Researcher:
Atasoy, Kayhan Çetin

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Kayhan Çetin

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Atasoy

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Atasoy, Kayhan Çetin

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2019 - 201912020 - 20227

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    Scrape cytology and radiological solid size correlation can be used in the intraoperative management of subsolid lung nodules
    (Wiley) N/A; N/A; N/A; N/A; N/A; N/A; Bulutay, Pınar; Atasoy, Kayhan Çetin; Erus, Suat; Tanju, Serhan; Dilege, Şükrü; Fırat, Pınar Arıkan; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 133565; 189220; 175565; 214690; 122573; 207545
    Background: The term radiologic subsolid lung nodule (SLN) represents a heterogeneous group of non-neoplastic and neoplastic lesions. Intraoperative evaluation (IO) is often required to differentiate and diagnose. The current study aims to investigate the feasibility and reliability of scrape cytology (SC) and radiologic solid size correlation for the IO diagnosis of SLNs.Methods: Sixty-eight patients with SLN signs were eligible to take part in the study due to intraoperatively prepared SC slides. We managed to complete the blind radio logic solid size measurement and cytologic evaluation retrospectively. Cases were grouped into three categories based on their cytological features: Group-0 (Benign), Group-1 (mild atypical features), and Group-2 (severe atypical features/unequivocally carcinoma). IO diagnoses were given by combining the radiologic solid size and cytological findings.Results: Cytological features of Group-1 were observed in 100%, 93%, 32.5%, and 17% of the AIS, MIA, IA, and benign lesions, respectively. Cytological features of Group-2 were observed in 67.5%, and 7% of the IA and MIA, respectively. By combining cytology with radiologic solid size, 100%, 85%, 71%, and 83% of the AIS, IA, MIA, and benign lesions respectively were diagnosed correctly. Fifteen (15%) percent of the IA cases were underdiagnosed as MIA since their radiological solid sizes were less than 0.5 cm with cytological features of Group-1. Conversely, 29% of the MIA cases were overdiagnosed as IA since their radiological solid sizes were greater than 0.5 cm. Conclusion: SLNs should be handled with caution in terms of IO management. SC and radiologic solid size correlation both provide a practical and tissue-protecting approach for the IO evaluation of SLNs, ensuring a high consistency between IO and definitive diagnosis.
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    Biphasic split-bolus injection protocol for routine contrast-enhanced chest CT: comparison with conventional early-phase single bolus technique
    (British Institute of Radiology, 2022) Kul, Melahat; Öz, Diğdem Kuru; Coruh, Ayşegül Gürsoy; Ateş, Funda Özalp; Gülpinar, Başak; Uzun, Çağlar; N/A; Atasoy, Kayhan Çetin; Faculty Member; School of Medicine; 189220
    Objectives: To present a routine contrast-enhanced chest CT protocol with a split-bolus injection technique achieving combined early- and delayed phase images with a single aquisition, and to compare this technique with a conventional early-phase single-bolus chest CT protocol we formerly used at our institution, in terms of attenuation of great thoracic vessels, pleura, included hepatic and portal venous enhancement, contrast-related artifacts, and image quality. Methods: A total of 202 patients, who underwent routine contrast-enhanced chest CT examination aquired with either conventional early-phase single-bolus technique (group A,n = 102) or biphasic split-bolus protocol (group B,n = 100), were retrospectively included. Attenuation measurements were made by two radiologists independently on mediastinal window settings using a circular ROI at the following sites: main pulmonary artery (PA) at its bifurcation level, thoracal aorta (TA) at the level of MPA bifurcation,portal vein (PV) at porta hepatis, left and right hepatic lobe, and if present, thickened pleura (>2 mm) at the level with the most intense enhancement. Respective normalized enhancement values were also calculated. Contrast-related artifacts were graded and qualitative evaluation of mediastinal lymph nodes was performed by both reviewers independently. Background noise was measured and contrast-to-noise ratios (CNRs) of the liver and TA were calculated. Results: While enhancement of thoracic vessels and normalised MPA enhancement did not differ significantly between both groups (p > 0.05), enhancement and normalised enhancement of pleura, liver parenchyma and PV was significantly greater in group B (p < 0.001). Perivenous artifacts limiting evaluation were less frequent in group B than in A and mediastinal lymph nodes were judged to be evaluated worse in group A than in group B with an excellent agreement between both observers. No significant difference was detected in CNRTA (p = 0.633), whereas CNR liver was higher in group B (p < 0.001). Conclusion: Our split-bolus chest CT injection protocol enables simultaneous enhancement for both vascular structures and soft tissues, and thus, might raise diagnostic confidence without the need of multiple acquisitions. Advances in knowledge: We think that this CT protocol might also be a promising alternative in lung cancer staging, where combined contrast-enhanced CT of the chest and abdomen is indicated. We therefore suggest to further evaluate its diagnostic utility in this setting, in particular in comparison with a late delayed chest-upper abdominal CT imaging protocol. © 2022 The Authors.
