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Zaman SU, Rangankar VP, Krishnarjun M, Kalekar TM, Shah VP, Pawar R, Kulothungan G. Readout-Segmented Echoplanar (RESOLVE) Diffusion-Weighted Imaging on 3T MRI in Detection of Cholesteatoma-Our Experience. Indian J Radiol Imaging 2024; 34:16-24. [PMID: 38106850 PMCID: PMC10723965 DOI: 10.1055/s-0043-1776054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Background Several research studies have demonstrated the utility of diffusion-weighted imaging (DWI) in detecting middle ear cholesteatomas, especially with the non-echoplanar imaging (non-EPI) DWI technique. REadout Segmentation Of Long Variable Echo trains (RESOLVE), a multishot-EPI DWI, has better spatial resolution at a thinner section acquisition with reduced image distortion compared to the single-shot-EPI DWI technique. Purpose In this study, we evaluated the diagnostic ability of RESOLVE -DWI in middle ear cholesteatomas with surgical and histopathological support. Patients and Methods Fifty patients with clinical suspicion of primary cholesteatoma or postoperative recurrence were subjected to routine sequences and RESOLVE-DWI on magnetic resonance imaging (MRI). Thirty-eight patients had unilateral disease, while 12 patients had bilateral disease. The bilateral temporal bones of 50 patients were evaluated on MRI. The results attained by RESOLVE-DWI were correlated with intraoperative and histopathological findings. Results RESOLVE-DWI truly detected 55 of the 58 surgically proven cholesteatomas. RESOLVE-DWI could not detect three cholesteatoma lesions due to their small size and falsely diagnosed one case each of impacted wax and non-cholesteatomatous otitis media as cholesteatoma. With a 95% confidence interval, RESOLVE-DWI showed 94.8% sensitivity, 95.2% specificity, 96% positive predictive value, 93% negative predictive value, and 95% diagnostic accuracy in cholesteatoma detection. Conclusion RESOLVE-DWI is a sensitive and specific DWI technique for detecting middle ear cholesteatoma. However, RESOLVE-DWI has limitations in the diagnosis of small (<3 mm) cholesteatomas.
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Affiliation(s)
- Sameeh Uz Zaman
- Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal, Karnataka, India
| | - Varsha P. Rangankar
- Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India
| | - Muralinath Krishnarjun
- Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India
| | - Tushar M. Kalekar
- Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India
| | - Viraj Pankaj Shah
- Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India
| | - Rishikesh Pawar
- Seth A.J.B ENT Municipal Hospital, Mumbai, Maharashtra, India
| | - Gowtham Kulothungan
- Shri Sathya Sai Medical College and Hospital, Chengalpattu, Tamil Nadu, India
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Lin M, Lin N, Sheng Y, Sha Y, Zhang Z, Zhou K. Detection of cholesteatoma: 2D BLADE turbo gradient- and spin-echo imaging versus readout-segmented echo-planar diffusion-weighted imaging. Eur Arch Otorhinolaryngol 2022; 279:5223-5229. [PMID: 35482118 DOI: 10.1007/s00405-022-07370-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/21/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This study is to compare the accuracy of 2D BLADE turbo gradient- and spin-echo imaging (TGSE BLADE) diffusion-weighted imaging (DWI) with that of readout-segmented echo-planar (RESOLVE) DWI in the detection of primary and residual/recurrent temporal bone cholesteatoma. METHODS The prospective study population consisted of 58 patients who were underwent magnetic resonance (MR) imaging for the evaluation of suspected temporal bone cholesteatoma. Two radiologists independently evaluated the two sequences. Kappa (k) statistics, the intra-class correlation coefficient (ICC), and a paired t test were used for statistical analysis. RESULTS Of the 58 patients included, all had histo-pathologically confirmed cholesteatomas. In ≤ 3 mm group (n = 13), TGSE BLADE sequence correctly identified all cases except one that was recorded as equivocal on both sequences because of high signal intensity on T1WI; while on RESOLVE sequences, 6 were positive, 4 were equivocal, and 3 were false negative. For > 3 mm group (n = 45), detection performance was similar between the two sequences. The mean ADC of cholesteatoma on TGSE BLADE DWI was 0.923 × 10-3 mm2/s, and the mean ADC of cholesteatoma on RESOLVE DWI was 0.949 × 10-3 mm2/s, with no significant difference in the mean ADC values of cholesteatoma measured on the two sequences (p = 0.9216). CONCLUSION TGSE BLADE outperforms RESOLVE in the detection of small temporal bone cholesteatoma ≤ 3 mm.
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Affiliation(s)
- Mengyan Lin
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Naier Lin
- Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Yaru Sheng
- Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Yan Sha
- Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
| | - Zhongshuai Zhang
- Scientific Marketing, Siemens Healthcare, Shanghai, 200336, China
| | - Kun Zhou
- Scientific Marketing, Siemens Healthcare, Shanghai, 200336, China
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Kosyakov SY, Pchelenok EV, Stepanova EA, Tarasova OY. [Combination of CT and MRT in the diagnostic of middle ear cholesteatoma. Fusion technology is precise localization tool]. Vestn Otorinolaringol 2021; 86:90-96. [PMID: 34783480 DOI: 10.17116/otorino20218605190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Computed tomography (CT) and magnetic resonance imaging (MRI) methods of the middle ear cholesteatoma diagnostic have its advantages and disadvantages. Fusion technology is a post-processing process of CT and MRI images. Its main advantage is the localization of MR-hyperintensive cholesteatoma within the bony anatomical structures obtained on CT, which provides the surgeon with important information both before planning the primary surgical intervention and during a second revision for recurrent cholesteatoma.
