Ahmet Burak Kale

PURPOSE This study aimed to characterize the contrast-enhanced mammography (CEM) findings of histopathologically confirmed idiopathic granulomatous mastitis (IGM), compare isolated mass and non-mass enhancement (NME) phenotypes, and explore the cumulative burden of malignancy-mimicking imaging…

Objectives: To evaluate the diagnostic performance of ultrasound‐derived fat fraction (UDFF) in detecting and grading hepatosteatosis using liver histology as the reference, and to assess the effectiveness of point shear wave elastography (pSWE), UDFF, and auto‐pSWE in diagnosing steatohepatitis and detecting fibrosis in metabolic dysfunction‐associated steatotic liver disease (MASLD). Methods: In this prospective study, patients underwent liver biopsy following UDFF and pSWE measurements using deep abdominal transducer (DAX) and conventional abdominal probes by 2 operators. Imaging findings were compared with histopathology to assess diagnostic performance. Associations between nonalcoholic fatty liver disease activity score (NAS), fibrosis stage, and imaging parameters were also evaluated. Results: A total of 121 patients were included. The median age was 50 years, and 57 (41%) were male. Histology confirmed steatotic liver disease in 43 cases. Excellent interobserver agreement was observed for UDFF (ICC = 0.974), pSWE (ICC = 0.958), and auto‐pSWE (ICC = 0.960). UDFF showed a stepwise increase with steatosis grade and was moderately correlated with histological fat content ( r = 0.676 for Sonographer 1, r = 0.638 for Sonographer 2; P < .001). For detecting S ≥ 1 steatosis, the optimal UDFF thresholds were ≥8.4% (Area Under the Curve (AUC) = 0.968; Se = 92.5%, Sp = 93.2%) for Sonographer 1 and ≥8.6% (AUC = 0.951; Se = 90.0%, Sp = 86.3%) for Sonographer 2. For moderate steatosis (S ≥ 2), the cutoffs were ≥10.4% (AUC = 0.932; Se = 100%, Sp = 79.6%) and ≥10.6% (AUC = 0.925; Se = 100%, Sp = 76.5%), and for severe steatosis (S = 3), ≥18.3% (AUC = 0.961; Se = 100%, Sp = 77.4%) and ≥18.7% (AUC = 0.949; Se = 100%, Sp = 77.4%) for Sonographer 1 and 2, respectively. UDFF positively correlated with body mass index and subcutaneous fat thickness, and negatively with both pSWE and auto‐pSWE. A strong correlation was observed between pSWE and auto‐pSWE for both observers. A weak positive correlation was found between NAS and auto‐pSWE in MASLD cases. The optimal thresholds to detect fibrosis (≥F1) were 5.05 and 4.95 kPa for Sonographer 1, and 5.05 and 4.85 kPa for Sonographer 2, for pSWE and auto‐pSWE measurements, respectively. Conclusion: DAX‐derived UDFF and auto‐pSWE are reproducible, noninvasive biomarkers with strong diagnostic value in assessing steatosis and fibrosis in MASLD.

To evaluate the frequency of abdominal computed tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19) and interrogate the relationship between abdominal CT findings and patient demographic features, clinical findings, and laboratory test results as well as the CT atherosclerosis score in the abdominal aorta. This study was designed as a multicenter retrospective study. The abdominal CT findings of 1.181 patients with positive abdominal symptoms from 26 tertiary medical centers with a positive polymerase chain-reaction test for severe acute respiratory syndrome coronavirus 2 were reviewed. The frequency of ischemic and non-ischemic CT findings as well as the association between CT findings, clinical features, and abdominal aortic calcific atherosclerosis score (AA-CAS) were recorded. Ischemic and non-ischemic abdominal CT findings were detected in 240 (20.3%) and 328 (27.7%) patients, respectively. In 147 patients (12.4%), intra-abdominal malignancy was present. The most frequent ischemic abdominal CT findings were bowel wall thickening (n = 120; 10.2%) and perivascular infiltration (n = 40; 3.4%). As for non-ischemic findings, colitis (n = 91; 7.7%) and small bowel inflammation (n = 73; 6.2%) constituted the most frequent disease processes. The duration of hospital stay was found to be higher in patients with abdominal CT findings than in patients without any positive findings (13.8 ± 13 vs. 10.4 ± 12.8 days, P < 0.001). The frequency of abdominal CT findings was significantly higher in patients who did not survive the infection than in patients who were discharged after recovery (41.7% vs. 27.4%, P < 0.001). Increased AA-CAS was found to be associated with a higher risk of ischemic conditions in abdominal CT examinations. Abdominal symptoms in patients with COVID-19 are usually associated with positive CT findings. The presence of ischemic findings on CT correlates with poor COVID-19 outcomes. A high AA-CAS is associated with abdominal ischemic findings in patients with COVID-19.