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Öğe Applicability of 3.0 T MRI images in the estimation of full age based on shoulder joint ossification: Single-centre study(Elsevier Ireland Ltd, 2020) Altinsoy, Hasan Baki; Gurses, Murat Serdar; Bogan, Mustafa; Unlu, Nisa ElifSkeletal maturity is evaluated by many radiological methods for forensic age estimation. Direct radiography and computed tomography lead to a rise in ethical concerns due to radiation exposure. Therefore, magnetic resonance imaging (MRI) has currently been used in recent studies. In this study, the ossification stage of the shoulder joint was determined retrospectively in 178 male and 109 female individuals in the age group 12 to 30 years using 3.0 T MRI. All the images were evaluated with T1-weighted turbo spin echo (T1 TSE) sequence and T1 fast low angle shot two-dimensional sequence (T1 FL2D). The combined staging method, which was defined by Kellinghaus et al. and Schmeling et al., was used. The infra- and inter-observer agreement levels were very good (kappa and kappa(w)). There were no significant age differences between males and females in all stages. In most of the stages, the ossification of the proximal humeral epiphyses occurred earlier in females than in males. Stage 4 did not occur in either of the sexes before the 18th birthday as the youngest patients in this stage was at 19 and 18 years of age in males and females, respectively. We concluded that evaluating the ossification of the proximal humeral epiphysis with MRI imaging for forensic age estimation may be beneficial. Evaluating the same anatomical structure with different MRI sequences may be useful for accurate staging diagnosis.Öğe Applicability of proximal humeral epiphysis ossification for forensic age estimation according to the Vieth method: a 3.0 T MRI study(Springer, 2021) Altinsoy, Hasan Baki; Gurses, Murat SerdarA retrospective study was conducted to explore the possibility of determining the age of majority via examination of the proximal humeral epiphyseal-diaphyseal fusion by 3.0 T magnetic resonance imaging (MRI) using the Vieth classification. Proximal humeral epiphyses were retrospectively studied on 3.0 T MRI in 315 participants (122 females, 193 males) between 10 and 28 years of age, using T1-weighted turbo spin echo (T1W TSE) and proton density fat-saturated TSE sequence (PD FS TSE). A 5-stage scoring system was used following the method of Vieth et al. The relevant statistics were defined, the intraobserver and interobserver agreements were determined (Cohen's kappa) and the differences between the sexes were analyzed (Mann-Whitney U-test, p < 0.05, exact, two-sided). According to this study, stage 5 and stage 6 made it possible to correctly assess the majority in both sexes by examination of the epiphyses of the shoulder joint. The kappa statistics were a good level of agreement for the interobserver and intraobserver evaluations of the shoulder. There were no significant age differences between males and females in any of the stages (all p-values > 0.05). The Vieth classification provides important information in determining whether a person has reached the age of 18 years or not in both sexes through 3.0 T MRI of the shoulder joint.Öğe Evaluation of distal femoral epiphysis and proximal tibial epiphysis ossification using the Vieth method in living individuals: applicability in the estimation of forensic age(Taylor & Francis Ltd, 2021) Gurses, Murat Serdar; Altinsoy, Hasan BakiIn this study, ossification stages of distal femoral epiphysis and proximal tibial epiphysis were retrospectively evaluated with a 1.5-T magnetic resonance imaging (MRI) scanner according to the newly developed five-stage Vieth method. A total of 367 male and 231 female patients aged 12-30 years were scanned between January 2012 and July 2019. A 1.5-T MRI scanner was used to obtain a T1-weighted turbo spin-echo (TSE) sequence and a fat-suppressed proton density-weighted TSE image. The kappa statistics were good level of agreement for inter- and intra-observer evaluations of the ossification stages for knee. Comparison of male and female data revealed significant between-sex differences in the ages when the stages 3, 4 and 5 ossifications of the distal femoral epiphysis and the stages 4 and 5 ossifications of the proximal tibial epiphysis were first detected. In the proximal tibial epiphysis, stage 6 was observed at age 18 years for males and at age 17 years for females. In the distal femoral epiphysis, stage 6 was initially observed at age 20 years for both sexes. Thus, stage 6 ossification, which is determined through 1.5-T MRI of the knee joint, allows for the determination of the completion of the 18th year of life in either sex.