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Affiliation(s)
- S Ya Kosyakov
- Russian Medical Academy for Continuous Professional Education, Moscow, Russia
| | - E V Pchelenok
- Russian Medical Academy for Continuous Professional Education, Moscow, Russia
| | - E A Stepanova
- Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia
| | - O Yu Tarasova
- Russian Medical Academy for Continuous Professional Education, Moscow, Russia
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Russo C, Di Lullo AM, Cantone E, Klain M, Motta G, Elefante A, Cavaliere M. Combining Thin-Section Coronal and Axial Diffusion Weighted Imaging: Good Practice in Middle Ear Cholesteatoma Neuroimaging. Front Neurol 2021; 12:606692. [PMID: 34557138 PMCID: PMC8454914 DOI: 10.3389/fneur.2021.606692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 08/02/2021] [Indexed: 12/19/2022] Open
Affiliation(s)
- Camilla Russo
- Dipartimento di Scienze Biomediche Avanzate - Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Antonella Miriam Di Lullo
- Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche - Università degli Studi di Napoli "Federico II", Naples, Italy.,CEINGE - Advanced Biotechnology, Naples, Italy
| | - Elena Cantone
- Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche - Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Michele Klain
- Dipartimento di Scienze Biomediche Avanzate - Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Gaetano Motta
- Dipartimento di Scienze Anestesiologiche, Chirurgiche e dell'Emergenza - Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Elefante
- Dipartimento di Scienze Biomediche Avanzate - Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Michele Cavaliere
- Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche - Università degli Studi di Napoli "Federico II", Naples, Italy
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Wiesmueller M, Wuest W, May MS, Ellmann S, Heiss R, Saake M, Janka R, Uder M, Laun FB. Comparison of Readout-Segmented Echo-Planar Imaging and Single-Shot TSE DWI for Cholesteatoma Diagnostics. AJNR Am J Neuroradiol 2021; 42:1305-1312. [PMID: 33926901 DOI: 10.3174/ajnr.a7112] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 01/23/2021] [Indexed: 01/18/2023]
Abstract
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.
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Affiliation(s)
- M Wiesmueller
- From the Institute of Radiology (M.W., W.W., M.S.M., S.E., R.H., M.S., R.J., M.U., F.B.L.) .,Image Science Institute (M.W., W.W., M.S.M., R.H., M.S., R.J., M.U.), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - W Wuest
- From the Institute of Radiology (M.W., W.W., M.S.M., S.E., R.H., M.S., R.J., M.U., F.B.L.).,Image Science Institute (M.W., W.W., M.S.M., R.H., M.S., R.J., M.U.), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M S May
- From the Institute of Radiology (M.W., W.W., M.S.M., S.E., R.H., M.S., R.J., M.U., F.B.L.).,Image Science Institute (M.W., W.W., M.S.M., R.H., M.S., R.J., M.U.), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Ellmann
- From the Institute of Radiology (M.W., W.W., M.S.M., S.E., R.H., M.S., R.J., M.U., F.B.L.)
| | - R Heiss
- From the Institute of Radiology (M.W., W.W., M.S.M., S.E., R.H., M.S., R.J., M.U., F.B.L.).,Image Science Institute (M.W., W.W., M.S.M., R.H., M.S., R.J., M.U.), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M Saake
- From the Institute of Radiology (M.W., W.W., M.S.M., S.E., R.H., M.S., R.J., M.U., F.B.L.).,Image Science Institute (M.W., W.W., M.S.M., R.H., M.S., R.J., M.U.), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - R Janka
- From the Institute of Radiology (M.W., W.W., M.S.M., S.E., R.H., M.S., R.J., M.U., F.B.L.).,Image Science Institute (M.W., W.W., M.S.M., R.H., M.S., R.J., M.U.), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M Uder
- From the Institute of Radiology (M.W., W.W., M.S.M., S.E., R.H., M.S., R.J., M.U., F.B.L.).,Image Science Institute (M.W., W.W., M.S.M., R.H., M.S., R.J., M.U.), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - F B Laun
- From the Institute of Radiology (M.W., W.W., M.S.M., S.E., R.H., M.S., R.J., M.U., F.B.L.)
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Benson JC, Carlson ML, Lane JI. Non-EPI versus Multishot EPI DWI in Cholesteatoma Detection: Correlation with Operative Findings. AJNR Am J Neuroradiol 2021; 42:573-577. [PMID: 33334855 DOI: 10.3174/ajnr.a6911] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/29/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND PURPOSE Although multishot EPI (readout-segmented EPI) has been touted as a robust DWI sequence for cholesteatoma evaluation, its efficacy in disease detection compared with a non-EPI (eg, HASTE) technique is unknown. This study sought to compare the accuracy of readout-segmented EPI with that of HASTE DWI in cholesteatoma detection. MATERIALS AND METHODS A retrospective review was completed of consecutive patients who underwent MR imaging for the evaluation of suspected primary or recurrent/residual cholesteatomas. Included patients had MR imaging examinations that included both HASTE and readout-segmented EPI sequences and confirmed cholesteatomas on a subsequent operation. Two neuroradiologist reviewers assessed all images, with discrepancies resolved by consensus. The ratio of signal intensity between the cerebellum and any observed lesion was noted. RESULTS Of 23 included patients, 12 (52.2%) were women (average age, 47.8 [SD, 25.2] years). All patients had surgically confirmed cholesteatomas: Six (26.1%) were primary and 17 (73.9%) were recidivistic. HASTE images correctly identified cholesteatomas in 100.0% of patients. On readout-segmented EPI sequences, 16 (69.6%) were positive, 5 (21.7%) were equivocal, and 2 (8.7%) were falsely negative. Excellent interobserver agreement was noted between reviews on both HASTE (κ = 1.0) and readout-segmented EPI (κ = 0.9) sequences. The average signal intensity ratio was significantly higher on HASTE than in readout-segmented EPI, facilitating enhanced detection (mean difference 0.5; 95% CI, 0.3-0.8; P = .003). CONCLUSIONS HASTE outperforms readout-segmented EPI in the detection of primary cholesteatoma and disease recidivism.
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Affiliation(s)
- J C Benson
- Department of Radiology (J.C.B., J.I.L.)
| | - M L Carlson
- Otolaryngology-Head and Neck Surgery (M.L.C.), Mayo Clinic, Rochester, Minnesota
| | - J I Lane
- Department of Radiology (J.C.B., J.I.L.)
