Publications by authors named "Mesude Tosun"

6 Publications

  • Page 1 of 1

Comparison of superb microvascular imaging and shear wave elastography for assessing liver fibrosis in chronic hepatitis B.

Ultrasonography 2021 Nov 25. Epub 2021 Nov 25.

Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey.

Purpose: The present study investigated the effectiveness and applicability of superb microvascular imaging (SMI) in determining the degree of liver fibrosis noninvasively in comparison with shear wave elastography (SWE).

Methods: Ninety-eight consecutive patients with chronic hepatitis B who underwent ultrasound (US)-guided needle biopsy were examined using US combined with SMI and SWE. The predictive performance of the two US techniques in staging liver fibrosis and inflammation was compared with reference to the histological findings obtained from liver biopsy. The intraobserver and interobserver reproducibility of SMI in vascularity scores were evaluated.

Results: SWE values and SMI vascular scores were statistically significantly different among fibrosis stages (χ2(3)=76.3, χ2(3)=81.5, P<0.001). The SWE and SMI models significantly predicted fibrosis stages separately, and SMI scores alone predicted fibrosis stages better than SWE values (50.1% for SWE, 63.5% for SMI, P<0.001). A model with both SMI scores and SWE values together explained 73.2% of variance in fibrosis stages. When other clinical and laboratory predictors were added to the model (81.5%, P<0.001), SWE values and SMI scores remained the main predictors of fibrosis stages. SWE and SMI were also applicable in predicting inflammatory grades, explaining 31% and 34% of variance, respectively, and 37.7% when used together (P<0.001).

Conclusion: Both SWE and SMI had good diagnostic performance in determining the degree of liver fibrosis in chronic hepatitis B patients. The efficacy of SMI was better than that of SWE. SMI can improve diagnostic performance for staging liver fibrosis and shows potential for estimating necroinflammation of the liver.
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http://dx.doi.org/10.14366/usg.21136DOI Listing
November 2021

Prebiopsy multiparametric MRI and PI-RADS version 2.0 for differentiating histologically benign prostate disease from prostate cancer in biopsies: A retrospective single-center comparison.

Clin Imaging 2021 Oct 20;78:98-103. Epub 2021 Mar 20.

Department of Radiology, Kocaeli University Hospital, Kocaeli, Turkey.

Purpose: To investigate the diagnostic performance of Prostate Imaging-Reporting and Data System version 2.0 (PI-RADSv2.0) for differentiating clinically significant prostate cancer (csPCa) from benign prostate disease on prebiopsy multiparametric MRI stratified by total prostate specific antigen (PSA) concentration.

Materials And Methods: 150 patients who had prebiopsy mpMRI, serum PSA concentration and subsequent biopsy were retrospectively analyzed. Patients were stratified by PSA concentration (Group1 ≥ 10 ng/mL; Group2 4.0-<10 ng/mL). MRI findings were assessed using PI-RADSv2.0 by two blinded radiologists. Lesions were graded histopathologically using the International Society of Urological Pathology (ISUP) score. Diagnostic performance of PI-RADSv2.0 was evaluated and compared to PSA and PSA Density (PSAD). The performance of the radiologists was compared including inter-observer agreement for PI-RADSv2.0. The correlation between imaging and histopathological biopsy results was analyzed.

Results: The differences in total PSA, free/total PSA ratio and PSAD between benign (n = 78) and malignant (n = 72) groups were significant (p < 0.05). The PI-RADSv2.0 scores of the radiologists were strongly correlated (r = 0.912, p < 0.001) with excellent agreement, κ = 0.97 (95%CI: 0.90-1.03; p < 0.005). Receiver operating characteristics curve analysis showed significantly high predictive power for PI-RADSv2.0, total PSA and PSAD alone. Comparison of age, prostate volume, PSAD, free/total PSA ratio and total PSA values between ISUP1 and ISUP ≥ 2 cases revealed significantly increased PSAD (p < 0.001) and total PSA (p = 0.001) in the ISUP ≥ 2 group.

