Browsing by Author "Açar Ç.R."

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    Contrast-enhanced spectral mammographic findings of phyllodes tumor of the breast
    (Springer Science and Business Media Deutschland GmbH, 2022) Orguc S.; Mavili S.; Açar Ç.R.; Aydede H.; Kandiloğlu A.R.
    Background: Phyllodes tumors of breast are rare fibroepithelial neoplasms. They have similar radiological findings with fibroadenomas. While fibroadenomas are benign lesions, phyllodes tumors may have malignant potential. Therefore, any imaging findings to differentiate fibroadenoma from phyllodes tumor are valuable. Case presentation: A 51-year-old female patient was admitted to our clinic with the complaint of a palpable mass. Tru-Cut biopsy resulted as phyllodes tumor, and excision was recommended. However, the patient neglected herself during the COVID-19 pandemic, and 20 months later, she presented with a huge and complex mass. On CESM imaging, cystic areas and clefts were identified. The case was diagnosed as borderline phyllodes tumor. Conclusions: Although MRI findings of phyllodes tumor are well known and reported many times, there is no information about CESM findings of this tumor in literature. Bubbly appearance on CESM is useful finding in the diagnosis of phyllodes tumor of breast. © 2022, The Author(s).
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    Correlation of Shear-Wave Elastography and Apparent Diffusion Coefficient Values in Breast Cancer and Their Relationship with the Prognostic Factors
    (Multidisciplinary Digital Publishing Institute (MDPI), 2022) Orguc S.; Açar Ç.R.
    Background: Diffusion-weighted imaging and elastography are widely accepted methods in the evaluation of breast masses, however, there is very limited data comparing the two methods. The apparent diffusion coefficient is a measure of the diffusion of water molecules obtained by diffusion-weighted imaging as a part of breast MRI. Breast elastography is an adjunct to conventional ultrasonography, which provides a noninvasive evaluation of the stiffness of the lesion. Theoretically, increased tissue density and stiffness are related to each other. The purpose of this study is to compare MRI ADC values of the breast masses with quantitative elastography based on ultrasound shear wave measurements and to investigate their possible relation with the prognostic factors and molecular subtypes. Methods: We retrospectively evaluated histopathologically proven 147 breast lesions. The molecular classification of malignant lesions was made according to the prognostic factors. Shear wave elastography was measured in kiloPascal (kPa) units which is a quantitative measure of tissue stiffness. DWI was obtained using a 1.5-T MRI system. Results: ADC values were strongly inversely correlated with elasticity (r = −0.662, p < 0.01) according to Pearson Correlation. In our study, the cut-off value of ADC was 1.00 × 10−3 cm2/s to achieve a sensitivity of 84.6% and specificity of 75.4%, and the cut-off value of elasticity was 105.5 kPa to achieve the sensitivity of 96.3% and specificity 76.9% to discriminate between the malignant and benign breast lesions. The status of prognostic factors was not correlated with the ADC values and elasticity. Conclusions: Elasticity and ADC values are correlated. Both cannot predict the status of prognostic factors and differentiate between molecular subtypes. © 2022 by the authors.
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    Comparison of Performance in Diagnosis and Characterization of Breast Lesions: Contrast-Enhanced Mammography Versus Breast Magnetic Resonance Imaging
    (Elsevier Inc., 2024) Açar Ç.R.; Orguc S.
    Introduction: In contemporary medical practice, magnetic resonance imaging (MRI) is the most sensitive modality for detecting breast cancer. Contrast-enhanced mammography (CEM), a relatively recent technology, represents another contrast-enhanced imaging technique that has the potential to serve as an alternative to breast MRI. Our main goal is to compare the diagnostic accuracy including assessment of sensitivity and specificity of these 2 contrast-enhanced breast imaging methods, CEM and MRI, in the diagnosis and characterization of breast lesions. Material and methods: Our prospective study included patients who were clinically suspected of malignancy and/or had suspicious findings detected by mammography or ultrasound. A total of 116 patients were included, and both CEM and MRI examinations were performed on all patients. All CEM examinations were conducted at our institution, while 56.89% of all MRI examinations were carried out at external centers. While histopathological results were accessible for all malignant lesions, the final diagnosis for 80.5% of benign lesions was established through typical imaging findings and adequate follow-up. Results: This study encompassed a total of 219 lesions, with 125 out of 219 (57.07%) malignant lesions and 94 out of 219 (42.92%) benign lesions. The sensitivity and specificity values were 98.40% and 81.91%, respectively, for CEM, and 100% and 75.33%, respectively, for MRI. Moreover, CEM showcased comparable performance to MRI in evaluating women with dense breasts. Conclusion: CEM and MRI were compared for breast lesion diagnosis, with MRI showing higher sensitivity and CEM higher specificity; however, the differences were not statistically significant. © 2024 Elsevier Inc.
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    Giant Cell Tumor of the Spine
    (Springer Science and Business Media Deutschland GmbH, 2024) Orguc S.; Açar Ç.R.; Arkun R.
    Giant cell tumor (GCT) of the spine is a rare condition characterized by locally aggressive osteolytic tumors. While GCTs commonly occur in the epiphysiometaphysis of long bones, spinal lesions are relatively uncommon. The pathologic features of GCTs involve a vascularized stroma composed of spindle-shaped mononuclear cells and multinucleated giant cells. Although GCTs are typically considered benign, approximately 10% may exhibit malignant behavior. Spinal GCTs can present with pain, weakness, and neurological deficits due to compression of neural elements. Imaging techniques such as conventional radiography, computed tomography (CT), magnetic resonance imaging (MRI), and PET/CT can help in diagnosis and staging. The solid portions of GCTs typically demonstrate low signal intensity on T2-weighted images (WI) and intermediate signal intensity on T1-WI, due to the presence of collagen within the fibrous components and hemosiderin deposition. Treatment typically involves complete resection of the tumor, preferably with en bloc resection for better prognosis. However, surgery may be challenging due to the soft and easily ruptured nature of GCTs. In cases where complete surgical resection is not feasible or the tumor exhibits aggressive behavior, adjuvant treatments such as radiotherapy may be considered to control local disease progression, while the use of denosumab has shown promise in reducing tumor size and inhibiting osteolysis in unresectable or recurrent giant cell tumors of the spine. Histopathological verification is essential for a definitive diagnosis, and differential diagnoses include other bone tumors and cystic lesions. Various classification systems exist to assess the aggressiveness and guide treatment decisions, although their correlation with local recurrence and metastases is uncertain. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.