Person: TÜRELİ, DERYA
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TÜRELİ
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DERYA
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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.Publication Metadata only 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, DeryaBackground: 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.Publication Metadata only Effects of nodule characteristics on sampling number and duration of thyroid fine-needle aspiration biopsy: size does not matter, but cystic degeneration ratio does(SAGE PUBLICATIONS LTD, 2017) TÜRELİ, DERYA; Cengic, Ismet; Tureli, Derya; Altas, Hilal; Ozden, Ferhat; Bugdayci, Onur; Aribal, ErkinBackground: Ultrasound-guided fine needle aspiration biopsy (FNAB) of thyroid nodules, though the most accurate method to rule out malignancy, still has an inherent risk of yielding non-diagnostic specimens despite immediate assessment of specimen adequacy by an on-site cytopathologist. Purpose: To evaluate the effects of nodule volume and extent of cystic degeneration on total biopsy time and number of aspirations required for obtaining an adequate specimen. Material and Methods: A total of 510 patients underwent FNAB by a single radiologist accompanied by a cytopathologist who immediately assessed each sample for specimen adequacy. All sampled nodules were single and had one maximum diameter > 10 mm. Nodule volumes and cystic degeneration ratios were calculated prior to the intervention. Aspirations were repeated until the cytological material was deemed adequate by the cytopathologist; the number of aspirations and total biopsy time were then recorded. Results: Nodule volumes did not have significant effect on neither number of aspirations necessary for achieving specimen adequacy (P > 0.05) nor total biopsy time (r = -0.148 with P = 0.001). Predominantly cystic nodules, compared to predominantly solid nodules, required more sampling per nodule (4.58 +/- 1.11 vs. 3.44 +/- 1.19 aspirations, P = 0.001) and longer total biopsy time (16.40 +/- 6.19 vs. 11.15 +/- 6.18 min, P = 0.001). Conclusion: Predominantly cystic nodules require allocation of more time for biopsy. To ensure specimen adequacy when immediate specimen evaluation by an on-site cytopathologist is not possible, four samples from predominantly solid nodules and five passes through predominantly cystic nodules are required.