Publications by authors named "Murat Yavuz Koparal"

8 Publications

  • Page 1 of 1

The role of histopathological and biochemical parameters for predicting metastatic disease on Ga-PSMA-11 PET in prostate cancer.

Prostate 2021 Sep 13. Epub 2021 Sep 13.

Department of Nuclear Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.

Background: The aim of this study was to evaluate the role of histopathological and biochemical parameters in the prediction of the presence and number of PSMA positive lesions consistent with the metastatic spread of prostate cancer on Ga-PSMA PET images.

Methods: Biochemical, histopathological and imaging data of 302 prostate cancer patients who underwent Ga-PSMA-11 PET/CT or PET/MR imaging for primary staging were retrospectively analyzed. Patients were divided into two groups as "PET positive" and "PET negative" according to the presence of pathologic extraprostatic PSMA involvement. "PET positive" patients were additionally divided into two groups: oligometastatic (1-3 metastatic lesion) and multimetastatic (>3 metastatic lesions).

Results: The mean age of patients was 66.8 ± 7.6 years. Imaging modality was PET/MR in 223 (73.8%) and PET/CT in 79 (26.2%) of patients. Total PSA, PSA density (PSAD), ALP, and tumor ratio in biopsy specimens were found to be significantly higher in "PET positive" group compared to "PET negative" group and in multimetastatic group compared to oligometastatic group. PET positivity was observed in 3.8% of the low-intermediate risk groups (ISUP 1-3 and total PSA ≤ 20 ng/ml and PSAD < 0.15 ng/ml/cc). This ratio was 46% in the high-risk group (ISUP 4-5 or total PSA > 20 ng/ml or PSAD ≥ 0.15 ng/ml/cc) with a relative risk of 12 (p < .001). The prediction models to predict the PET positivity and the presence of distant metastasis had AUCs of 0.901 and 0.925, respectively; with ALP, total PSA, and tumor ratio in needle biopsy specimen as significant independent predictors (p < .05).

Conclusions: In this study, Ga-PSMA-11 PET positivity was significantly higher in the high-risk patient group than in the low-intermediate risk groups. The prediction models used for predicting the PET positivity and the presence of distant metastasis on PET imaging were successful with high discriminatory powers. In addition to total PSA and ISUP GG, ALP and tumor ratio in biopsy specimens can be used to identify high-risk patients.
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http://dx.doi.org/10.1002/pros.24231DOI Listing
September 2021

External validation of a prostate cancer nomogram on magnetic resonance/transrectal ultrasound fusion biopsy in men with prior negative systematic biopsy.

Int J Clin Pract 2021 Oct 9;75(10):e14654. Epub 2021 Aug 9.

Department of Urology, School of Medicine, Gazi University, Ankara, Turkey.

Objective: To observe how the nomogram, which was created by Truong et al, works in an independent patient group by performing external validation.

Patients And Methods: One hundred and eighty-one patients who had at least one prior negative 12-core standard systematic biopsy and lesions with PI-RADS scores of 3 or higher that were detected as a result of mpMRI were included in the study. Targeted biopsy with 12-core standard systematic biopsy was performed on all patients. Clinical and pathological features of the patients were recorded. The discrimination, calibration and decision curve analysis were performed to externally validate the nomogram.

Results: A total of 181 patients with previous negative 12-core systematic biopsies were analysed. One hundred and thirty-four patients (74%) had benign pathology. Radiological volume and PI-RADS scores of 4 and 5 were found as independent predictors of benign pathology. The area under the curve (CI 95%) was found to be 0.80 (0.73-0.87), indicating good discrimination. The median residual was calculated as -0.0873, the intercept as -0.0690, the slope as 0.8927 and r as 0.2586, indicating good calibration. The standardised net benefit of follow-up decisions was found to be 0.54 and 0.36 at the probability threshold of 0.7 and 0.8, respectively.

Conclusion: The original model showed good discrimination and calibration with our data. Defining a high probability threshold for clinical use would be appropriate for centres with high benign biopsy rates similar to our centre.
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http://dx.doi.org/10.1111/ijcp.14654DOI Listing
October 2021

Lymphoepithelioma like carcinoma of the urinary bladder, treated with transurethral resection and intravesical Bacillus Calmette Guerin therapy only: A case report.

Acta Biomed 2021 05 12;92(2):e2021031. Epub 2021 May 12.

, Recep Tayyip Erdogan University Training and Research Hospital, Department of Urology.