Conclusion: PI-RADSv2.0 had high diagnostic accuracy in both PSA groups. PI-RADSv2.0, PSAD and total PSA alone had significant high predictive power to detect csPCa. However, the combination of PI-RADSv2.0 and PSAD or total PSA for each reader showed no statistically significant improvement when compared to PI-RADSv2.0 alone.
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http://dx.doi.org/10.1016/j.clinimag.2021.03.011DOI Listing
October 2021

Intravoxel incoherent motion magnetic resonance imaging for breast cancer: A comparison with molecular subtypes and histological grades.

Magn Reson Imaging 2021 05 6;78:35-41. Epub 2021 Feb 6.

Department of General Surgery, School of Medicine, Kocaeli University, Kocaeli, Turkey.

Purpose: The purpose of this paper is to investigate whether the IVIM parameters (D, D *, f) helps to determine the molecular subtypes and histological grades of breast cancer.

Methods: Fifty-one patients with breast cancer were included in the study. All subjects were examined by 3 T Magnetic Resonance Imaging (MRI). Diffusion-weighted imaging (DWI) was undertaken with 16 b-values. IVIM parameters [D (true diffusion coefficient), D* (pseudo-diffusion coefficient), f (perfusion fraction)] were calculated. Histopathological reports were reviewed to histological grade, histological type, and immunohistochemistry. IVIM parameters of tumors with different histological grades and molecular subtypes were compared.

Results: D* and f were significantly different between molecular subtypes (p = 0.019, p = 0.03 respectively). D* and f were higher in the HER-2 group and lower in Triple negative (-) group (D*:36.8 × 10 ± 5.3 × 10 mm/s, f:29.5%, D*:29.8 × 10 ± 5.6 × 10 mm/s, f:21.5% respectively). There was a significant difference in D* and f between HER-2 and Triple (-) subgroups (p = 0,028, p = 0.024, respectively). D* was also significantly different between the HER-2 group and the Luminal group (p = 0,041). While histological grades increase, D and f values tend to decrease, and D* tends to increase. While the Ki-67 index increases, D* and f values tend to increase, and D tend to decrease.

Conclusion: D* and f values measured with IVIM imaging were useful for assessing breast cancer molecular subtyping. IVIM imaging may be an alternative to breast biopsy for sub-typing of breast cancer with further research.
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http://dx.doi.org/10.1016/j.mri.2021.02.005DOI Listing
May 2021

Proton magnetic resonance spectroscopic analysis of changes in brain metabolites following electroconvulsive therapy in patients with major depressive disorder.

Int J Psychiatry Clin Pract 2020 Mar 11;24(1):96-101. Epub 2019 Dec 11.

The Nathan S. Kline Psychiatric Research Institute, Orangeburg, NY, USA.

The aim of this study was to evaluate the metabolic changes in the anterior cingulate cortex (ACC) induced by electroconvulsive therapy (ECT) in patients with MDD via H-MRS. The study was conducted on 13 MDD patients receiving ECT treatment and 14 healthy controls matched in terms of age, gender and education. The patients underwent six sessions of ECT. H-MRS imaging and psychometric evaluations obtained before 1st and after the 6th sessions. The control group also went through the same procedures except for ECT. -Acetyl aspartate (NAA), choline (Cho) and creatine (Cr) metabolite levels and the creatine to metabolite ratios were measured. There was no significant difference in the ACC metabolite levels of the patients and those of the controls at the baseline. ECT associated with a statistically significant decrease in the NAA/Cr ratio in ACC. All of the patients had responded to ECT treatment as measured with the clinical scales. The results has suggested that indirect proof of an increase in energy metabolism without any evidence of impaired neuronal viability in the ACC induced by ECT. The relative increase in Cr levels following ECT in MDD seems to be associated with improvement in clinical severity.Key pointsECT is one the most effective method in the treatment of acute MDD.The mechanism of ECT's antidepressant activity remains unclear but it is thought to be related to the regulation of prefrontal cortical or cingulate areas.In this study the patients underwent six sessions of ECT and after H-MRS imaging.The study revealed that baseline levels of metabolites in patients with MDD were not significantly different than those of control group.
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http://dx.doi.org/10.1080/13651501.2019.1699118DOI Listing
March 2020

Intravoxel incoherent motion imaging for diagnosing and staging the liver fibrosis and inflammation.

