Hostname: page-component-848d4c4894-xm8r8 Total loading time: 0 Render date: 2024-06-22T06:04:00.862Z Has data issue: false hasContentIssue false
  • English
  • Français

Magnetic resonance non-echo planar diffusion-weighted imaging accuracy in detecting cholesteatoma in comparison with clinical and surgical findings

Part of: JLO Editors' Choice Papers 2022

Published online by Cambridge University Press:  18 August 2021

N Al Zuhir ,
I Zammit-Maempel ,
P Yates  and
J Dixon
N Al Zuhir*
Affiliation:
Department of Radiology, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
I Zammit-Maempel
Affiliation:
Department of Radiology, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
P Yates
Affiliation:
Department of ENT, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
J Dixon
Affiliation:
Department of Radiology, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
*
Author for correspondence: Dr Naail Al Zuhir, Department of Radiology, Freeman Hospital, Freeman Road, Newcastle upon TyneNE7 7DN, UK E-mail: naail.alzuhir@nhs.net
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Magnetic resonance imaging utilising non-echo planar diffusion-weighted imaging is known to have high sensitivity and specificity in detecting cholesteatoma.

Method

Data was retrospectively collected from patients who had undergone non-echo planar diffusion-weighted imaging from 1 January 2010 to 31 December 2016. The ratio of average pixel grey-scale values between the middle-ear lesion, pons and temporal lobe was used to quantify the degree of restricted diffusion and assess the statistical significance to detect cholesteatoma.

Results

A total of 107 patients had non-echo planar diffusion-weighted imaging during the study period. Non-echo planar diffusion-weighted imaging shows good specificity and sensitivity with an excellent positive predictive value and accuracy. Analysis of the grey-scale pixel ratio for cholesteatoma detection showed statistically significant results.

Conclusion

Non-echo planar diffusion-weighted magnetic resonance imaging is accurate for cholesteatoma assessment. When the middle-ear lesion non-echo planar diffusion-weighted imaging intensity is higher than the ipsilateral temporal lobe, it is highly suggestive of a cholesteatoma formation.

Keywords

CholesteatomaDiagnosisMagnetic Resonance ImagingDiffusion Magnetic Resonance Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 3 , March 2022 , pp. 208 - 214
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr N Al Zuhir takes responsibility for the integrity of the content of the paper

Presented as a poster at the British Society of Head and Neck Imaging: Head and Neck Imaging Refresher Course, 9 February 2018, Newcastle upon Tyne, UK.

References

Rosito, LS, Netto, LF, Teixeira, AR, Da Costa, SS. Classification of cholesteatoma according to growth patterns. JAMA Otolaryngol Head Neck Surg 2016;142:168–7210.1001/jamaoto.2015.3148CrossRefGoogle ScholarPubMed
Schwartz, KM, Lane, JI, Bolster, BD, Neff, BA. The utility of diffusion-weighted imaging for cholesteatoma evaluation. AJNR Am J Neuroradiol 2011;32:430–6CrossRefGoogle ScholarPubMed
Crowson, MG, Ramprasad, VH, Chapurin, N, Cunningham, CD 3rd, Kaylie, DM. Cost analysis and outcomes of a second-look tympanoplasty-mastoidectomy strategy for cholesteatoma. Laryngoscope 2016;126:2574–9CrossRefGoogle ScholarPubMed
Muzaffar, J, Metcalfe, C, Colley, S, Coulson, C. Diffusion-weighted magnetic resonance imaging for residual and recurrent cholesteatoma: a systematic review and meta-analysis. Clin Otolaryngol 2017;42:536–4310.1111/coa.12762CrossRefGoogle ScholarPubMed
Russo, C, Elefante, A, Di Lullo, AM, Carotenuto, B, D'Amico, A, Cavaliere, M et al. ADC benchmark range for correct diagnosis of primary and recurrent middle ear cholesteatoma. Biomed Res Int 2018;2018:794548210.1155/2018/7945482CrossRefGoogle ScholarPubMed
Fukuda, A, Morita, S, Harada, T, Fujiwara, K, Hoshino, K, Nakamaru, Y et al. Value of T1-weighted magnetic resonance imaging in cholesteatoma detection. Otol Neurotol 2017;38:1440–410.1097/MAO.0000000000001558CrossRefGoogle ScholarPubMed
De Foer, B, Vercruysse, JP, Bernaerts, A, Meersschaert, J, Kenis, C, Pouillon, M et al. Middle ear cholesteatoma: non-echo-planar diffusion-weighted MR imaging versus delayed gadolinium-enhanced T1-weighted MR imaging—value in detection. Radiology 2010;255:866–7210.1148/radiol.10091140CrossRefGoogle ScholarPubMed
Lingam, RK, Khatri, P, Hughes, J, Singh, A. Apparent diffusion coefficients for detection of postoperative middle ear cholesteatoma on non-echo-planar diffusion-weighted images. Radiology 2013;269:504–10CrossRefGoogle ScholarPubMed
Na, DG, Thijs, VN, Albers, GW, Moseley, ME, Marks, MP. Diffusion-weighted MR imaging in acute ischemia: value of apparent diffusion coefficient and signal intensity thresholds in predicting tissue at risk and final infarct size. AJNR Am J Neuroradiol 2004;25:1331–6Google ScholarPubMed
She, NN, Zhang, XB. Diagnostic value of magnetic resonance imaging for middle ear cholesteatoma: a meta-analysis [in Chinese]. Lin Chuang Erh Pi Yen Hou Ko Tsa Chih 2017;31:1833–8Google Scholar
Cavaliere, M, Di Lullo, AM, Cantone, E, Scala, G, Elefante, A, Russo, C et al. Cholesteatoma vs granulation tissue: a differential diagnosis by DWI-MRI apparent diffusion coefficient. Eur Arch Otorhinolaryngol 2018;275:2237–4310.1007/s00405-018-5082-5CrossRefGoogle ScholarPubMed
Garcia-Iza, L, Guisasola, A, Ugarte, A, Navarro, JJ, Goiburu, M, Altuna, X. Utility of diffusion-weighted magnetic resonance imaging in the diagnosis of cholesteatoma and the influence of the learning curve. Eur Arch Otorhinolaryngol 2018;275:2227–3510.1007/s00405-018-5074-5CrossRefGoogle Scholar
Laske, RD, Roth, TN, Barath, K, Schuknecht, B, Huber, AM, Roosli, C. The role of non-echoplanar diffusion-weighted magnetic resonance imaging in diagnosis of primary cholesteatoma and cholesteatoma recidivism as an adjunct to clinical evaluation. Ann Otol Rhinol Laryngol 2018;127:919–2510.1177/0003489418800833CrossRefGoogle ScholarPubMed