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Yıl 2013, Cilt: 26 Sayı: 3, 151 - 157, 30.09.2015

Direnç Aksoy Zeynep Kılıçoğlu Gökalp Yılmaz Ercüment Kadıoğlu Mehmet Masum Şimşek Seçil Telli

Öz

Objective: To assess whether identified scoring system and various guantitative data would help clinicians to distinguishing malignant from benign breast lesions more accurately on the dynamic contrast enhancedmagnetic resonance images (DCE-MRI).Patients and Methods: Ninety-five lesions included in our research were evaluated by a scoring system (Fischer’s score) that can be accepted as an analogue of breast imaging-reporting and data systems (BI-RADS). Time to peak enhancement (Tpeak), maximum slope of enhancement curves (Smax) and washout values which are quantitative parameters computed from kinetic data were calculated.Results: In the evaluation the Fischer scoring system, specificities of total points 0-3, 4 and 5-8 were 23.40%, 78.87% and 97.87% respectively. The parameters of the scoring system showed that the shape of a lesion which is one of the morphologic characteristics, was statistically the most significant parameter (p=0.001). Rim enhancement had the highest specificity (97.87%) of the morphologic parameters. There was no significant difference between malignant and benign lesions in the percentage of early enhancement when we examined the kinetic data. There was significant difference between kinetic curves of type 1 compared to types 2-3 (p=0.001). The quantitative parameters Tpeak and Smax, were statistically significant.Conclusion: Scoring systems in which both morphologic parameters and kinetic curves are evaluated give useful information in distinguishing benign from malignant breast lesions. Also, statistically significant Tpeak and Smax quantitative values can be useful in the diagnosis of breast lesions.

