No abstract

tion alone is not sufficient. Preoperative axillary ultrasonography (AUS) with the sensitivity of 50-70% and specificity of 87-95% is an indispensable part of staging [1]. When AUS is positive, sentinel lymph node biopsy (SLNB), which is an invasive procedure and requires additional costs, is passed and axillary lymph node dissection (ALND) can be applied [2][3][4]. Thus. time and expense can be saved. However, as the false-negative rates of AUS (21%-48%) are not optimal, the demand for axillary surgery remains even if AUS is negative [5][6][7][8]. Therefore, in many centers AUS is combined with fine needle aspiration biopsy (FNAB) and the accuracy is increased in the determination of metastatic axillary lymph nodes [9][10][11]. However, a negative FNAB still does not remove the necessity for SLNB. All this classic information started to change with the recent Z0011 Trial Abstract Aims: As the false-negative rates of axillary ultrasonography (AUS) (21%-48%) are not optimal, the demand for axillary surgery remains even if AUS is negative. The aim of this study is to determine the histopathological and tumor characteristics associated with false-negative AUS results. Materials and methods: Patients with normal AUS were divided into two groups as true-negative and false-negative according to the histopathology results of axillary lymph nodes. Two groups were compared in terms of age, histological grade of the primary tumor, histological size of the primary tumor, histological type, lymphovascular invasion (LVI), and ultrasonography BI-RADS classification of the primary tumor. The number of metastatic lymph nodes, size of the largest metastatic lymph node and the number of micrometastatic lymph nodes were also noted in the false-negative group. Results: There were 152 patients with normal preoperative AUS in the study group. The false-negative AUS rate was 20.4%. The incidence of invasive lobular carcinoma (ILC) and the mean tumor size was significantly greater in the false-negative group. Micrometastasis was present in 3 patients (3/31, 9.6%), the mean of the largest metastatic lymph nodes was 12.5 mm, the mean total number of malignant lymph nodes was 1.9 in the false-negative group. In 25/31 (80.6%) of the patients, there were less than or equal to 2 metastatic lymph nodes. The presence of LVI was higher in the false-negative group. There was no significant difference between the groups in terms of the other parameters. Conclusion: Before stating that the axilla is normal on ultrasonography, a careful evaluation should be made in patients with a mass >2 cm in size and/ or ILC diagnosis.

The aim of this study was to determine the accuracy of MRI in meniscus and cruciate ligament (CL) pathologies. Another aim of the study was to determine the accuracy of MRI in the determination of meniscus tears in cases with and without ACL tear. The study included 96 patients who were applied for meniscus and/or CL injury and examined by MRI between 2015-2018.The meniscus and CL were examined by MRI for findings of tears. The arthroscopy results were accepted as the gold standard and compared with the MRI results. The sensitivity, specificity, PPV, NPV, accuracy of MRI were calculated in the determination of meniscus and CL tears. The patients were also separated into 2 groups as those with ACL tear and without ACL tear. MRI accuracy in meniscus tear was compared between the 2 groups. The sensitivity, specificity, PPV, NPV and accuracy rates of MRI in the evaluation of the medial meniscus tears were 93.5%, 88.8%, 97.3%, 76.1% and 92.7% respectively. These values were 64.8%, 94.9%, 88.8%, 81.1% and 83.3% for the lateral meniscus (LM), 55.5%, 81.6%, 64.5%, 75.3% and 71.8% for ACL and 100%, 98.9%, 66.6%, 100% and 98.9% for posterior cruciate ligament. In the determination of LM tears, the specificity of MRI was significantly lower in the group with ACL tear (p=0.021).No statistically significant difference was found in respect of the other values. MRI has lower accuracy rates for ACL tear than for the meniscus. There was no significant difference in the accuracy of the MRI of meniscus tears between the groups with and without ACL tear.

Aim: In this study, the relationship between MRI parameters and upgrade in Gleason score after radical prostatectomy was investigated. Materials and Methods: Between November 2017 and July 2020, 112 patients who underwent multiparametric MRI with suspected prostate cancer, TRUS systematic and cognitive fusion biopsy and subsequent radical prostatectomy were involved this study. The patients were evaluated in two groups as those with and without the Gleason score upgrade after surgery. These two groups was compared in terms of ADC, k-trans, tumor size and PI-RADS score. Radiological evaluation was consensus using PI-RADS version 2.1 by two radiologists who lacked clinical knowledge. ADC and k-trans were measured in the MR workstation. ISUP scoring system was used in pathological evaluation. Results: Upgrade in Gleason score was found in 51/112 of the cases. Only 2/51 cases were PI-RADS score 1. Upgrade rate of Gleason score were 15,6% for PI-RADS score