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