Anahtar Kelimeler

Breast DCE-MRI Dynamic Quantitative Scoring

Kaynakça

  • 1. Jansen SA, Fan X, Karczmar GS, Abe H, Schmid RA. DCEMRI of breast lesions: Is kinetic analysis equally effective for both mass and nonmass-like enhancement? Med Phys 2008; 35: 3102–9. doi: 10.1118/1.2936220
  • 2. Abraham DC, Jones RC, Jones SE, et al. Evaluation of neoadjuvant chemotherapeutic response of locally advanced breast cancer by magnetic resonance imaging. Cancer 1996; 78: 91–100. doi: 10.1002/ (SICI]1097-0142(19960701]78:1<91::AID-CNCR14>3.0.CO;2-2
  • 3. Boetes C, Mus RD, Holland R, et al. Breast tumors: Comparative accuracy of MR imaging relative to mammography and US for demonstrating extent. Radiology 1995; 197: 743–7.
  • 4. Fischer U, Kopka L, Grabbe E. Breast carcinoma: effect of preoperative contrast enhanced MR imaging on the therapeutic approach. Radiology 1999; 213:881-8.
  • 5. Siegmann KC, Müller-Schimpfle MM, Schick F, et al. MR imaging– detected breast lesions: histopathological correlation of lesion characteristics and signal intensity data. AJR Am J Roentgenol 2002;178:1403-19. doi:10.2214/ajr.178.6.1781403
  • 6. KarahaliouA, Vassiou K, Arikidis NS, et al. Assessing heterogeneity of lesion enhancement kinetics in dynamic contrast-enhanced MRI for breast cancer diagnosis. Br J Radiol 2010;83:296-306. doi:10.1259/ bjr/50743919
  • 7. Orel SG. Differentiating benign from malignant enhancing lesions identified at MR imaging of the breast: Are time-signal intensity curves an accurate predictor? Radiology 1999;211:5-7.
  • 8. Kaiser WA, Zeitler E. MR imaging of the breast: fast imaging sequences with and without Gd-DTPA-preliminary observations. Radiology 1989;170:681-6
  • 9. Lee CH. Problem solving MR imaging of the breast. Radiol Clin North Am 2004;42:919–34. doi:10.1016/j.rcl.2004.05.001
  • 10. Sivarjan U, Jayapragasam KJ, Abdul Aziz YF, Rahmat K, Bux SI. Dynamic contrast enhancement magnetic rezonance imaging evaluation of breast lesions: a morphological and quantitative analysis. JHK Coll Radiol 2009;12:43-52.
  • 11. Heywang SH, Wolf A, Pruss E, Hilbertz T, Eiermann W, Permanetter W. MR imaging of breast wth Gd-DTPA: use and limitations. Radiology 1993;171:95-103.
  • 12. Heywang-Kobrunner SH, Viehweg P, Heinig A, Kuchler C. Contrastenhanced MRI of the breast: accuracy, value, controversies, solutions. Eur J Radiol 1997;24:94–108. doi: 10.1016/S0720-048X(96]01142-4
  • 13. Schnall MD, Blume J, Bluemke DA, et al. Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology 2006; 238:42–5. doi:10.1148/radiol.2381042117
  • 14. Harms SE, Flamig DP, Hesley KL, et al. MR imaging of the breast with rotating delivery of excitation off resonance: clinical experience with pathologic correlation. Radiology 1993; 187: 493–501.
  • 15. Kuhl CK, Schmutzler R, Leutner CC, et al. Breast MR imaging screening in 192 women proved or suspected to be carriers of a breast cancer susceptibility gene: preliminary results. Radiology 2000; 215: 267–79.
  • 16. American Collage of Radiology Breast Imaging Reporting and Data System (BI-RADS]. 4th edition. Reston (VA): American Collage of Radiology; 2003.
  • 17. Nunes LW, Schnall MD, Orel SG, et al. Breast MR imaging: interpretation model. Radiol 1997;202:833–41.
  • 18. Nunes LW, Schnall MD, Siegelman ES, et al. Diagnostic performance characteristics of architectural features revealed by high spatialresolution MR imaging of the breast. AJR Am J Roentgenol 1997; 169:409-15. doi:10.2214/ajr.169.2.9242744
  • 19. Al-Khawari H, Athyal R, Kovacs A, Al-Saleh M, Madda JP. Accuracy of the Fischer scoring system and the Breast Imaging Reporting and Data System in identification of malignant breast lesions. Ann Saudi Med 2009;29:280-7. doi:10.4103/0256-4947.55310
  • 20. Kuhl CK, Schild HH, Morakkabati N. Dynamic bilateral contrastenhanced MR imaging of the breast:trade-off between spatial and temporal resolution .Radiology 2005;236:789-800. doi:10.1148/ radiol.2363040811