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7
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Touska P, Connor S. Imaging of the temporal bone. Clin Radiol 2020; 75:658-674. [DOI: 10.1016/j.crad.2020.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/22/2020] [Indexed: 12/20/2022]
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8
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Russo C, Elefante A, Cavaliere M, Di Lullo AM, Motta G, Iengo M, Brunetti A. Apparent diffusion coefficients for predicting primary cholesteatoma risk of recurrence after surgical clearance. Eur J Radiol 2020; 125:108915. [PMID: 32114332 DOI: 10.1016/j.ejrad.2020.108915] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/18/2020] [Accepted: 02/23/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Beside the well-known accuracy of non-EPI DWI techniques and relative ADC maps in detecting cholesteatomatous tissue, ADC can also represent a useful tool for stratifying cholesteatoma risk of recurrence. Aim of this study is to test the role of ADC in determining risk of recurrence for primary middle ear cholesteatoma, proposing stratification based on pre-operative mean (mADC) and normalized (nADC) ADC values. METHODS In this prospective study, 60 patients with primary unilateral middle ear cholesteatoma underwent a three-years-long follow-up to assess the presence of recurrent disease after macroscopically complete excisional surgery. Baseline MRI examination mADC and nADC values in the group with early evidence of recurrent cholesteatoma were compared to the group with no evidence of recurrence by using T statistics. RESULTS ADC values on pre-operative MRI examination were lower in cholesteatomas with early evidence of recurrence, and statistical significance was slightly higher for nADC compared to mADC measurements. We also determined a cut-off between the two groups, proposing stratification in high-risk of recurrence cholesteatomas (mADC≤ 1000 or nADC< 1.3) and low-risk cholesteatomas (mADC>1000 or nADC≥1.3). CONCLUSIONS ADC values resulted discriminating in identifying cholesteatomas with higher risk of early recurrence, both for mean and normalized ADC, with optimized tissue characterization and outcome prediction.
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Affiliation(s)
- Camilla Russo
- Dipartimento di Scienze Biomediche Avanzate - Università degli Studi di Napoli "Federico II", Naples, Italy.
| | - Andrea Elefante
- Dipartimento di Scienze Biomediche Avanzate - Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Michele Cavaliere
- Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche - Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Antonella M Di Lullo
- Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche - Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Gaetano Motta
- Dipartimento di Scienze Anestesiologiche, Chirurgiche e dell'Emergenza - Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Maurizio Iengo
- Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche - Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Arturo Brunetti
- Dipartimento di Scienze Biomediche Avanzate - Università degli Studi di Napoli "Federico II", Naples, Italy
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Yamashita K, Hiwatashi A, Togao O, Kikuchi K, Shimomiya Y, Kamei R, Momosaka D, Matsumoto N, Kobayashi K, Takemura A, Kwee TC, Takahara T, Honda H. Improved Visualization of Middle Ear Cholesteatoma with Computed Diffusion-weighted Imaging. Magn Reson Med Sci 2019; 18:233-237. [PMID: 30518733 PMCID: PMC6630047 DOI: 10.2463/mrms.tn.2018-0068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Computed DWI (cDWI) is a mathematical technique that calculates arbitrary higher b value images from at least two different lower b values. In addition, the removal of high intensity noise with image processing on cDWI could improve cholesteatoma-background contrast-to-noise ratio (CNR). In the present study, noise reduction was performed by the cut-off values of apparent diffusion coefficient (ADC) less than 0 and 0.4 × 10−3 s/mm2. The cholesteatoma to non-cholesteatoma CNR was increased using a noise reduction algorithm for clinical setting.
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Affiliation(s)
- Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
| | - Akio Hiwatashi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
| | - Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
| | - Yamato Shimomiya
- Division of Marketing, Department of Clinical Application Development, Ziosoft, Inc
| | - Ryotaro Kamei
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
| | - Daichi Momosaka
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
| | - Nozomu Matsumoto
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University
| | - Kouji Kobayashi
- Department of Medical Technology, Kyushu University Hospital
| | | | - Thomas Christian Kwee
- Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen
| | - Taro Takahara
- Department of Biomedical Engineering, Tokai University, School of Engineering
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
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Fischer N, Schartinger VH, Dejaco D, Schmutzhard J, Riechelmann H, Plaikner M, Henninger B. Readout-Segmented Echo-Planar DWI for the Detection of Cholesteatomas: Correlation with Surgical Validation. AJNR Am J Neuroradiol 2019; 40:1055-1059. [PMID: 31122917 DOI: 10.3174/ajnr.a6079] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/21/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging has become an important tool for the detection of cholesteatomas of the middle ear. Various diffusion-weighted imaging sequences are available and have shown promising results. This study aimed to evaluate readout-segmented echo-planar DWI for the detection of cholesteatoma and compare the results with surgical validation. MATERIALS AND METHODS Fifty patients with chronic otitis media (24 females and 26 males; range, 12-76 years of age; mean age, 41 years) who underwent MR imaging before an operation of the middle ear (1-169 days) were included. The MR imaging protocol consisted of axial and coronal readout-segmented echo-planar DWI with b-values of 0 and 1000 s/mm2 and 3-mm slice thickness. The readout-segmented echo-planar diffusion-weighted images were fused with standard T2-weighted sequences for better anatomic assignment. The results of the MR imaging evaluation were correlated with the results from the operation. RESULTS Readout-segmented echo-planar DWI detected 22 of the 25 cases of surgically proved cholesteatoma. It has an accuracy of 92% (95% confidence interval, 80.8%-97.8%), a sensitivity of 88%, a specificity of 96%, a positive predictive value of 96%, and a negative predictive value of 89%. In 1 case, a positive finding for cholesteatoma with readout-segmented echo-planar DWI could not be proved by histology, and in 3 cases, histology yielded a cholesteatoma that was not detected with MR imaging. CONCLUSIONS Readout-segmented echo-planar DWI is a promising and reliable MR imaging sequence for the detection and exclusion of cholesteatoma.