Öğe Evaluation of distal tibial epiphysis and calcaneal epiphysis according to the Vieth method in 3.0 T magnetic resonance images: a pilot study(Springer, 2023) Gurses, Murat Serdar; Has, Busra; Altinsoy, Hasan Baki; Suzen, Halit SinanIn forensic medicine practice, age estimation-both in living and deceased individuals-can be requested due to legal requirements. Radiologic methods, such as X-rays, for the estimation of bone age have been discussed, and ethical concerns have been raised. Given these factors, radiologic methods that reduce radiation exposure have gained importance and have become one of the research topics in forensic medicine. In this study, the MR images of the ankles of patients aged between 8 and 25 years, obtained with a 3.0 T MR scanner, were evaluated retrospectively according to the staging method defined by Vieth et al. In the study, the ankle MR images of 201 cases (83 females and 118 males) with sagittal T1-weighted turbo spin echo and T2-weighted short tau inversion recovery sequences were evaluated independently by two observers. According to the results of our study, the intra- and inter-observer agreements are at a very good level for both the distal tibial and calcaneal epiphyses. All the cases detected as stages 2, 3, and 4 in both sexes for both the distal tibial and the calcaneal epiphyses have been determined to be under the age of 18 years. According to the data obtained from our study, we consider that stage 5 for males and stage 6 for both sexes in the distal tibial epiphysis and stage 6 for males in the calcaneal epiphysis can be used to estimate the age of 15 years. As far as we know, our study is the first to evaluate ankle MR images with the method defined by Vieth et al. Further studies should be conducted to evaluate the validity of the procedure.Öğe Evaluation of knee ossification on 1.5 T magnetic resonance images using the method of Vieth et al. A retrospective magnetic resonance imaging study(Springer, 2021) Alatas, Ozkan; Altinsoy, Hasan Baki; Gurses, Murat Serdar; Balci, AliMagnetic resonance imaging (MRI) is a noninvasive method with the absence of ionizing radiation exposure and is therefore, preferable in studies for forensic age estimation. The purpose of this study was to investigate the degree of ossification of the knee in a Turkish population following the Vieth et al. method. We scanned 709 Turkish patients in the age bracket 12-27 years utilizing a T1weighted (T1W) turbo spin echo sequence (TSE) and a T2-W TSE sequence with fat suppression by spectral presaturation with inversion recovery. Minimum, maximum, mean +/- standard deviation andmedian values were defined. Intraobserver and interobserver correlations were determined (Cohen's kappa). The statistical relevance of sex-related differences was analyzed (Student's t-test, Mann-Whitney U-test, p< 0.05, exact test, two-sided). The kappa statisticswere relatively high, indicating very good agreement for interobserver and intraobserver evaluations. Comparison of male and female data revealed significant between-gender differences for most stages (p< 0.05). The earliest mean ages at which ossification of stages 4, 5 and 6 were evident in the distal femoral epiphysis were 14.84, 15.81, and 20.76 years in males and 13.77, 14.77, and 20.45 years in females, respectively. Proximal tibial epiphysis of stages 4, 5, and 6 ossification was first noted at ages 13.57, 15.59, and 18.91 years in males and 13.29, 14.38, and 16.87 years in females, respectively. In the distal femoral epiphysis, stage 6 was found at 20 years of age for both genders and it can be employed to differentiate above and below the majority age cut-off.Öğe Evaluation of proximal humeral epiphysis ossification in 3.0 T MR images according to the Dedouit staging method: Is it be used for age of majority?(Elsevier Sci Ltd, 2021) Altinsoy, Hasan Baki; Gurses, Murat Serdar; Alatas, OzkanMagnetic resonance imaging (MRI) for forensic age estimation is among the research issues since it does not lead to radiation exposure. In this study, the ossification stage of the proximal humeral epiphysis was determined retrospectively in 178 male and 109 female individuals in the 12 to 30-year age group using 3.0 T MRI. All images were evaluated with the proton density fat saturated turbo spin echo (PD TSE FS) sequence and the T2 TSE FS sequence. A five-stage scoring system was used following the method of Dedouit et al. The relevant statistics were defined as minimum, maximum, mean +/- standard deviation, 95% confidence interval of mean and median and the intra- and interobserver agreement levels were very good (kappa > 0.80). There were no significant age differences between males and females in any of the stages (all p-values>0.05). According to the present study, stage 5 was initially observed at age 22 years for both genders. According to our results, it is possible to determine the completion of the 18th year of life in either gender on the shoulder joint. Proximal humeral epiphysis ossification may be used as an additional method for forensic age estimation through MRI.