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TÜRELİ, DERYA

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TÜRELİ

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Start date: 2020 ×

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Now showing 1 - 3 of 3
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    PublicationOpen 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 Yusuf
    Background 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.
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    PublicationOpen 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, Derya
    Objective: 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.
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    Diminished Sphenous Compartment Connective Tissue Elasticity has Little Impact on Low Grade Venous Insufficiency: An Ultrasound Shearwave Elastography Study
    (BENTHAM SCIENCE PUBL LTD, 2021) TÜRELİ, DERYA; Baltacioglu, A. Nurten; Tureli, Derya
    Background: Greater Saphenous Vein (GSV) courses within saphenous compartment, an adipose-filled space bound by fasciae provides structural support. Ultrasound Shear-Wave Elastography (SWE) provides objective and quantitative data on tissue shear elasticity modulus. Objective: This study aims to analyze possible associations between early stage GSV insufficiency and saphenous intracompartmental SWE measurements. Methods: Two-hundred consecutive patients, ages 22 to 81 (mean=44.3) years, with venous insufficiency symptoms underwent Doppler and SWE examinations. Patients had no visible or palpable sign of venous disease or had telangiectasia and reticular veins only. Analyses regarding patient age, gender, presence of venous insufficiency of GSV proper and intracompartmental connective tissue elasticity were performed. Results: Ninety-six patients had Doppler evidence for either bilateral or unilateral insufficiency of GSV proper at mid-thigh level. Intracompartmental elasticity of patients with venous insufficiency (mean=4.36 +/- 2.24 kilopascals; range 1.55 to 10.44 kPa) did not differ significantly from those with normal veins (mean=4.82 +/- 2.61 kPa; range 2.20 to 12.65 kPa) (p=0.231). No threshold for predicting the presence of venous insufficiency could be determined. Neither were there any correlations between age, gender and intracompartmental elasticity. In patients with unilateral insufficiency, however, elastography values around insufficient veins were significantly lower compared to contralateral normal GSV (p<0.001). Conclusion: Many intrinsic and patient factors affect intracompartmental connective tissue elastography measurements; thus, cut-off values obtained from specific populations have limited generalizability. Nevertheless, statistically significant intrapatient differences of intracompartmental elasticity among diseased and normal saphenous veins indicate that lack of elastic support from surrounding connective tissues contributes to venous insufficiency in early stages.