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    Is it possible to discriminate pulmonary carcinoids from hamartomas based on CT features?
    (Elsevier Science Inc, 2020) Coruh, Aysegul Gursoy; Kul, Melahat; Oz, Digdem Kuru; Yenigun, Bulent; Ersoz, Cevriye Cansiz; Ates, Funda Ozalp; N/A; Atasoy, Kayhan Çetin; Faculty Member; School of Medicine; Koç University Hospital; 189220
    Purpose: The purpose of this study was to determine whether the computed tomography (CT) features might be used in distinguishing pulmonary carcinoids from hamartomas. Materials and methods: Ninety solid pulmonary nodules (43 carcinoids and 47 hamartomas) in 90 patients were evaluated. The following CT scan features were evaluated: size, location (peripheral/central), contour (lobulated/nodular), number of lobulation, attenuation, calcification, endobronchial status, bronchial extension and involvement, parenchymal abnormalities distal to the lesion e.g. hyperlucency, atelectasis, and nodularity. The final pathologic diagnosis of the lesions and bronchial extension were confirmed by review of histopathological specimens. Results: Out of 43 carcinoids, 37 (86%) were typical. Twenty-three carcinoids and four hamartomas were central (p < 0.001). Ten carcinoids and one hamartoma were endobronchial. The majority of tumors had lobulated contours (65% of carcinoids, 44% of hamartomas) and carcinoids tended to have more lobulations (p = 0.052). Distal nodularity (p = 0.001), distal hyperlucency (p < 0.001), and atelectasis (p = 0.005) were significantly more common in carcinoids. Carcinoids had significantly more bronchial extension and involvement (p < 0.001; respectively). In addition, a new sign that we call "bronchial triangle sign" differentiated carcinoids with a sensitivity and specificity of 84.9% (95% CI: 69,1%-93.4%) and 91% (95% CI: 79.7%-96.6%). Conclusion: To the best of our knowledge this is the first study on discrimination of carcinoids and hamartomas. A new CT sign called "bronchial triangle sign" might be used to differentiate carcinoids from hamartomas. Distal parenchymal abnormalities are more common in carcinoids than in hamartomas.
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    Correlation of computed tomography findings with histopathology in small lung adenocancer
    (Ankara Üniversitesi Tıp Fakültesi, 2019) Kul, Melahat; N/A; Atasoy, Kayhan Çetin; Faculty Member; School of Medicine; 189220
    Objectives: To analyse the correlation between computed tomography (CT) features and histopathological findings of small lung adenocancers using the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification of Lung Adenocancer. Materials and Methods: A retrospective review of 34 nodules (size ≤2 cm) representing lung adenocancer was performed. Besides their attenuation type (solid, mixed, pure ground glass), tumours were defined as air-containing type if their vanishing ratio was ≥%50 and as solid-density type if the vanishing ratio was<%50 The correlation between CT findings (size, air bronchogram, intranodular lucencies, spiculation, lobulation, notches, pleural retraction and thickening, thickening of bronchovascular bundle) and pathological results was investigated. Tumours representing adenocancer in situ (AIS) and minimally invasive adenocancer (MIA) were investigated in one group as non-/minimally invasive adenocancer (NMIA). Results: of the 34 nodules 23 (67.7%) were invasive adenocancer, nine (26.4%) were AIS, and two (5.9%) were MIA. Lesions diagnosed as invasive adenocancer were more often of solid-density type (19, 82.6%), and solid (13, 56.5%) or mixed nodules (10, 43.5%) whereas NMIA group lesions were more often of air-containing type (9, %81.8), and pure ground-glass (3, 27.3%) or mixed nodules (7, 63.6%) with a statistically significant difference between invasive adenocancer and NMIA group (p≤0.05). Furthermore, invasive adenocancer nodules had a larger maximum diameter (15.09±3.32 mm) than NMIA nodules (12.28±3.23 mm) (p=0.031). Thickening of bronchovascular bundle was another CT finding that was significantly more common in invasive adenocancer (p=0.024). The other CT findings showed also a higher frequency in invasive adenocancer compared to NMIA group except for intranodular lucency which was observed in both pathological groups equally. But this difference