Çakmak, Vefa; Çakmak, Pınar; Herek, Duygu; Aydın, Sonay

Migrants and refugees tend to use emergency departments as their primary source of care, leading to a substantial increase in emergency radiological imaging. Migrants and refugees have risk factors, such as low vaccination rates, poor hygiene, malnutrition, and inadequate self-care, which increase their risk of contracting infectious diseases. For example, the prevalence of tuberculosis among refugee populations in host countries is increasing, and imaging findings related to tuberculosis are frequently observed by radiologists. Strengthening screening programs in host countries for tuberculosis and other infectious diseases among migrant populations can help mitigate the risk of transmission within migrant communities. Another condition, cystic echinococcosis, is more common among refugees and migrants from the Middle East and Afghanistan. For radiologists working in host countries, echinococcosis involving the liver and lungs should be considered in the differential diagnosis. Both intentional (e.g., violence, assault) and unintentional (e.g., workplace injuries, accidents) traumas are frequently encountered in emergency radiology, particularly among refugees and immigrants. Workplace injuries are four times more common among migrants and refugees than among the local population due to their work in high-risk industries, such as construction and heavy industry, and emergency radiology frequently encounters radiological findings of organ injuries due to falls from height. In addition, healthcare professionals in emergency radiology face various challenges when dealing with migrant and refugee patients, such as communication barriers, social security problems, and psychological distress. Copyright @ 2026 Author(s)

Kadırhan, Özlem; Aydın, Sonay; Keskin, Ercüment; Kantarcı, Mecit

PURPOSE Urolithiasis is a common health problem with a high recurrence rate, and effectively balancing follow-up with intervention is important for patient safety. In this context, our study aims to identify criteria that can predict the likelihood of spontaneous passage (SP) of ureteral stones. METHODS A retrospective analysis was performed on 2,773 patients who presented to our hospital with renal colic over a 4-year period. The study included 897 patients with unilateral ureteral stones measuring ≤10 mm, identified using non-contrast computed tomography, and inflammatory serum markers assessed through biochemical testing. Variables analyzed to predict the likelihood of SP included stone size, lateralization and location, ureteral wall thickness (UWT) at the stone site, stone density, degree of hydronephrosis (HN), ureteral length, parenchymal thickness and density, and various biochemical parameters. RESULTS It was determined that the SP of ureteral stones was considerably affected by larger stone size (right >6.5 mm, left >6 mm), higher stone density (>957 Hounsfield units), increased UWT (>1.7 mm), presence of high-grade HN (grade ≥2), and elevated neutrophil-lymphocyte ratio (NLR) (>2.15) and platelet-lymphocyte ratio (PLR) (>10.28) values in blood. No statistically significant relationship was observed between SP and ureteral length, renal parenchymal thickness, or renal parenchymal density. It was found that when the UWT at the level of the ureteral stone exceeded 1.7 mm, the risk of the stone not passing spontaneously increased by 706.5 times in univariate logistic regression (LR) analysis and by 337.9 times in multivariate LR analysis compared with individuals with a wall thickness below this threshold. CONCLUSION Our study demonstrated that, in addition to stone size and location, increased UWT at the stone level, higher stone density, the presence of concomitant high-grade HN, and elevated NLR and PLR values in the blood could be used as criteria to determine the likelihood of SP of ureteral stones. According to our results, UWT was shown to be a stronger risk factor for failure of SP than stone size. CLINICAL SIGNIFICANCE The findings indicate that wall thickness around ureteral stones is a risk factor with a higher negative predictive value for SP than the stone size and location. Copyright @ 2026 Author(s)

Kantarcı, Mecit; Kızılgöz, Volkan; Terzi, Ramazan; Kılıç, Ahmet Enes; Kabalcı, Halime; Durmaz, Önder; Tokgöz, Nil; Harman, Mustafa; Kahraman, Ayşegül Sağır; Avanaz, Ali

