Fatih Kantarci

Istanbul University, İstanbul, Istanbul, Turkey

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Publications (134)308.34 Total impact

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    ABSTRACT: Objectives: Axillary lymph node status is one of the important prognostic factors in early-stage breast cancer. Despite the combined use of sonography, fine-needle aspiration, and sentinel lymph node (SLN) dissection, there is a gap between the potential effectiveness of those techniques and current success to determine the axillary lymph node status. The main aim of this study was to evaluate the baseline accuracy of shear wave elastography for differentiation of benign versus malignant SLNs in an ex vivo artifact-free environment. Methods: Thirty patients with breast cancer scheduled for SLN dissection were enrolled prospectively after informed consent and Institutional Review Board approval were obtained. After dissection, lymph nodes were embedded in ultrasound gel and examined with grayscale sonography and shear wave elastography. Findings were compared to histopathologic results. Results: A total of 64 SLNs obtained from the 30 patients were evaluated. Twelve of them (18.8%) were metastatic, and 52 (81.2%) were benign. The mean cortical thickness (benign versus metastatic, 1.6 versus 4.4 mm), short-axis length (4.63 versus 7.50 mm), cortical stiffness (10.7 versus 25.5 kPa), and hilar stiffness (7.5 versus 11.3 kPa) were statistically higher in metastatic lymph nodes (P ≤ .02). Area under the receiver operator characteristic curve values for these variables were 0.814, 0.768, 0.786, and 0.759, respectively. Cortical thickness was found to have the highest diagnostic performance, followed by cortical stiffness. Conclusions: Shear wave elastography can be used with grayscale sonography for evaluation of cases to decide on needle biopsy sampling. However, it cannot be used as a replacement for fine-needle aspiration or SLN dissection.
    No preview · Article · Dec 2015 · Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine

  • No preview · Article · Nov 2015 · Medicine
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    Fatih Kantarci · Ismail Mihmanli

    Preview · Article · Jul 2015
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    Full-text · Article · Jun 2015 · Diagnostic and interventional imaging
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    ABSTRACT: We have previously shown that venous claudication is significantly more common among patients with Behçet's disease (BD) and had proposed that this was a "venous claudication" because it was specifically more common among men with lower extremity venous thrombosis (LEVT). With this study, we reassessed the presence of claudication prospectively by a questionnaire and a treadmill exercise. We studied all men: 61 BD patients with LEVT, 40 BD patients without vascular involvement, and 56 healthy controls. Venous claudication was assessed by a standardized questionnaire. In addition, patients were asked to walk on a treadmill for 10 minutes. Patients who experienced symptoms consistent with venous claudication but still able to walk and those who had to give up the treadmill exercise were noted. Ankle-brachial pressure indices measured before and after the treadmill test did not indicate any peripheral arterial disease. Twenty-one BD patients with LEVT (34%), two BD patients without vascular involvement (5%), and none of the healthy controls described venous claudication when assessed with the questionnaire (P < .001). There were significantly more patients who described claudication during the treadmill exercise among patients with LEVT (21%) compared with those with no vascular disease (8%) and healthy controls (2%) (P = .002). Finally, only those with LEVT (6 of 61) had to stop the treadmill challenge because of claudication. Venous claudication is a severe and frequent symptom, being present in up to one third of BD patients with LEVT. It impairs walking capacity in 10% of these patients. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.
    No preview · Article · Apr 2015 · Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
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    Deniz Çebi Olgun · Fatih Kantarci
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    ABSTRACT: A 31-year-old woman with Marfan's syndrome presented with amblyopia and a history of gradual bilateral vision loss over the previous 3 to 4 months. She had also had mild sensorineural hearing loss within the previous 2 weeks.
