Person: BUĞDAYCI, ONUR
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BUĞDAYCI
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Publication Open Access Effect of denosumab treatment on bone mineral density and bone turnover markers in osteoporotic patients: real-life experience 2-year follow-up(2022-12-01) DİNÇER YAZAN, CEYDA; BUĞDAYCI, ONUR; ILGIN, CAN; YAVUZ, DİLEK; DİNÇER YAZAN C., BUĞDAYCI O., ILGIN C., YAVUZ D.Summary Denosumab leads to improvements in BMD levels and is a well-tolerated agent according to results of randomized controlled studies but results in real-life setting are important to evaluate drug adherence and real-life efciency. In this study, we present the results of 305 patients that were treated with denosumab in our clinic. Introduction The long-term efcacy of anti-osteoclastic drugs in treatment of osteoporosis is well known. Denosumab, a novel human monoclonal antibody, is an anti-osteoclastic agent that has been shown to lead to reductions in vertebral, nonvertebral, and hip fracture risk in randomized and observational studies. Real-life data of this agent is increasing. In this study, we presented our real-life data about the 2-year follow-up of patients under denosumab treatment. Methods Osteoporotic patients who were treated with at least one denosumab injection between 2014 and 2020 years were included. Clinical and demographic data, bone turnover markers, and radiological reports (bone mineral densitometry (BMD), vertebral x-ray) were obtained from patient fles retrospectively. Results A total of 305 patients (f/m: 275/30, 68.1±11.05 years) were included. The median injection number was 4 (1–10). Two hundred seventy-three patients (89.8%) were persistent on treatment at the 12th month; 175 patients (57.3%) were persistent at 24th month. Sixty-eight patients (22%) were not using denosumab anymore, 55 of the patients were not continuing by doctor desicion and 13 were not continuing due to patient-related causes. Median BMD levels signifcantly increased from 0.809 (0.2–1.601, IQR: 0.136) to 0.861 (0.517–1.607, IQR: 0.14) in L1–L4 and from 0.702 (0.349–0.997, IQR: 0.125) to 0.745 (0.508–1.008, IQR: 0.137) in femur area at the 24th month of treatment. An improvement of 8.04% in L1–L4 BMD and 4.5% in femur neck BMD levels at the 24th month of treatment was observed. There was a signifcant decrease in bone turnover markers at the 24th month of treatment. Conclusion In our group of patients under denosumab treatment, 53% of persistence was found at 24 months and associated with improvement in BMD levels without any signifcant side efects except one case with urticarial reaction. Denosumab leads to improvements in BMD levels and is a well-tolerated agent in a real-life setting comparable to results of randomized controlled studies in patients with diferent comorbidities.Publication Open Access Morphometric analysis of middle and posterior cranial fossae foramina in 3d reconstructions of ct images: A midline asymmetry evaluation(2022-01-01) VERİMLİ, URAL; BUĞDAYCI, ONUR; BEKİROĞLU, GÜLNAZ NURAL; VERİMLİ U., BUĞDAYCI O., Yildiz S. D., Ozkilic E., BEKİROĞLU G. N., ÖZDOĞMUŞ N. Ö.Objective: The cranial base harbours numerous foramina, and the anatomical properties of the foramina are crucial in clinical interventions. The purpose of the current study is to evaluate possible asymmetries regarding the middle and posterior cranial fossae foramina using 3D reconstructions of high-resolution computed tomography (CT) images. Patients and Methods: High-resolution cranial CT images of 253 female and 287 male adult patients were used in the study. The patients were 18 to 40 years of age without any apparent cranial pathology. The distances from the foramen rotundum, foramen ovale, foramen spinosum, internal acoustic meatus, hypoglossal canal to the midline were measured bilaterally to compare both sides. Results: The foramen spinosum and the mid-clival line measurements demonstrated statistically significant results favoring the right side (p=0.03, right mean 3.052 ± 0.253 cm, left mean 2.982 ± 0.193 cm). In males, the right foramen spinosum to mid-clival line measurements were significantly longer