Background and Objective: The aim of this study is to evaluate the effectiveness of apparent diffusion coefficient (ADC) values in predicting pathologic subtypes and grade in non-small-cell lung cancer (NSCLC). Materials and Methods: From January 2018 to March 2020, 48 surgically diagnosed NSCLC cases were included in this study. To obtain ADC values, ADC maps were constructed, and a region of interest was put on the tumor. The values were measured three times from different places of the lesion, and the mean value of these measurements was recorded. All MRI scans were evaluated by two radiologists in consensus. Results: A total of 14 cases were squamous cell cancer, 32 cases were adenocarcinoma, and 2 cases were large cell carcinoma. The mean ADC values of adenocarcinoma, squamous cell carcinoma, and large cell cancer were 1.51 ± 0.19 × 10⁻³ mm²/s, 1.32 ± 0.15 × 10⁻³ mm²/s, and 1.39 ± 0.25 × 10⁻³ mm²/s, respectively. There were 11 grade 1, 27 grade 2, and 10 grade 3 NSCLC cases. The mean ADC value was 1.44 ± 0.14 × 10⁻³ mm²/s in grade 1 tumors, 1.25 ± 0.10 × 10⁻³ mm²/s in grade 2 tumors, and 1.07 ± 0.15 × 10⁻³ mm²/s in grade 3 tumors. The cut-off value to discriminate grade 2 from grade 1 tumors was 1.31 ± 0.11 × 10⁻³ mm²/s (85% sensitivity, 75% specificity). The cut-off value to discriminate grade 3 from grade 2 tumors was 1.11 ± 0.15 × 10⁻³ mm²/s (87% sensitivity, 69% specificity). Conclusions: ADC values can accurately predict NSCLC histopathologic subtypes and tumor grade.

ObjectivesTo evaluate success, complications and efficacy for endovascular management for carotid blowout syndrome.MethodsImages were evaluated for contrast extravasation, vessel wall irregularity, pseudoaneurysm/aneurysm formation. Hemostatic results in the immediate postprocedural period and procedure related infarcts were assessed.ResultsTotal of 20 lesions in 21 patients were detected on digital subtraction angiography (DSA). In a case of esthesioneuroblastoma with active bleeding, DSA failed to show vascular abnormality. There was active contrast extravasation in 7 cases. Treatment modalities included covered stent placement (n = 3), pseudoaneurysm/aneurysm embolization (n = 4), parent artery occlusion (n = 13) and PVA injection (n = 1) in the immediate postoperative period was achieved in all except one case. During the post-procedural period, 6 patients (28.6%) suffered from cerebral ischemia. Rebleeding episodes were encountered in 10 cases (47.6%) after a mean duration of 35 days which responded to tamponade in 4 cases. Diagnostic DSA was performed in 5 of the cases, which failed to identify bleeding source in 2 and remaining 3 cases were treated by endovascular means. A case with massive hemorrhage 1-hour after endovascular treatment died before any intervention could be performed.ConclusionEndovascular treatment can achieve immediate hemostasis to prevent otherwise a highly morbid and mortal complication. However, rebleeding rates are high and cerebral ischemia with or without neurologic deficit occur in a non-negligible percentage of patients.

Bu çalışmada amacımız koronovirüs hastalığı-2019 (COVID-19) pnömoni sonrası kısa dönemde oluşan akciğer bulgularını bilgisayarlı tomografi (BT) ile değerlendirmektir. Mart 2019 – Aralık 2021 tarihleri arasında hastanemize başvuran, COVID-19 enfeksiyonu nedeniyle tedavi edilen ve kontrol görüntülemesi yapılan olgular retrospektif olarak incelendi. Hastaların yaş, cinsiyet, altta yatan komorbidite, pnömoni şiddeti, semptom başlangıç zamanı, hastane yatışı ve yatış süresi bilgileri kaydedildi. Hastaların tanı anında ve ortalama 3 ay sonra çekilen toraks BT görüntüleri değerlendirildi. BT şiddet skorlaması her bir akciğer lobuna 0-5 aralığında puan verilerek 0-25 arasında puanlandı. Tek değişkenli ve çok değişkenli logistic regresiyon analizi ile akciğerde persisten anormallik oluşumu için risk faktörleri araştırıldı. Toplamda 62 hasta (33 erkek, 29 kadın; ortalama yaş 55,2±13,2; yaş aralığı 31-80) çalışmaya dahil edildi. Hastalar total rezolüsyon (27/62; %44) ve rezidü (35/62; %56) grubu olarak ikiye ayrıldı. Rezidü grubunda kontrol BT’de en sık görülen bulgular buzlu cam opasitesi (25/35; %71) ardından parankimal bant (24/35; %69) idi. Retikülasyon (4/35; %11) ve plevral kalınlaşma (14/35; %40) sadece kontrol BT’de görülen bulgulardı. Volüm kaybı hem tanı BT’de (4/35; %11) hem de kontrol BT’de (8/35; %23) görüldü (p=0,344). İleri yaşın (>50 yaş) (OR:23,447 p=0,03) rezidüel akciğer bulgularının oluşmasında bağımsız risk faktörü olduğu saptandı. Post-COVID 3. Ayda kısa dönemde toraks BT’de persistan anormallik oluşma riski ileri yaşta (>50 yaş) yüksektir. Persistan toraks BT bulgularının ne kadarının gerçek fibrozisi yansıttığı uzun dönem takip sonucu ortaya konabilir.

Underlying Malignancy in Patients Initially Diagnosed with Organizing Pneumonia on CT-Guided Lung Biopsy: When Should Repeat Biopsy be Considered? - Advanced Radiology and Imaging