Readout-Segmented Echo-Planar DWI for the Detection of Cholesteatomas: Correlation with Surgical Validation

Fischer, Natalie; Schartinger, Volker Hans; Dejaco, Daniel; Schmutzhard, Joachim; Riechelmann, Herbert; Plaikner, Michaela; Henninger, Benjamin

doi:10.3174/ajnr.a6079

Cited by 15 publications

(24 citation statements)

References 29 publications

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“…These are caused by field inhomogeneities and do not depend on TE. 22 We could not confirm the high sensitivity and specificity values for rsDWI reported by both Fischer et al 24 and Algin et al 21 In contrast to in our study, Algin et al used longer TEs for rsDWI (91-124 versus 66 ms). This might increase the T2 hyperintense signal of cholesteatomas, which could possibly lead to a higher detection rate.…”

Section: Discussioncontrasting

confidence: 72%

Comparison of Readout-Segmented Echo-Planar Imaging and Single-Shot TSE DWI for Cholesteatoma Diagnostics

Wiesmueller

Wuest

May

et al. 2021

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The high diagnostic value of DWI for cholesteatoma diagnostics is undisputed. This study compares the diagnostic value of readout-segmented echo-planar DWI and single-shot TSE DWI for cholesteatoma diagnostics. MATERIALS AND METHODS:Thirty patients with newly suspected cholesteatoma were examined with a dedicated protocol, including readout-segmented echo-planar DWI and single-shot TSE DWI at 1.5T. Acquisition parameters of both diffusion-weighted sequences were as follows: b=1000 s/mm, 2 axial and coronal section orientations, and section thickness of 3 mm. Image quality was evaluated by 2 readers on a 5-point Likert scale with respect to lesion conspicuity, the presence of susceptibility artifacts mimicking cholesteatomas, and overall subjective image quality. Sensitivity and specificity were calculated using histology results as the gold standard.RESULTS: Twenty-five cases of histologically confirmed cholesteatomas were included in the study group. Lesion conspicuity was higher and fewer artifacts were found when using TSE DWI (both P , .001). The overall subjective image quality, however, was better with readout-segmented DWI. For TSE DWI, the sensitivity for readers 1 and 2 was 92% (95% CI, 74%-99%) and 88% (95% CI, 69%-97%), respectively, while the specificity for both readers was 80% (95% CI, 28%-99%). For readout-segmented DWI, the sensitivity for readers 1 and 2 was 76% (95% CI, 55%-91%) and 68% (95% CI, 46%-85%), while the specificity for both readers was 60% (95% CI, 15%-95%). CONCLUSIONS:The use of TSE DWI is advisable for cholesteatoma diagnostics and preferable over readout-segmented DWI.ABBREVIATIONS: rsDWI ¼ readout-segmented echo-planar DWI; tseDWI ¼ TSE DWI C holesteatoma is a common non-neoplastic disease in otology,

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Section: Discussioncontrasting

confidence: 72%

Comparison of Readout-Segmented Echo-Planar Imaging and Single-Shot TSE DWI for Cholesteatoma Diagnostics

Wiesmueller

Wuest

May

et al. 2021

AJNR Am J Neuroradiol

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“…Diffusion‐weighted imaging (DWI) has emerged as a powerful diagnostic tool for the detection of cholesteatoma and is able to differentiate cholesteatoma from granulation tissue, scar, encephalocele, and benign fluid 1–4 . Non‐echo planar imaging (non‐EPI) DWI sequences, used because of their relative lack of susceptibility artifacts and geometric distortions near the skull base, have reported sensitivity and specificity of 91% and 96% for cholesteatoma detection, respectively 5 .…”