than the left side (p=0.027, right mean 3.150 ± 0.250 cm, left mean 3.070 ± 0.180 cm). Conclusion: As predicted, the male measurements were significantly longer than the female measurements regardless of sides in all measurements. The measurements of cranial asymmetries may help describe anomalies and may contribute to the clinical approachesPublication Open Access Prediction of nipple involvement in breast cancer after neoadjuvant chemotherapy: Should we rely on breast MRI to preserve the nipple(2023-01-01) UĞURLU, MUSTAFA ÜMİT; BUĞDAYCI, ONUR; AKMERCAN, AHMET; KAYA, HANDAN; AKOĞLU, HALDUN; GÜLLÜOĞLU, MAHMUT BAHADIR; UĞURLU M. Ü., BUĞDAYCI O., AKMERCAN A., KAYA H., AKIN TELLİ T., AKOĞLU H., GÜLLÜOĞLU M. B.Background: Indications for nipple sparing mastectomy (NSM) is extending to post-neoadjuvant chemotherapy (NAC) setting. Eligibility for NSM with an optimum tumor-nipple distance (TND) after NAC is unclear. We examined predictive factors for nipple tumor involvement in patients undergoing total mastectomy following NAC. Methods: Clinical and pathological data from prospectively collected medical records of women with invasive breast carcinoma, who were undergone NAC and total mastectomy with sentinel lymph node biopsy and/or axillary lymph node dissection were analyzed. PreNAC and postNAC magnetic resonance imaging (MRI) views were examined and a cut-off TND value for predicting the negative nipple tumor status was determined. Results: Among 180 women, the final mastectomy specimen analysis revealed that 12 (7%) had nipple involvement as invasive carcinoma. Patients with nipple involvement had more postNAC multifocal/multicentric tumors (p: 0.03), larger tumors on preNAC and postNAC images (p: 0.002 and p 2mm) on preNAC and postNAC images (p < 0.001 and p: 0.01). The best likelihood ratios (LR) belonged to the postNAC positivity of the < 20 mm TND, with a + LR of 3.40, and − LR of 0.11 for nipple involvement. PreNAC positivity of the < 20 mm TND also had a similar − LR of 0.14. Conclusion: A TND-cut-off ≥ 2 cm on preNAC and postNAC MRI was shown to be highly predictive of negative nipple tumor involvement.Publication Open Access Adenoid cystic carcinoma of the breast: multimodality imaging findings and review of the literature(2022-01-01) BUĞDAYCI, ONUR; Guldogan N., ICTEN S. G. , KAYADİBİ Y., TAŞKIN F., Alfatli A. O. , Boy F. N. S. , BALCI P., BUĞDAYCI O., TOKAT F., ÖZTÜRK T., et al.© 2022 The Association of University RadiologistsRationale and Objectives: Adenoid cystic carcinoma (ACC) of the breast is a rare type of breast cancer with favorable prognosis. There is limited data on the radiological findings of this rare tumor in literature. The aim of this study is to determine the most common imaging features and review the literature. Materials and Methods: Pathological databases of seven institutions from 2009 to 2021 were retrospectively reviewed, and patients with a diagnosis of ACC of the breast were determined. Thirteen patients whose imaging studies could be recalled from the picture archiving systems (PACS) were included in the study. Clinical and pathological findings as well as follow-up data were recorded. Radiological findings were analyzed and categorized based on BI-RADS 5th edition. Results: There were 16 mass lesions in 13 patients (two multifocal cases, one case with recurrence). Mammography demonstrated 14 masses, while ultrasound (US) demonstrated all. MRI was available in only seven cases, with eight masses. The most common findings were round or oval shape on all modalities (78.57%–93.75%). Other frequent findings were parallel orientation (81.25%), isoechoic or hyperechoic echogenicity (62.5%), high T2 signal (87.5%), restricted diffusion (71.43%), and homogeneous enhancement (62.5%). Mammography, US and MRI showed circumscribed margins resembling a benign lesion in 35.71%, 37.5% and 50% of the lesions respectively. Three patients had a cyst-like echogenicty on US. Half of the lesions were avascular on Doppler US (6/12) and half were soft (2/4) on strain elastography. Although there were benign features on all imaging modalities seperately, all lesions could be categorized as BI-RADS 4 or 5 when