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TOKDEMİR, SEVİL

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SEVİL
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TOKDEMİR
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    PublicationOpen Access
    Use of cement combined grafting in upper and lower extremity benign bone tumors
    (2020-01-01T00:00:00Z) Pulatkan, Anil; Ucan, Vandet; TOKDEMİR, SEVİL; ELMALI, NURZAT; GÜRKAN, Volkan; UÇAN, VAHDET; TOKDEMİR, SEVİL; ELMALI, NURZAT; GÜRKAN, VOLKAN
    Objectives: This study aims to investigate the effectivity of cement combined demineralized bone matrix (DBM) treatment on new bone formation in the cortical window as well as to evaluate the effect of new bone formation on functional outcomes. Patients and methods: Thirty-two benign bone tumor patients (15 males, 17 females; median age 38 years; range, 12 to 68 years), who were treated with cement combined DBM between February 2010 and December 2014, were evaluated retrospectively. Patient characteristics were recorded as age, gender, tumor localization, histological diagnosis, Enneking stage, tumor size, size of the cortical window, usage of prophylactic fixation, time to return to work, Musculoskeletal Tumor Society (MSTS) functional score, tumor relapse, and new bone formation on the cortical window in the computed tomography scans after one year of surgery. Results: Median tumor volume was 17.2 cm 3 (range, 2.8 to 139.6 cm 3 ), median area of the cortical window was 8.3 cm 2 (range, 1.6 to 28.4 cm 2 ), and median postoperative one-year MSTS score was 84.5 (range, 66 to 97). MSTS scores were significantly worse with the usage of prophylactic fixation (p<0.001). There was a statistically significant difference between the usage of prophylactic fixation and cortical window size (p=0.013). There was a low-level negative correlation in terms of age and bone formation on the cortical window (p=0.046, r= -0.356) and mid -level negative correlation between cortical window size and functional scores (p=0.001, r= -0.577). Conclusion: Application of cement combined with DBM procedure is an effective, alternative, and biological treatment in bone tumors that provides immediate stability and stimulates new bone formation on the cortical window.
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    PublicationOpen Access
    Multiparametric MRI Features and Pathologic Outcome of Wedge-Shaped Lesions in the Peripheral Zone on T2-Weighted Images of the Prostate
    (2019-01-01T00:00:00Z) Chatterjee, Aritrick; TOKDEMİR, SEVİL; Gallan, Alexander J.; Yousuf, Ambereen; Antic, Tatjana; Karczmar, Gregory S.; Oto, Aytekin; TOKDEMİR, SEVİL
    OBJECTIVE. This study investigates the multiparametric MRI (mpMRI) characteristics and pathologic outcome of wedge-shaped lesions observed on T2-weighted images. MATERIALS AND METHODS. Seventy-six patients with histologically confirmed prostate cancer underwent preoperative 3-T MRI before undergoing radical prostatectomy. Two radiologists worked in consensus to mark wedge-shaped regions of hypointensity on T2-weighted images and assess their appearance on apparent diffusion coefficient (ADC) maps (to determine the degree of hypointensity) and dynamic contrast-enhanced (DCE) MRI (DCE-MRI) (to assess whether they showed early enhancement). The pathologic outcome of wedge-shaped lesions was assessed by matching MR images with whole-mount histologic specimens retrospectively. The difference in quantitative ADC values between malignant and benign wedge-shaped lesions was assessed using a t test. RESULTS. Thirty-five wedge-shaped regions were identified, 12 (34%) of which were found be malignant. Most malignant wedge-shaped regions were highly hypointense (10/12; 83%) on ADC maps and showed early enhancement on DCE-MRI (7/12; 58%). However, benign wedge-shaped lesions were predominantly mildly hypointense (13/23; 57%) on ADC maps and showed no early enhancement (15/23; 65%). Histologic correlates of the benign wedge-shaped regions showed prostatitis (acute inflammation [7/23; 30%] or chronic inflammation [9/23; 39%]), hemosiderin-laden macrophages (6/23; 26%), prominent blood vessels (7/23; 30%), intraluminal blood (6/23; 26%), and nonspecific atrophy (6/23; 26%). The mean (± SD) quantitative ADC value of malignant wedge-shaped regions (1.13 ± 0.11 μm2/ms) was significantly lower (p = 0.0001) than that of benign wedge-shaped regions (1.52 ± 0.27 μm2/ms). CONCLUSION. This study shows that a greater percentage of wedge-shaped features are malignant than was previously thought. Of importance, mpMRI (specifically, ADC maps) can distinguish between malignant and benign wedge-shaped features.