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    Asbestos-related Diseases in Turkey: caused not only by naturally occurring fibers but also by industrial exposures
    (American Thoracic Society, 2019) Bayram, Mehmet; Özkan, Didem; Hayat, Esat; Bilgin, Mehmet; Mehdi, Elnur; Bilgin, Sabriye Şennur; Akkoyunlu, Muhammed Emin; Okyaltırık, Fatmanur; Kansu, Abdullah
    Many publications have been devoted to the epidemiology of asbestos exposure in Turkey. However, they have all focused on environmental exposure to “naturally occurring asbestos” (natural component of soils or rocks)”, ignoring potential industrial asbestos exposure(1-4). Yet, many industrial activities involved occupational asbestos exposure during Turkey’s industrialization, including construction, shipbuilding, automotive manufacturing, and others. Between 1900 and 2003, 1.2 million tons of asbestos were used in Turkish industry(5). The use of asbestos was officially banned in 2010.
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    Diffusion tensor imaging can discriminate the primary cell type of intracranial metastases for patients with lung cancer
    (Japanese Society for Magnetic Resonance in Medicine, 2022) Bilgin, Sabriye Şennur; Gültekin, Mehmet Ali; Yurtsever, İsmail; Yılmaz, Temel Fatih; Çesme, Dilek Hacer; Bilgin, Melike; Topcu, Atakan; Beşiroğlu, Mehmet; Türk, Hacı Mehmet; Alkan, Alpay; Bilgin, Mehmet
    Purpose: Histopathological differentiation of primary lung cancer is clinically important. We aimed to investigate whether diffusion tensor imaging (DTI) parameters of metastatic brain lesions could predict the histopathological types of the primary lung cancer. Methods: In total, 53 patients with 98 solid metastatic brain lesions of lung cancer were included. Lung tumors were subgrouped as non-small cell carcinoma (NSCLC) (n = 34) and small cell carcinoma (SCLC) (n = 19). Apparent diffusion coefficient (ADC) and Fractional anisotropy (FA) values were calculated from solid enhanced part of the brain metastases. The association between FA and ADC values and histopathological subtype of the primary tumor was investigated. Results: The mean ADC and FA values obtained from the solid part of the brain metastases of SCLC were significantly lower than the NSCLC metastases (P < 0.001 and P = 0.003, respectively). ROC curve analysis showed diagnostic performance for mean ADC values (AUC=0.889, P = < 0.001) and FA values (AUC = 0.677, P = 0.002). Cut-off value of > 0.909 × 10-3 mm2/s for mean ADC (Sensitivity = 80.3, Specificity = 83.8, PPV = 89.1, NPV = 72.1) and > 0.139 for FA values (Sensitivity = 80.3, Specificity = 54.1, PPV = 74.2, NPV= 62.5) revealed in differentiating NSCLC from NSCLC. Conclusion: DTI parameters of brain metastasis can discriminate SCLC and NSCLC. ADC and FA values of metastatic brain lesions due to the lung cancer may be an important tool to differentiate histopathological subgroups. DTI may guide clinicians for the management of intracranial metastatic lesions of lung cancer.
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    Inflammatory fibroid polyp of the stomach mimics malignancy on F-18 FDG PET/CT imaging
    (Lippincott Williams & Wilkins, 2016) Bilgin, Sabriye Şennur; Bilgin, Mehmet; Savaş, Recep; Erdoğan, Ezgi Başak
    Inflammatory fibroid polyps (IFPs) are rare non-neoplastic and proliferating submucosal lesions of the gastrointestinal tract. The classic IFP, which was first described by Vanek, consists of prominent blood vessels and is characterized by a heavy inflammatory infiltrate, which is rich in eosinophilic granulocytes. The clinical presentation depends on the size and location. Inflammatory fibroid polyps cannot be differentiated from malignancy without histological examination. We report a case of IFP in the stomach that mimicked a primary gastric malignancy showing an increased F-18-FDG uptake.
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    MRI of pancreas in patients with chronic pancreatitis and healthy volunteers: Can pancreatic signal intensity and contrast enhancement patterns be valuable predictors of early chronic pancreatitis?
    (Bentham Science Publishers Ltd, 2017) Şennur Bilgin, Sabriye; Bilgin, Mehmet; Toprak, Hüseyin; Burgazlı, Kamil Mehmet; Chasan, Ritvan; Erdoğan, Ali; Balcı, Numan Cem
    Background: Chronic pancreatitis is a progressive inflammatory disease of the pancreatic parenchyma and ductal structures. Typical MR imaging features of chronic pancreatitis include dilatation of the main pancreatic duct and irregularities of branch pancreatic ducts that can be evaluated with MRCP, loss of the normal high signal intensity of the pancreatic parenchyma on T1-weighted images, and decreased enhancement on dynamic contrast-enhanced sequences. Objective: The aim was to evaluate the parenchymal MRI findings of the pancreas in conjunction with MRCP in patients with chronic pancreatitis and normal healthy subjects. Methods: MRI and MRCP findings of 90 consecutive patients with chronic pancreatitis and 26 healthy volunteers were evaluated in this study. Patients were divided into five groups according to Cambridge classification system considering ERCP, MRCP, CT, US and EUS findings. On MRI, signal intensity ratios of the pancreas and the spleen on unenhanced T1 weighted fat saturated spoiled gradient echo images (SIR P/S) along with the enhancement ratio between the arterial phase and the portal venous phase (SIR A/V) were calculated and their frequency in each Cambridge score were documented. MRI findings in normal subjects were compared to patients with chronic pancreatitis. Results: MRCP findings were normal and pancreatic signal intensity was higher than spleen (SIR P/S > 1) in 26 healthy control subjects. Mean pancreas signal in control group (SIR P/S; 1.48 +/- 0.13) was significantly higher (P < 0,001) than mean signal intensity in patients with chronic pancreatitis (SIR P/S; 1.18 +/- 0.24). In the control group, the highest contrast enhancement occurred in arterial phase (SIR A; 1.7 +/- 0.32) and this was significantly higher (P < 0,001) than portal venous phase (SIR V; 1.45 +/- 0.28). In chronic pancreatitis group, the highest contrast enhancement occurred in portal venous phase (SIR V; 1.56 +/- 0.18) but there was no statistically significant difference (P = 0.06) compared to arterial phase (SIR A; 1.51 +/- 0.21). Mean SIR A/V values of control group were 1.18 +/- 0.08, and SIR A/V values of patients with chronic pancreatitis were 0.97 +/- 0.12 respectively. Mean SIR A/V value in control group was statistically higher than patients with chronic pancreatitis (P < 0.05). Between the control group and patients with chronic pancreatitis in terms of SIR statistically significant differences were found SIR P/S (Spearman correlation coefficient (rs) = -0.76, P < 0.001), SIR A (rs = -0.28, P = 0.003), SIR V (rs = 0.43, P < 0.001), SIR LV (rs = 0.54, P < 0.001) and SIR A/V (rs = -0.68, P < 0.001). Conclusion: In our study, MRI findings were significantly different in subjects with chronic pancreatitis compared to the control group. MRI findings correlated well with the ductal changes according to Cambridge classification. However, MRI findings may occur prior to ductal changes.