    Full-text · Article · Feb 2015 · New England Journal of Medicine
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    ABSTRACT: Background Cell-based strategies that combine in vitro- expanded autologous chondrocytes with matrix scaffolds are currently preferred for full-thickness cartilage lesions of the knee ≥2 cm2. Although this approach is reasonable, continuing advances in the field of cartilage repair will further expand the options available to improve outcomes. Hypothesis/purpose In the present clinical study, we compared the outcomes of matrix-induced autologous mesenchymal stem cell implantation (m-AMI) with matrix-induced autologous chondrocyte implantation (m-ACI) for the treatment of isolated chondral defects of the knee. Study design Prospective, single-site, randomized, single-blind pilot study. Methods Fourteen patients with isolated full-thickness chondral lesions of the knee >2 cm2 were randomized into two treatment groups: m-AMI and m-ACI. Outcomes were assessed pre-operatively and 3, 6, 12 and 24 months post-operatively. Results Clinical evaluations revealed that improvement from pre-operation to 24 months post-operation occurred in both groups (p
    Full-text · Article · Dec 2014 · Archives of Orthopaedic and Trauma Surgery
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    ABSTRACT: BACKGROUND: Behçet's syndrome (BS) is a well-recognized cause of Budd-Chiari syndrome (BCS); however, information about its clinical characteristics and outcome is limited. METHODS: We reviewed the records of about 9000 patients with BS registered at the multidisciplinary Behçet's syndrome outpatient clinic at Cerrahpasa Medical Faculty between July 1977 and October 2013. We identified 43 (40 M/3 F) patients who were diagnosed as having BCS. Their outcome was evaluated between September 2012 and October 2013. RESULTS: In total, 33 patients (77%) had presented with liver-related symptoms (Group I), while 10 (23%) were asymptomatic for liver disease (Group II). This latter group had presented with symptoms related to the presence of major vessel disease such as fever, leg swelling, or dyspnea. The site of venous obstruction determined in 41 patients was inferior vena cava (IVC) and hepatic veins combined in 25 (61%), IVC alone in 12 (29%), and only hepatic veins in 4 patients (10%). The number of patients with concurrent obstruction in the hepatic veins and the IVC was less in Group II than in Group I (3/10 vs 22/31, p = 0.06). A total of 20 (19 M/1 F) patients (47%) had died at a median of 10 months after diagnosis. Mortality was significantly lower in Group II (10%) than in Group I (58%), (p = 0.011). By the end of the survey, 23 patients were alive, of whom 21 could be re-evaluated at the clinic. CONCLUSIONS: BCS associated with BS is usually due to IVC thrombosis with or without hepatic vein thrombosis. Silent cases exist and have a better prognosis. The mortality rate among the patients symptomatic for liver disease remains high.
    Full-text · Article · Dec 2014 · Seminars in Arthritis and Rheumatism
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    ABSTRACT: To evaluate the effect of ShearWave™ elastography (SWE) for the assessment of liver fibrosis after radioembolization (RE) in patients with liver malignancies. We prospectively examined the effects of SWE before and after RE in 17 adult patients, from June 2012 to September 2013. All patients underwent SWE within 1 month before and 3 months (96.3 ± 22.9 days) after RE. Measurements were taken in segments III, IV, V, and VI (lateral/medial left lobe and anterior/posterior right lobe, respectively). Liver stiffness was studied in the 39 treated segments. The mean stiffness of liver tissue according to the pre-RE SWE measurements was not different from the post-RE SWE measurements in the segments that did not undergo RE. Conversely, segments treated with RE were significantly stiffer according to the post-RE SWE measurements (mean SWE 17.4 kPa) than according to the baseline measurements (7.0 kPa) (p < 0.001). Patients with hepatocellular carcinoma and preexisting infection with hepatitis B and C viruses had higher pre-embolization stiffness, and the post-embolization stiffness of the treated segments in these patients was higher than that in the remainder of the study population. These data suggest that SWE measurements of liver stiffness increase as early as the third month after RE. SWE could be used as a noninvasive complementary imaging method for preliminary assessment of liver fibrosis before and after RE.