Öğe Forensic age estimation in living individuals by 1.5T magnetic resonance imaging of the knee: a retrospective MRI study(Taylor & Francis Ltd, 2020) Altinsoy, Hasan Baki; Alatas, Ozkan; Gurses, Murat Serdar; Turkmen Inanir, NurselOur aim is to analyse proximal tibial epiphysis and distal femoral epiphysis patterns according to the Dedouit staging method using 1.5 T magnetic resonance imaging (MRI) with fast spin echo (FSE) for proton density images. In addition, we discuss the results in relation to the literature for forensic age estimation. In this study, images belonging to 195 female and 277 male patients ranging in age from 10 to 30 years who had a knee MRI for any reason in our Radiology Clinic between January 2014 and December 2016 were retrospectively evaluated. According to the Dedouit et al. five-stage method, they were evaluated by two radiologists. The kappa value was calculated for intra-observer and inter-observer compliance. The evaluation of knee epiphysis patterns from MRI is an alternative, efficient, radiation-free and non-invasive method that is helpful in forensic age estimation. In particular, stage 5 in distal femoral epiphysis can determine the 21st year of life in both sexes, and proximal tibial epiphysis could present evidence of age 18 in males. It should be used for evaluation in addition to other methods for determining skeletal system maturity.Öğe PFP-HOG: Pyramid and Fixed-Size Patch-Based HOG Technique for Automated Brain Abnormality Classification with MRI(Springer, 2023) Kaplan, Ela; Chan, Wai Yee; Altinsoy, Hasan Baki; Baygin, Mehmet; Barua, Prabal Datta; Chakraborty, Subrata; Dogan, SengulDetecting neurological abnormalities such as brain tumors and Alzheimer's disease (AD) using magnetic resonance imaging (MRI) images is an important research topic in the literature. Numerous machine learning models have been used to detect brain abnormalities accurately. This study addresses the problem of detecting neurological abnormalities in MRI. The motivation behind this problem lies in the need for accurate and efficient methods to assist neurologists in the diagnosis of these disorders. In addition, many deep learning techniques have been applied to MRI to develop accurate brain abnormality detection models, but these networks have high time complexity. Hence, a novel hand-modeled feature-based learning network is presented to reduce the time complexity and obtain high classification performance. The model proposed in this work uses a new feature generation architecture named pyramid and fixed-size patch (PFP). The main aim of the proposed PFP structure is to attain high classification performance using essential feature extractors with both multilevel and local features. Furthermore, the PFP feature extractor generates low- and high-level features using a handcrafted extractor. To obtain the high discriminative feature extraction ability of the PFP, we have used histogram-oriented gradients (HOG); hence, it is named PFP-HOG. Furthermore, the iterative Chi2 (IChi2) is utilized to choose the clinically significant features. Finally, the k-nearest neighbors (kNN) with tenfold cross-validation is used for automated classification. Four MRI neurological databases (AD dataset, brain tumor dataset 1, brain tumor dataset 2, and merged dataset) have been utilized to develop our model. PFP-HOG and IChi2-based models attained 100%, 94.98%, 98.19%, and 97.80% using the AD dataset, brain tumor dataset1, brain tumor dataset 2, and merged brain MRI dataset, respectively. These findings not only provide an accurate and robust classification of various neurological disorders using MRI but also hold the potential to assist neurologists in validating manual MRI brain abnormality screening.Öğe Posterior shoulder labrocapsular structures in all aspects; 3D volumetric MR arthrography study(British Inst Radiology, 2021) Ogul, Hayri; Taydas, Onur; Sakci, Zakir; Altinsoy, Hasan Baki; Kantarci, MecitPathologies of the posterior labrocapsular structures of the shoulder joint are far less common than anterior labrocapsuloligamentous lesions. Most of these pathologies have been associated with traumatic posterior dislocation. A smaller portion of the lesions include posterior extension of superior labral anteroposterior lesions, posterior superior internal impingement, and damage to the posterior band of the inferior glenohumeral ligament. Labrocapsular anatomic variations of the posterior shoulder joint can mimic labral pathology on conventional MR and occasionally on MR arthrographic images. Knowledge of this variant anatomy is key to interpreting MR images and studying MR arthrography of the posterior labrocapsular structure to avoid misdiagnosis and unnecessary surgical procedures. In this article, we review normal and variant anatomy of the posterior labrocapsular structure of the shoulder joint based on MR arthrography and discuss how to discriminate normal anatomic variants from labrocapsular damage.