Lymphoepithelioma-like urotehelial carcinoma which was first identified by Zukerberg, constitutes 0,4-1,3% of all urothelial carcinomas and has similar histomorphological features with nasopharyngeal lymphoepithelioma. We report a case of predominant lymphoepithelioma like bladder carcinoma in a 72 years old male patient. Transuretheral resection of the bladder and adjuvant intravesical Bacillus Calmette Guerin treatment was applied. The patient is currently at the 16th month after diagnosis and no recurrence or metastasis has been observed in cystoscopic and radiological examinations.
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http://dx.doi.org/10.23750/abm.v92i2.9837DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182593PMC
May 2021

Diagnostic accuracy of Ga-PSMA PET/MRI and multiparametric MRI in detecting index tumours in radical prostatectomy specimen.

Int J Clin Pract 2021 Aug 20;75(8):e14287. Epub 2021 May 20.

Department of Urology, School of Medicine, Gazi University, Ankara, Turkey.

Objective: To evaluate the diagnostic accuracy of the gallium ( Ga) prostate-specific membrane antigen (PSMA) positron emission tomography/magnetic resonance imaging (PET/MRI) and multiparametric MRI (mpMRI) by region-based comparison of index tumour localisations using histopathological tumour maps of patients who underwent radical prostatectomy because of clinically significant prostate cancer.

Patients And Methods: The study included 64 patients who underwent radical prostatectomy after primary staging with mpMRI and Ga-PSMA PET/MRI. Diagnostic analysis was performed by dividing the prostate into four anatomic regions as left/right anterior and left/right posterior. The extension of the lesions in mpMRI and the pathological uptake in Ga-PSMA PET/MRI were matched separately for each region with the extension of the index tumour into each region.

Results: The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and the accuracy of mpMRI and Ga-PSMA PET/MRI are shown as 55.7%, 91.8%, 80.6%, 77.2%, 78.1%, and 60.8%, 94.3%, 86.8% 79.8%, 83.5%, respectively. Ga-PSMA PET/MRI has higher sensitivity and specificity compared with mpMRI. However, no statistically significant difference was found (P = .464). Combined imaging had significantly higher diagnostic accuracy compared with mpMRI and Ga-PSMA PET/MRI (change in AUC: 0.084 and 0.046, P < .001 and P = .028, respectively), while no statistically significant difference was found between mpMRI and Ga-PSMA PET/MRI (change in AUC: 0.038, P = .246).

Conclusion: Ga-PSMA PET/MRI had higher clinical diagnostic accuracy in prostate cancer compared with mpMRI. Diagnostic accuracy was significantly increased in the combined use of both imaging modalities.
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http://dx.doi.org/10.1111/ijcp.14287DOI Listing
August 2021

The effect of COVID-19 epidemic on the sexual function of healthcare professionals.

Andrologia 2021 Apr 13;53(3):e13971. Epub 2021 Jan 13.

Department of Urology, School of Medicine, Gazi University, Ankara, Turkey.

Studies have shown that healthcare professionals struggling with epidemics develop symptoms of post-traumatic stress disorder. The aim of this study is to show how often and severely erectile dysfunction, one of the components of post-traumatic stress disorder, is seen among healthcare professionals during COVID-19 outbreak. The Impact of Event Scale-Revised (IES-R) and the Index of Erectile Function-5 (IIEF-5) were applied to 159 male healthcare professionals working in COVID-19 units and a control group of 200 people. Healthcare professional group was divided into subgroups according to occupation (physician, nurse), age-group (18-25, 26-30, >30), marital status and unit of work (Suspected Patient Area, Diagnosed Patient Area). Both stress disorder and erectile dysfunction were seen at higher rates in healthcare professionals group (p < .001). The median IIEF-5 scores of nurses, married subjects and those working in the Diagnosed Patient Area, were found to be higher (p < .001, p = .014, p = .011 respectively). During the COVID-19 outbreak, healthcare professionals are exposed to psychological trauma and their sexual function may be negatively affected. The measures to be taken are important to estimate which groups are more affected.
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http://dx.doi.org/10.1111/and.13971DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995045PMC
April 2021

Efficiency of radiation-free retrograde intrarenal surgery (RIRS) in children and evaluation of factors affecting surgical success.

Arch Esp Urol 2020 Nov;73(9):843-851

Department of Urology. School of Medicine. Gazi University. Ankara. Turkey.