the findings were combined. However 9/16 masses were BI-RADS 4A, emphasizing the subtlety of the malignant features. Conclusion: ACC of the breast can present with findings resembling a benign lesion on different imaging modalities. Although combination of all imaging findings correctly indicated the suspicious nature of the lesions in all cases, final classification was BI-RADS 4A in most of them. Radiologists should be aware of the more frequent findings of ACC of the breast for early diagnosis. US findings of isoechoic or hyperechoic appearance, and cyst-like echogenicity have not been reported previously in literature.Publication Open Access Impact of skeletal muscle measurements by chest computed tomography on survival and postoperative complications in patients with soft tissue sarcoma(2022-01-01) ARIKAN, RUKİYE; EROL, BÜLENT; KÖSTEK, OSMAN; BAYOĞLU, İBRAHİM VEDAT; DANE, FAYSAL; YUMUK, PERRAN FULDEN; ÖZGEN, ZERRİN; BUĞDAYCI, ONUR; AKIN TELLİ T., BUĞDAYCI O., Alan O., Sariyar N., Isik S., Arikan R., Yasar A., Majidova N., Celebi A., EROL B., et al.© 2022 Taylor & Francis Group, LLC.This study aims to evaluate whether sarcopenia, measured by chest computed tomography (CT), affects survival outcomes and postoperative complications in soft tissue sarcoma (STS) patients undergoing surgery. In this retrospective study, CT scans of 79 patients were reviewed to measure pectoralis and T12 vertebra muscle area. Both were then adjusted for height (cm2/m2) as pectoralis muscle index (PMI) and T12 vertebra muscle index (TMI). Analyses were performed by dichotomizing muscle indices at gender-specific 50th percentile; PMI and TMI < 50th percentile were defined as low, and ≥50th percentile as high. Overall postsurgical complication rate (PCR) was 16%. Median length of hospital stay (LOHS) was 10 days (3–90). PMI and TMI were significantly lower in women (p = 0.02, p = 0.04). Median body mass index was significantly higher in high PMI and TMI groups (p = 0.01 for both). PCR and LOHS were similar between low and high PMI and TMI groups. Median follow-up was 29 months, 37 patients had recurrence and 23 died. No significant difference was noted between low and high PMI and TMI groups, in terms of disease-free or overall survival. PMI and TMI as measured by chest CT had no impact on survival outcomes or postoperative complications in localized STS.Publication Open Access Clinical predictors of incipient vertebral fractures and bone mineral density in kidney transplant patients(2022-09-01) APAYDIN, TUĞÇE; VELİOĞLU, ARZU; YAVUZ, DİLEK; BUĞDAYCI, ONUR; TUĞLULAR, ZÜBEYDE SERHAN; YAVUZ D., Aydin K., Apaydin T., VELİOĞLU A., Mert M., Pekkolay Z., Parmaksiz E., Mese M., Pazir A. E., Aydin E., et al.© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Purpose: Kidney transplant recipients are prone to metabolic bone diseases and consequent fractures. This study aimed to evaluate the incidence of incipient vertebral fractures, osteopenia, osteoporosis, and the clinical factors associated with incipient vertebral fractures in a group of kidney transplant patients. Methods: Two hundred sixty-four patients (F/M 124/140, 45.3 ± 13 years) who had undergone kidney transplantation in tertiary care centers were included. Vertebral fractures were assessed semiquantitatively using conventional thoracolumbar lateral radiography in 202 of the patients. Results: Vertebral fractures were observed in 56.4% (n = 114) of the study group. The frequency of osteoporosis was 20.0% (53 of 264 patients), and osteopenia was 35.6% (94 of 264 patients). Bone mineral density (BMD) levels were in the normal range in 40.3% (n = 46) of the subjects with vertebral fractures. It was in the osteoporotic range in 20.1% (n = 23) and the osteopenic range in 40.3% (n = 46). Vertebral fractures were associated with age, duration of hemodialysis, BMI, and femoral neck Z score (R2 37.8%, p = 0.027). Conclusion: As incipient vertebral fractures can be observed in patients with normal BMD levels in kidney transplant recipients, conventional X-ray screening for vertebral fractures may be beneficial for a proper therapy decision of metabolic bone disease in kidney transplant recipients.