in frequency was not statistically significant (p>0.05). Conclusion: Invasive adenocancer and NMIA lesions can be differentiated by their CT features. But greater study populations are needed for further confirmation. / Öz: Amaç: Bu çalışmada küçük akciğer adenokanserlerinin bilgisayarlı tomografi (BT) bulguları ile histopatolojik bulguları, Uluslararası Akciğer Kanserini Araştırma Derneği, Amerikan Toraks Derneği ve Avrupa Solunum Derneği’nin sınıflaması esas alınarak karşılaştırılmıştır. Gereç ve Yöntem: Akciğer adenokanser tanısı alan 34 nodül (≤2 cm) retrospektif olarak tarandı. Attenüasyon tiplerinin (solid, mikst, saf buzlu cam) yanı sıra, kaybolma oranları ≥%50 olan tümörler hava-içerikli tip, kaybolma oranları
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    PublicationOpen Access
    Changes in computed tomography findings of COVID-19 pneumonia: less extensive lung involvement with decreasing disease prevalence
    (Wiley, 2020) Gümüş, Terman; Cengiz, Duygu; Kartal, Furkan; Atçeken, Zeynep; Tekin, Süda; Atasoy, Kayhan Çetin; Doctor; Faculty Member; School of Medicine
    It has been observed that the degree of pulmonary involvement shown in chest computed tomography (CT) scans tended to decrease as the prevalence of coronavirus disease 2019 (COVID-19) infection decreased in the Turkish population. The purpose of this study was to investigate the relationship between the disease severity based on chest CT scans and the temporal evolution of the epidemic. This study recruited 179 patients with confirmed COVID-19 disease who had received a chest CT scan between March 14 and April 28, 2020. The participants were divided into three successive temporal groups based on their date of CT examination. The early (March 14-29), mid (March 30-April 13), and late (April 14-28) groups were compared regarding the presence and extent of pulmonary involvement and CT characteristics of lesions. COVID-19 pneumonia was less extensive in participants under 45 years of age and patients presenting late in the course of epidemic (i.e., the late group) compared those presenting earlier. When each group was subcategorized on the basis of age, older patients in the late group had less extensive lung involvement than older patients in the early group. However, there was no significant difference in the extent of lung involvement in younger patients between the late and early groups. The severity of COVID-19 pneumonia appears to be variable at different temporal windows of the epidemic curve and decreases in patients presenting in the later weeks compared to the earlier weeks, particularly in older patients.
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    PublicationOpen Access
    Preoperative computerized tomography screening for COVID-19 pneumonia in asymptomatic patients: experiences from two centers
    (Springer, 2020) Kabaoğlu, Zeynep Ünal; Coşkun, Bilgen; Artukoğlu, Feyzi; Gümüş, Terman; Kartal, Furkan; Atasoy, Kayhan Çetin; Faculty Member; School of Medicine; Koç University Hospital
    Purpose: the aim of this retrospective study is to evaluate the preoperative screening performance of chest CT (computerized tomography) examination to detect COVID-19 positive individuals. Materials and methods: in this retrospective study 218 adult patients who had preoperative chest CT and RT-PCR were enrolled. CT imaging results, which have been reported according to the Radiological Society of North America expert consensus on COVID-19, were collected from the picture archiving and communicating system. Demographic data, planned surgeries, and postoperative outcomes were collected from the electronic patient records. Results: one patient (0.5%) showed typical CT features for COVID-19 pneumonia; 12 patients (5.5%) were reported as indeterminate, and eight (3.7%) were reported as atypical for COVID-19 pneumonia. Only one of the three patients with positive RT-PCR had abnormalities on CT. When RT-PCR tests were taken as reference, the sensitivity, specificity, and accuracy of chest CT in showing COVID-19 infection in asymptomatic patients were 33.3%, 90.7%, and 90.0%, respectively. Conclusion: chest CT screening for COVID-19 has a very low yield in asymptomatic preoperative patients and shows false-positive findings in 9.2% of cases, potentially leading to unnecessary postponing of the surgery.
