Is Preoperative Computed Tomographic Density Measurement of Soft Tissues Helpful in the Diagnosis of Cholesteatoma?

Lee, Dong-Hee; Kim, Choung‐Soo; Park, Chang‐Woo; Chung, Dae-Young

doi:10.1177/000348941212101204

Cited by 5 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To increase the accuracy, we used the same value for the ROI surface area in every measurement. Despite our efforts, our results showed a fairly wide HU index distribution range, which is similar to the study by Lee et al, 12 who measured a ROI of 1.5 mm 2 and still demonstrated a wide variation.…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Are Hounsfield Unit Measurements of Bony Absorption Changes in Cholesteatoma Helpful?

Shemesh¹,

Luckman

Marom³

et al. 2021

Int Arch Otorhinolaryngol

View full text Add to dashboard Cite

Introduction High-resolution computed tomography (HRCT) scans of the temporal bone are used to assess the bony erosion of the middle-ear structures whenever cholesteatoma is suspected. Objective To study the differences in HRCT Hounsfield unit (HU) index measurements of middle-ear bony structures between an ears with and without cholesteatoma. Methods A retrospective study of 59 patients who underwent surgery due to unilateral cholesteatoma. The HRCT HU index of the scutum, of three middle-ear ossicles, of the lateral semicircular canal (LSCC), and of the fallopian canal was measured in both ears. A comparison was made between the cholesteatoma and the non-cholesteatomatous ear (control). All measurements were conducted by an otolaryngologist. To assess the interobserver bias, 10% of the samples were randomly and independently assessed by another otolaryngologist and a neuroradiologist who were blinded. Results The average HU index was lower in the ear with cholesteatoma when compared with the non-cholesteatomatous ear. While the differences were statistically significant regarding the measurements of the scutum (516.02 ± 311.693 versus 855.64 ± 389.999; p = 0.001), the malleus (1049.44 ± 481.765 versus 1413.47 ± 313.376; p = 0.01), and the incus (498.03 ± 264.184 versus 714.25 ± 405.631; p = 0.001), the differences in the measurements of the LSCC (1042.34 ± 301.066 versus 1154.53 ± 359.609; p = 0.69) and of the fallopian canal (467.19 ± 221.556 versus 543.51 ± 263.573; p = 0.108) were not significantly different between both groups. The stapes was immeasurable in both groups due to its small size. Conclusion Hounsfield unit index measurements are a useful tool that may aid in the diagnosis of early-stage cholesteatoma.

show abstract

Section: Discussionsupporting

confidence: 90%

“…On the other hand, in a retrospective study published in 2012, Lee et al 12 measured the differences in the HU index in preoperative HRCT scans of COM and cholesteatoma patients. The sample was composed of 91 patients who underwent tympanomastoidectomy.…”

Section: Discussionmentioning

confidence: 99%

Are Hounsfield Unit Measurements of Bony Absorption Changes in Cholesteatoma Helpful?

Shemesh¹,

Luckman

Marom³

et al. 2021

Int Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…Shie et al proposed a feature-based classification system for otoscopic diagnosis of MEI, including, but not limited to, HIS features [ 21 ]. In a study including 91 patients, Lee et al concluded that measurements of Hounsfield units (HU)—i.e., HIS features—are not sufficient to distinguish between the two diseases [ 22 ]. Park et al, however, found HU values to be significantly different between cholesteatoma and inflammatory tissue in 82 patients [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Radiomics of high-resolution computed tomography for the differentiation between cholesteatoma and middle ear inflammation: effects of post-reconstruction methods in a dual-center study

et al. 2020

View full text Add to dashboard Cite

Objectives To evaluate the performance of radiomic features extracted from high-resolution computed tomography (HRCT) for the differentiation between cholesteatoma and middle ear inflammation (MEI), and to investigate the impact of post-reconstruction harmonization and data resampling. Methods One hundred patients were included in this retrospective dual-center study: 48 with histology-proven cholesteatoma (center A: 23; center B: 25) and 52 with MEI (A: 27; B: 25). Radiomic features (co-occurrence and run-length matrix, absolute gradient, autoregressive model, Haar wavelet transform) were extracted from manually defined 2D-ROIs. The ten best features for lesion differentiation were selected using probability of error and average correlation coefficients. A multi-layer perceptron feed-forward artificial neural network (MLP-ANN) was used for radiomics-based classification, with histopathology serving as the reference standard (70% of cases for training, 30% for validation). The analysis was performed five times each on (a) unmodified data and on data that were (b) resampled to the same matrix size, and (c) corrected for acquisition protocol differences using ComBat harmonization. Results Using unmodified data, the MLP-ANN classification yielded an overall median area under the receiver operating characteristic curve (AUC) of 0.78 (0.72–0.84). Using original data from center A and resampled data from center B, an overall median AUC of 0.88 (0.82–0.99) was yielded, while using ComBat harmonized data, an overall median AUC of 0.89 (0.79–0.92) was revealed. Conclusion Radiomic features extracted from HRCT differentiate between cholesteatoma and MEI. When using multi-centric data obtained with differences in CT acquisition parameters, data resampling and ComBat post-reconstruction harmonization clearly improve radiomics-based lesion classification. Key Points • Unenhanced high-resolution CT coupled with radiomics analysis may be useful for the differentiation between cholesteatoma and middle ear inflammation. • Pooling of data extracted from inhomogeneous CT datasets does not appear meaningful without further post-processing. • When using multi-centric CT data obtained with differences in acquisition parameters, post-reconstruction harmonization and data resampling clearly improve radiomics-based soft-tissue differentiation.