  • 21. Goto M, Ito H, Akazawa K, Kubota T, Kizu O, Yamada K, Nishimura T. Diagnosis of breast tumors enhancement patterns and morphologic features. J Magn Reson Imaging 2007; 25:104–12. doi:10.1002/ jmri.20812
  • 22. Jansen SA, Fan X, Karczmar GS, Abe H, Schmidt RA. Differentiation between benign and malignant breast lesions detected by bilateral dynamic contrast-enhanced MRI: A sensitivity and specificity study. Magn Reson Med 2008 ; 59: 747–54. doi: 10.1002/mrm.21530
  • 23. Morris EA. Breast cancer imaging with MRI. Radiol Clin Nort Am 2002;40:443-66. doi:10.1016/S0033-8389(01]00005-7
  • 24. Kuhl CK, Mielcareck P, Klaschik S, et al. Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions? Radiology 1999; 211: 101-10.
  • 25. Kinkel K, Helbich TH, Esserman LJ, et al. Dynamic high-spatialresolution MR imaging of suspicious breast lesions: diagnostic criteria and interobserver variability. AJR 2000;175:35–43. doi:10.2214/ ajr.175.1.1750035
  • 26. Szabó BK, Aspelin P, Wiberg MK, Boné B. Dynamic MR imaging of the breast. Analysis of kinetic and morphologic diagnostic criteria. Acta Radiol 2003;44:379–86. doi:10.1080/j.1600-0455.2003.00084.x
  • 27. Eyal E, Degani H. Model-based and model-free parametric analysis of breast dynamic-contrast-enhanced MRI. NMR Biomed 2009;22:40– 53. doi:10.1002/nbm.1221
  • 28. Tofts PS, Brix G, Buckley DL. et al. Estimating kinetic parameters from dynamic contrast-enhanced T1-weighted MRI of a diffusible tracer: standardized quantities and symbols. J Magn Reson Imaging 1999;10:223–32. doi:10.1002/(SICI]1522- 2586(199909]10:3<223::AID-JMRI2>3.0.CO;2-S
  • 29. Boetes C, Barentsz JO, Mus RD, et al. MR characterization of suspicious breast lesions with a gadolinium-enhanced turbo-FLASH substraction technique. Radiology 1994;193:777-81.
  • 30. El Khouli RH, Macura KJ, Jacobs MA, et al. Dynamic contrastenhanced MRI of the breast: Quantitative method for kinetic curve type asseessment. AJR Am J Roentgenol 2009;193:W295-W300. doi: 10.2214/AJR.09.2483
  • 31. Gilles R, Guinebretiere JM, Lucidarme O,et al. Nonpalpable breast tumors: diagnosis with contrast-enhanced substraction dynamic MR imaging. Radiology 1994;191:625-31. .
  • 32. Gribbestad IS, Nilsen G, Fjosne HE,Kvinnsland S, Haugen OA, Rinck PA. Comparative signal intensity measurements in dynamic gadolinium-enhanced MR mammography. JMRI 1994;4:477-80. doi:10.1002/jmri.1880040339
  • 33. Orel SG, Schnall MD. MR imaging of the breast for the detection, diagnosis, and staging of breast cancer. Radiology 2001;220:13-30.
  • 34. Orel SG, Schnall MD, LiVolsi VA, Troupin RH. Suspicious breast lesions: MR imaging with radiologic-pathologic correlation. Radiology 1994;190:485-93.
  • 35. Hickman PF, Moore NR, Shepstone BJ. The indeterminate breast mass: assessment using contrast enhanced magnetic resonance imaging. Br J Radiol 1994; 67: 14–20. doi:10.1259/0007-1285-67-793-14
  • 36. Stomper PC, Herman S, Klippenstein DL, et al. Suspect breast lesions: findings at dynamic gadolinium-enhanced MR imaging correlated with mammographic and pathologic features. Radiology 1995; 197:387–95.
  • 37. Brinck U, Fischer U, Korabiowska M, Jutrowski M, Schauer A, Grabbe E. The variability of fibroadenoma in contrastenhanced dynamic MR mammography. AJR Am J Roentgenol 1997; 168:1331– 4.
  • 38. Liu PF, Debatin JF, Caduff RF, et al. Improved diagnostic accuracy in dynamic contrast enhanced MRI of the breast by combined quantitative and qualitative analysis. Br J Radiol 1998; 71:501–9.
  • 39.  Siegmann-Luz KC, Bahrs SD, Preibsch H, et al. Management of breast lesions detectable only on MRI. Fortschr Röntgenstr 2013; doi: 10.1055/s-0033-1335972
  • 40. Sittek H, Perlet C, Untch M, Kessler M, Reiser M. Dynamic MRmammography in invasive lobular breast cancer [in German]. Rontgenpraxis 1998;51: 235–42.
  • 41. Wang S, DelProposto Z, Wang H, et al. Differentiation of breast cancer from fibroadenoma with dual-echo dynamic contrast-enhanced MRI. PLOS ONE 2013; 8: e67731. doi:10.1371/journal.pone.0067731.

