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Öğe Bilgisayarlı Toraks Tomografisinde Saptanan İnsidental Meme Lezyonları Incidental(2015) Poyraz, Necdet; Emlik, Ganime Dilek; Suat , Keskin; Kalkan, HavvaAmaç: Mamografi memenin primer görüntüleme yöntemi olmasına kar- şılık, değişik patolojileri saptamak amacıyla çekilen bilgisayarlı tomografilerde insidental (rastlantısal) benin ya da malin meme lezyonlarıyla giderek daha sık karşılaşılmaktadır. Dolayısıyla bu lezyonların saptanması ve doğru tanımlanması önem kazanmıştır. Bu çalışmada meme dışı patolojiler için çekilen bilgisayarlı tomografilerde saptanan insidental meme lezyonlarının sıklığını, morfolojik özelliklerini ve sonuçlarını değerlendirmeyi amaçladık. Yöntem ve Gereçler: Bölümümüzde 2011-2013 tarihleri arasında çekilen bilgisayarlı tomografilerde insidental saptanan meme lezyonları de- ğerlendirildi. Daha önce tanı konmuş meme lezyonu olan hastalar çalışma dışında bırakıldı. Histopatolojik tanısı olan ya da en az 2 yıl boyunca takip edilmiş hastalar çalışmaya alındı. Bulgular: Çalışma grubunu oluşturan ortalama 551,38 yaşındaki (aralık 37-78 yıl) toplam 33 kadının 12sinde (%36) malin, 21inde (%64) benin ya da normal bulgular saptandı. En sık saptanan patoloji malin lezyonlar arasında invaziv duktal karsinom, benin lezyonlarda ise fibroadenomdu. En önemli bilgisayarlı tomografi bulgusu, malin lezyonlarda düzensiz kontur yapısı ve lenfadenopati varlığı, benin lezyonlarda ise düzgün kontur yapısıydı. Sonuç: Bilgisayarlı tomografi incelemelerde kesite girdiğinde meme mutlaka dikkatli bir şekilde değerlendirilmelidir. Meme lezyonlarının uygun şekilde raporlanması erken tanı ve tedaviye olanak sağlayacaktır.Öğe Detection of microcalcification in digitized mammograms with multistable cellular neural networks using a new image enhancement method: automated lesion intensity enhancer (ALIE)(2015) Civcik, Levent; Yılmaz, Burak; Yüksel, Özbay; Emlik, Ganime DilekAbstract: Microcalcification detection is a very important issue in early diagnosis of breast cancer. Generally physicians use mammogram images for this task; however, sometimes analyzing these images become a hard task because of problems in images such as high brightness values, dense tissues, noise, and insufficient contrast level. In this paper, we present a novel technique for the task of microcalcification detection. This technique consists of three steps. The first step is focused on removing pectoral muscle and unnecessary parts from the mammogram images by using cellular neural networks (CNNs), which makes this a novel process. In the second step, we present a novel image enhancement technique focused on enhancing lesion intensities called the automated lesion intensity enhancer (ALIE). In the third step, we use a special CNN structure, named multistable CNNs. After applying the combination of these methods on the MIAS database, we achieve 82.0% accuracy, 90.9% sensitivity, and 52.2% specificity values.Öğe Detection of microcalcification in digitized mammograms with multistable cellular neural networks using a new image enhancement method: automated lesion intensity enhancer (ALIE)(Tubitak Scientific & Technological Research Council Turkey, 2015) Civcik, Levent; Yilmaz, Burak; Ozbay, Yuksel; Emlik, Ganime DilekMicrocalcification detection is a very important issue in early diagnosis of breast cancer. Generally physicians use mammogram images for this task; however, sometimes analyzing these images become a hard task because of problems in images such as high brightness values, dense tissues, noise, and insufficient contrast level. In this paper, we present a novel technique for the task of microcalcification detection. This technique consists of three steps. The first step is focused on removing pectoral muscle and unnecessary parts from the mammogram images by using cellular neural networks (CNNs), which makes this a novel process. In the second step, we present a novel image enhancement technique focused on enhancing lesion intensities called the automated lesion intensity enhancer (ALIE). In the third step, we use a special CNN structure, named multistable CNNs. After applying the combination of these methods on the MIAS database, we achieve 82.0% accuracy, 90.9% sensitivity, and 52.2% specificity values.