Person: TÜRELİ, DERYA
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TÜRELİ
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DERYA
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Publication Metadata only Evaluation of sacroiliac joint MRI for pelvic venous congestion signs in women clinically suspected of sacroiliitis(SAGE PUBLICATIONS LTD, 2017) YOLDEMİR, AHMET TEVFİK; Cimsit, Canan; Yoldemir, Tevfik; Tureli, Derya; Aribal, Mustafa ErkinBackground: Pelvic congestion syndrome (PCS) is a commonly overlooked condition which is a potential cause of chronic pelvic pain. Magnetic resonance imaging (MRI) of the sacroiliac joint (SIJ) may demonstrate unexpected conditions that can mimic sacroiliitis (SI). Awareness of MRI-defined pelvic venous congestion (PVC) may help in identifying PCS, where vascular abnormality may be the sole manifestation of SIJ pain. Purpose: To detect incidental MRI-defined PVC in patients who underwent SIJ-MRI for presumed SI and define the variance of its incidence. Material and Methods: A total of 870 women who underwent SIJ-MRI were retrospectively evaluated. Incidental findings of PVC and other genitourinary and musculoskeletal system disorders were documented. Results: Of the 774 included patients, 37% demonstrated incidentally detected imaging findings related to the genitourinary system, musculoskeletal system, and PVC. The prevalence of MRI-defined PVC signs was higher in patients without SI than with SI. The prevalence of musculoskeletal disorders was higher in patients with SI whereas prevalence for genitourinary disorders was similar. Binary logistic regression analysis revealed a statistically significant correlation between SI-PVC and SI-genitourinary disorders but not between SI-musculoskeletal disorders pairs (P = 0.001, 0.001, and 0.057> 0.05). The probability of observing SI in SIJ-MRI is positively correlated with the absence of PVC or genitourinary disorders. Conclusion: Patients who underwent MRI for presumed SI demonstrated incidental PVC as well as other genitourinary and musculoskeletal findings. An awareness of these imaging findings can help identify PVC and may draw clinicians' attention to the possibility of PCS.Publication Metadata only Stent-assisted coil embolization of challenging intracranial aneurysms: initial and mid-term results with low-profile ACCLINO devices(SPRINGER WIEN, 2016) TÜRELİ, DERYA; Tureli, Derya; Sabet, Soheil; Senol, Serkan; Andac, Nurten; Donmez, Halil; Geyik, Serdar; Baltacioglu, Feyyaz; Cekirge, SaruhanStent-assisted coiling using low-profile, self-expandable and retrievable stents is a valid option in endovascular treatment of challenging intracranial aneurysms. This study aims to evaluate the feasibility and efficacy of ACCLINO 1.9 F and ACCLINO Flex stent systems, designed for use as adjunctive products in coil embolization of intracranial aneurysms. Case files of 47 patients, and 52 aneurysms in total, treated with at least one ACCLINO 1.9 F or ACCLINO Flex stent were retrospectively evaluated. Technical success, complications, and angiographic outcomes were assessed based on immediate post-procedural controls along with 6th and 12th month angiograms. Mechanical untoward event rate, including asymptomatic complications, is 9.6 % (five out of 52 aneurysms). Failed dual-stenting attempt rate is 15.4 % (two out of 13). Overall procedure-related morbidity is 4.2 % with no neurologic sequelae. Initial occlusion rate is 90.4 % (47 aneurysms). One patient had residual filling in the aneurysm neck, which was stable throughout follow-up. The remaining four cases had spontaneous follow-up occlusion. Recanalization rate at 6th month is 2.1 % with one aneurysm requiring retreatment. One patient was lost to follow-up. There is no mortality associated with treatment. Stent-assisted coil embolization with ACCLINO stents in single or dual configurations is a feasible treatment option for challenging intracranial aneurysms. Follow-up results are encouraging; techniques were effective in complex cases and there were no clinically significant adverse outcomes.Publication Metadata only Outcomes of unconventional utilization of BI-RADS category 3 assessment at opportunistic screening(SAGE PUBLICATIONS LTD, 2016) TÜRELİ, DERYA; Altas, Hilal; Tureli, Derya; Cengic, Ismet; Kucukkaya, Fikret; Aribal, Erkin; Kaya, HandanBackground An important difficulty regarding the Breast Imaging Reporting and Data System (BI-RADS) category 3 assessment is the need for extensive diagnostic workup and an additional 6-month follow-up study. Purpose To evaluate the feasibility of the BI-RADS