Dinamik kontrastlı meme magnetik rezonans görüntülemesinde tanımlanmış skorlama sisteminin ve eklenebilecek kantitatif verilerin tanıya katkısı

Yıl 2013, Cilt: 26 Sayı: 3, 151 - 157, 30.09.2015

Direnç Aksoy Zeynep Kılıçoğlu Gökalp Yılmaz Ercüment Kadıoğlu Mehmet Masum Şimşek Seçil Telli

Öz

Amaç: Dinamik kontrastlı magnetik rezonans görüntüleme (DK-MRG)
tekniği ile meme kitlelerinin değerlendirilmesinde tanımlanmış olan
skorlama sisteminin ve farklı kantitatif verilerin, lezyonların malign
veya benign ayırımındaki katkısını değerlendirmek.
Hastalar ve Yöntem: Çalışmamızda 95 lezyon, meme görüntülemeraporlama
ve veri [(breast imaging-reporting and data system (BIRADS)]
sisteminin analoğu olarak kabul edilebilecek bir skorlama
sistemi (Fischer’s score) ile değerlendirildi. Ayrıca kinetik verilerden
hesaplanan kantitatif parametreler time to peak enhancement (Tpeak),
maximum slope of enhancement curve (Smax) ve washout değerleri
hesaplandı. Bulgular istatistiksel olarak değerlendirildi.
Bulgular:Fischer skorlama sisteminin total puanının değerlendirilmesinde
sırasıyla 0-3, 4 ve 5-8 puanların spesifite değerleri: %23,40,
%78,87 ve %97,87 bulunmuştur. Skorlama sisteminin parametreleri ayrı
ayrı değerlendirildiğinde: morfolojik özelliklerden şekil, istatistiksel
olarak en anlamlı (p=0,001) grup olarak karşımıza çıkmaktadır. Halkasal
kontrastlanma ise spesifitesi en yüksek morfolojik parametredir (%97,87).
Kinetik verilerden erken dönem kontrastlanma yüzdesinin malign
ve benign lezyonlarda anlamlı farklılık göstermediği görülmektedir..
Kinetik eğri tipleri, tip 1 ve tip 2-3 şeklinde değerlendirmeye
katıldığında istatistiksel olarak anlamlı bulunmuştur (p=0,001). Kantitatif
parametrelerden Tpeak ve Smax istatistiksel olarak anlamlı bulundu.
Sonuç: Morfolojik parametreler ile kinetik eğri verilerinin birlikte
değerlendirildiği skorlama sistemi, lezyonların benign-malign
ayırımında faydalı bilgiler sağlamaktadır. Ayrıca, kantitatif
parametrelerden anlamlı bulunan Tpeak ve Smax değerlerinin de
tanısal başarıya katkı sağlayabilecek potansiyele sahip veriler olduğu
düşünülmektedir.