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Affiliation(s)
- N Fischer
- From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.)
| | - V H Schartinger
- From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.)
| | - D Dejaco
- From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.)
| | - J Schmutzhard
- From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.)
| | - H Riechelmann
- From the Departments of Otorhinolaryngology (N.F., V.H.S., D.D., J.S., H.R.)
| | - M Plaikner
- Radiology (M.P., B.H.), Medical University of Innsbruck, Innsbruck, Austria
| | - B Henninger
- Radiology (M.P., B.H.), Medical University of Innsbruck, Innsbruck, Austria
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Comparison of multi-shot and single shot echo-planar diffusion tensor techniques for the optic pathway in patients with neurofibromatosis type 1. Neuroradiology 2019; 61:431-441. [PMID: 30684113 DOI: 10.1007/s00234-019-02164-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Diffusion tensor imaging (DTI) may be helpful in assessing optic pathway integrity as a marker for treatment in neurofibromatosis type 1 (NF1) patients with optic gliomas (OG). However, susceptibility artifacts are common in typical single-shot echo planar imaging (ssDTI). A readout-segmented multi-shot EPI technique (rsDTI) was utilized to minimize susceptibility distortions of the skull base and improve quantitative metrics. METHODS Healthy controls, children with NF1 without OG, and NF1 with OG ± visual symptoms were included. All subjects were scanned with both rsDTI and ssDTI sequences sequentially. Diffusion metrics and deterministic fiber tracking were calculated. Tract count, volume, and length were also compared by a two-factor mixed ANOVA. RESULTS Five healthy controls, 7 NF1 children without OG, and 12 NF1 children with OG were imaged. Six OG patients had visual symptoms. Four subjects had no detectable optic pathway fibers on ssDTI due to susceptibility, for which rsDTI was able to delineate. Tract count (p < 0.001), tract volume (p < 0.001), and FA (P < 0.001) were significantly higher for rsDTI versus ssDTI for all subjects. MD (p < 0.001) and RD (p < 0.001) were significantly lower for rsDTI vs ssDTI. Finally, MD, AD, and RD had a significantly lower difference in NF1 children with visual symptoms compared to NF1 children without visual symptoms only on ssDTI scans. CONCLUSION DTI with readout-segmented multi-shot EPI technique can better visualize the optic pathway and allow more confident measurements of anisotropy in NF1 patients. This is shown by a significant increase in FA, tract count, and volume with rsDTI versus ssDTI.
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Dudau C, Draper A, Gkagkanasiou M, Charles-Edwards G, Pai I, Connor S. Cholesteatoma: multishot echo-planar vs non echo-planar diffusion-weighted MRI for the prediction of middle ear and mastoid cholesteatoma. BJR Open 2019; 1:20180015. [PMID: 33178911 PMCID: PMC7592409 DOI: 10.1259/bjro.20180015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/31/2018] [Accepted: 12/15/2018] [Indexed: 01/15/2023] Open
Abstract
Objective We aimed to compare a newer readout-segmented echoplanar imaging (RS-EPI) technique with the established single shot turbo spin echo (SS-TSE) non-EPI diffusion-weighted imaging (DWI) in detecting surgically validated cholesteatoma. Methods We retrospectively reviewed 358 consecutive MRI studies in 285 patients in which both RS-EPI and non-EPI DWI sequences were performed. Each diffusion sequence was reviewed independently and scored negative, indeterminate or positive for cholesteatoma in isolation and after reviewing the T 1W sequence. Average artefacts scores were evaluated and the lesion size measured as a distortion indicator. The imaging scores were correlated with surgical validation, clinical and imaging follow-up. Results There were 239 middle ear and central mastoid tract and 34 peripheral mastoid lesions. 102 tympanomastoid operations were performed. The positive predictive value ( PPV), post-operative PPV, primary PPV, negative predictive value were 93%, 95%, 87.5%, 70% for RS-EPI and 92.5%, 93.6%, 90%, 79% for non-EPI DWI. There was good agreement between the two techniques (k = 0.75). Non-EPI DWI is less susceptible to skull base artefacts although the mean cholesteatoma measurement difference was only 0.53 mm. Conclusion RS-EPI has comparable PPV with non-EPI DWI in both primary and post-operative cholesteatoma but slightly lower negative predictive value. When there is a mismatch, non-EPI DWI better predicts the presence of cholesteatoma. There is good agreement between the sequences for cholesteatoma diagnosis. The T 1W sequence is very important in downgrading indeterminate DWI signal lesions to a negative score. Advances in knowledge This is, to our knowledge, the first study to compare a multishot EPI DWI technique with the established non- EPI DWI in cholesteatoma diagnosis.
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Affiliation(s)
- Cristina Dudau
- Department of Radiology, Guy's and St Thomas' Hospital, and Department of Neuroradiology, King's College Hospital, London
| | - Ashleigh Draper
- GKT School of Medicine, King's College, London, United Kingdom
| | | | - Geoffrey Charles-Edwards
- Department of Medical Physics, Guy's and St Thomas' Hospital, and School of Biomedical Engineering and Imaging Sciences, King's College London, London
| | - Irumee Pai
- Department of Otolaryngology, Guy's and St. Thomas' Hospital, London
| | - Steve Connor
- Department of Radiology, Guy's and St Thomas' Hospital, and Department of Neuroradiology, King's College Hospital, London
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Tang C, Lin MB, Xu JL, Zhang LH, Zuo XM, Zhang ZS, Liu MX, Xu JM. Are ADC values of readout-segmented echo-planar diffusion-weighted imaging (RESOLVE) correlated with pathological prognostic factors in rectal adenocarcinoma? World J Surg Oncol 2018; 16:138. [PMID: 30001205 PMCID: PMC6043992 DOI: 10.1186/s12957-018-1445-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 07/05/2018] [Indexed: 02/06/2023] Open
Abstract
Background Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values as imaging biomarkers of rectal cancer are currently a hot research spot. The use of ADC values for preoperative judgment of pathological features in rectal cancer has been generally accepted. The image quality evaluation of conventional diffusion is severe deformation, and the measurement of ADC values can easily lead to bias. Readout-segmented echo-planar diffusion-weighted imaging (RESOLVE) provides high signal-to-noise ratio images and significantly reduces distortions caused by magnetosensitive effects. The purpose of this study was to explore the correlations between ADC values of RESOLVE and pathological prognostic factors in rectal adenocarcinoma. Methods We collected pathological data of 89 patients with pathologically confirmed rectal adenocarcinoma who directly underwent surgical resection without receiving adjuvant therapy. The patients were grouped according to the pathologic type, gross classification, degree of differentiation, TN stage, and immunohistochemical expression of epidermal growth factor receptor (EGFR). Results RESOLVE ADC values of rectal cancer were measured at b = 800, and correlations between the RESOLVE ADC values obtained in different groups were analysed. We found that RESOLVE ADC values in the ulcer-type group were significantly higher than those in the eminence-type group. Conclusion RESOLVE ADC values in different pathologic types of rectal cancer were significantly different. RESOLVE ADC values in the EGFR-positive group were significantly lower than those in the EGFR-negative group. There was no significant difference in RESOLVE ADC values between different degrees of pathologic differentiation, TN stages, and positive or negative lymph nodes. The quantitative description of RESOLVE ADC values could be used to assess the biological behaviour of rectal adenocarcinoma.