PURPOSE This study aimed to evaluate the effectiveness of artificial intelligence (AI) in diagnosing focal nodular hyperplasia (FNH) of the liver using magnetic resonance imaging (MRI) and compare its perfor mance with that of radiologists. METHODS In the first phase of the study, the MRIs of 60 patients (30 patients with FNH and 30 patients with no lesions or lesions other than FNH) were processed using a segmentation program and introduced to an AI model. After the learning process, the MRIs of 42 different patients that the AI model had no experience with were introduced to the system. In addition, a radiology resident and a radiology specialist evaluated patients with the same MR sequences. The sensitivity and specificity values were obtained from all three reviews. RESULTS The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the AI model were found to be 0.769, 0.966, 0.909, and 0.903, respectively. The sensitivity and specificity values were higher than those of the radiology resident and lower than those of the radiology specialist. The results of the specialist versus the AI model revealed a good agreement level, with a kappa (κ) value of 0.777. CONCLUSION For the diagnosis of FNH, the sensitivity, specificity, PPV, and NPV of the AI device were higher than those of the radiology resident and lower than those of the radiology specialist. With additional studies focused on different specific lesions of the liver, AI models are expected to be able to diagnose each liver lesion with high accuracy in the future. CLINICAL SIGNIFICANCE AI is studied to provide assisted or automated interpretation of radiological images with an accurate and reproducible imaging diagnosis.

Kantarcı, Mecit; Aydın, Sonay; Oğul, Hayri; Kızılgöz, Volkan

Radiography is a field of medicine inherently intertwined with technology. The dependency on technology is very high for obtaining images in ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Although the reduction in radiation dose is not applicable in US and MRI, advancements in technology have made it possible in CT, with ongoing studies aimed at further optimization. The resolution and diagnostic quality of images obtained through advancements in each modality are steadily improving. Additionally, technological progress has significantly shortened acquisition times for CT and MRI. The use of artificial intelligence (AI), which is becoming increasingly widespread worldwide, has also been incorporated into radiography. This technology can produce more accurate and reproducible results in US examinations. Machine learning offers great potential for improving image quality, creating more distinct and useful imag-es, and even developing new US imaging modalities. Furthermore, AI technologies are increasingly prevalent in CT and MRI for image evaluation, image generation, and enhanced image quality.

Aydin, Sonay; Kazci, Omer; Ece, Bunyamin; Kantarci, Mecit

Earthquakes are among the most destructive and unpredictable natural disasters. Various diseases and ailments, such as bone fractures, organ and soft-tissue injuries, cardiovascular diseases, lung diseases, and infectious diseases, can develop in the aftermath of severe earthquakes. Digital ra-diography, ultrasound, computed tomography, and magnetic resonance imaging are significant imaging modalities utilized for the quick and reliable assessment of earthquake-related ailments to facilitate the planning of suitable therapy. This article examines the usual radiological imaging characteristics observed in individuals from quake-damaged regions and summarizes the strengths and functionality of imaging modalities. In such circumstances, where quick decision-making processes are life-saving and essential, we hope this review will be a practical reference for readers.

Kantarcı, Mecit; Bayraktutan, Ümmügülsüm; Akbulut, Abdusselam; Taydaş, Onur; Ceviz, Naci; Güven, Fadime; Oğul, Hayri; Aydın, Sonay

PURPOSE The inflammation of the heart muscle is referred to as acute myocarditis. Cardiac magnetic resonance imaging (CMR) has become the primary method for a non-invasive assessment of myocardial inflammation. However, there are several drawbacks of CMR. During the last decade, dual energy computed tomography (DECT) has been used in cardiac imaging. The current study aims to assess the efficacy and feasibility of DECT in acute myocarditis and compare the results to CMR. METHODS This prospective study included patients who had myocarditis but no coronary artery pathology. Two observers evaluated the patients for acute myocarditis using DECT and CMR. CMR was performed on 22 patients within 24 hours of DECT, which was administered within 12 hours following the onset of chest pain. Inter-observer agreement was tested with Cohen’s Kappa coefficient, and Spearman’s correlation was used to examine the possible correlations. A P value of <0.050 was ac-cepted as statistically significant. RESULTS The DECT and CMR agreement was significant for transmural diagnoses, excellent for subepicardial and intramyocardial diagnoses, and perfect for nodular and band-like patterns. CONCLUSION The findings of this study showed that the dark areas on the color-coded iodine map created with DECT were strongly correlated with CMR in acute cases of myocarditis. In addition, DECT is a ro-bust imaging method that can also be used in the diagnosis of acute myocarditis. Furthermore, it provides information about coronary arteries faster and more reliably than magnetic resonance imaging without any limitations.

