Merve Şam Özdemir

Objective: Neoadjuvant chemoradiotherapy (NACRT) plays an important role in the treatment of esophageal cancer. Current studies show that increased pathological response and R0-resection rates positively affect treatment outcomes. This study aimed to evaluate the clinical outcomes of patients who received NACRT with or without surgery. Methods: In this study, 72 patients diagnosed with esophageal cancer who underwent NACRT, with or without subsequent surgery, were retrospectively analyzed. Radiotherapy (RT) fields were defined based on the primary tumor location, and the median RT dose was 50.4 Gy (range: 41.4–54 Gy). The patients received a chemotherapy regimen consisting of 5 cycles of carboplatin and paclitaxel. Following CRT, patients who were eligible for surgery depending on their pathological response rates underwent surgical resection. Results: Overall survival and progression-free survival were found to be statistically significantly higher in the surgical group (P = .03 and P = .01). Overall survival (P = .001) and progression-free survival (P = .001) were significantly higher in patients with pathological yp-Stage 0–1 compared to those with higher pathological stages. Conclusion: This study highlights the impact of pathological response rates following NACRT, with or without surgery, on treatment outcomes in esophageal cancer. Cite this article as: Çepni K, Uçgun TH, Şam Özdemir M, Aydın SN, Çepni B, Kızıltan HS. Impact of response rates on overall survival following chemoradiotherapy with or without surgery in esophageal cancer. Cerrahpaşa Med J 2026, 50, 0079, doi:10.5152/cjm.2026.25079.

Background/Objectives: Early identification of vasculitic acute kidney injury (AKI) is crucial for timely immunosuppression and improved renal outcomes; however, noninvasive adjunctive diagnostic tools remain limited. Renal elastography, a noninvasive technique that quantifies renal cortical stiffness, has been primarily investigated in chronic kidney disease, whereas evidence in acute kidney injury is scarce. This study aimed to evaluate the diagnostic utility of renal shear wave elastography for differentiating vasculitic from non-vasculitic AKI and to explore the association between baseline renal cortical stiffness and vasculitic renal outcomes. Materials and Methods: This prospective observational study included three groups: vasculitic AKI, non-vasculitic AKI, and healthy controls. Renal cortical stiffness was measured at admission using two-dimensional shear-wave elastography (2D-SWE) by radiologists blinded to clinical information. After clinicopathological confirmation of definitive diagnoses, between-group comparisons were performed and the diagnostic performance of elastography was evaluated. Additionally, in a biopsy-confirmed immunoglobulin A vasculitis nephritis (IgAVN) cohort (n = 12), baseline elastography measurements were examined in relation to one-year renal outcomes to explore potential prognostic associations. Results: The vasculitic AKI group exhibited significantly higher mean renal cortical stiffness values (9.5 ± 1.9 kPa) compared with both healthy controls (5.53 ± 0.92 kPa) and the non-vasculitic AKI group (6.61 ± 1.89 kPa) (both p < 0.01). Mean renal cortical stiffness demonstrated good diagnostic performance for distinguishing vasculitic from non-vasculitic AKI (AUC 0.86, 95% CI 0.73–0.97), with an optimal threshold of 6.79 kPa yielding 91% sensitivity and 72% specificity. In the prospective one-year follow-up of the IgAVN subcohort (n = 12), patients with unfavorable renal outcomes tended to have higher baseline renal cortical stiffness compared with those with favorable outcomes [median (min–max), 11.2 (10.8–13.3) vs. 9.1 (5.6–11.2), p = 0.046]. Conclusions: These findings suggest that renal elastography may aid in distinguishing vasculitic from non-vasculitic acute kidney injury and may provide exploratory information on the relationship between baseline cortical stiffness and renal outcomes in IgAVN.