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Affiliation(s)
- Cui Tang
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China
| | - Mou-Bin Lin
- Department of General Surgery, Tongji University Affiliated Yangpu Hospital, Shanghai, 200090, China
| | - Jin-Lei Xu
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China
| | - Lan-Hua Zhang
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China
| | - Xiao-Ming Zuo
- Department of Pathology, Tongji University Affiliated Yangpu Hospital, Shanghai, 200090, China
| | | | | | - Jin-Ming Xu
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China.
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Russo C, Elefante A, Di Lullo AM, Carotenuto B, D'Amico A, Cavaliere M, Iengo M, Brunetti A. ADC Benchmark Range for Correct Diagnosis of Primary and Recurrent Middle Ear Cholesteatoma. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7945482. [PMID: 29854790 PMCID: PMC5941773 DOI: 10.1155/2018/7945482] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 02/02/2018] [Accepted: 03/20/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Magnetic resonance imaging (MRI) and in particular diffusion-weighted imaging (DWI) have been broadly proven to be the reference imaging method to discriminate between cholesteatoma and noncholesteatomatous middle ear lesions, especially when high tissue specificity is required. The aim of this study is to define a range of apparent diffusion coefficient (ADC) values within which the diagnosis of cholesteatoma is almost certain. METHODS The study was retrospectively conducted on a cohort of 124 patients. All patients underwent first- or second-look surgery because primary or secondary acquired cholesteatoma was clinically suspected; they all had preoperative MRI examination 15 days before surgery, including DWI from which the ADC maps were calculated. RESULTS Average ADC value for cholesteatomas was 859,4 × 10-6 mm2/s (range 1545 × 10-6 mm2/s; IQR = 362 × 10-6 mm2/s; σ = 276,3 × 10-6 mm2/s), while for noncholesteatomatous inflammatory lesions, it was 2216,3 × 10-6 mm2/s (range 1015 × 10-6 mm2/s; IQR = 372,75 × 10-6 mm2/s; σ = 225,6 × 10-6 mm2/s). Interobserver agreement with Fleiss' Kappa statistics was 0,96. No overlap between two groups' range of values was found and the difference was statistically significant for p < 0.0001. CONCLUSIONS We propose an interval of ADC values that should represent an appropriate benchmark range for a correct differentiation between cholesteatoma and granulation tissue or fibrosis of noncholesteatomatous inflammatory lesions.
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Affiliation(s)
- Camilla Russo
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | - Andrea Elefante
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | - Antonella M. Di Lullo
- Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | - Barbara Carotenuto
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | - Alessandra D'Amico
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | - Michele Cavaliere
- Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | - Maurizio Iengo
- Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | - Arturo Brunetti
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli “Federico II”, Naples, Italy
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Comparison of DWI Methods in the Pediatric Brain: PROPELLER Turbo Spin-Echo Imaging Versus Readout-Segmented Echo-Planar Imaging Versus Single-Shot Echo-Planar Imaging. AJR Am J Roentgenol 2018; 210:1352-1358. [PMID: 29570373 DOI: 10.2214/ajr.17.18796] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The purpose of this study is to compare DWI for pediatric brain evaluation using single-shot echo-planar imaging (EPI), periodically rotated overlapping parallel lines with enhanced reconstruction (Blade), and readout-segmented EPI (Resolve). MATERIALS AND METHODS Blade, Resolve, and single-shot EPI were performed for 27 pediatric patients (median age, 9 years), and three datasets were independently reviewed by two radiologists. Qualitative analyses were performed for perceptive coarseness, image distortion, susceptibility-related changes, motion artifacts, and lesion conspicuity using a 5-point Likert scale. Quantitative analyses were conducted for spatial distortion and signal uniformity of each sequence. RESULTS Mean scores were 2.13, 3.17, and 3.76 for perceptive coarseness; 4.85, 3.96, and 2.19 for image distortion; 4.76, 3.96, and 2.30 for susceptibility-related change; 4.96, 3.83, and 4.69 for motion artifacts; and 2.71, 3.75, and 1.92 for lesion conspicuity, for Blade, Resolve, and single-shot EPI, respectively. Blade and Resolve showed better quality than did single-shot EPI for image distortion, susceptibility-related changes, and lesion conspicuity. Blade showed less image distortion, fewer susceptibility-related changes, and fewer motion artifacts than did Resolve, whereas lesion conspicuity was better with Resolve. Blade showed increased signal variation compared with Resolve and single-shot EPI (coefficients of variation were 0.10, 0.08, and 0.05 for lateral ventricle; 0.13, 0.09, and 0.05 for centrum semiovale; and 0.16, 0.09, and 0.06 for pons in Blade, Resolve, and single-shot EPI, respectively). CONCLUSION DWI with Resolve or Blade yields better quality regarding distortion, susceptibility-related changes, and lesion conspicuity, compared with single-shot EPI. Blade is less susceptible to motion artifacts than is Resolve, whereas Resolve yields less noise and better lesion conspicuity than does Blade.
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Detection of cholesteatoma: High-resolution DWI using RS-EPI and parallel imaging at 3 tesla. J Neuroradiol 2017; 44:388-394. [DOI: 10.1016/j.neurad.2017.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 04/02/2017] [Accepted: 05/20/2017] [Indexed: 11/17/2022]
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Diffusivity of intraorbital lymphoma vs. inflammation: comparison of single shot turbo spin echo and multishot echo planar imaging techniques. Eur Radiol 2017; 28:325-330. [DOI: 10.1007/s00330-017-4995-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/27/2017] [Accepted: 07/14/2017] [Indexed: 11/27/2022]
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Henninger B, Kremser C. Diffusion weighted imaging for the detection and evaluation of cholesteatoma. World J Radiol 2017; 9:217-222. [PMID: 28634512 PMCID: PMC5441457 DOI: 10.4329/wjr.v9.i5.217] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 02/23/2017] [Accepted: 03/13/2017] [Indexed: 02/06/2023] Open
Abstract
Cholesteatoma is a collection of keratinous debris and stratified squamous epithelium. It is trapped in the middle ear and can lead to bony erosion. The disease is treated surgically often followed by a second-look procedure to check for residual tissue or recurrence. Cholesteatoma has specific signal-intensity characteristics on magnetic resonance imaging with very high signal intensity on diffusion weighted imaging (DWI). Various DWI techniques exist: Echo-planar imaging (EPI)-based and non-EPI-based techniques as well as new approaches like multi-shot EPI DWI. This article summarizes all techniques, discusses the significance in detecting cholesteatoma and mentions actual studies. Further recommendations for daily clinical practise are provided.
