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  • Küçük Resim
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    An early warning system using machine learning for the detection of intracranial hematomas in the emergency trauma setting
    (Turkish Neurosurgical Society, 2022) Aydoseli, Aydın; Ünal, Tuğrul Cem; Kardeş, Onur; Doğuç, Özge; Dolaş, İlyas; Adıyaman, Ali Ekrem; Ortahisar, Emircan; Silahtaroğlu, Gökhan; Aras, Yavuz; Sabancı, Pulat Akın; Sencer, Serra; Sencer, Altay
    AIM: To present an early warning system (EWS) that employs a supervised machine learning algorithm for the rapid detection of extra-axial hematomas (EAHs) in an emergency trauma setting. MATERIAL and METHODS: A total of 150 sets of cranial computed tomography (CT) scans were used in this study with a total of 11,025 images. Of the CTs, 75 were labeled as EAH, the remaining 75 were normal. A random forest algorithm was utilized for the detection of EAHs. The CTs were randomized into two groups: 100 samples for training of the algorithm (split evenly between EAH and normal cases), and 50 samples for testing. In the training phase, the algorithm scanned every CT slice separately for image features such as entropy, moment, and variance. If the algorithm determined an EAH on two or more images in a CT set, then the workflow produced an alert in the form of an email. RESULTS: Data from 50 patients (25 EAH and 25 controls) were used for testing the EWS. For all CTs with an EAH, an alert was produced, with a 0% false-negative rate. For 16% of the cases, the practitioner received an email from the EWS that the patient might have an EAH despite having a normal CT scan. Positive and negative predictive values were 86% and 100%, respectively. CONCLUSION: An EWS based on a machine learning algorithm is an efficient and inexpensive way of facilitating the work of emergency practitioners such as emergency physicians, neuroradiologists, and neurosurgeons.
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    Special designed routing device to ease endoscopic transforaminal lumbar disc surgery: A cadaveric study
    (2019) Göker, Burcu; Tahta, Alican; Yörükoğlu, Ali; Akçakaya, Mehmet; Şencan, Fahir; Aydoseli, Aydın; Sencer, Altay; Kırış, Talat; Canbolat, Ali
    Background Data: Fully endoscopic lumbar disc (FELD) surgery via transforaminal (TF) approach may be more demanding to adopt for surgeons experienced with conventional microdiscectomy, due to the necessity of a new anatomic orientation and understanding. We designed a routing device to facilitate access to safe anatomic triangle defined by Kambin at the level of foramen in cadavers. Purpose: To show that the transforaminal route for endoscopic lumbar disc herniations is safely applicable with the aid of a new routing device. Materials and Methods: Ten cadavers between the ages 18-75, with no history of lumbar spinal surgery or trauma, with previous abdominal computed tomography (CT) scans included in our study. Postmortem abdominal CT scans were performed. Images were examined and transforaminal entrance angles without causing damage to retroperitoneal structures for each lumbar disc space and anatomical differences were recorded. TF approach was performed in cadavers using the angles measured from abdominal CTs and the entry point determined with the help of routing device. Results: L1-L2, L2-L3, L3-L4, L4-L5 disc spaces were operated in ten cadavers. Kambin’s triangle was successfully reached with help of routing device using data obtained from CT (X’, ?) and C-arm fluoroscopy (X, Y, Y’). Y’ marker with protractor on routing device, and the metal rod on this Y’ marker with an opening through which only the punction needle could pass were very important in reaching the target. The metal bar horizontal movement and fixation to this mechanism contributed to operation of device. Entrance points and angles calculated with the help of CT scans were found to be compatible with the images obtained from fluoroscopy and endoscopy during operation. Conclusions: In this study, it has been showed that TF approach can be safely performed with help of the new designed routing device.