category 3 assessments at opportunistic screening. Material and Methods Mammography charts of 9062 screening patients in a major teaching hospital situated in an urban setting of a developing country were evaluated retrospectively (1997-2010). BI-RADS category 3 patients, called for a 6-month follow-up, which comprised a single-view spot or magnification mammogram. The length of follow-up period, compliance to periodic mammographic surveillance, cancer detection rate, and negative predictive values of category 3 assessments were calculated. Results Of the screened population, 9.2% were assigned BI-RADS category 3, and 31.2% of these cases were lost to follow-up. The mean follow-up period for 606 patients was 36.9 months. The negative predictive values for 6-month, 12-month, and final control studies were 90.9%, 87.5%, and 100%, respectively. Patient compliance for 6 months, 12 months, and any control evaluations beyond 12 months was low (50.0%, 29.8%, and 47.5%, respectively). Cancer detection rate was 0.8%. Conclusion Results of the study supports the feasibility of the BI-RADS category 3 assessments at opportunistic screening without any additional diagnostic workup. The practice of category 3 assessment following screening mammograms may be a more cost-effective method for developing countries with high recall rates and low resources in eliminating the maximum risk with minimum cost within the limits of available resources.Publication Metadata only Is any landmark reliable in vertebral enumeration? A study of 3.0-Tesla lumbar MRI comparing skeletal, neural, and vascular markers(ELSEVIER SCIENCE INC, 2014) TÜRELİ, DERYA; Tureli, Derya; Ekinci, Gazanfer; Baltacioglu, FeyyazPurpose: This study aimed to determine the reliability of the iliolumbar ligament (ILL), 12th costa, aortic bifurcation (AB), Tight renal artery (RRA), and conus medullaris (CM) for numbering of vertebral segments. Subjects and methods: Five hundred five patients underwent routine lumbar MRI examinations including a cervicothoracic sagittal scout and T1 and T2-weighted sagittal and axial turbo spin echo images. Images were evaluated by two radiologists separately. Results: The identifiability of ILL and 12th costa were 85.7% and 48.1%. AB, RRA, and CM were located more caudally in lumbarized S1 and more cranially in sacralized L5 cases. Conclusion: Landmarks suggested by previous studies are not reliable alternatives to cervicothoracic scout images due to wide ranges of distribution and inconsistencies in identification. (C) 2014 Elsevier Inc. All rights reserved.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 Metadata only Thyroid fine needle aspiration biopsy: Do we really need an on-site cytopathologist?(ELSEVIER IRELAND LTD, 2014) TÜRELİ, DERYA; Cengic, Ismet; Tureli, Derya; Ahiskali, Rengin; Bugdayci, Onur; Aydin, Hilal; Aribal, ErkinPurpose: The aim of this single center study is to evaluate the effectiveness of performing ultrasound-guided thyroid fine-needle aspiration biopsies (FNAB) performed by the radiologist alone without an on-site cytopathologist. Materials and methods: In this prospective randomized study, 203 patients with single nodules measuring 10 mm or more underwent ultrasound-guided FNAB: 102 patients underwent FNAB performed by the radiologist accompanied by a cytopathologist (control group); 101 patients underwent FNAB by the radiologist alone (study group). In both groups biopsy time, specimen adequacy ratio, total aspiration number, cytopathologist's cytological diagnosis time (t1), cytopathologist's total time consumption (t2) were evaluated. Results: Mean total biopsy time was 8.74 +/- 2.31 min in the study group and was significantly shorter than the control group's 11.97 +/- 6.75 min (p = 0.004). The average number of aspirations per patient in the study group was 4.00 +/- 0; compared to the control group's 3.56 +/- 1.23 this was significantly higher (p = 0.001). t1 of the study group was 307.48 +/- 226.32 s; compared to 350.14 +/- 247.64 s in the control group, there was no statistically significant difference (p = 0.137). t2 of the study group was 672.93 +/- 270.45 s; compared to the control group (707.03 perpendicular to 258.78 s) there was no statistically significant difference (p = 0.360). Diagnostic adequacy of aspirated specimens was reassessed in the pathology laboratory. In the study group, 84 out of 101 aspirations and in the control group 89 out of 102 aspirations was determined as adequate with no statistically significant difference (p = 0.302). Conclusions: We believe that in centers where a cytopathologist is not available, ultrasound-guided thyroid FNAB can be adequately performed by an experienced radiologist who was effectively trained in smear preparation. (C) 2014 Elsevier Ireland Ltd. All rights reserved.