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Hiwatashi A, Togao O, Yamashita K, Kikuchi K, Yoshikawa H, Obara M, Honda H. High Resolution Diffusion-Weighted Imaging for Solitary Orbital Tumors. Clin Neuroradiol 2017; 28:261-266. [DOI: 10.1007/s00062-016-0556-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 12/19/2016] [Indexed: 01/30/2023]
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Alzahrani M, Alhazmi R, Bélair M, Saliba I. Postoperative diffusion weighted MRI and preoperative CT scan fusion for residual cholesteatoma localization. Int J Pediatr Otorhinolaryngol 2016; 90:259-263. [PMID: 27729145 DOI: 10.1016/j.ijporl.2016.09.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/17/2016] [Accepted: 09/25/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate the ability of preoperative mastoid high resolution Computerized tomography (CT Scan) fusion with the postoperative diffusion weighted magnetic resonance imaging (Non-EPI DWI) to accurately localize the residual cholesteatoma thus sparing an unnecessary postoperative CT scan radiation. PATIENTS AND METHODS this is a prospective study performed in our tertiary care center. We followed up prospectively a consecutive group of patients presenting with middle ear cholesteatoma using preoperative mastoid CT scans, postoperative mastoid CT scan and mastoid diffusion weighted MRI (DWI) between 2012 and 2013. Postoperative DWI were fused to both: the preoperative and postoperative mastoid CT scans. Fused images were evaluated for their ability to detect accurately the location of residual cholesteatoma if any. Results were correlated to the surgical findings. RESULTS Twenty-eight patients were included in this study. Ten patients showed middle ear opacity on the postoperative CT scans; the remaining negatively patients were excluded. DWI detected residual cholesteatoma in 3 out of the ten patients. Both CT scans; the pre and postoperative were able to precisely localize the residual cholesteatoma when fused to the postoperative DWI. Intra-operatively, three patients had a residual cholesteatoma that corresponded to the fused radiological images while a fourth patient presenting low signal intensity on the Non-EPI DWI had no cholesteatoma. CONCLUSION Diffusion weighted MRI/CT scan fusion combines the advantages of residual cholesteatoma detection and precise localization. Preoperative CT scans performed before the first surgery can be used for the fusion with the Non-EPI DWI in order to spare the patient an unnecessary another CT scan and thus decreasing radiation exposure.
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Affiliation(s)
- Musaed Alzahrani
- Department of Surgery, Division of Otolaryngology, King Fahad Specialist Hospital-Dammam, Saudi Arabia
| | - Rami Alhazmi
- Department of Medical Imaging, King Fahad Specialist Hospital-Dammam, Saudi Arabia
| | - Manon Bélair
- Department of Neuroradiology, Montreal University Hospital Center (CHUM), Quebec, Canada
| | - Issam Saliba
- Department of Surgery, Division of Otorhinolaryngology, Montreal University Hospital Center (CHUM), Quebec, Canada.
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Zhang SW, Xu L, Zhong TK, Diao HS. Comments on "Standard-b-value vs low-b-value DWI for differentiation of benign and malignant vertebral fractures: a meta-analysis". Br J Radiol 2016; 89:20160224. [PMID: 27052684 DOI: 10.1259/bjr.20160224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Si W Zhang
- Department of Radiology, Guangdong Provincial Traditional Chinese Medicine Hospital and postdoctoral mobile research station of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Li Xu
- Department of Radiology, Guangdong Provincial Traditional Chinese Medicine Hospital and postdoctoral mobile research station of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Ting K Zhong
- Department of Radiology, Guangdong Provincial Traditional Chinese Medicine Hospital and postdoctoral mobile research station of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Huan S Diao
- Department of Radiology, Guangdong Provincial Traditional Chinese Medicine Hospital and postdoctoral mobile research station of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
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Kanoto M, Sugai Y, Hosoya T, Toyoguchi Y, Konno Y, Watarai F, Ito T, Watanabe T, Kakehata S. Detectability and anatomical correlation of middle ear cholesteatoma using fused thin slice non-echo planar imaging diffusion-weighted image and magnetic resonance cisternography (FTS-nEPID). Magn Reson Imaging 2015; 33:1253-1257. [DOI: 10.1016/j.mri.2015.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 08/08/2015] [Indexed: 11/25/2022]
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Chronic inflammatory middle ear disease: Postoperative CT and MRI findings. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2015. [DOI: 10.1016/j.ejrnm.2015.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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The Efficacy of Color Mapped Fusion Images in the Diagnosis and Treatment of Cholesteatoma Using Transcanal Endoscopic Ear Surgery. Otol Neurotol 2015; 36:763-8. [DOI: 10.1097/mao.0000000000000675] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Diffusion weighted MR imaging of primary and recurrent middle ear cholesteatoma: an assessment by readers with different expertise. BIOMED RESEARCH INTERNATIONAL 2015; 2015:597896. [PMID: 25722983 PMCID: PMC4333184 DOI: 10.1155/2015/597896] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 11/11/2014] [Accepted: 11/12/2014] [Indexed: 12/14/2022]
Abstract
Introduction and Purpose. Diffusion weighted imaging (DWI) has been proven to be valuable in the diagnosis of middle ear cholesteatoma. The aims of our study were to evaluate the advantage of multi-shot turbo spin echo (MSh TSE) DWI compared to single-shot echo-planar (SSh EPI) DWI for the diagnosis of cholesteatoma. Material and Methods. Thirty-two patients with clinical suspicion of unilateral cholesteatoma underwent preoperative MRI (1.5T) with SSh EPI and MSh TSE. Images were separately analyzed by 4 readers with different expertise to confirm the presence of cholesteatoma. Sensitivity, specificity, diagnostic accuracy, and positive (PPV) and negative predictive values (NPV) were assessed for each observer and interrater agreement was assessed using kappa statistics. Diagnosis was obtained at surgery. Results. Overall MSh TSE showed higher diagnostic accuracy and lower negative predictive value (NPV) compared to conventional SSh EPI. Interreader agreement between the observers revealed the superiority of MSh TSE compared to SSh EPI. Interrater agreement among all the four observers was higher by using MSh TSE compared to SSh EPI. Conclusion. Our findings suggest that MSh TSE DWI has higher sensitivity for detection of cholesteatoma and lower probability of misdiagnosis. MSh TSE DWI is useful in guiding less experienced observers to the diagnosis.