Section: Introductionmentioning

confidence: 99%

Cholesteatoma Localization Using Fused Diffusion‐Weighted Images and Thin‐Slice T2 Weighted Images

et al. 2020

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Background Fusion of diffusion‐weighted imaging (DWI) to computed tomography (CT) has been touted as a possible technique to improve cholesteatomas localization. This study set out to assess the ability of DWI images fused with thin‐slice heavily T2‐weighted images to similarly localize surgically‐confirmed cholesteatomas. Materials and Methods A retrospective review was completed of consecutive patients that underwent MR temporal bone imaging (9/2011–3/2020) with both DWI and thin‐slice T2‐weighted imaging. Included patients underwent surgical resection of primary or recidivistic cholesteatoma after preoperative MR imaging. A neuroradiologist, who was blinded to operative and clinical notes, localized each lesion on both DWI and fused DWI‐T2 images in 11 anatomic subdivisions of the temporal bone. Surgical confirmation of cholesteatoma location was used as the gold standard for comparison. Results Of 24 included examinations, the average age at time of MR was 48.2 ± 24.7 years; 12/24 (50.0%) were female. Five of 24 had primary cholesteatoma, while the remainder had recidivistic disease. Sensitivity, specificity, and accuracy of unfused DWI images were 52.1%, 88.9%, and 75.8%, respectively. Sensitivity, specificity, and accuracy of fused DWI‐T2 images were 57.1%, 94.8%, and 81.8%, respectively. Conclusion Fused DWI‐T2 images outperformed unfused DWI images in the anatomic localization of temporal bone cholesteatomas. This method represents a potential alternative to MR‐CT fusion for pre‐operative cholesteatoma evaluation, and warrants future investigations. Opposed to MR‐CT fusion, this method only necessitates MR sequences and removes the need for additional CT acquisition. Level of Evidence 3 Laryngoscope, 131:E1662–E1667, 2021

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“…ossicular state. 6,14 Type of tympanic membrane perforation proved to be a confounding variable that affects the intraoperative ossicular status of CSOM patients. In this study, erosion of the three ossiculars (ossicular status score 4) was found to be the most common in total perforations (45%) followed by attic perforations (33).…”

Section: Characteristics Of Research Subjectsmentioning

confidence: 99%

Correlation between Intraoperative Ossicular Status and Conductive Hearing Loss Degree among Chronic Suppurative Otitis Media Patients in Dr Mohammad Hoesin General Hospital Palembang

Rizandiny

Hifni

Bahar

et al. 2021

bsm

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Background: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the mucosa and periosteum of the middle ear and mastoid cavity that defined as a perforated tympanic membrane with persistent drainage for more than 2 months. Preoperative hearing threshold and air bone gap (ABG) assessment are expected to predict the ossicular status which can only be ascertained intraoperatively. This study aimed to determine the correlation between intra-operative ossicular status and the degree of conductive hearing loss assessed based on the hearing threshold and average ABG among CSOM patients in RSUP Dr. Mohammad Hoesin Palembang. Methods: Observational research using a cross sectional design. The data were collected using medical record on 64 subjects with a diagnosis of CSOM who underwent mastoidectomy surgery at Dr. Mohammad Hoesin Hospital Palembang for the period of March 2019 to June 2021. Results: From 64 samples conducted in the study, the average ossicular status score in CSOM patients was 1.84 ± 1.48, with the highest group scoring 0 being the malleus incus and intact stapes as many as 21 patients (31.3%). There was a strong positive correlation between hearing threshold scores and intra-operative ossicular status scores (p<0.005, R=0.5) and there was a strong positive correlation between ABG scores and intra-operative ossicular status scores (p <0.005, R=0.6). From the linear regression test, the most influential in predicting intra-operative ossicular status scores were gender, hearing threshold value, ABG value, and the presence of cholesteatoma Conclusions: There is a significant relationship between intra-operative ossicular status and the degree of conductive hearing loss in CSOM patients.

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Readout-Segmented Echo-Planar DWI for the Detection of Cholesteatomas: Correlation with Surgical Validation

Cited by 15 publications

References 29 publications

Comparison of Readout-Segmented Echo-Planar Imaging and Single-Shot TSE DWI for Cholesteatoma Diagnostics

Comparison of Readout-Segmented Echo-Planar Imaging and Single-Shot TSE DWI for Cholesteatoma Diagnostics

Cholesteatoma Localization Using Fused Diffusion‐Weighted Images and Thin‐Slice T2 Weighted Images

Correlation between Intraoperative Ossicular Status and Conductive Hearing Loss Degree among Chronic Suppurative Otitis Media Patients in Dr Mohammad Hoesin General Hospital Palembang

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