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JOURNAL OF BACK AND MUSCULOSKELETAL REHABILITATION
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Background: Ischiofemoral impingement syndrome (IFI) is a condition characterized by narrowing of the space between the ischium and femur, potentially compressing the quadratus femoris muscle. Although associated with hip pain, its role in groin pain is underexplored. Objective To assess the relationship between IFI and groin pain and examine the association between quadratus femoris muscle edema and ischiofemoral space (IFS) and quadratus femoris space (QFS) measurements. Methods: A retrospective study was performed on 568 hips from 284 patients who underwent pelvic MRI between January and September 2024. Patients were grouped based on groin pain. IFS and QFS were measured on T1-weighted axial MRI images, and quadratus femoris muscle edema was evaluated on T2-weighted fat-suppressed axial images. Statistical analysis included the Independent Samples t-test, Pearson Chi-square test, and ROC analysis, with significance set at p < 0.005. Results: Groin pain was present in 23 of 568 hips (4%), with quadratus femoris muscle edema detected in 19 of these cases (82.6%, p < 0.001). Quadratus femoris edema was found in 116 of the 568 hips (20.4%). IFS and QFS measurements were significantly lower in patients with quadratus femoris edema. ROC analysis revealed an IFS cut-off of 16 mm (86.5% sensitivity, 80.3% specificity) and a QFS cut-off of 9.5 mm (92% sensitivity, 93.2% specificity). Conclusions: IFI should be considered in the differential diagnosis of unexplained groin pain, as smaller IFS and QFS are linked to quadratus femoris muscle edema.
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magnetic resonance imaging musculoskeletal pain radiology
ChatGPT-4o's Performance in Brain Tumor Diagnosis and MRI Findings: A Comparative Analysis with Radiologists
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Ozenbas, C (Ozenbas, Cemre) ; Engin, D (Engin, Duygu) ; Altinok, T (Altinok, Tayfun) ; Akcay, E (Akcay, Emrah) ; Aktas, U (Aktas, Ulas) ; Tabanli, A (Tabanli, Alper)
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ACADEMIC RADIOLOGY
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Rationale and objectives: To evaluate the accuracy of ChatGPT-4o in identifying magnetic resonance imaging (MRI) findings and diagnosing brain tumors by comparing its performance with that of experienced radiologists. Materials and methods: This retrospective study included 46 patients with pathologically confirmed brain tumors who underwent preoperative MRI between January 2021 and October 2024. Two experienced radiologists and ChatGPT 4o independently evaluated the anonymized MRI images. Eight questions focusing on MRI sequences, lesion characteristics, and diagnoses were answered. ChatGPT-4o's responses were compared to those of the radiologists and the pathology outcomes. Statistical analyses were performed, which included accuracy, sensitivity, specificity, and the McNemar test, with p<0.05 considered to indicate a statistically significant difference. Results: ChatGPT-4o successfully identified 44 of the 46 (95.7%) lesions; it achieved 88.3% accuracy in identifying MRI sequences, 81% in perilesional edema, 79.5% in signal characteristics, and 82.2% in contrast enhancement. However, its accuracy in localizing lesions was 53.6% and that in distinguishing extra-axial from intra-axial lesions was 26.3%. As such, ChatGPT-4o achieved success rates of 56.8% and 29.5% for differential diagnoses and most likely diagnoses when compared to 93.2-90.9% and 70.5-65.9% for radiologists, respectively (p<0.005). Conclusion: ChatGPT-4o demonstrated high accuracy in identifying certain MRI features but underperformed in diagnostic tasks in comparison with the radiologists. Despite its current limitations, future updates and advancements have the potential to enable large language models to facilitate diagnosis and offer a reliable second opinion to radiologists.
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Artificial intelligence ChatGPT-4oBrain tumor MRI
The role of MRS in the differentiation of benign and malignant soft tissue and bone tumors
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Doganay, S (Doganay, Selim) ; Altinok, T (Altinok, Tayfun) ; Alkan, A (Alkan, Alpay) ; Kahraman, B (Kahraman, Bayram) ; Karakas, HM (Karakas, Hakki Muammer)
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EUROPEAN JOURNAL OF RADIOLOGY
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Objective: The aim of our study was to investigate the value of choline in the discrimination of benign and malignant soft tissue and bone tumors.
Materials and methods: The study group consisted of thirty subjects with bone or soft tissue tumors larger than 1.5 cm in diameter. The experiments were performed in a 1.5 T MR scanner. Coils were selected according to specific locations. A single-voxel MRS was performed for three different TE (time to echo) (31, 136, 272 ms). The volume of interest was positioned on the brightest enhancement. The presence of a cholin peak on at least 2 of these spectrums was considered as the marker of malignancy. The sensitivity, specificity and accuracy of the MRS in the detection and diagnosis of malignant lesions were calculated. The reproducibility of MRS and histopathological results were tested with kappa statistics.
Results: Histopathologically, 18 (60%) of the lesions were classed as malignant whereas 12 (40%) were classed as benign. With MRS, 15 (50%) of these lesions were classed as malignant and 15 (50%) as benign. Two patients who were found spectroscopically to have malignant tumors were shown histopathologically to have benign types. Five patients with an MRS showing a benign type were classed with malignant types in histopathological examinations. MRS had a sensitivity rate of 72.2%, specificity of 83.3%, and an accuracy rate of 76.6% in detecting malignant bone and soft tissue tumors. The interrater reliability of both techniques had a kappa value of 0.533.
