Diagnostic accuracy of susceptibility-weighted magnetic resonance imaging for the evaluation of pineal gland calcification

Abstract

ObjectivesTo determine the diagnostic performance of susceptibility-weighted magnetic resonance imaging (SWMR) for the detection of pineal gland calcifications (PGC) compared to conventional magnetic resonance imaging (MRI) sequences, using computed tomography (CT) as a reference standard.Methods384 patients who received a 1.5 Tesla MRI scan including SWMR sequences and a CT scan of the brain between January 2014 and October 2016 were retrospectively evaluated. 346 patients were included in the analysis, of which 214 showed PGC on CT scans. To assess correlation between imaging modalities, the maximum calcification diameter was used. Sensitivity and specificity and intra- and interobserver reliability were calculated for SWMR and conventional MRI sequences.ResultsSWMR reached a sensitivity of 95% (95% CI: 91%-97%) and a specificity of 96% (95% CI: 91%-99%) for the detection of PGC, whereas conventional MRI achieved a sensitivity of 43% (95% CI: 36%-50%) and a specificity of 96% (95% CI: 91%-99%). Detection rates for calcifications in SWMR and conventional MRI differed significantly (95% versus 43%, p<0.001). Diameter measurements between SWMR and CT showed a close correlation (R2 = 0.85, p<0.001) with a slight but not significant overestimation of size (SWMR: 6.5 mm ± 2.5; CT: 5.9 mm ± 2.4, p = 0.02). Interobserver-agreement for diameter measurements was excellent on SWMR (ICC = 0.984, p < 0.0001).ConclusionsCombining SWMR magnitude and phase information enables the accurate detection of PGC and offers a better diagnostic performance than conventional MRI with CT as a reference standard.

Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the detection of calcifications: A systematic review and meta-analysis

“…1 for the study selection flowchart). Overall, 12 suitable clinical studies were identified and included in the present meta-analysis 1 , 2 , 9 – 18 . See Supplementary Information S2 for a list of studies, which were excluded at the level of full-text search, including the individual reason for exclusion.…”

“…In half of the studies 1 , 2 , 9 , 15 , 17 , 21 direct comparison to standard MRI was performed with a pooled sensitivity of 36.7% (95% CI: 29.2–44.8%) and a pooled specificity of 94.2% (95% CI: 88.9–96.7%).…”

“…The fields of clinical application for SW-MRI include the imaging of venous blood in acute or chronic ischemia, the visualization of the vascularization, haemorrhage and calcification of tumors, the identification of epilepsy-associated calcified and vascular abnormalities and measuring calcification or iron deposition in neurodegenerative diseases 2 , 9 – 12 , 14 , 15 , 18 , 22 , 35 – 39 . It has been indicated that with regard to the differentiation between small calcification and haemorrhage, SW-MRI might even be superior to the reference standard CT, as due to a considerable overlap of attenuation values these conditions are not always easy to distinguish on CT scans 19 , 40 .…”

“…and Zulfiqar et al .) 9 – 12 , 14 , 15 , 17 , 18 , 46 . Pertaining to the body-axis, Bai and Dou et al .…”

Tau deposition is associated with imaging patterns of tissue calcification in the P301L mouse model of human tauopathy

“…5, 6). Studies using clinical brain imaging data suggest that the diagnostic accuracy of SWI outperformed conventional MRI and CT in detecting brain calcifications [1,32,71,72,76], although the diagnostic accuracy of different methods might depend on disease indication, MRI parameters and field strengths used. 1 3 In non-transgenic littermates, imaging abnormalities were found confined to the choroid plexus.…”