Öğe Digital breast tomosynthesis and ultrasonography: diagnostic performance and effect on recall rates versus digital mammography in category O(E-Century Publishing Corp, 2017) Emlik, Ganime Dilek; Poyraz, Necdet; Altunkeser, AysegulThe purpose of this study was to compare diagnostic performance and screening recall rates of digital breast tomosynthesis (DBT) and ultrasound (US) added to digital mammography (DM) in the category O. This study was approved by the local ethics committee and informed consent was obtained. The additional breast US and DBT performed 216 women categorized as BI-RADS category O according to screening DM between January 2014 and February 2015. A total of 22 women that previously underwent breast surgery, radiotherapy, chemotherapy were excluded. Finally 194 patients were enrolled in this study. The DM+DBT images and DM+DBT images with US images of patients were independently reviewed by three breast radiologists and than recategorized according to BI-RADS category. Among 194 lesions, 165 (85%) were benign and 29 (14.9%) were malign. DBT reduced recall rate by 70%. For DBT, sensitivity, specificity, PPV, NPV and diagnostic accuracy were 97%, 82%, 48%, 99%, and 84%, whereas for US sensitivity, specificity, PPV, NPV and diagnostic accuracy were 93%, 79%, 47%, 98%, and 81%, respectively. AUC value was 0.89 and 0.86 for DBT and US. In conclusion, DBT reduced recall rates. DBT showed better diagnostic performance than breast US for category O. Reduction in RR was independent from breast parenchymal patterns.Öğe Incidental Breast Lesions Detected on Computed Thorax Tomography(Aves, 2015) Poyraz, Necdet; Emlik, Ganime Dilek; Keskin, Suat; Kalkan, HavvaObjective: Although mammography is the primary imaging method of the breast, incidental benign and malignant breast lesions are increasingly being detected on computed tomographies (CTs) performed to detect different pathologies. Therefore, the detection and accurate identification of these lesions is important. In this study, we aimed to evaluate the frequency, morphological features, and results of incidental breast lesions on CTs performed for the detection of extramammarian pathologies. Materials and Methods: Incidental breast lesions on CTs performed in our department between 2011 and 2013 were evaluated. Patients who had previously diagnosed breast lesions were excluded from the study. The inclusion criteria were histopathologic diagnose and being followed - up for at least 2 years. Results: The study population consisted of 33 women whose mean age was 55 +/- 1.38 (37-78) years. Of the 33 women, 12 (36%) had malignant and 21 (64%) had benign or normal findings. The most common malignant lesion was invasive ductal carcinoma, and the most common benign lesion was fibroadenoma. Ill-defined contour and lymphadenopathy in malignant lesions and well-defined contour in benign lesions were the most important CT findings. Conclusion: Breast must be carefully evaluated if it is included in the scans. An accurate report of breast lesions gives an opportunity for early diagnosis and treatment.Öğe Interesting X-ray and computed tomography images of a cervical trauma patient(2016) Kalkan, Havva; Emlik, Ganime Dilek; Sivri, MesutAcil servise düşme veya motorlu taşıt kazası sonrası bilinç kaybıyla gelen olguların yaklaşık %5-10'unda servikal vertebra kırığı ve kord hasarlanması vardır. Tanıda görüntüleme yöntemleri özellikle bilgisayarlı tomografi (BT) ve direkt grafi önemli role sahiptir. Amacımız C3-4 dislokasyonu ve dist-raksiyonu olan ve shearing hasarlanma olarak adlandırılan servikal travma olgusunda ilginç BT ve direkt grafi bulgularını tanımlamaktır. C3-4 vertebra korpusları arasında hematom nedeniyle belirgin genişleme görülmüştür fakat kırık hattı ve majör vasküler yaralanma saptanmamıştır. Görüntüler oldukça ilginçti. Ayrıca klinik değerlendirmede NEXUS ve Kanada kuralları dikkate alınmıştır. Görüntüleme yöntemleri özellikle de reformat BT görüntüleri hasarın ne olduğu ve nerede olduğunu bulmada kolaylık sağlar.Öğe Magnetic Resonance Imaging Features of Idiopathic Granulomatous Mastitis: A Retrospective Analysis(Kowsar Publ, 2016) Poyraz, Necdet; Emlik, Ganime Dilek; Batur, Abdussamet; Gundes, Ebubekir; Keskin, SuatBackground: Granulomatous mastitis is a rare and benign inflammatory breast disease that may clinically and radiologically mimic breast cancer. Objectives: The aim of this study was to evaluate the features of idiopathic granulomatous mastitis (IGM) on breast magnetic resonance imaging (MRI) with mammographic and sonographic findings. Patients and Methods: A retrospective analysis was conducted on 20 patients with IGM who had been diagnosed by needle core or excisional biopsy at a single institution between 2006 and 2012. All of the patients underwent MRI for suspicious breast findings prior to biopsy. MRI