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High-resolution three-dimensional diffusion-weighted MRI/CT image data fusion for cholesteatoma surgical planning: a feasibility study. Eur Arch Otorhinolaryngol 2014; 272:3821-4. [DOI: 10.1007/s00405-014-3467-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 12/19/2014] [Indexed: 11/26/2022]
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Cavaliere M, Di Lullo AM, Caruso A, Caliendo G, Elefante A, Brunetti A, Iengo M. Diffusion-Weighted Intensity Magnetic Resonance in the Preoperative Diagnosis of Cholesteatoma. ORL J Otorhinolaryngol Relat Spec 2014; 76:212-21. [DOI: 10.1159/000365931] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 07/11/2014] [Indexed: 11/19/2022]
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Usefulness of free-breathing readout-segmented echo-planar imaging (RESOLVE) for detection of malignant liver tumors: comparison with single-shot echo-planar imaging (SS-EPI). Eur J Radiol 2014; 83:1728-33. [PMID: 25043495 DOI: 10.1016/j.ejrad.2014.06.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 06/10/2014] [Accepted: 06/14/2014] [Indexed: 01/08/2023]
Abstract
PURPOSE We aimed to clarify the usefulness of free-breathing readout-segmented echo-planar imaging (RESOLVE), which is multi-shot echo-planar imaging based on a 2D-navigator-based reacquisition technique, for detecting malignant liver tumor. MATERIALS AND METHODS In 77 patients with malignant liver tumors, free-breathing RESOLVE and respiratory-triggered single-shot echo-planar imaging (SS-EPI) at 3-T MR unit were performed. We set a scan time up to approximately 5 min (300s) before examination, measured actual scan time and assessed (1) susceptibility and (2) motion artifacts in the right and left liver lobes (3, no artifact; 1, marked), and (3) detectability of malignant liver tumors (3, good; 1, poor) using a 3-point scale. RESULTS The median actual scan time of RESOLVE/SS-EPI was 365/423s. The median scores of each factor in RESOLVE/SS-EPI were as following in this order: (1) 3/2 (right lobe); 3/3 (left lobe), (2) 2/3 (right lobe); 1/2 (left lobe), and (3) 3/3, respectively. Significant differences were noted between RESOLVE and SS-EPI in all evaluated factors (P<0.05) except for susceptibility of left lobe and detectability of the lesions. CONCLUSION Despite the effect of motion artifacts, RESOLVE provides a comparable detectability of the lesion and the advantage of reducing scanning time compared with SS-EPI.
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Ginat DT, Mangla R, Yeaney G, Ekholm S. Diffusion-weighted imaging of skull lesions. J Neurol Surg B Skull Base 2014; 75:204-13. [PMID: 25072014 PMCID: PMC4078190 DOI: 10.1055/s-0034-1371362] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Accepted: 11/03/2012] [Indexed: 12/16/2022] Open
Abstract
Diffusion-weighted imaging can increase the conspicuity of skull lesions and be applied toward noninvasive differentiation of malignant from benign lesions. Malignant skull lesions generally display lower diffusivity than benign lesions, although there are exceptions, and clinical parameters and conventional imaging modalities should also be considered in the evaluation of skull lesions. Nevertheless, in some instances diffusion-weighted imaging (DWI) can be used for problem solving when conventional imaging features are indeterminate, such as with skull base involvement by nasopharyngeal carcinoma versus osteomyelitis. In addition, DWI may be useful for monitoring treatment effects. The use of readout segmented technique, parallel imaging, multishot acquisition, turbo spin-echo DWI, diffusion tensor imaging, and higher field strengths can improve image quality. The feasibility of implementing DWI for characterizing skull lesions, the DWI findings of benign and malignant skull lesions, and technical considerations are discussed in this article.
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Affiliation(s)
- Daniel T. Ginat
- Department of Radiology, University of Chicago Medical Center, Chicago, Illinois, United States
- Address for correspondence Daniel T. Ginat, MD, MS Department of Radiology, University of Chicago Medical Center5841 South Maryland Avenue Chicago, IL 60637United States
| | - Rajiv Mangla
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, United States
| | - Gabrielle Yeaney
- Department of Pathology, University of Rochester Medical Center, Rochester, New York, United States
| | - Sven Ekholm
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, United States
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Yamashita K, Yoshiura T, Hiwatashi A, Obara M, Togao O, Matsumoto N, Kikuchi K, Honda H. High-resolution three-dimensional diffusion-weighted imaging of middle ear cholesteatoma at 3.0 T MRI: usefulness of 3D turbo field-echo with diffusion-sensitized driven-equilibrium preparation (TFE-DSDE) compared to single-shot echo-planar imaging. Eur J Radiol 2013; 82:e471-5. [PMID: 23701953 DOI: 10.1016/j.ejrad.2013.04.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 04/19/2013] [Accepted: 04/19/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To prospectively evaluate the usefulness of a newly developed high-resolution three-dimensional diffusion-weighted imaging method, turbo field-echo with diffusion-sensitized driven-equilibrium (TFE-DSDE) in diagnosing middle-ear cholesteatoma by comparing it to conventional single-shot echo-planar diffusion-weighted imaging (SS-EP DWI). MATERIALS AND METHODS Institutional review board approval and informed consent from all participants were obtained. We studied 30 patients with preoperatively suspected acquired cholesteatoma. Each patient underwent an MR examination including both SS-EP DWI and DSDE-TFE using a 3.0 T MR scanner. Images of the 30 patients (60 temporal bones including 30 with and 30 without cholesteatoma) were reviewed by two independent neuroradiologists. The confidence level for the presence of cholesteatoma was graded on a scale of 0-2 (0=definite absence, 1=equivocal, 2=definite presence). Interobserver agreement as well as sensitivity, specificity, and accuracy for detection were assessed for the two reviewers. RESULTS Excellent interobserver agreement was shown for TFE-DSDE (κ=0.821) whereas fair agreement was obtained for SS-EP DWI (κ=0.416). TFE-DSDE was associated with significantly higher sensitivity (83.3%) and accuracy (90.0%) compared to SS-EP DWI (sensitivity=35.0%, accuracy=66.7%; p<0.05). No significant difference was found in specificity (96.7% for TFE-DSDE, 98.3% for SS-EP DWI) CONCLUSION: With increased spatial resolution and reduced susceptibility artifacts, TFE-DSDE improves the accuracy in diagnosing acquired middle ear cholesteatomas compared to SS-EP DWI.