show abstract

“…Non-contrast-enhanced temporal bone computed tomography has its limitations with a soft tissue lesion and does not show any pathognomonic bony erosion pattern for cholesteatoma. The "gold standard" method adopted by clinicians for the accurate diagnosis of cholesteatoma is still combining a "detailed otologic history, physical examination of ears, and the temporal bone computed tomography findings interpretation" [39,40] . Echo-planar diffusion-weighted magnetic resonance imaging is also a valuable technique for cholesteatoma imaging [41] .…”

Section: Inflammation Statusmentioning

confidence: 99%

Cholesteatoma Definition and Classification: A Literature Review

Rutkowska

Özgirgin²,

Olszewska³

2017

Int Adv Otol

View full text Add to dashboard Cite

Review INTRODUCTIONThe management of cholesteatoma continues to be a challenge for otolaryngologists around the world. Even in countries with advanced healthcare facilities, undertaking routine physical examinations, with good access to specialists, and where efforts are taken for the prevention, early detection, and treatment of cholesteatoma, there is a considerable prevalence of cholesteatoma and its complications in children and adults.Diagnosis of cholesteatoma is performed by otolaryngologists using different methods, including obtaining the history that is characteristic for cholesteatoma suspicion, searching for or evidence of cholesteatoma during the physical examination using otoscopy and/or otomicroscopy, and interpretation of imaging (computed tomography and/or magnetic resonance) [1].Despite the fact that cholesteatoma is diagnosed throughout the world, there are differences in the definition, classification, and management of cholesteatoma. These differences make it difficult to compare the reports in the literature, and limit the ability to derive further conclusions from individual or regional outcomes. Therefore, it is essential to create a common scientific language, with the definitions of an issue as a principle. Furthermore, utilizing a comparable classification system will allow investigators to share their experience across the world, leading to better assessment and management of cholesteatoma.To achieve this, a recent initiative aimed to explore opinions among the members of European Academy of Otology & Neuro-otology (EAONO) regarding the definition and classification of cholesteatoma. Although consensus was achieved on the cholesteatoma definitions, it could not be achieved on its classification [2] . The process of development of the questionnaires, the responses obtained from the EAONO members through three cycles of questionnaires, and the final set of statements were reported in detail. Here we report the literature review that led to the development of the questionnaire on the definitions and classification to provide a basis for the outcome. In addition, we present various classifications of cholesteatoma in the literature and emphasize the strengths and weaknesses of each of these classifications to stimulate an effort to develop a consensus on the classification as well. METHODSEAONO steering group decided to undertake the task of developing guidelines in the field of otology and neurotology. Guidelines regarding the assessment and management of cholesteatoma were established as a priority. Among the committees established, the task of developing the guidelines for the definition and classification of cholesteatoma was assigned to Ewa Olszewska in June Cholesteatoma Definition and Classification: A Literature ReviewCholesteatoma is a serious otolaryngologic condition that to date remains an important problem and poses a challenge to otolaryngologists around the world. To improve the approach pertaining to the diagnosis and management of middle ear cholesteatoma, clear, clinical...

show abstract

Is Preoperative Computed Tomographic Density Measurement of Soft Tissues Helpful in the Diagnosis of Cholesteatoma?

Abstract: This study showed that the HU values on preoperative computed tomography did not suffice for the detection of cholesteatoma lesions. A clinician's physical examination together with an interpretation of computed tomography is still the "gold standard" method.

Cited by 5 publications

References 15 publications

Are Hounsfield Unit Measurements of Bony Absorption Changes in Cholesteatoma Helpful?

Are Hounsfield Unit Measurements of Bony Absorption Changes in Cholesteatoma Helpful?

Radiomics of high-resolution computed tomography for the differentiation between cholesteatoma and middle ear inflammation: effects of post-reconstruction methods in a dual-center study

Cholesteatoma Definition and Classification: A Literature Review

Contact Info

Product

Resources

About