examinations were performed on a 1.5 T scanner. The MRI findings were evaluated in accordance with the breast imaging-reporting and data system (BI-RADS) MRI lexicon established by the American College of Radiology. Results: MRI detected a total of 29 lesions in the 20 patients. Fourteen of these lesions were seen as mass enhancements, with the remaining 15 identified as non-mass enhancements (NMEs). The median size of all lesions was 3.6 cm (range, 0.7-6.7 cm). The most frequently observed features were masses with a round shape (9 out of 14, 64%), smooth contour (11 out of 14, 78%), and a rim enhancement pattern (10 out of 14, 71%). The most common features of the 15 NME lesions were segmental distribution (6 out of 15, 40%) and heterogeneous enhancement patterns (8 out of 15, 53%). The time-intensity curves of the dynamic studies showed benign type one signal intensity (persistent enhancement pattern) in the majority of lesions (10 out of 20, 50%). Conclusion: Our study suggests that breast MRI findings of IGM have a wide spectrum. Rim enhancement patterns are frequently seen on contrast enhanced images, but the imaging findings are nonspecific and cannot be used definitively to distinguish between benign and malignant lesions.Öğe A new method for skull stripping in brain MRI using multistable cellular neural networks(Springer London Ltd, 2018) Yilmaz, Burak; Durdu, Akif; Emlik, Ganime DilekThis study proposes a new method on detecting brain region in MRI data. This task is generally named as skull stripping in the literature. The algorithm is developed by using the cellular neural networks (CNNs) and multistable CNN structures. It also includes a contrast enhancement and noise reduction algorithm. The algorithm is named as multistable cellular neural network on MRI for skull stripping (mCNN-MRI-SS). Three different case studies are performed for measuring the success of the algorithm. Also a fourth case study is performed to evaluate the supporting algorithm, the CEULICA. First two evaluations are performed by using well-known MIDAS-NAMIC and Brainweb databases, which are properly organized Talairach-compatible databases. The third database was obtained from the research and application hospital of Necmettin Erbakan University Meram Faculty of Medicine. These MRI data were not Talairach-compatible and less sampled. The algorithm achieved 0.595 Jaccard, 0.744 Dice, 0.0344 TPF and 0.383 TNF mean values with the Brainweb T1-weighted images and 0.837 Jaccard, 0.898 Dice, 0.0124 TPF and 0.1511 TNF mean values with the MIDAS-NAMIC T2-weighted images. The algorithm achieved 0.8297 Jaccard, 0.9012 Dice, 0.0951 TPF and 0.1225 TNF mean values and achieved with the obtained data the best values among the other algorithms. As a result, it can be claimed that algorithm performs best with the non-Talairach-compatible MRI data due to its nature of performing at cellular level.Öğe Primary Neuroendocrine Carcinoma of the Breast: A Report of Three Cases(2014) Aksoy, Faruk; Gündeş, Ebubekir; Vatansev, Celalettin; Çakır, Murat; Toy, Hatice; Emlik, Ganime DilekPrimary neuroendocrine carcinoma of the breast is extremely rare. More than 97% of neuroendocrine tumors occur in the gastrointestinal and respiratory tracts. Three cases that have been operated in our clinic and had a diagnosis of primary neuroendocrine carcinoma of the breast were assessed, along with literature data. Histopathological diagnoses were obtained by preoperative core needle biopsy. Breast-conserving surgery was performed in two cases, and modified radical mastectomy in one. In all cases, immunohistochemical studies were positive for neuron-specific enolase and synaptophysin. All patients received adjuvant chemotherapy (CT) and one patient received additional radiotherapy (RT). Recurrence or distant metastasis was not detected during long-term follow-up after surgery.Öğe A Rare Presentation of Sphingomonas paucimobilis in a Healthy Child: Acute Ischemic Stroke(Georg Thieme Verlag Kg, 2023) Yilmaz, Busra Zeynep; Akcan, Ozge Metin; Pekcan, Sevgi; Parlatan, Havva; Emlik, Ganime Dilek; Dogan, MetinSphingomonas paucimobilis is a rarely pathogenic organism that usually infects immunocompromised patients and causes nosocomial infections, but a few community-acquired infections have been identified in relatively healthy adult patients. Herein we report a 5-year-old child who presented with acute ischemic stroke caused by S. paucimobilis that was treated successfully with antibiotics and antithrombotic agents. According to our knowledge, this is the first case of acute ischemic infarction with S. paucimobilis in a previously healthy child.