    No preview · Article · Nov 2014 · CardioVascular and Interventional Radiology
  • Fatih Kantarci · Emire Seyahi

    No preview · Article · Sep 2014 · Clinical and experimental rheumatology
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    ABSTRACT: Aims and background: There is limited data regarding outcomes of Ewing's sarcoma family of tumors in adolescents and adults compared with the same tumors in childhood. The aim of the study was to analyze prognostic factors and treatment results in a cohort of adolescents and adults with non-metastatic skeletal Ewing's sarcoma family of tumors. Methods and study design: From 1992-2008, 90 adolescents and adults with Ewing's sarcoma family of tumors of the bone were referred to our institution. Sixty-five (72%) non-metastatic patients with analyzable data and treated in our institution were retrospectively evaluated. All patients were treated with alternated chemotherapy regimens administered every 3 weeks. The local treatment modality was selected according to tumor and patient characteristics. Results: The median age was 21 years (range, 13-50). Most patients (74%) were >17 years of age. Forty-six percent of the tumors were located in the extremities. Local therapy was surgery in 45 patients and radiotherapy alone in 19 patients. Twenty-one patients received preoperative and 13 patients postoperative radiotherapy. Median follow-up was 43 months (range, 7-167). The 5-year event-free and overall survival rates for all patients were 44% and 49%, respectively. On univariate survival analysis, event-free and overall survival were worse for patients >17 years of age, tumor size >8 cm in diameter, an axial location, positive surgical margins, and poor histopathological response (<90% necrosis). Age, tumor site and tumor size on event-free and overall survival remained significant on multivariate analysis. Conclusions: We identified age, tumor size, and tumor site as independent prognostic factors, in accord with the Western literature. These patients require novel treatment modalities.
    No preview · Article · Jul 2014 · Tumori
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    E Demirci · R Akyel · F Kilic · F Kantarci · M Halac · K Sonmezoglu

    Full-text · Article · May 2014 · Revista Española de Medicina Nuclear e Imagen Molecular
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    ABSTRACT: The malignant parotid lesions are fast growing and rapidly become symptomatic. Ultrasonography and fine needle aspiration biopsy are mainly used in the differential diagnosis of parotid lesions. The most common treatment of all parotid lesions is surgical excision. Here, we present a case of a very rapidly enlarging, painful parotid lesion with no etiology. A 30-year-old man presented with a rapidly progressive, enlarging, painful mass on the left side of the parotid region. The size of the lesion had enlarged rapidly day by day. The patient had no history of head and neck surgery or trauma. After evaluation of the patient with radiologic examinations, no certain diagnosis could be made; we thought that the patient might be experiencing spontaneous intraparotid bleeding with unknown etiology. We decided to wait for a time for spontaneous resolution. The lesion resolved spontaneously in a few months, without any complications or sequelae.
    No preview · Article · May 2014 · The Journal of craniofacial surgery
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    O Tutar · M Velidedeoglu · I Yanik · B Kocak · A Bas · B Tutar · F Kantarci
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    ABSTRACT: Meckel's diverticulum is the most common congenital anomaly of the small intestine. Common complications related to a Meckel's diverticulum include hemorrhage, intestinal obstruction, and inflammation. Small bowel obstruction due to mesodiverticular band of Meckel's diverticulum is a rare complication. Herein, we report a case of small bowel obstruction occurring due to mesodiverticular band of a Meckel's diverticulum. The important aspect of our case is clear demonstration of the mesodiverticular band adjacent to the Meckel's diverticulum on pre-operative computed tomography (CT).
    Full-text · Article · Apr 2014 · JBR-BTR: organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR)
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    ABSTRACT: Objectives: The purpose of this study was to evaluate whether the relative proportions of stromal to cellular components of pleomorphic adenomas have an effect on the shear elastic modulus determined by shear wave elastography (SWE). Methods: This study was approved by the Ethics Committee of our institution and performed between September 2011 and December 2012. Thirty-five patients who underwent surgery for a parotid mass were included in the study. The maximum shear elastic modulus of the mass was measured by SWE. Pleomorphic adenomas were histopathologically subdivided into stroma-poor, intermediate-stroma, and stroma-rich tumors based on the relative proportion of stromal to cellular components. Results: The maximum shear elastic modulus values of the pleomorphic adenomas ranged from 12.6 to 291.9 kPa (mean ± SD, 120.9 ± 92.8 kPa). The Friedman test revealed a statistically significant relationship between the stromal amount and maximum shear elastic modulus (P < .001). Stroma-poor adenomas (mean, 32.3 ± 27.7 kPa; range, 12.6-81.1 kPa) were softer on SWE than stroma-rich adenomas (mean, 174.1 ± 48.4 kPa; range, 92.7-217.2 kPa; P = .009). No such significant difference was detected between stroma-poor and intermediate-stroma tumors (mean, 146.3 ± 106.1 kPa; range, 19.1-291.9 kPa; P = .062) or between intermediate-stroma and stroma-rich tumors (P = .465). Conclusions: Shear wave elastography depicts pleomorphic adenomas with a variable appearance, which is due to the relative proportions of stromal to cellular contents in the tumors.