Anahtar Kelimeler

Meme DK-MRG Dinamik Kantitatif Skorlama

Kaynakça

  • 1. Jansen SA, Fan X, Karczmar GS, Abe H, Schmid RA. DCEMRI of breast lesions: Is kinetic analysis equally effective for both mass and nonmass-like enhancement? Med Phys 2008; 35: 3102–9. doi: 10.1118/1.2936220
  • 2. Abraham DC, Jones RC, Jones SE, et al. Evaluation of neoadjuvant chemotherapeutic response of locally advanced breast cancer by magnetic resonance imaging. Cancer 1996; 78: 91–100. doi: 10.1002/ (SICI]1097-0142(19960701]78:1<91::AID-CNCR14>3.0.CO;2-2
  • 3. Boetes C, Mus RD, Holland R, et al. Breast tumors: Comparative accuracy of MR imaging relative to mammography and US for demonstrating extent. Radiology 1995; 197: 743–7.
  • 4. Fischer U, Kopka L, Grabbe E. Breast carcinoma: effect of preoperative contrast enhanced MR imaging on the therapeutic approach. Radiology 1999; 213:881-8.
  • 5. Siegmann KC, Müller-Schimpfle MM, Schick F, et al. MR imaging– detected breast lesions: histopathological correlation of lesion characteristics and signal intensity data. AJR Am J Roentgenol 2002;178:1403-19. doi:10.2214/ajr.178.6.1781403
  • 6. KarahaliouA, Vassiou K, Arikidis NS, et al. Assessing heterogeneity of lesion enhancement kinetics in dynamic contrast-enhanced MRI for breast cancer diagnosis. Br J Radiol 2010;83:296-306. doi:10.1259/ bjr/50743919
  • 7. Orel SG. Differentiating benign from malignant enhancing lesions identified at MR imaging of the breast: Are time-signal intensity curves an accurate predictor? Radiology 1999;211:5-7.
  • 8. Kaiser WA, Zeitler E. MR imaging of the breast: fast imaging sequences with and without Gd-DTPA-preliminary observations. Radiology 1989;170:681-6
  • 9. Lee CH. Problem solving MR imaging of the breast. Radiol Clin North Am 2004;42:919–34. doi:10.1016/j.rcl.2004.05.001
  • 10. Sivarjan U, Jayapragasam KJ, Abdul Aziz YF, Rahmat K, Bux SI. Dynamic contrast enhancement magnetic rezonance imaging evaluation of breast lesions: a morphological and quantitative analysis. JHK Coll Radiol 2009;12:43-52.
  • 11. Heywang SH, Wolf A, Pruss E, Hilbertz T, Eiermann W, Permanetter W. MR imaging of breast wth Gd-DTPA: use and limitations. Radiology 1993;171:95-103.
  • 12. Heywang-Kobrunner SH, Viehweg P, Heinig A, Kuchler C. Contrastenhanced MRI of the breast: accuracy, value, controversies, solutions. Eur J Radiol 1997;24:94–108. doi: 10.1016/S0720-048X(96]01142-4
  • 13. Schnall MD, Blume J, Bluemke DA, et al. Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology 2006; 238:42–5. doi:10.1148/radiol.2381042117
  • 14. Harms SE, Flamig DP, Hesley KL, et al. MR imaging of the breast with rotating delivery of excitation off resonance: clinical experience with pathologic correlation. Radiology 1993; 187: 493–501.
  • 15. Kuhl CK, Schmutzler R, Leutner CC, et al. Breast MR imaging screening in 192 women proved or suspected to be carriers of a breast cancer susceptibility gene: preliminary results. Radiology 2000; 215: 267–79.
  • 16. American Collage of Radiology Breast Imaging Reporting and Data System (BI-RADS]. 4th edition. Reston (VA): American Collage of Radiology; 2003.
  • 17. Nunes LW, Schnall MD, Orel SG, et al. Breast MR imaging: interpretation model. Radiol 1997;202:833–41.
  • 18. Nunes LW, Schnall MD, Siegelman ES, et al. Diagnostic performance characteristics of architectural features revealed by high spatialresolution MR imaging of the breast. AJR Am J Roentgenol 1997; 169:409-15. doi:10.2214/ajr.169.2.9242744
  • 19. Al-Khawari H, Athyal R, Kovacs A, Al-Saleh M, Madda JP. Accuracy of the Fischer scoring system and the Breast Imaging Reporting and Data System in identification of malignant breast lesions. Ann Saudi Med 2009;29:280-7. doi:10.4103/0256-4947.55310
  • 20. Kuhl CK, Schild HH, Morakkabati N. Dynamic bilateral contrastenhanced MR imaging of the breast:trade-off between spatial and temporal resolution .Radiology 2005;236:789-800. doi:10.1148/ radiol.2363040811