Endometriosis is a chronic gynecological disorder characterized by the ectopic presence of endometrial tissue, often resulting in pelvic pain, infertility, and decreased quality of life. Magnetic Resonance Imaging (MRI) plays a crucial role in noninvasive diagnosis and preoperative assessment of endometriosis, particularly in evaluating complex or deep infiltrative diseases. A detailed and structured report on lesion depth, extension, and involvement of critical anatomical structures is vital for multidisciplinary teams’ decision-making. By comprehensively understanding and recognizing the complete range of endometriosis manifestations, radiologists can significantly enhance individualized treatment strategies and improve patient outcomes. This pictorial review highlights the key MRI features of endometriosis and provides essential guidance for radiologists during the imaging and reporting process.

Objectives: To evaluate the role of shear wave elastography (SWE) in distinguishing acute from subacute thrombi in thrombosed arteriovenous fistulas (AVFs) and explore the relationship between thrombus stiffness and outcomes of balloon angioplasty.Materials and Methods: This retrospective study included 44 dialysis patients with thrombosed AVFs from June 2022 to June 2024. Patients underwent Doppler ultrasound and SWE to assess thrombus age, followed by balloon angioplasty. Based on ultrasound findings and clinical history, patients were classified into acute and subacute thrombus groups. SWE was used to measure thrombus stiffness (kPa values). Procedural outcomes, including technical and clinical success, and primary and secondary patency, were compared between groups.Results: The study included 23 patients with acute and 21 with subacute thrombus. SWE measurements (average, median, and maximum kPa) were significantly higher in subacute thrombi (P < .001). A strong positive correlation existed between thrombus age and kPa values (r = .770, r = .727, r = .835). Receiver operating characteristic analysis showed SWE could effectively distinguish acute from subacute thrombi, with an average cut‐off of 31.733 kPa (sensitivity: 90.5%, specificity: 73.9%). No significant correlation was found between SWE values and procedural outcomes (P > .05).Conclusion: SWE is a promising tool for assessing thrombus age in AVF thrombosis, effectively differentiating between acute and subacute thrombi. Although it did not predict procedural success, SWE could complement existing imaging for improved thrombus characterization and treatment planning.

Purpose: Although 18 F-FDG-PET/CT is helpful in defining many types of cancer, localized prostate cancer should not be treated with this technique. This study describes the use of multi-parametric MRI (mpMRI) to characterize incidental 18 F-FDG uptake in the prostate. Methods and Materials: While 18 F-FDG-PET/CT is useful for characterizing a variety of cancers, it is not advised for prostate cancer that is localized. This work investigates the use of mpMRI to describe incidental 18 F-FDG uptake in the prostate.mpMRI included T2-weighted (T2W), dynamic contrast enhancement (DCE), and apparent diffusion coefficient (ADC) sequences. Patients were classified according to PI-RADS (Prostate Imaging Reporting and Data System) version 2.1 by an experienced uroradiologist, and 18 F-FDG-PET was evaluated to determine whether the area of involvement on CT had a counterpart in mpMRI. A biopsy was performed on 30 of the 92 patients. These patients’ maximum standardized uptake values (SUVmax) 6 < and ≥ 6, PS(PSA) density 0.15 < and ≥ 0.15, PSA level, uptake pattern (focal involvement/diffuse involvement), and PI-RADS scores were compared. P < .05 was considered statistically significant. Logistic regression was used to analyze PI-RADS score groups age, PSA, PSA density and SUVmax. Results: In the study, 92 patients with incidental 18 F-FDG-PET/CT prostate uptake were examined. Median age was 66, PSA median was 3.6 ng/ml (range: 0-3198 ng/ml). Notably, in 70.6% of cases, PET/CT uptake didn’t correlate with mp-MRI findings. Among PI-RADS 3-4-5 patients (29.3%), there was a correlation. Biopsies in 30 patients revealed 43.3% benign, 56.7% malignant. Significant differences between benign and malignant cases were observed in PSA density, PI-RADS scores, and PSA levels (p < .05), while SUVmax and uptake pattern were not significant. In multivariate logistic regression analysis, PI-RADS score groups were found to be independent risk factors for predicting malignancy. Conclusions: Our study showed that incidental 18 F-FDG-PET/CT prostate uptake was detected and that high PSA density values, PI-RADS scores, and PSA values, such as in routine patients, and not PET-CT findings such as SUVmax and uptake pattern, were more predictive of malignancy.