    No preview · Article · Mar 2014 · Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine
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    ABSTRACT: Background: To assess the long term clinical outcome of preoperative radiotherapy with or without chemotherapy followed by limb sparing surgery in patients with non-metastatic soft tissue sarcomas (STS) of the extremities. Materials and methods: Sixty patients with locally advanced STS were retrospectively analyzed. The median tumor diameter was 12 cm. All patients were treated with preoperative radiotherapy delivered with two different fractionation schedules (35Gy/10fr or 46-50Gy/23-25fr). Neoadjuvant chemotherapy was added to 44 patients with large and/or high grade tumors. Surgery was performed 2-6 weeks after radiotherapy. Chemotherapy was completed up to 6 courses after surgery in patients who had good responses. Results: Median follow-up time was 67 months (8-268 months). All of the patients had limb sparing surgery. The 5-year local control (LC), disease free (DFS) and overall survival (OSS) rates for all of the patients were 81%, 48.1% and 68.3% respectively. 5-year LC, DFS and cause specific survival (CSS) were 81.7%, 47%, 69.8%, and 80%, 60%, 60% in the chemoradiotherapy and radiotherapy groups, respectively. On univariate analysis, patients who were treated with hypofractionation experienced significantly superior LC, DFS and CSS rates with similar rates of late toxicity when compared with patients who were treated with conventional fractionation and statistical significance was retained on multivariate analysis. Conclusions: Treatment results are consistent with the literature. As neoadjuvant chemoradiotherapy provides effective LC and CSS with acceptable morbidity, it should be preferred for patients with large and borderline resectable STS.
    No preview · Article · Feb 2014 · Asian Pacific journal of cancer prevention: APJCP
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    ABSTRACT: Shear-wave elastography (SWE) is a novel non-invasive method that involves applying local mechanical compression on soft tissue using focused ultrasonography (US) and acquiring strain images that show tissue response. In this study, our goal was to assess the performance of SWE in the staging of liver fibrosis in children with chronic liver disease. The study involved measuring SWE values in the right lobe of the liver in a patient group of 76 children with chronic liver disease and a control group of 50 healthy subjects. In the patient group, the shear elastic modulus values were correlated with biopsy results according to the Brunt scoring system (F0: portal fibrosis, F1: perisinusoidal or portal/periportal fibrosis, F2: both perisinusoidal and portal/periportal fibrosis, F3: bridging fibrosis and F4: cirrhosis). Performance of SWE in estimating liver fibrosis in children was determined based on a receiver-operating characteristics (ROC) analysis. Mean SWE values of the control group and F0 group were not statistically significantly different (p = 0.106). The mean SWE values of the F1, F2, F3, and F4 groups were higher than that of the control group (all p < 0.001). Based on kPa measurement values, the area under the ROC curve was 95.2% (95% CI = 92.1-99.5%) with a sensitivity for diagnosing liver fibrosis of 91.5%, a specificity of 94.0%, a positive predictive value of 93.1%, and a negative predictive value of 92.6%. Based on m/s measurement values, the area under the ROC curve was 96.3% (95% CI = 92.7-99.8%) with a sensitivity for diagnosing liver fibrosis of 93.2%, a specificity of 94.0%, a positive predictive value of 93.2%, and a negative predictive value of 94.0%. Mean SWE values for patients with non-alcoholic steatohepatitis (NASH) were higher than those in the remainder of the study group. Although liver fibrosis can be detected using SWE, differentiation of fibrosis stages could not be achieved. The presence of steatosis significantly increased the mean SWE values on elastography and so care should be taken when assessing children with NASH.
