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Detection of cholesteatoma: High-resolution DWI using RS-EPI and parallel imaging at 3 tesla.

O Algin1, H Aydın2, E Ozmen3

  • 1Department of Radiology, Ataturk Training and Research Hospital, 06050 Ankara, Turkey; National MR Research Center (UMRAM), Bilkent University, Bilkent, Ankara, Turkey.

Journal of Neuroradiology = Journal De Neuroradiologie
|July 5, 2017
PubMed
Summary

Rapid-acquisition echo-planar diffusion-weighted imaging (RS-EPI-DWI) offers superior cholesteatoma detection compared to single-shot echo-planar diffusion-weighted imaging (SS-EPI-DWI), showing fewer artifacts and better lesion visibility.

Keywords:
CholesteatomaDiffusion-weighted imagingRESOLVEReadout-segmented EPISingle-shot EPI

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Area of Science:

  • Radiology
  • Medical Imaging
  • Otolaryngology

Background:

  • Cholesteatoma detection in the middle ear is crucial for effective treatment.
  • Diffusion-weighted imaging (DWI) is a valuable tool for identifying cholesteatoma.
  • Comparing different DWI techniques is essential for optimizing diagnostic accuracy.

Purpose of the Study:

  • To evaluate the diagnostic performance of rapid-acquisition echo-planar diffusion-weighted imaging (RS-EPI-DWI) for cholesteatoma detection.
  • To compare RS-EPI-DWI with single-shot echo-planar diffusion-weighted imaging (SS-EPI-DWI).

Main Methods:

  • 30 patients with suspected cholesteatoma underwent both RS-EPI and SS-EPI DWI and apparent diffusion-coefficient (ADC) imaging.
  • Cholesteatoma presence, artifact levels, lesion visibility, and ADC values were assessed.
  • Results were compared against a gold-standard (GS) test.

Main Results:

  • RS-EPI-DWI demonstrated significantly higher lesion visibility and fewer artifacts than SS-EPI-DWI.
  • RS-EPI-DWI achieved higher sensitivity (100% vs. 91%), specificity (78% vs. 60%), and overall agreement (87% vs. 75%) compared to SS-EPI-DWI.
  • ADC measurements were better on axial planes, and RS-EPI-DWI showed good agreement (κ=0.74) with GS, while SS-EPI-DWI showed moderate agreement (κ=0.50).

Conclusions:

  • RS-EPI-DWI offers improved spatial resolution and reduced susceptibility to artifacts compared to SS-EPI-DWI.
  • RS-EPI-DWI is a more effective technique for cholesteatoma detection, providing superior diagnostic performance.