Onur, Mehmet Ruhi; Özbay, Yakup; İdilman, İlkay; Karaosmanoğlu, Ali Devrim; Ramadan, Selma Uysal; Barlık, Funda; Aydın, Sonay; Odaman, Hüseyin; Altay, Canan; Akın, Işıl Başara

PURPOSE 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. METHODS 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. RESULTS 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. CONCLUSION 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.

Aydın, Sonay; Karavaş, Erdal; Ünver, Edhem; Şenbil, Düzgün Can; Kantarcı, Mecit

PURPOSE Although the findings of acute new coronavirus disease (COVID-19) infection on dual-energy computed tomography (DECT) have recently been defined, the long-term changes in lung perfusion associated with COVID-19 pneumonia have not yet been clarified. We aimed to examine the long-term course of lung perfusion in COVID-19 pneumonia cases using DECT and to compare changes in lung perfusion to clinical and laboratory findings. METHODS On initial and follow-up DECT scans, the presence and extent of perfusion deficit (PD) and paren-chymal changes were assessed. The associations between PD presence and laboratory parameters, initial DECT severity score, and symptoms were evaluated. RESULTS The study population included 18 females and 26 males with an average age of 61.32 ± 11.3 years. Follow-up DECT examinations were performed after the mean of 83.12 ± 7.1 (80–94 days) days. PDs were detected on the follow-up DECT scans of 16 (36.3%) patients. These 16 patients also had ground-glass parenchymal lesions on the follow-up DECT scans. Patients with persistent lung PDs had significantly higher mean initial D-dimer, fibrinogen, and C-reactive protein values than patients without PDs. Patients with persistent PDs also had significantly higher rates of persistent symptoms. CONCLUSION Ground-glass opacities and lung PDs associated with COVID-19 pneumonia can persist for up to 80–90 days. Dual-energy computed tomography can be used to reveal long-term parenchymal and perfusion changes. Persistent PDs are commonly seen together with persistent COVID-19 symptoms.

Kantarcı, Mecit; Aydın, Sonay; Kahraman, Ayşegül; Oğul, Hayri; İrgül, Barış; Levent, Akın

PURPOSE When a suspected hepatic alveolar echinococcosis (AE) lesion is detected on a contrast enhanced computed tomography (CT) scan, an additional triphasic or non-enhanced CT scan is required to determine the presence of calcification and enhancement. As a result, imaging costs and exposure to ionizing radiation will increase. We can create a non-enhanced series from routine contrast-en-hanced images using dual-energy CT (DECT) and virtual non-enhanced (VNE) images. This study’s objective is to assess virtual non-enhanced DECT reconstruction as a potential diagnostic tool for hepatic AE. METHODS Triphasic CT scans and a routine dual energy venous phase were acquired using a third-generation DECT system. A commercially available software package was used to generate VNE images. Indi-vidual evaluations were conducted by two radiologists. RESULTS The study population consisted of 100 patients (30 AE, 70 other solid liver masses). All AE cases were diagnosed [no false positives/negatives, 95% confidence interval (CI) sensitivity: 91.3%–100%; 95% CI specificity: 95.3%–100%]. Interrater agreement was k: 0.79. In total, 33 (33.00%) of the patients had AE, which was detected using both true non-enhanced (TNE) and VNE images. The mean dose-length product of a standard triphasic CT was significantly higher than biphasic dual-energy VNE images. CONCLUSION In terms of diagnostic confidence, VNE images are comparable with actual non-enhanced imaging when evaluating hepatic AE. Further, VNE images could replace TNE images with a substantial radiation dose reduction. Advances in knowledge: hepatic cystic echinococcosis and AE are serious and severe diseases with high fatality rates and a poor prognosis if managed incorrectly, especially AE. Moreover, VNE images produce equal diagnostic confidence to TNE images for assessing liver AE, with a significant reduction in radiation dose.