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Affiliation(s)
- Koji Yamashita
- Department of Clinical Radiology, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Más-Estellés F, Mateos-Fernández M, Carrascosa-Bisquert B, Facal de Castro F, Puchades-Román I, Morera-Pérez C. Contemporary non-echo-planar diffusion-weighted imaging of middle ear cholesteatomas. Radiographics 2012; 32:1197-213. [PMID: 22787002 DOI: 10.1148/rg.324115109] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Middle ear cholesteatoma is a common inflammatory disease that requires surgery due to potentially serious intracranial complications. Diagnosis of cholesteatoma is mainly clinical, with computed tomography (CT) used to evaluate disease extension before surgery. Certain patterns of bone erosion are specific, but CT attenuation does not allow differentiation from other inflammatory middle ear diseases. With its high tissue discrimination and contrast resolution, magnetic resonance imaging is valuable in diagnosis of cholesteatomas. Absent enhancement at delayed postcontrast imaging has been used for diagnosis. Diffusion-weighted imaging (DWI) is highly specific due to the high keratin content of cholesteatomas. New non-echo-planar DWI sequences, such as periodically rotated overlapping parallel lines with enhanced reconstruction, are superior to conventional echo-planar DWI, since they minimize susceptibility artifacts at the skull base and increase sensitivity for detection of lesions as small as 2 mm. This technique is indicated when clinical diagnosis is difficult and high tissue specificity is necessary, as in congenital, temporal bone, or atypical acquired middle ear cholesteatomas and residual or recurrent disease after surgery. Non-echo-planar DWI has been proposed for screening of postsurgical (residual or recurrent) cholesteatomas, thus obviating many second-look revision surgeries, especially after more conservative canal wall up surgery.
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Affiliation(s)
- Fernando Más-Estellés
- Departments of Radiology and ENT Surgery, Hospital Universitari í Politècnic La Fé de Valencia, Bulevar Sur s/n, 46026 Valencia, Spain.
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Yazbek S, Aggarwal A, Simpson DM, Som PM. Imaging findings of atypical mycobacterial infection in the temporal bone. Clin Imaging 2012. [PMID: 23206623 DOI: 10.1016/j.clinimag.2012.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Atypical mycobacterial (AM) infection of the temporal bone is rare, and its early diagnosis is critical for a good patient outcome. The imaging findings of AM infection have been only briefly reported. We present the computed tomographic and magnetic resonance findings of AM involvement of the entire temporal bone in an immunocompromised patient, and we discuss the differential diagnosis. The scattered areas of both bone sclerosis and erosion may help the radiologist suggest the diagnosis of an indolent process such as tuberculosis or AM and allow initiation of early treatment.
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Affiliation(s)
- Sandrine Yazbek
- Department of Radiology, The Mount Sinai School of Medicine, New York University, New York, NY 10030, USA
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Fahmy DM, Ragab SM. Detection of post operative residual cholesteatoma using PROPELLER DWI combined with conventional MRI. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2012. [DOI: 10.1016/j.ejrnm.2012.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Iima M, Yamamoto A, Brion V, Okada T, Kanagaki M, Togashi K, Le Bihan D. Reduced-distortion diffusion MRI of the craniovertebral junction. AJNR Am J Neuroradiol 2012; 33:1321-5. [PMID: 22383239 DOI: 10.3174/ajnr.a2969] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE CVJ lesion suffers from a high sensitivity to susceptibility and distortion artifacts, which sometimes makes diffusion image difficult to interpret. Our purpose was to evaluate the potential for diffusion MR imaging using RS-EPI compared with SS-EPI in the assessment of the CVJ. MATERIALS AND METHODS RS-EPI and SS-EPI DTI images were acquired from 10 healthy volunteers using 3T MRI with a 32-channel head coil. For both sequences, the following parameters were used: 1-mm(2) in-plane resolution; 3-mm section thickness; TR = 5200 ms; 1 acquisition at b = 0 and 12 different encoding directions at b = 1000 seconds/mm(2). The RS-EPI sequence scan time was 9.44 minutes (1 average). The SS-EPI sequence was 9.37 minutes (8 averages). Diffusion tensor calculation and image analysis were performed using DTIStudio software. Diffusion trace images and color-coded fiber orientation maps were evaluated by 2 independent readers for distortion and delineation of fine structure using a semiquantitative scale in selected landmark locations. The absolute distances between the temporal base and the cerebellar contour between the T2-weighted images and the diffusion trace images obtained with RS-EPI and SS-EPI were also compared. RESULTS The contours of the temporal lobe and cerebellum were better delineated and distortion artifacts were clearly reduced with the RS-EPI sequence. More fine structures were also visible in the brain stem and cerebellum with the RS-EPI sequence. The amount of distortion was significantly reduced with RS-EPI compared with SS-EPI (P < .01). CONCLUSIONS The RS-EPI DTI sequence was less prone to geometric distortion than the SS-EPI sequence and allowed a better delineation of CVJ internal structure. Although the acquisition time is still relatively long, the RS-EPI appears as a promising approach to perform DTI studies in CVJ lesions, such as brain stem ischemia, neurodegenerative diseases, brain and skull base tumors, or inflammation.
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Affiliation(s)
- M Iima
- Department of Diagnostic Imaging and Nuclear Medicine and Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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