Objective: To investigate the factors affecting surgical success rates and duration of operation in retrograde intrarenal surgery (RIRS) without fluoroscopy in children. The aim of the study was to demonstrate the efficacy of RIRS without fluoroscopy on the treatment of renal stones in children. MATERIALS AND METHODS: All RIRS procedures were performed on pediatric patients at our clinic from August 2013 to January 2017. We studied 52 pediatric patients who had one stone in one kidney and under went one session. We mapped the kidney collecting system anatomically, and stone localization was defined according to this mapping. Size and localization of the stone, placement of preoperative J stent, use of ureteral access sheath (UAS), and surgical success rates were recorded. The effects of these factors on surgical success rates and the duration of the operations were analyzed.

Results: Each patient underwent RIRS once. Of these 52 pediatric patients, 23 (44%) were between 0-5 years of age children (Group 1), 13 (25%) were between 6-11 years of age children (Group 2), and 16 (31%) were between 11-17 years of age children (Group 3). The surgical success rates for each group were 65%, 77%, and 81%, respectively (73% overall). The surgical success rates were found to be affected only by stone size (p<0.01). The durations of the operations were found to be affected by stone size, stone localization, passive dilatation of ureter, and the application of an UAS (p<0.05).

Conclusion: RIRS is a safe and effective method for the treatment of intrarenal stones in pediatric patients. High success rates can be achieved using kidney mapping without the use of fluoroscopy.
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November 2020

Prognostic role of preoperative albumin to globulin ratio in predicting survival of clear cell renal cell carcinoma.

Int Braz J Urol 2018 Sep-Oct;44(5):933-946

Department of Urology, School of Medicine, Gazi University, Ankara, Turkey.

Purpose: To investigate the prognostic role of preoperative albumin/globulin ratio (AGR) in predicting disease-free survival (DFS) and overall survival (OS) in localized and locally advanced clear cell renal cell carcinoma (RCC) patients.

Patients And Methods: 162 patients who met the criteria specified were included in the study. The DFS and OS ratios were determined using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were performed to determine the prognostic factors affecting DFS and OS.

Results: Median follow-up period was 27.5 (6-89) months. There was a statistically significant relationship between low AGR and high pathological tumor (pT) stage, presence of collecting system invasion, presence of tumor necrosis, and a high platelet count (p = 0.012, p = 0.01, p = 0.001, and p = 0.004, respectively). According to the Kaplan-Meier survival analysis, both OS and DFS were found to be significantly lower in the low AGR group (p = 0.006 and p = 0.012). In the multivariate Cox regression analysis, collecting system invasion and tumor necrosis were found to be independent prognostic factors in predicting OS and pT stage was found to be an independent prognostic factor in predicting DFS (HR: 4.08, p = 0.043; HR: 8.64, p = 0.003 and HR: 7.78, p = 0.041, respectively).

Conclusion: In our study, low AGR was found to be associated with increased mortality and disease recurrence in localized and locally advanced RCC.
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http://dx.doi.org/10.1590/S1677-5538.IBJU.2018.0012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237545PMC
December 2018

Factors Affecting the Success Rate of Percutaneous Nephrolithotomy in Paediatric Patients.

J Clin Med 2018 Mar 4;7(3). Epub 2018 Mar 4.

Department of Urology, School of Medicine, Gazi University, Ankara 06500, Turkey.

In this study, we aimed to determine factors affecting the success rate of percutaneous nephrolithotomy (PNL) in children. The series consisted of 41 consecutive children operated on by the same surgical team for renal calculi with PNL between June 2002 and May 2015 in our institution. A single calyx or pelvic stone was described as simple, while calculi located in more than one location (calyx and pelvis or more than one calices) or staghorn stones were described as complex. The procedure was deemed successful if the patient was completely stone-free (SF) or had residual fragments <4 mm. Thirty-four patients were found to be SF or had residual fragments <4 mm on the postoperative first day, thus the success rate was 82.9%. In complex stones, the success rate was significantly lower (45.5%) than simple stones (96.7%) ( < 0.001). The grade of hydronephrosis (Grade 0-1 vs. Grade 2-3) also had a negative impact on the success, with rates of 92.6% vs. 64.3%, respectively ( = 0.022). Previous urological procedure history on the same side yielded a success rate of 58.3%, whereas the success rate in the primary patients was 93.1% ( < 0.001). The localization of the stone (complex vs. simple), degree of hydronephrosis, and history of previous urological procedures were found to be the factors that affected the success of the paediatric PNL.
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http://dx.doi.org/10.3390/jcm7030043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867569PMC
March 2018
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