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 Metadata only Long-term results and comparison of flow re-direction endoluminal device and pipeline embolization device in endovascular treatment of intracranial carotid aneurysms *(SAGE PUBLICATIONS INC) GÜNDOĞMUŞ, CEMAL AYDIN; Gundogmus, Cemal A.; Sabet, Soheil; Baltacioglu, Nurten A.; Tureli, Derya; Bayri, Yasar; Baltacioglu, FeyyazObjective This study aims to compare the efficacy, safety, and long-term outcomes of two flow diverters, i.e., pipeline embolization device and flow re-direction endoluminal device, in the treatment of distal carotid aneurysms. Methods A total of 138 patients with 175 aneurysms were included from February 2012 to September 2019. Ninety-nine aneurysms were treated with flow re-direction endoluminal device and 76 with pipeline embolization device. Angiographic follow-ups were at the 6th, 12th, 24th, 36th, and 60th months; the O'Kelly-Marotta grading scale was used to assess aneurysms occlusion. Outcomes of two devices were compared; possible associations regarding patient characteristics, aneurysm properties, treatment details, and adverse events were evaluated. Results The mean follow-up period was 33 months, with 10 patients lost to follow-up. Occlusion rates at the 6th and 12th months and during the last follow-up were similar for flow re-direction endoluminal device (81%, 84%, and 90%) and pipeline embolization device (82%, 85%, and 93%). Occlusion rates were also similar after stand-alone use without coiling. There was no significant difference regarding adverse event rates with a 10.9% overall complication rate, 3.6% mortality, and 0.7% permanent morbidity. All the mortality and morbidity were related to hemorrhagic complications. Device deployment failure was observed with five flow re-direction endoluminal devices and two pipeline embolization devices, whereas two severe in-stent stenoses occurred with each device. Conclusions Both flow re-direction endoluminal device and pipeline embolization device are feasible and effective in flow diversion of distal internal carotid artery aneurysms, with similar adverse events rates and aneurysm occlusion success. Aneurysm occlusion rates increase with time, while the presence of an integrated branch significantly decreases treatment success.Publication Metadata only Thyroid fine needle aspiration biopsy: do nodule volume and cystic degeneration ratio affect specimen adequacy and cytological diagnosis time?(SAGE PUBLICATIONS LTD, 2015) TÜRELİ, DERYA; Cengic, Ismet; Tureli, Derya; Ozden, Ferhat; Bugdayci, Onur; Aydin, Hilal; Aribal, ErkinBackground A fine needle aspiration biopsy (FNAB) of thyroid nodules - the least invasive and most accurate method used to investigate malignant lesions - may yield non-diagnostic specimens even under ultrasonographic guidance. Purpose To evaluate the effects of thyroid nodule volume and extent of cystic degeneration on both the non-diagnostic specimen ratio as well as cytopathologist's definitive cytological diagnosis time. Material and Methods In this single center study, FNAB was performed on 505 patients with single thyroid nodules greater than 10mm. Nodule volume was calculated prior to FNAB and cystic degeneration ratio was recorded. All biopsies were performed by a single radiologist who also prepared specimen slides. Specimen adequacy and final diagnosis were made in the pathology laboratory by a single-blinded cytopathologist based on the Bethesda system. Definitive cytological diagnosis time was recorded upon reaching a definitive diagnosis. Results The specimen adequacy ratio was 85.3%. The mean nodule volume of adequate specimens was larger than those of non-diagnostic samples (6.00mL vs. 3.05mL; P=0.001). There was no correlation between nodule volume and cytopathologist's definitive cytological diagnosis time (r=0.042). Biopsy of predominantly solid nodules yielded better specimen adequacy ratios compared to predominantly cystic nodules (87.8% vs. 75.3%; P=0.028). Definitive cytological diagnosis times were longer in predominantly cystic nodules compared to predominantly solid nodules (376s vs. 294s; P=0.019). Conclusion Predominantly cystic nodules are likely to benefit from repeated nodular sampling until the specimen is declared adequate by an on-site cytopathologist. If a cytopathologist is not available, obtaining more specimens per nodule may achieve desired adequacy ratios.