Conclusions: MRS may help in the differentiation of benign and malignant soft tissue and bone tumors. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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Bone tumor Soft tissue tumor MR spectroscopy
Long-term effects of percutaneous nephrolithotomy on renal morphology and arterial vascular resistance as evaluated by color Doppler ultrasonography:: preliminary report
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Kiliç, S (Kiliç, S. leyman) ; Altinok, T (Altinok, Tayfun) ; Altunoluk, B (Altunoluk, B. lent) ; Erdogan, Ö (Erdogan, Özg l) ; Oguz, F (Oguz, Fatih)
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UROLOGICAL RESEARCH
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We evaluated the long-term effects of percutaneous nephrolithotomy (PNL) on renal morphology and vascular resistance. Parenchyma thickness, echogenicity and resistive index (RI) of upper, middle and lower poles of operated and contralateral kidneys of 41 patients with 82 renal units who underwent unilateral PNL with single pole access between 2000 and 2002 were examined separately by color Doppler ultrasonography. Mean patient age and duration between PNL and evaluation time were 38.29 +/- 11.53 years and 46.44 +/- 10.9 months, respectively. In operated kidney, mean RI, parenchyma thickness and echogenicity of the access pole were not statistically different than those of the adjacent two poles (0.608 +/- 0.053 vs. 0.608 +/- 0.052 for RI, P=0.895; 11.46 +/- 2.58 vs. 11.41 +/- 2.68 mm for parenchyma thickness, P=0.838; 0.049 +/- 0.31 vs. 0.073 +/- 0.33 for parenchyma echogenicity, P=0.160, respectively). Although mean RI and parenchyma thickness of access pole were statistically significantly different than the mean values of contralateral kidney (0.562 +/- 0.032 and 14.31 +/- 1.37 mm, respectively), no statistical difference was found between mean parenchyma echogenicities of both of them (echogenicity of contralateral kidney was 0, P=0.317). No significant difference was found between the average echogenicities of the three poles of the operated and contralateral kidneys (0.063 +/- 0.32 vs. 0, P=0.080). In 14 patients RI decreased from 0.694 +/- 0.058 to 0.602 +/- 0.056 in operated kidney (P=0.001) and from 0.604 +/- 0.06 to 0.559 +/- 0.031 in contralateral kidney (P=0.018) following PNL. It seems that PNL does not cause renal scarring, renal parenchymal loss or increase in renal vascular resistance in the long term. However, prospective studies must be performed for more definitive conclusions.
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renal stone disease percutaneous nephrolithotomy color Doppler ultrasonography resistive index renal damage
BILATERAL SEMINAL VESICLE AND UNILATERAL RENAL AGENESIS IN CASE WITH PRIMARY INFERTILISM
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Erdem, G (Erdem, Glnur) ; Karakas, HM (Karakas, Hakki Muammer) ; Ugras, M (Ugras, Murat) ; Alkan, A (Alkan, Alpay) ; Altinok, T (Altinok, Tayfun) ; Doganay, S (Doganay, Selim)
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TURKISH JOURNAL OF UROLOGY
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Introduction: Agenesia of the seminal vesicle is an uncommon cause of the male infertility. While unilateral agenesia of seminal vesicle is observed in 0.6-1% of male population, bilateral agenesia is extremely rare. These malformations may be associated with unilateral or bilateral agenesia of the vas deferens or unilateral renal agenesia. 70-80% of the cases with bilateral agenesia of the seminal vesicle have gene mutations related to cystic fibrosis. In his article we presented the ultrasonographic and magnetic resonance imaging findings of bilateral agenesia of the seminal vesicle and unilateral renal agenesia in primary infertile case who has not cystic fibrosis.
Materials and Methods: Pelvic magnetic resonance imaging (MRI) and abdominal ultrasonography was utilized in 29 years old male patient with primary infertility. Results: Bilateral seminal vesicle agenesis was found in MRI. In spermiogram, neither live nor dead spermium was detected. Abdominal ultrasonography was yielded as unilateral renal agenesis and contralateral compensatris hypertrophy consecutively on left and right sides.
Conclusion: Pelvic and transrectal ultrasonography gives valuable data on investigation of the etiology of primary infertility. Pelvic MRI is important to distinguish the hypoplasia and the agenesis of the seminal vesicle.
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Primary infertilism Seminal vesicle agenesis Renal agenesis Ultrasonography Magnetic resonance imaging
Aneurysmatic bone cyst of the second metacarpal: en-block resection and bicortical iliac crest graft replacement
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Ertem, K (Ertem, Kadir) ; Karadag, N (Karadag, Nese) ; Altinok, T (Altinok, Tayfun) ; Karakas, HM (Karakas, H. Muammer)
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EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY
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Hand is an unusual location for aneurysmal bone cysts. A case in whom the second metacarpal of the left hand was presented. Because of its rapidly growing nature, a radical excision was performed. The resected segment was replaced by a bicortical iliac crest graft. The graft healed without complications, and result was functional. On the follow-up at the 36th month no sign of relapse was found.
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Aneurysma lbone cyst graft