The Clinical Role of Diffusion-Weighted MRI for Detecting Residual Cholesteatoma in Canal Wall up Mastoidectomy

Ismaeel, Amr M.; El-Tantawy, Amir Monier; Eissawy, Mohamed Gaber; Gomaa, Mohamed; Rahman, Ahmed Abdel; Elkholy, Tawfeek; Hamead, Khalf

doi:10.1007/s12070-021-02744-0

Cited by 2 publications

(5 citation statements)

References 37 publications

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“…Figure 1 shows details regarding study selection. Sixteen of 32 articles (50%) were rated as low risk of bias [13][14][15]17,18,22,[24][25][26][27][28][29][30]40,41,43]. There were 23 prospective studies and nine retrospective studies.…”

Section: Resultsmentioning

confidence: 99%

Non-echo Planar Diffusion-Weighted Imaging in the Detection of Recurrent or Residual Cholesteatoma: A Systematic Review and Meta-Analysis of Diagnostic Studies

Amoodi¹,

Mofti²,

Fatani³

et al. 2022

Cureus

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We performed a systematic review and meta-analysis of patients with suspected recurrent cholesteatoma who underwent non-echo planar imaging (non-EPI) using diffusion-weighted magnetic resonance imaging (MRI), with surgery as the reference standard. We searched Medline, Google Scholar, and the Cochrane database for diagnostic test accuracy studies. The following prespecified subgroup analyses were performed: patient age, number of radiologists interpreting MRI, study design, and risk of bias. We used a bivariate model using a generalized linear mixed model to pool accuracies. Of the 460 records identified, 32 studies were included, of which 50% (16/32) were low risk of bias. The overall pooled sensitivity was 92.2% (95% CI 87.3-95.3%), and specificity was 91.7% (85.2-95.5%). The positive likelihood ratio was 11.1 (4.5-17.8), and the negative likelihood ratio was 0.09 (0.04-0.13). The pooled diagnostic odds ratio was 130.3 (20.5-240). Heterogeneity was moderate on visual inspection of the hierarchical summary receiver operating characteristic curve. Subgroup analyses showed prospective studies reporting higher accuracies (p=0.027), which were driven by higher specificity (prospective 93.1% (88.4-96.0%) versus retrospective 81.2% (81.0-81.4%)). There was no difference in subgroups comparing patient age (p=0.693), number of radiologists interpreting MRI (p=0.503), or risk of bias (p=0.074). No publication bias was detected (p=0.98). In conclusion, non-EPI is a highly sensitive and specific diagnostic test able to identify recurrent cholesteatomas of moderate to large sizes. This test can be considered a non-invasive alternative to secondlook surgery.

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Section: Resultsmentioning

confidence: 99%

Non-echo Planar Diffusion-Weighted Imaging in the Detection of Recurrent or Residual Cholesteatoma: A Systematic Review and Meta-Analysis of Diagnostic Studies

Amoodi¹,

Mofti²,

Fatani³

et al. 2022

Cureus

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“…Single-shot EPI-DWI can be seen as a widely available standard DWI technique, which is robust and relatively insensitive to motion artifacts [30]. Cholesteatoma appears hyperintense on DWI, whereas granulation tissue or fibrous tissue has a low signal intensity on DWI (at a b-factor of 800 sec/mm 2 ) [30][31][32][33][34]. The reason is not fully understood but may be explained by a combination of T2 shine-through and diffusion restriction effects in cholesteatoma [5,31,35].…”

Section: Cholesteatoma Of the External Ear Canalmentioning

confidence: 99%

“…Cholesteatoma appears hyperintense on DWI, whereas granulation tissue or fibrous tissue has a low signal intensity on DWI (at a b-factor of 800 sec/mm 2 ) [30][31][32][33][34]. The reason is not fully understood but may be explained by a combination of T2 shine-through and diffusion restriction effects in cholesteatoma [5,31,35]. Non-EPI-based sequences reduce most susceptibility artifacts and permit thinner sections, resulting in improved sensitivity of 90-100% for lesions as small as 2 mm [31].…”

Section: Cholesteatoma Of the External Ear Canalmentioning

confidence: 99%

“…The reason is not fully understood but may be explained by a combination of T2 shine-through and diffusion restriction effects in cholesteatoma [5,31,35]. Non-EPI-based sequences reduce most susceptibility artifacts and permit thinner sections, resulting in improved sensitivity of 90-100% for lesions as small as 2 mm [31]. In this context, the most common cause for missing residual cholesteatoma on DWI sequences is a small lesion size of <4 mm [31].…”

Section: Cholesteatoma Of the External Ear Canalmentioning

confidence: 99%

“…Non-EPI-based sequences reduce most susceptibility artifacts and permit thinner sections, resulting in improved sensitivity of 90-100% for lesions as small as 2 mm [31]. In this context, the most common cause for missing residual cholesteatoma on DWI sequences is a small lesion size of <4 mm [31].…”

Section: Cholesteatoma Of the External Ear Canalmentioning

confidence: 99%

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Imaging of Pathologies of the Temporal Bone and Middle Ear: Inflammatory Diseases, Their Mimics and Potential Complications—Pictorial Review

Kloth,

Beck,

Sollmann

et al. 2023

Tomography

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Imaging of the temporal bone and middle ear is challenging for radiologists due to the abundance of distinct anatomical structures and the plethora of possible pathologies. The basis for a precise diagnosis is knowledge of the underlying anatomy as well as the clinical presentation and the individual patient’s otological status. In this article, we aimed to summarize the most common inflammatory lesions of the temporal bone and middle ear, describe their specific imaging characteristics, and highlight their differential diagnoses. First, we introduce anatomical and imaging fundamentals. Additionally, a point-to-point comparison of the radiological and histological features of the wide spectrum of inflammatory diseases of the temporal bone and middle ear in context with a review of the current literature and current trends is given.

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The Clinical Role of Diffusion-Weighted MRI for Detecting Residual Cholesteatoma in Canal Wall up Mastoidectomy

Cited by 2 publications

References 37 publications

Non-echo Planar Diffusion-Weighted Imaging in the Detection of Recurrent or Residual Cholesteatoma: A Systematic Review and Meta-Analysis of Diagnostic Studies

Non-echo Planar Diffusion-Weighted Imaging in the Detection of Recurrent or Residual Cholesteatoma: A Systematic Review and Meta-Analysis of Diagnostic Studies

Imaging of Pathologies of the Temporal Bone and Middle Ear: Inflammatory Diseases, Their Mimics and Potential Complications—Pictorial Review

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