Background/Aims: Hepatocellular carcinoma (HCC) is a prevalent cancer that significantly contributes to mortality globally, primarily due to its late diagnosis. Early detection is crucial yet challenging. This study leverages the potential of deep learning (DL) technologies, employing the You Only Look Once (YOLO) architecture, to enhance the detection of HCC in computed tomography (CT) images, aiming to improve early diagnosis and thereby patient outcomes. Materials and methods: We used a dataset of 1290 CT images from 122 patients, segmented according to a standard 70:20:10 split for training, validation, and testing phases. The YOLO-based DL model was trained on these images, with subsequent phases for validation and testing to assess the model’s diagnostic capabilities comprehensively. Results: The model exhibited exceptional diagnostic accuracy, with a precision of 0.97216, recall of 0.919, and an overall accuracy of 95.35%, significantly surpassing traditional diagnostic approaches. It achieved a specificity of 95.83% and a sensitivity of 94.74%, evidencing its effectiveness in clinical settings and its potential to reduce the rate of missed diagnoses and unnecessary interventions. Conclusion: The implementation of the YOLO architecture for detecting HCC in CT scans has shown substantial promise, indicating that DL models could soon become a standard tool in oncological diagnostics. As artificial intelligence technology continues to evolve, its integration into healthcare systems is expected to advance the accuracy and efficiency of diagnostics in oncology, enhancing early detection and treatment strategies and potentially improving patient survival rates. Cite this article as: Şahin E, O, Tatar C, et al. Diagnostic performance of deep learning applications in hepatocellular carcinoma detection using computed tomography imaging. Turk J Gastroenterol. 2025;36(2):124-130.

BACKGROUND: Fournier gangrene (FG) is a rapidly progressive soft-tissue necrosis that may be life-threating unless aggressive treatment is applied immediately. FG severity index was described first by Laor et al. to predict mortality rate but there are few studies on the prognostic significance of FG severity index and especially the microbial agents isolated from debridement on patient prognosis. Hence, in the present study, it has been aimed to investigate the significance of FG severity index and infective agents on hospital stay, frequency of debridement, and mortality. METHODS: Thirty-four patients who were operated with the diagnosis of FG between January 2013 and January 2018 were retrospectively analyzed. FG severity index scores in admission were calculated and patient was divided into two groups according to the cutoff value of FG severity index. Patient was categorized according to the microbial agents isolated from debridement cultures. Patient characteristics were compared between the group of survivors and non-survivors. The effect of FG severity index and microbial agent type on hospital stay, frequency of debridement, and mortality was analyzed. RESULTS: It was found that mortality rate was significantly higher in the group of FG severity index score >9 than the other group (100% vs. 6.7%; p=0.001>) and it was observed that FG severity index had predicted the mortality rate as 100% and survival rate as 93.3% but there were no significant relation between FG severity index with the frequency of debridement and hospital stay. The mortality rate (50% vs. 4.2%; p=0.005) and frequency of debridement (3.10 +/- 0.73 vs. 2.00 +/- 0.72; p=0.001) were significantly higher in the subgroup of patient infected with clostridial and atypical agents. CONCLUSION: FG severity index was found to be insufficient in determining the frequency of debridement and the hospital stay but it accurately predicts the rates of mortality and survival. The patients who were infected with clostridial and atypical agents are more likely to develop mortality and tend to be need more aggressive surgical interventions than the others.

BACKGROUND: This study presents the diagnosis and treatment of rare small bowel tumors through clinical cases. METHODS: Patients treated between 2000 and 2023 were included in the study. The clinical records of the patients were analyzed retrospectively. RESULTS: A total of 34 patients were included in the study. Of these patients, 26 (75.5%) were male and eight (23.5%) were female. The mean age of the patients was 62.1 years. The most common symptoms and signs were abdominal pain (76.4%), bloating (38.2%), and nausea and vomiting (17.6%). Diagnostic methods included computed tomography (CT) (82.3%), upper gastrointestinal double balloon enteroscopy (35.2%), and capsule endoscopy (5.8%). Diagnoses included adenocarcinoma in 13 cases, gastrointestinal stromal tumors (GISTs) in 12 cases, and neuroendocrine tumors (NETs) in two cases. CONCLUSION: Small bowel tumors frequently present with abdominal pain, bloating, and nausea and vomiting. CT and endoscopic procedures are the primary diagnostic tools. Small bowel cancers are often diagnosed late due to subtle clinical findings and the limitations of endoscopic imaging. Targeted screening strategies may be beneficial for certain at -risk and symptomatic patient groups. Early surgical intervention offers significant advantages for diagnosed patients.

Dünya genelinde ciddi bir sağlık sorunu olan obezitenin en etkin tedavisi olarak cerrahi işlemler uygulanmaktadır. Sleeve gastrektomi en sık uygulanan obezite cerrahisi tekniğidir. Obez bireylerde kanser riskinin arttığına dair görüşler mevcuttur. Ancak obezite cerrahisi sonrası da mide kanseri gelişen bazı olgular bildirilmiştir. Morbid obezite tanısı ile sleeve gastrektomi uygulanan bir hastanın ameliyatından 8 ay sonra dispeptik şikayetleri gelişmeye başlamıştır. Tetkikler neticesinde striktür tanısı konulan hastaya gastrik bypass revizyon cerrahisi uygulanmıştır. Hastanın bu operasyonundan sonra da şikayetlerinin devam etmesi üzerine yapılan detaylı incelemede hastaya mide adenokarsinomu tanısı konulmuştur ve hastaya total gastrektomi ameliyatı yapılmıştır. Obezite ciddi bir sağlık problemi olmasının yanında beraberinde birçok hastalık içinde risk faktörü olarak değerlendirilmektedir. Obez bireylerde kanser riskinin arttığı yönünde literatürde ciddi çalışmalar mevcuttur. Ancak obezite cerrahisi sonrasında kanser riskinin arttığına yönelik bazı çalışmalar mevcut olsa da henüz genel bir kanı oluşmamıştır. Ancak kanser riski artmış olan obez bireylerde cerrahi tedavi öncesinde kanser taraması amacıyla kontrol endoskopi yapılması ciddi şekilde önerilmektedir.