    No preview · Article · Feb 2014 · Journal of pediatric gastroenterology and nutrition
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    ABSTRACT: Background Budd-Chiari syndrome is a rare complication of BS with a frequency of < 1 %, and carries a high mortality rate. In a previous survey out of 14 Behcet patients with BCS, 10 (60 %) had died with a mean survival of 10 months (1). Objectives We assessed the outcome in a cohort of 40 BS patients with BCS diagnosed and followed by a single center between 1977 and 2012. Methods We reviewed records of about 8000 patients with BS who were registered at the multidisciplinary clinic at Cerrahpasa Medical Faculty between July 1977 and December 2012 (study closure). We identified 40 (37 M/ 3 F) patients who were diagnosed with BCS. The outcome of 40 patients was evaluated between September and December 2012. Attempts were made to contact every patient in this cohort by telephone calls or home visits. All thus contacted were called back to the outpatient clinic for a clinical evaluation, blood tests and hepatic Doppler USG. Hepatic Doppler USG specifically analyzed hepatic veins patency, intrahepatic collateral formation, caudate lobe hypertrophy, hepatomegaly, splenomegaly, and portal vein dilatation. Survival data were assessed by Kaplan-Meier analysis. Results A total of 40 BS patients with BCS were surveyed. The mean age of the patients at diagnosis of BS was 28.7 ± 8.6 years, and the mean age at the onset of BCS was 30.3 ± 8.5 years. A total of 35 patients received immunosuppressive treatment (cyclophophamide n= 31; azathioprine n =4) after being diagnosed with BCS. Only 2 patients had surgical interventions. One patient had percutaneous transluminal angioplasty another transjugular intrahepatic portosystemic shunting. Fifteen patients received anticoagulant treatment. Apart from this, 3 patients were treated with thrombolytic treatment which was ineffective. Additionally, 17 patients received diuretics. By the end of the study, we had the outcome information in all patients: 20 patients (19 M/1F) (50 %) had died, while the remaining 20 were alive. Of these, 17 could be re-evaluated in the clinic. Among the patients who had died, the median survival time was 8 months (IQR: 4- 54 months). The causes of mortality were mainly due to hepatic failure (n =17) (85 %). Additionally, one had died due to myocardial infarction, another due to suicide and another with unknown cause. Postmortem study was available in one patient. Mortality rate among patients diagnosed between 1977-2000 (10/15, 67 %) was somewhat higher (Log rank P= 0.75). compared to those diagnosed between 2001-2012 (10/25, 40 %), however, the difference did not reach statistical significance in the survival analysis. Final hepatic USG among 17 patients who survived showed occlusion in one ore more hepatic veins in 12, caudate lobe hypertrophy in 8, splenomegaly in 3, and portal vein dilatation in 3. It was noted that all 17 patients had multiple intrahepatic veno-venous collaterals with good drainage. Conclusions BCS due to BS still caries serious mortality. Mortality rate perhaps tend to decrease after 2000. Formation of intrahepatic veno-venous collaterals seem to be the only factor important in the survival. References Reference: Disclosure of Interest None Declared
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases
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    ABSTRACT: Intussusception is the most frequent complication of Peutz-Jeghers Syndrome (PJS), but usually seen in child age. It is a predictable, but infrequent complication in adults with PJS. However, there is no report about intussusception in pregnancy period secondary to Peutz-Jeghers (PJ) polyps in the literature. In this paper, we present a rare intussusception case in a pregnant woman with PJS, which was diagnosed with magnetic resonance imaging, and discuss this condition with a brief literature review.
    Full-text · Article · Jan 2014 · Scottish medical journal
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    ABSTRACT: A case of acute mesenteric ischemia due to thrombosis of superior mesenteric artery and vein in a 44-year-old woman following chemotherapy for invasive laryngeal carcinoma was diagnosed on a multi-detector CT scan. Although the link between malignancy and thromboembolism is widely recognized in patients with cancer, chemotherapy further elevates the risk of thrombosis. Acute mesenteric ischemia associated or not associated with chemotherapy rarely occurs in patients with cancer. Moreover, co-occurrence of superior mesenteric artery and superior mesenteric vein thrombosis is reported for the first time.
    No preview · Article · Jan 2014 · Japanese journal of radiology