Accuracy of 2D BLADE Turbo Gradient- and Spin-Echo Diffusion Weighted Imaging for the Diagnosis of Primary Middle Ear Cholesteatoma

Abstract

ObjectiveTo evaluate the diagnostic accuracy of 2D BLADE turbo gradient- and spin-echo diffusion weighted imaging (TGSE BLADE DWI) for primary middle ear cholesteatoma diagnosis, using qualitative and quantitative methods.Study DesignRetrospective case series.SettingUniversity hospital.PatientsParticipants included those with suspected primary middle ear cholesteatoma after assessment by clinical otorhinolaryngologists combined with magnetic resonance imaging (MRI) examination. Finally, of the 85 ears from 65 patients enrolled in the study, 73 had cholesteatoma, and 12 had otitis media.InterventionTwo radiologists independently assessed images and measured apparent diffusion coefficient (ADC) values. Sensitivity, specificity and accuracy were evaluated. Kappa (k) statistics, the intraclass correlation coefficient (ICC), the Kolmogorov–Smirnov normality test, the independent t test, and receiver operating characteristic (ROC) analysis were used for statistical analysis. Pair-wise comparison of the area under the ROC curve (AUC) was also performed using the Delong test.Main Outcome MeasuresImaging and histopathologic findings.ResultsThe mean ADC value of cholesteatoma group (mean, 0.923 ± 0.246 × 10–3 mm2/s) was significantly lower than that of noncholesteatoma group (mean, 1.744 ± 0.205 × 10–3 mm2/s; p < 0.001). In ≤3 mm cholesteatoma group, the AUC of qualitative DWI was 0.846; the sensitivity, specificity, and accuracy for diagnosing cholesteatoma were 69.23%, 100%, and 84%, respectively; while the AUC of quantitative diagnosis was significantly increased to 1.0 (p = 0.0209); and based on the optimal threshold of ADC, ≤1.352 × 10–3 mm2/s, the sensitivity, specificity and accuracy improved to 100%. For >3 mm cholesteatoma group, there were no significant differences in diagnostic performance. Excellent interobserver agreement and ICC for the qualitative and quantitative evaluations (k = 0.90 and ICC = 0.80, respectively) was noted between reviewers.ConclusionTGSE BLADE DWI is useful for the detection of primary middle ear cholesteatomas, especially ≤3 mm lesions.

Evaluation of Three Imaging Methods to Quantify Key Events in Pelvic Bone Metastasis

“…Due to the lack of unique frequency or phase encoding direction, noise from moving anatomy does not propagate as an artifact along a single direction and oversampling in the center of K space in all directions. The technique has been employed in the pediatric population, as well as for imaging of the head and abdomen, and has exhibited improved image quality in patients with voluntary or involuntary movement [ 17 , 18 , 19 ]. The BLADE technique in our institute was employed in abdominopelvic imaging to address the issue of artifacts caused by pulsation and susceptibility, which present a considerable obstacle when imaging pelvic bone metastases.…”

A 3D and Explainable Artificial Intelligence Model for Evaluation of Chronic Otitis Media Based on Temporal Bone Computed Tomography: Model Development, Validation, and Clinical Application

“…In this study, the 3D model outperformed junior clinicians and demonstrated equivalent or superior performance to senior experts in identifying cholesteatoma based on CT. Notably, the 3D model achieved outcomes that were on par with or better than those based on human interpretation of MRI, which, despite its higher sensitivity, is a more expensive diagnostic method [22,43,45,[51][52][53].…”