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    PublicationOpen Access
    Effect of high-risk Obstructive sleep apnea on clinical outcomes in adults with Coronavirus Disease 2019: a multicenter, prospective, observational cohort study
    (American Thoracic Society (ATS), 2021) Işık, Sacide Rana; Balcan, Baran; Çetin, Betül; OSACOVID-19 Study Collaborators; Ertuğ, Elif; Peker, Yüksel; Çelik, Yeliz; Arbatlı, Semih; Baygül, Arzu Eden; Yazıcı, Duygu; Bayram, Hasan; Karataş, Ferhan; Uzel, Fatma Işıl; İliaz, Sinem; Tabak, Levent; Öztürk, Ayşe Bilge; Atasoy, Kayhan Çetin; Kapmaz, Mahir; Durmaz Çetin, Birsen; Çağlayan, Benan Niku; Faculty Member; Researcher; PhD Student; PhD Student; Faculty Member; Doctor; Doctor; Doctor; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; Graduate School of Health Sciences; Koç University Hospital; 234103; N/A; N/A; 272290; N/A; 4890; N/A; N/A; 168584; N/A; 147629; N/A; N/A; 111719; 230719
    Rationale: obstructive sleep apnea (OSA) may contribute to poor outcomes in adults with Coronavirus Disease 2019 (COVID-19). Objective: to determine the effect of OSA on clinical outcomes in patients with COVID-19. Methods: the current prospective observational study was conducted in three hospitals in Istanbul, Turkey from March 10 to June 22, 2020. The participants were categorized as modified high-risk (mHR), or low-risk (mLR)-OSA according to a modified version of the Berlin questionnaire. Snoring patterns (intensity and/or frequency), breathing pauses and morning/daytime sleepiness, without taking obesity and hypertension into account, were used in the regression models. Results: the primary outcome was clinical improvement defined as a decline of 2 categories from admission on a 7-category ordinal scale. Secondary outcomes included worsening (increase of 1 category), need for hospitalization, supplemental oxygen and intensive care. In total, 320 eligible patients were enrolled. According to the modified scoring, 70 (21.9%) had mHR-OSA. Among 242 patients requiring hospitalization, clinical improvement within 2 weeks occurred in 75.4 % of the mHR-OSA group compared to 88.4 % of the modified low-risk (mLR-OSA) group (P = 0.014). In multivariate regression analyses, mHR-OSA (adjusted OR 0.42; 95% CI 0.19-0.92) predicted the delayed clinical improvement. In the entire study population (n=320), mHR-OSA was associated with clinical worsening and need for supplemental oxygen. Snoring patterns, especially louder snoring, were significantly predicted delayed clinical improvement, worsening, need for hospitalization, supplemental oxygen, and intensive care. Conclusions: adults with mHR-OSA in our Covid-19 cohort had poorer clinical outcomes than those with mLR OSA independent of age, sex and comorbidities.
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    PublicationOpen Access
    Deep COVID DeteCT: an international experience on COVID-19 lung detection and prognosis using chest CT
    (Nature Publishing Group (NPG), 2021) Lee, Edward H.; Zheng, Jimmy; Colak, Errol; Mohammadzadeh, Maryam; Houshmand, Golnaz; Bevins, Nicholas; Kitamura, Felipe; Reis, Eduardo Pontes; Kim, Jae-Kwang; Klochko, Chad; Han, Michelle; Moradian, Sadegh; Mohammadzadeh, Ali; Sharifian, Hashem; Hashemi, Hassan; Firouznia, Kavous; Ghanaati, Hossien; Gity, Masoumeh; Salehinejad, Hojjat; Alves, Henrique; Seekins, Jayne; Abdala, Nitamar; Pouraliakbar, Hamidreza; Maleki, Majid; Wong, S. Simon; Yeom, Kristen W.; Altınmakas, Emre; Doğan, Hakan; Atasoy, Kayhan Çetin; Other; Researcher; Faculty Member; School of Medicine; N/A; 327614; N/A
    The Coronavirus disease 2019 (COVID-19) presents open questions in how we clinically diagnose and assess disease course. Recently, chest computed tomography (CT) has shown utility for COVID-19 diagnosis. In this study, we developed Deep COVID DeteCT (DCD), a deep learning convolutional neural network (CNN) that uses the entire chest CT volume to automatically predict COVID-19 (COVID+) from non-COVID-19 (COVID-) pneumonia and normal controls. We discuss training strategies and differences in performance across 13 international institutions and 8 countries. The inclusion of non-China sites in training significantly improved classification performance with area under the curve (AUCs) and accuracies above 0.8 on most test sites. Furthermore, using available follow-up scans, we investigate methods to track patient disease course and predict prognosis.
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    PublicationOpen Access
    Radiological approach to COVID-19 pneumonia with an emphasis on chest CT
    (Aves, 2020) Güneyli, Serkan; Atçeken, Zeynep; Doğan, Hakan; Altınmakas, Emre; Atasoy, Kayhan Çetin; Doctor; Researcher; Other; Faculty Member; School of Medicine
    Coronavirus disease 2019 (COVID-19) has recently become a worldwide outbreak with several millions of people infected and more than 160.000 deaths. A fast and accurate diagnosis in this outbreak is critical to isolate and treat patients. Radiology plays an important role in the diagnosis and management of the patients. Among various imaging modalities, chest CT has received attention with its higher sensitivity and specificity rates. Shortcomings of the real-time reverse transcriptase-polymerase chain reaction test, including inappropriate sample collection and analysis methods, initial false negative results, and limited availability has led to widespread use of chest CT in the diagnostic algorithm. This review summarizes the role of radiology in COVID-19 pneumonia, diagnostic accuracy of imaging, and chest CT findings of the disease.