Abdom Radiol (NY) 2020 01;45(1):15-23

Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Kocaeli, Turkey.

Purpose: To evaluate the diagnostic accuracy of intravoxel incoherent motion (IVIM) model parameters for the diagnosis and staging of liver fibrosis and inflammation in patients with chronic hepatitis B.

Methods: Fifty-four patients with chronic hepatitis B and 42 healthy volunteers were included in the study. All subjects were examined by 3 T magnetic resonance imaging. Diffusion-weighted imaging was undertaken with sixteen b values. IVIM parameters [D (true diffusion coefficient), D* (pseudo-diffusion coefficient), f (perfusion fraction)] were calculated. Histological evaluation of biopsy samples was considered the reference standard for the staging of liver fibrosis and inflammation. Differences in IVIM parameters between patient and control groups were analyzed. In the patient group, fibrosis stage and inflammation grade groups were analyzed with respect to IVIM parameters. The correlation was assessed between IVIM parameters and Ishak-modified scale of fibrosis stages and inflammation grades.

Results: The D was significantly lower in the patient group than the control group, p = 0.038 with Cohen's d effect size of 0.452. D was significantly different between fibrosis stage levels. D values decreased in fibrosis stages from the minimal to moderate to marked fibrosis. Fibrosis grades significantly negatively correlated with D and D* values, p = 0.001, and 0.021, respectively. In addition, inflammation grades negatively correlated with f values, p = 0.047.

Conclusion: D values measured with IVIM imaging may help to diagnose liver fibrosis. IVIM imaging could be an alternative to liver biopsy for the staging of liver fibrosis.
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http://dx.doi.org/10.1007/s00261-019-02300-zDOI Listing
January 2020

Diagnostic performance of conventional diffusion weighted imaging and diffusion tensor imaging for the liver fibrosis and inflammation.

Eur J Radiol 2013 Feb 2;82(2):203-7. Epub 2012 Nov 2.

Department of Radiology, School of Medicine, University of Kocaeli, Turkey.

Objective: To evaluate the diagnostic accuracy of liver apparent diffusion coefficient (ADC) measured with conventional diffusion-weighted imaging (CDI) and diffusion tensor imaging (DTI) for the diagnosis of liver fibrosis and inflammation.

Materials And Methods: Thirty-seven patients with histologic diagnosis of chronic viral hepatitis and 34 healthy volunteers were included in this prospective study. All patients and healthy volunteers were examined by 3T MRI. CDI and DTI were performed using a breath-hold single-shot echo-planar spin echo sequence with b factors of 0 and 1000 s/mm(2). ADCs were obtained with CDI and DTI. Histopathologically, fibrosis of the liver parenchyma was classified with the use of a 5-point scale (0-4) and inflammation was classified with use of a 4-point scale (0-3) in accordance with the METAVIR score. Quantitatively, signal intensity and the ADCs of the liver parenchyma were compared between patients stratified by fibrosis stage and inflammation grade.

Results: With a b factor of 1000 s/mm(2), the signal intensity of the cirrhotic livers was significantly higher than those of the normal volunteers. In addition, ADCs reconstructed from CDI and DTI of the patients were significantly lower than those of the normal volunteers. Liver ADC values inversely correlated with fibrosis and inflammation but there was only statistically significant for inflammatory grading. CDI performed better than DTI for the diagnosis of fibrosis and inflammation.

Conclusion: ADC values measured with CDI and DTI may help in the detection of liver fibrosis. They may also give contributory to the inflammatory grading, particularly in distinguishing high from low grade.
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http://dx.doi.org/10.1016/j.ejrad.2012.09.009DOI Listing
February 2013
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