  • 21. Goto M, Ito H, Akazawa K, Kubota T, Kizu O, Yamada K, Nishimura T. Diagnosis of breast tumors enhancement patterns and morphologic features. J Magn Reson Imaging 2007; 25:104–12. doi:10.1002/ jmri.20812
  • 22. Jansen SA, Fan X, Karczmar GS, Abe H, Schmidt RA. Differentiation between benign and malignant breast lesions detected by bilateral dynamic contrast-enhanced MRI: A sensitivity and specificity study. Magn Reson Med 2008 ; 59: 747–54. doi: 10.1002/mrm.21530
  • 23. Morris EA. Breast cancer imaging with MRI. Radiol Clin Nort Am 2002;40:443-66. doi:10.1016/S0033-8389(01]00005-7
  • 24. Kuhl CK, Mielcareck P, Klaschik S, et al. Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions? Radiology 1999; 211: 101-10.
  • 25. Kinkel K, Helbich TH, Esserman LJ, et al. Dynamic high-spatialresolution MR imaging of suspicious breast lesions: diagnostic criteria and interobserver variability. AJR 2000;175:35–43. doi:10.2214/ ajr.175.1.1750035
  • 26. Szabó BK, Aspelin P, Wiberg MK, Boné B. Dynamic MR imaging of the breast. Analysis of kinetic and morphologic diagnostic criteria. Acta Radiol 2003;44:379–86. doi:10.1080/j.1600-0455.2003.00084.x
  • 27. Eyal E, Degani H. Model-based and model-free parametric analysis of breast dynamic-contrast-enhanced MRI. NMR Biomed 2009;22:40– 53. doi:10.1002/nbm.1221
  • 28. Tofts PS, Brix G, Buckley DL. et al. Estimating kinetic parameters from dynamic contrast-enhanced T1-weighted MRI of a diffusible tracer: standardized quantities and symbols. J Magn Reson Imaging 1999;10:223–32. doi:10.1002/(SICI]1522- 2586(199909]10:3<223::AID-JMRI2>3.0.CO;2-S
  • 29. Boetes C, Barentsz JO, Mus RD, et al. MR characterization of suspicious breast lesions with a gadolinium-enhanced turbo-FLASH substraction technique. Radiology 1994;193:777-81.
  • 30. El Khouli RH, Macura KJ, Jacobs MA, et al. Dynamic contrastenhanced MRI of the breast: Quantitative method for kinetic curve type asseessment. AJR Am J Roentgenol 2009;193:W295-W300. doi: 10.2214/AJR.09.2483
  • 31. Gilles R, Guinebretiere JM, Lucidarme O,et al. Nonpalpable breast tumors: diagnosis with contrast-enhanced substraction dynamic MR imaging. Radiology 1994;191:625-31. .
  • 32. Gribbestad IS, Nilsen G, Fjosne HE,Kvinnsland S, Haugen OA, Rinck PA. Comparative signal intensity measurements in dynamic gadolinium-enhanced MR mammography. JMRI 1994;4:477-80. doi:10.1002/jmri.1880040339
  • 33. Orel SG, Schnall MD. MR imaging of the breast for the detection, diagnosis, and staging of breast cancer. Radiology 2001;220:13-30.
  • 34. Orel SG, Schnall MD, LiVolsi VA, Troupin RH. Suspicious breast lesions: MR imaging with radiologic-pathologic correlation. Radiology 1994;190:485-93.
  • 35. Hickman PF, Moore NR, Shepstone BJ. The indeterminate breast mass: assessment using contrast enhanced magnetic resonance imaging. Br J Radiol 1994; 67: 14–20. doi:10.1259/0007-1285-67-793-14
  • 36. Stomper PC, Herman S, Klippenstein DL, et al. Suspect breast lesions: findings at dynamic gadolinium-enhanced MR imaging correlated with mammographic and pathologic features. Radiology 1995; 197:387–95.
  • 37. Brinck U, Fischer U, Korabiowska M, Jutrowski M, Schauer A, Grabbe E. The variability of fibroadenoma in contrastenhanced dynamic MR mammography. AJR Am J Roentgenol 1997; 168:1331– 4.
  • 38. Liu PF, Debatin JF, Caduff RF, et al. Improved diagnostic accuracy in dynamic contrast enhanced MRI of the breast by combined quantitative and qualitative analysis. Br J Radiol 1998; 71:501–9.
  • 39.  Siegmann-Luz KC, Bahrs SD, Preibsch H, et al. Management of breast lesions detectable only on MRI. Fortschr Röntgenstr 2013; doi: 10.1055/s-0033-1335972
  • 40. Sittek H, Perlet C, Untch M, Kessler M, Reiser M. Dynamic MRmammography in invasive lobular breast cancer [in German]. Rontgenpraxis 1998;51: 235–42.
  • 41. Wang S, DelProposto Z, Wang H, et al. Differentiation of breast cancer from fibroadenoma with dual-echo dynamic contrast-enhanced MRI. PLOS ONE 2013; 8: e67731. doi:10.1371/journal.pone.0067731.
Toplam 41 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Direnç Aksoy Bu kişi benim