Öğe SURGICAL TREATMENT OF PHYLLODES TUMORS OF THE BREAST: A SINGLE CENTER EXPERIENCE(Aves, 2013) Aksoy, Faruk; Gundes, Ebubekir; Vatansev, Celalettin; Emlik, Ganime Dilek; Dogan, SerhatObjective: Phyllodes tumor of the breast is a rare fibroepithelial tumor. In this study, our aim is to present the clinicopathological characteristics of our patients diagnosed with phyllodes tumor of the breast and our treatment approach to the cases. Materials and Methods: The medical records of a total of 9 patients who had been treated at our clinic between 2003 and 2011 for phyllodes tumor were analyzed retrospectively. Results: The median age of the patients was 38 (20-70) years. The presenting complaint of all patients was a palpable mass in the breast. Six of the patients were diagnosed by tru-cut biopsy, two were diagnosed through excisional biopsy, and one was diagnosed through fine-needle aspiration biopsy (FNAB). Median tumor size was 9.3 (4-20) cm. Local excision was performed on all but two patients so as to have the surgical border negative and no adjuvant additional treatment was initiated. Mastectomy was performed for one of the two patients and modified radical mastectomy was performed for the other. The follow-up period of the patients was an average of 43 (5-95) months. No breast recurrences were seen during the follow-up period. Conclusion: Pre-operative diagnosis is important for these cases in order to determine the surgical approach. It is difficult to differentiate these tumors from fibroadenoma by ultrasonography and mammography. It is possible to diagnose patients through tissue biopsy. In conclusion, a surgical approach with negative margins for all patients should be taken into consideration since phyllodes tumors are generally benign both clinically and pathologically.Öğe Surgical treatment of phyllodes tumors of the breast: A single center experience(2013) Aksoy, Faruk; Gündeş, Ebubekir; Vatansev, Celalettin; Emlik, Ganime Dilek; Doğan, SerhatAmaç: Memenin fillodes tümörü nadir görülen fibroepitelyal bir tümördür. Bu çalışmada memenin fillodes tümörü tanılı hastalarımızın klinikopatolojik bulgularını ve tedavi yaklaşımımızı sunmayı amaçladık. Yöntem ve Gereçler: Kliniğimizde 2003-2011 yılları arasında memenin fillodes tümörü nedeniyle tedavi gören 9 hastanın tıbbi kayıtları geriye dönük olarak incelendi. Bulgular: Hastaların ortanca yaşı 38 (20-70) yaş olarak saptanmıştır. Hastaların tümünün başvuru şikayeti memede ele gelen kitle idi. Hastalardan altısına kalın-iğne biyopsi, ikisine eksizyonel biyopsi, birine de ince iğne aspirasyon biyopsisi (İİAB) ile tanı konuldu. Ortalama tümör büyüklüğü 9.3 (4-20) cm olarak hesaplandı. İki hasta dışında tüm olgulara cerrahi sınır negatif olacak şekilde lokal eksizyon uygulandı ve adjuvan ek bir tedavi verilmedi. İki hastadan birine mastektomi, diğerine ise modifiye radikal mastektomi işlemi uygulandı. Hastalar ortalama 43 (5-95) ay takip edildi. Takip süresince hastalarda memede nüks saptanmadı. Sonuç: Bu olgularda preoperatif tanı cerrahi yaklaşımı belirlemek açısından önemlidir. Ayırıcı tanıda yapılan ultrasonografi ve mamografi gibi radyolojik tetkiklerde bu tümörleri fibroadenomdan ayırt etmek zordur. Doku biyopsisi ile tanıya gitmek mümkündür. Sonuç olarak, fillodes tümörler genellikle klinik ve patolojik olarak selim olduğundan tüm hastalarda sınır negatif olacak şekilde cerrahi yaklaşım düşünülmelidir.Öğe Symptomatic Solid Ectopic Cervical Thymus in a 2-Month-Old Infant: Case Report(Galenos Yayincilik, 2021) Abakir, Nursultan; Eravci, Fakih Cihat; Emlik, Ganime DilekEctopic cervical thymus (ECT) is a rare pediatric pathology usually with an asymptomatic course. In fewer cases, the patient may present with dyspnea, hoarseness, stridor, dysphagia and pain. The mass may present in cystic or solid forms. Solid forms are rare, constituting only 10% of all ECT cases and these are mostly symptomatic. We aimed to present the case of an infant with ECT in the submandibular region that led to shortness of breath. ECTs in the submandibular region are mostly solid and larger in size, and therefore, likely to result in compressive symptoms. In this case report, we tried to cover the important aspects of the diagnosis of ECT, its treatment, and discussed the results with a literature review. We additionally aimed to emphasize the importance of considering pediatric ECT in the differential diagnosis of pediatric neck mass as well as considering surgical excision to prevent serious consequences.
