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    Diagnostic performance of prostate imaging reporting and data system v2.1: Single center experience
    (2019) Bekci, Tumay; Oguz, Ural; Tosun, Alptekin; Demirelli, Erhan; Ogreden, Ercan; Sengul, Demet
    Aim: To assess the diagnostic accuracy of PI-RADS v2.1 using multi-parametric magnetic resonance imaging (mpMRI) to detect prostate cancer (pCa) and comparison with transrectal biopsy/radical prostatectomy results.Material and Methods: Between June 2017 and April 2019, 124 patients who underwent mpMRI prior to transrectal biopsy/ radical prostatectomy were evaluated by a pathology results-blinded uroradiologist using PI-RADS v2.1 categories, retrospectively. PIRADS v2.1 category results were compared with transrectal biopsy/radical prostatectomy results. All clinical data were used in statistical analysis.Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy values of mpMRI using PI-RADS v2.1 categorization were 96%, 44%, 73%, 88% and 75%, respectively. A significant correlation was observed between a high PI-RADS score and high pathological grade (p0.001). The inter observer agreement expressed as the ICC was 0.65 (95% CI: 0.33–0.84, p 0.001).Conclusions: The mpMRI, used in conjunction with PI-RADS v2.1, is a useful and promising imaging method in detection of pCa. Keywords: Prostate cancer; multiparametric MRI; PI-RADS; transrectal biopsy; radical prostatectomy.
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    Fatal systemic juvenile xanthogranuloma with multiple central nervous system lesions
    (2021) Bekci, Tumay; Aslan, Serdar; Cakir, Ismet Mirac; Bulut, Muhammet
    Juvenile xanthogranuloma (JXG) is a rare and benign proliferative disease of histiocytes (1). Its systemic form is rarer and while the condition is benign, prognosis is poor (1). Extra-cutaneous involvement of JXG can be seen in the eyes, lungs, liver, spleen, adrenals, gonads, kidneys, bowels, retroperitoneum, and rarely, central nervous system (CNS) (1,2). In current literature, systemic JXG cases with multiple CNS lesions with fatal outcome are very rare. The purpose of this case study is to present magnetic resonance imaging (MRI) findings of an 18-month-old patient with JXG who presented with multiple CNS lesions and later developed skin lesions. To the best of our knowledge, there are no reports in the literature of cases where skin lesions developed after presentation of isolated CNS lesions.
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    Mechanochemical ablation of varicose veins with N-Butyl Cyanoacrylate: Six-month follow-up
    (2019) Bekci, Tumay; Tosun, Alptekin
    Aim: The endovenous treatment with n-butyl cyanoacrylate (NBCA) is a new nontumescent ablation technique for symptomatic saphenous vein reflux. The aim of the present study is to present six-month follow-up results of NBCA (VenaBlock) mechanochemical ablation technique. Material and Methods: Endovenous ablation was performed on 29 saphenous veinsof 23 patients between January 2017 and October 2018 in our university hospital. All patients with six-month follow-up results were included. Patients’ pre- and postoperative data were recorded. Results: This procedure was performed on eight small saphenous veins in seven patients and 21 great saphenous veins in 16 patients. The mean saphenous vein diameters for great and small saphenous vein were 7.1 and 3.8, respectively. The mean lengths for great and small saphenous vein were 45 cm and 19 cm, respectively. Closure rates were 100% at one week, 100% at one month, 100% at three months and 96% at six months. CEAP score was significantly improved (p<0.001). There was one deep venous thrombosis patient as a complication. Conclusion: The NBCA-based vein ablation technique is a fast end affective treatment method with no tumescent anesthesia requirement and high patient toleration. Further large-scale studies with long-term follow-up results are required.
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    Ultrasonography evaluation of small bowel bezoars with suspicious findings on CT in the elderly
    (2019) Bekci, Tumay
    Aim: Our aim was to evaluate the feasibility of using ultrasonography (US) in the detection and management of small bowel bezoars in elderly patients (> 65 y).Material and Methods: This study included 15 elderly patients (> 65 y) with small bowel obstruction and initial diagnosis of small bowel bezoar using abdominal computed tomography (CT) from among 182 patients with small bowel obstruction. The diagnostic performance of US was prospectively evaluated and compared with the surgical or clinical diagnoses.Results: Among the 15 patients, ten of them were diagnosed via ultrasonography as having small bowel bezoar. Eight patients were also surgically diagnosed with phytobezoars, and the remaining two patients who showed bezoars on US showed complete symptomatic improvement with ultrasonographic follow-up showing the bezoar passing through the cecum. The other five patients were surgically diagnosed with brid ileus. US correctly diagnosed small bowel bezoars in all patients. The sonographic follow-up of the bezoars in the two patients who showed symptomatic improvement was also successful.Conclusion: US is a feasible imaging modality for the diagnosis and follow-up of small bowel bezoars. Timely diagnosis and management of bezoars is especially important in elderly patients. US can help both, radiologists and clinicians in easy diagnosis and timely management of small bowel bezoars in elderly patients.Keywords: Bezoar; phytobezoar; ultrasonography; computed tomography; elderly.