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    Efficacy and Safety of 20G vs. 22G Needles in CT-Guided Transthoracic Fine Needle Aspiration Biopsies
    (İstanbul Gelişim Üniversitesi Yayınları / Istanbul Gelisim University Press, 2024) Mutlu, İlhan Nahit; Özcan, Burcu; Dablan, Ali; Cingöz, Mehmet; Güzelbey, Tevfik; Kılıçkesmez, Özgür
    Aim: This study aims to compare the diagnostic accuracy and complication rates of 20G and 22G needles in transthoracic fine needle aspiration biopsy (TFNAB). Method: This retrospective study reviewed lung biopsy results from procedures performed between January 2018 and March 2020. Patients included had non-diagnostic bronchoscopic biopsies or were deemed inappropriate for bronchoscopic biopsy. A total of 127 patients underwent Computed tomography (CT) guided TFNAB using either 20G or 22G needles. Data on lesion size, localization, diagnostic adequacy, and complications were collected and analyzed. Results: The study cohort included 127 patients with a mean age of 63.21 years. Of these, 72 underwent biopsies with a 22G needle and 55 with a 20G needle. The overall diagnostic accuracy was 96.8%, with no significant differences between the 20G and 22G needle groups (p=0.206). Complications occurred in 59 patients (46.5%), with pneumothorax being the most common, and two cases required chest tube placement. The rate of pulmonary hemorrhage was 18.9%. There were no significant differences in complication rates between the needle sizes (p=0.985). Conclusion: CT-guided TFNAB using both 20G and 22G needles is safe and effective, with high diagnostic accuracy and low complication rates. The choice of needle size does not significantly impact diagnostic outcomes or complication rates, allowing clinicians flexibility based on patient-specific factors and procedural requirements.
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    Is Ultrasound-Guided Percutaneous Nephrostomy Efficacious and Safe in Pregnant Patients?: A Single Center Experience
    (İstanbul Gelişim Üniversitesi Yayınları / Istanbul Gelisim University Press, 2023) Mutlu, İlhan Nahit; Dablan, Ali; Cingöz, Mehmet; Arslanoğlu, Tuğçe; Kılıçkesmez, Özgür
    Aim: To evaluate the safety and efficacy of ultrasound-guided percutaneous nephrostomy (PCN) placement in pregnancy. Method: Medical records of 26 pregnant patients who were inserted with a total of 27 PCN catheters between June 2020 to June 2023 were retrospectively analyzed to assess imaging findings, procedural parameters, technical success, delivery outcomes, and procedural complications. Results: At the time of placement of the PCN, the mean gestational age was 29.04±7.01 weeks (range 7 - 36 weeks). The indications for insertion of the PCN catheter included: 1) obstructing calculi (46.2%), 2) pyelonephritis (34.6%), and 3) symptomatic hydronephrosis without calculi (19.2%). Successful catheter placement was achieved in 25/27 procedures, yielding a success rate of 92.59%, and no major complications. Minor instances of transient hematuria were encountered in three cases. The mean duration of catheter retention was 72.58 days. All patients exhibited significant clinical and symptomatic improvement. Among these patients, 22 patients (84.6%) delivered their babies at full-term, 3 patients (11.5%) delivered prematurely, and 1 patient (3.8%) experienced a miscarriage. Conclusion: Ultrasound-guided PCN placement is a reliable method with high success and efficacy that can be applied during pregnancy. This procedure avoids the use of ionizing radiation, ensuring safety for both the fetus and the mother.
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    Predictive Factors Influencing Diagnostic Yield in Image-Guided Bone Biopsies: A Retrospective Analysis
    (İstanbul Gelişim Üniversitesi Yayınları / Istanbul Gelisim University Press, 2025) Dablan, Ali; Mutlu, İlhan Nahit; Cingöz, Mehmet; Yıldırım Erdoğan, Nilsen; Kılıçkesmez, Özgür
    Aim: To evaluate the factors that influence the diagnostic yield of image-guided percutaneous core needle biopsy (CNB) for bone lesions. Method: A retrospective analysis was conducted on 211 patients who underwent 226 image-guided percutaneous core needle biopsies for bone lesions between June 2020 and June 2024. The variables evaluated included patient age, lesion location, the modality used for biopsy guidance (ultrasound vs. CT), and pre-biopsy imaging techniques (PET/CT, MRI). Results: Diagnostic adequacy was achieved in 70.1% of cases. Key findings revealed that patients with adequate diagnostic yield were significantly older than those with inadequate yield (p=0.001). Lesions located in the lower extremity were more frequently associated with inadequate diagnostic yield (p=0.029), and the use of CT guidance was more common in this group (p<0.001). Additionally, pre-biopsy MRI use was higher in the inadequate yield group (p=0.005), while pre-biopsy PET scan use was lower (p=0.034). Among patients who underwent pre-biopsy PET scans, those with adequate diagnostic yield had significantly higher SUV values compared to those with inadequate yield (p=0.004) Conclusion: This study highlights key factors influencing diagnostic yield in bone biopsies, providing insights that can guide clinical decision-making. Understanding these factors may help improve diagnostic yield, aiding in appropriate treatment planning for patients with bone lesions.