Zeynep Kılıçoğlu Bu kişi benim

Gökalp Yılmaz Bu kişi benim

Ercüment Kadıoğlu Bu kişi benim

Mehmet Masum Şimşek Bu kişi benim

Seçil Telli Bu kişi benim

Yayımlanma Tarihi 30 Eylül 2015
Yayımlandığı Sayı Yıl 2013 Cilt: 26 Sayı: 3

Kaynak Göster

APA Aksoy, D., Kılıçoğlu, Z., Yılmaz, G., Kadıoğlu, E., vd. (2015). Dinamik kontrastlı meme magnetik rezonans görüntülemesinde tanımlanmış skorlama sisteminin ve eklenebilecek kantitatif verilerin tanıya katkısı. Marmara Medical Journal, 26(3), 151-157.
AMA Aksoy D, Kılıçoğlu Z, Yılmaz G, Kadıoğlu E, Şimşek MM, Telli S. Dinamik kontrastlı meme magnetik rezonans görüntülemesinde tanımlanmış skorlama sisteminin ve eklenebilecek kantitatif verilerin tanıya katkısı. Marmara Med J. Eylül 2015;26(3):151-157.
Chicago Aksoy, Direnç, Zeynep Kılıçoğlu, Gökalp Yılmaz, Ercüment Kadıoğlu, Mehmet Masum Şimşek, ve Seçil Telli. “Dinamik Kontrastlı Meme Magnetik Rezonans görüntülemesinde tanımlanmış Skorlama Sisteminin Ve Eklenebilecek Kantitatif Verilerin tanıya katkısı”. Marmara Medical Journal 26, sy. 3 (Eylül 2015): 151-57.
EndNote Aksoy D, Kılıçoğlu Z, Yılmaz G, Kadıoğlu E, Şimşek MM, Telli S (01 Eylül 2015) Dinamik kontrastlı meme magnetik rezonans görüntülemesinde tanımlanmış skorlama sisteminin ve eklenebilecek kantitatif verilerin tanıya katkısı. Marmara Medical Journal 26 3 151–157.
IEEE D. Aksoy, Z. Kılıçoğlu, G. Yılmaz, E. Kadıoğlu, M. M. Şimşek, ve S. Telli, “Dinamik kontrastlı meme magnetik rezonans görüntülemesinde tanımlanmış skorlama sisteminin ve eklenebilecek kantitatif verilerin tanıya katkısı”, Marmara Med J, c. 26, sy. 3, ss. 151–157, 2015.
ISNAD Aksoy, Direnç vd. “Dinamik Kontrastlı Meme Magnetik Rezonans görüntülemesinde tanımlanmış Skorlama Sisteminin Ve Eklenebilecek Kantitatif Verilerin tanıya katkısı”. Marmara Medical Journal 26/3 (Eylül 2015), 151-157.
JAMA Aksoy D, Kılıçoğlu Z, Yılmaz G, Kadıoğlu E, Şimşek MM, Telli S. Dinamik kontrastlı meme magnetik rezonans görüntülemesinde tanımlanmış skorlama sisteminin ve eklenebilecek kantitatif verilerin tanıya katkısı. Marmara Med J. 2015;26:151–157.
MLA Aksoy, Direnç vd. “Dinamik Kontrastlı Meme Magnetik Rezonans görüntülemesinde tanımlanmış Skorlama Sisteminin Ve Eklenebilecek Kantitatif Verilerin tanıya katkısı”. Marmara Medical Journal, c. 26, sy. 3, 2015, ss. 151-7.
Vancouver Aksoy D, Kılıçoğlu Z, Yılmaz G, Kadıoğlu E, Şimşek MM, Telli S. Dinamik kontrastlı meme magnetik rezonans görüntülemesinde tanımlanmış skorlama sisteminin ve eklenebilecek kantitatif verilerin tanıya katkısı. Marmara Med J. 2015;26(3):151-7.
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