Person: TÜRELİ, DERYA
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TÜRELİ
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DERYA
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Publication Open Access Unexpected radiation pneumonitis after SIRT with significant decrease in DLCO with internal radiation exposure: a case report(BMC, 2020-12) TÜRELİ, DERYA; Kesim, Selin; Ones, Tunc; Eryuksel, Emel; Baltacioglu, Feyyaz; Tureli, Derya; Ozguven, Salih; Erdil, Tanju YusufBackground In the last years, Selective Internal Radiation Therapy (SIRT), using biocompatible Yttrium-90 (90Y) labeled microspheres have emerged for the treatment of malignant hepatic tumors. Unfortunately, a significant part of 90Y-labeled microspheres may shunt to the lungs after intraarterial injection. It can be predictable by infusing technetium-99 m-labeled macro-aggregated albumin particles through a catheter placed in the proper hepatic artery depending on the lobe to be treated with performing a quantitative lung scintigraphy. Radiation pneumonitis (RP) can occur 1 to 6 months after the therapy, which is a rare but severe complication of SIRT. Prompt timing of steroid treatment is important due to its high mortality rate. On the other hand, pulmonary diffusion capacity measured by carbon monoxide (DLCO) is an excellent way to measure the diffusing capacity because carbon monoxide is present in minimal amount in venous blood and binds to hemoglobin in the same manner as oxygen. Some authors reported that the most consistent changes after radiation therapy (RT) are recorded with this quantitative reproducible test. The relationship between the proportional reductions in DLCO and the severity of RP developing after this therapy may prove to be clinically significant. Case presentation We herein present a patient who developed RP after SIRT that could be quantified using DLCO. To the best of our knowledge, this case is the first who developed unexpected RP after SIRT with significant decrease in DLCO with internal radiation exposure. Conclusions RP is a very rare complication and may lead to a fatal outcome. Decline in DLCO could be a valuable parameter for follow-up and to identify potential candidates for RP and could be also another trigger for administration of steroid therapy with prompt timing in this patient group.Publication Open Access Ultrasound shear-wave elasticity and magnetic resonance diffusion coefficient show strong inverse correlation in small fibroadenomas(MARMARA UNIV, FAC MEDICINE, 2021-01-22) TÜRELİ, DERYA; Andac Baltacioglu, Nurten; Tureli, DeryaObjective: Stiffness of breast lesions helps distinguish malignant from benign solid masses. Stiffness can he quantitatively measured by magnetic resonance and ultrasound imaging using apparent diffusion coefficient (ADC) and shear-wave elastography (SWE) techniques, respectively. This study aims to analyze correlations between SWE and ADC in biopsy-proven small fibroadenomas. Patients and Methods: Shear-wave elastography and ADC measurements of 50 fibroadenomas were evaluated retrospectively. Mean patient age was 41 +/- 13 years (range 27-63). All lesions had maximum diameters of <= 20 millimeters. Correlations between intralesional ADC, lesion-parenchyma ADC ratio, intralesional SWE, SWE heterogeneity index and lesion volume were analyzed. Results: Mean values of lesions were as follows: ADC=1.71 +/- 0.22 x10-3mm2/s, ADC ratio=1.04 +/- 0.09, maximum SWE=73.4 +/- 28.8 kPa, minimum SWE=43.9 +/- 21.8 kPa and SWE heterogeneity index =29.4 +/- 12.7 kPa. There was a strong inverse correlation between fibroadenoma ADC and SWE values (rho - 0.746, p <0.01). Significant correlations were also found between fihroadenoma volume and ADC (rho = - 0.525, p <0.05) and SWE (rho = 0.840, p <0.01). Conclusion: Apparent diffusion coefficient and SWE values show strong inverse correlation in small fibroadenomas. If proven threshold values for lesion characterization are revealed, ultrasonographic SWE and diffusion-weighted MRI have potential to be used interchangeably.Publication Open Access Computed tomography findings of primary epiploic appendagitis as an easily misdiagnosed entity: Case series and review of literature(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2017) DEMİRBAŞ, BAHA TOLGA; Ergelen, Rabia; Asadov, Ruslan; Ozdemir, Burcu; Tureli, Derya; Demirbas, Baha Tolga; Tuney, DavutBACKGROUND: Primer epiploic appendagitis (PEA) is an uncommon condition. METHODS: We retrospectively reviewed the clinical records and computed tomography (CT) findings of 45 patients with PEA. RESULTS: On the basis of physical examination and pain localization, presumptive clinical diagnosis was acute appendicitis (n=13), acute cholecystitis (n=2), acute diverticulitis (n=19), renal colic (n=7) and ovarian pathology (n=4). CONCLUSION: Although it has no characteristic clinical and laboratory features, CT is the best modality for accurate diagnosis of PEA.Publication Open Access Magnetic resonance enterography in refractory iron deficiency anemia: A pictorial overview(BAISHIDENG PUBLISHING GROUP INC, 2014) TÜRELİ, DERYA; Cengic, Ismet; Tureli, Derya; Aydin, Hilal; Bugdayci, Onur; Imeryuz, Nese; Tuney, DavutAIM: To highlight magnetic resonance enterography (MRE) for diagnosis of patients with refractory iron deficiency anemia and normal endoscopy results. METHODS: Fifty-three patients diagnosed with iron deficiency anemia refractory to treatment and normal gastroscopy and colonoscopy results were admitted to this prospective study between June 2013 and December 2013. All patients underwent a standardized MRE examination with a 1.5 Tesla magnetic resonance imaging system using two six-channel phased-array abdominal coils. Adequate bowel distention and fast imaging sequences were utilized to achieve diagnostic accuracy. All segments of the small bowel, duodenum, jejunum, and ileum were examined in detail. All cases were examined independently by two radiologists with > 5 years of experience in abdominal magnetic resonance imaging. A consensus reading was performed for each patient following image examination. Both radiologists were blinded to patient history, laboratory findings, and endoscopy results. RESULTS: Twenty (37.7%) male and 33 (62.3%) female patients were included in the study. The mean age of the patients was 52.2 +/- 13.6 years (range: 19-81 years, median 51.0). The age difference between the male and female patient groups was not statistically significant (54.8 +/- 16.3 years vs 50.7 +/- 11.7 years). MRE results were normal for 49 patients (92.5%). Four patients had abnormal MRE results. One patient with antral thickening was diagnosed with antral gastritis in the second-look gastroscopy. One patient had focal wall thickening in the 3rd and 4th portions of the duodenum. The affected areas were biopsied in a subsequent duodenoscopy, and adenocarcinoma was diagnosed. One patient had a fistula and focal contrast enhancement in the distal ileal segments, consistent with Crohn's disease. One patient had focal wall thickening with luminal narrowing in the mid-jejunum that was later biopsied during a double-balloon enteroscopy, and lymphoma was diagnosed. CONCLUSION: MRE is a non-invasive and effective alternative for evaluating possible malignancies of the small intestines and can serve as a guide for a second-look endoscopy. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.