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Middle ear cholesteatoma: Compared diagnostic performances of two incremental MRI protocols including non-echo planar
J Lincot1, F Veillon2, S Riehm1
1Department of Radiology I, Strasbourg Hautepierre University Hospital, CHRU Hautepierre, avenue Molière, 67098 Strasbourg cedex, France.
Background And Purpose:
To compare diagnostic performances for cholesteatoma diagnosis of incremental MRI protocols including non-echo planar diffusion-weighted imaging (DWI) performed on 3T and 1.5T scanners.
Materials And Methods:
Thirty-nine patients with suspected cholesteatoma underwent 3T and 1.5T non-echo planar DWI and additional unenhanced T1-, delayed gadolinium-enhanced T1- and high-resolution T2-weighted standard acquisitions. Patients either underwent surgical tympanoplasty (n=21) or close clinicoradiological follow-up (n=18). Four radiologists independently and prospectively interpreted two incremental MRI protocols, differing in the magnetic field strength of the diffusion-weighted acquisition and comprising the three standard sequences. At each step, diagnostic performances were expressed as sensitivity, specificity, positive predictive value, negative predictive value and accuracy.
Results:
Forty middle ear lesions including 21 cholesteatomas were identified. Univariate and multivariate analysis did not demonstrate significant reader, sequence addition or DWI magnetic field effect on diagnostic performances. Concerning non-echo planar DWI alone, sensitivity, specificity, positive predictive value, negative predictive value and accuracy ranged between 90.5-100%, 68.4-100%, 76.9-100%, 90.0-100% and 82.5-95.0, respectively.
Conclusion:
Non-echo planar DWI for cholesteatoma diagnosis can be performed on 1.5T or 3T scanners indifferently. High sensitivity and negative predictive value and relatively lower specificity and positive predictive value are achieved by a single non-echo planar DWI protocol.
Insights
Non-echo planar diffusion-weighted imaging (DWI) for cholesteatoma diagnosis performs similarly on 1.5T and 3T MRI scanners. This technique offers high sensitivity and negative predictive value, though specificity and positive predictive value are lower.
Area of Science:
- Radiology
- Medical Imaging
- Otology
Background:
- Cholesteatoma diagnosis requires accurate imaging.
- Diffusion-weighted imaging (DWI) is a key MRI technique.
Purpose of the Study:
- To compare the diagnostic performance of incremental MRI protocols for cholesteatoma.
- To evaluate non-echo planar DWI on 3T and 1.5T scanners.
Main Methods:
- 39 patients with suspected cholesteatoma underwent MRI, including non-echo planar DWI at 3T and 1.5T.
- Four radiologists interpreted two incremental MRI protocols.
- Diagnostic performances (sensitivity, specificity, PPV, NPV, accuracy) were assessed.
Main Results:
- Non-echo planar DWI alone showed high sensitivity (90.5-100%) and NPV (90.0-100%).
- Specificity (68.4-100%) and PPV (76.9-100%) were relatively lower.
- No significant difference in diagnostic performance was found between 1.5T and 3T DWI.
Conclusions:
- Non-echo planar DWI is effective for cholesteatoma diagnosis on both 1.5T and 3T MRI scanners.
- The protocol achieves high sensitivity and NPV, suitable for ruling out cholesteatoma.
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