Öğe Shear Wave Ultrasound Elastography and Diffusion-Weighted Magnetic Resonance Imaging Findings of Pleural Based Masses with Histopathologic Correlation(Duzce Univ, Fac Medicine, 2021) Unlu, Elif Nisa; Altinsoy, Hasan Baki; Balaby, Ege Gulec; Sungur, Mehmet Ali; Boran, Mertay; Onal, BinnurObjective: The study aims to evaluate the usefulness of non-invasive diagnostic methods, shear wave elastography (SWE), and diffusion-weighted magnetic resonance imaging (DWI) to differentiate benign and malignant lesions in the thoracic pleural based masses by comparing them with histopathological findings. Methods: Sixty-three patients having a pleural-based peripheral mass on computed tomography (CT), admitted to the interventional radiology department for transthoracic biopsy, were included in the study. All patients underwent DWI, and ADC values of the groups were measured. Transthoracic biopsy was performed with the guidance of US from the area where the highest shear wave velocity (SWV) value was calculated. ADC and SWV values of histopathologically proven benign and malignant lesions were statistically compared. Results: Fifty-six patients were male, and seven were female. The mean age was 64.68 +/- 10.13 years (41-85 years). Fourty-four patients were malignant, and 19 were benign. The maximum SWV was found to be 4.13 +/- 0.59 m/s in malignant cases and 3.55 +/- 0.71 m/s in benign cases, and the difference was significant (p = 0.001). Mean ADC value was measured as 1.04 +/- 0.30 x 10-3 mm2/s in malignant cases and 1.32 +/- 0.33 x 10-3 mm2/s in benign cases on DWI and the difference was significant (p = 0.002). In malignant cases, the minimum ADC was 0.73 +/- 0.29 x 10-3 mm2/s, and 0.99 +/- 0.44 x 10-3 mm2/s in benign cases, the difference was significant (p = 0.024). ROC analysis revealed a cut-off value of >= 4.08 m/s for SWVmax, <= 1.01x10-3 mm2/s for mean ADC, and <0.8x10-3 mm2/s for minimum ADC showed a significant performance in distinguishing malignant and benign lesions. Conclusions: Transthoracic US elastography and DWI are useful in differentiating malignant and benign lesions in appropriate cases. Both SWE and DWI are useful in routine use because they are non-invasive and do not contain radiation. In particular, SWE is suitable for biopsy guidance and may prevent the possibility of insufficient material.Öğe Smartphone evaluation of postero-anterior chest x-rays: An inter-observer study(W B Saunders Co-Elsevier Inc, 2021) Bogan, Mustafa; Altinsoy, Hasan Baki; Karadag, MehmetBackground: Posterior-anterior chest x-ray (PA-CXR) is among the most commonly used imaging methods in the diagnosis both in the emergency departments (ED) and the other clinics. The aim of the present study was to evaluate the diagnostic reliability of PA-CXRs sent via a smartphone. Methods: This study was conducted as an inter-observer study. PA-CXRs were photographed with a smartphone and they were sent to two separate participants (emergency medicine specialists one with 4 years experience and another with 3) via the WhatsApp application. And the participants evaluated to these images on their mobile phone. Results: A poor concordance was determined in a ratio of 3/8 and good concordance was detected in a ratio of 3/8 between the two participants (p < 0.05). It was observed that only the mediastinum assessments could be an alternative to the gold standard (p < 0.01). Conclusion: We may conclude that the assessments done via a smartphone (photographing and sharing) may not be reliable. (C) 2020 Elsevier Inc. All rights reserved.Öğe Using Smartphone to Evaluate Cranial Computed Tomography Videos: An Inter-Observer Study(Duzce Univ, Fac Medicine, 2022) Naldemir, Ibrahim Feyyaz; Karaman, Ahmet Kursat; Altinsoy, Hasan Baki; Bogan, Mustafa; Karadag, MehmetObjective: Many clinicians receive Cranial Computed Tomography (CCT) images or videos by their smartphone. The aim of this study was to evaluate the reliability of the CCT videos that are shared through smartphone in the diagnosis. Methods: The CCT videos that were sent via WhatsApp were examined in 9 sections: soft tissue, bone structure, parenchyma, ventricle, vascular structures, middle ear, orbits, sinuses and the extra axial space. Results: The CCT videos were analyzed in 9 sections; there was a perfect agreement among specialists in one of these sections, good agreement in 6 and poor agreement in 2. When compared with the gold standard, it was shown that 5 out of 9 sections could be an alternative to the gold standard. Conclusions: It may be thought that evaluation of the CCT videos can be obtained with messenger applications such as WhatsApp, which is a cheap, fast and common application. But this study shows that diagnostic images and videos shared through the smartphone by a messenger application can not be an alternative to standard evaluations.
