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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2024; 34(01): 16-24
DOI: 10.1055/s-0043-1776054
Original Article

Readout-Segmented Echoplanar (RESOLVE) Diffusion-Weighted Imaging on 3T MRI in Detection of Cholesteatoma—Our Experience

Sameeh Uz Zaman 
1   Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal, Karnataka, India
,
Varsha P. Rangankar 
2   Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India
,
Muralinath Krishnarjun 
2   Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India
,
Tushar M. Kalekar 
2   Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India
,
Viraj Pankaj Shah 
2   Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India
,
Rishikesh Pawar 
3   Seth A.J.B ENT Municipal Hospital, Mumbai, Maharashtra, India
,
Gowtham Kulothungan 
4   Shri Sathya Sai Medical College and Hospital, Chengalpattu, Tamil Nadu, India
› Institutsangaben Funding None.
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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.

Keywords

cholesteatoma - hyperintense - keratin - MS-EPI - RESOLVE-DWI - sensitivity - specificity

Note

The study was conducted at the Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India.


Ethical Approval and Consent to Participate

This study was approved prior by the IEC with research protocol number IESC/PGS/2019/173. All patients or the parent/guardian of minor patients provided written and informed consent.




Publikationsverlauf

Artikel online veröffentlicht:
23. November 2023

© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Henninger B, Kremser C. Diffusion weighted imaging for the detection and evaluation of cholesteatoma. World J Radiol 2017; 9 (05) 217-222
    CrossrefPubMedSuche in Google Scholar
  • 2 Vaid S, Kamble Y, Vaid N. et al. Role of magnetic resonance imaging in cholesteatoma: the Indian experience. Indian J Otolaryngol Head Neck Surg 2013; 65 (Suppl. 03) 485-492
    CrossrefPubMedSuche in Google Scholar
  • 3 Castle JT. Cholesteatoma pearls: practical points and update. Head Neck Pathol 2018; 12 (03) 419-429
    CrossrefPubMedSuche in Google Scholar
  • 4 Tierney PA, Pracy P, Blaney SP, Bowdler DA. An assessment of the value of the preoperative computed tomography scans prior to otoendoscopic 'second look' in intact canal wall mastoid surgery. Clin Otolaryngol Allied Sci 1999; 24 (04) 274-276
    CrossrefPubMedSuche in Google Scholar
  • 5 Handi PS, Patil MN, Nisha P. High resolution computed tomography of temporal bone in the evaluation of otologic diseases. IntJ Otorhinolaryngol Head Neck Surg. 2018; 4: 87-92
    CrossrefSuche in Google Scholar
  • 6 Osman NM, Rahman AA, Ali MT. The accuracy and sensitivity of diffusion-weighted magnetic resonance imaging with apparent diffusion coefficients in diagnosis of recurrent cholesteatoma. Eur J Radiol Open 2017; 4: 27-39
    CrossrefPubMedSuche in Google Scholar
  • 7 Cimsit NC, Cimsit C, Baysal B, Ruhi IC, Ozbilgen S, Aksoy EA. Diffusion-weighted MR imaging in postoperative follow-up: reliability for detection of recurrent cholesteatoma. Eur J Radiol 2010; 74 (01) 121-123
    CrossrefPubMedSuche in Google Scholar
  • 8 Lincot J, Veillon F, Riehm S. et al. Middle ear cholesteatoma: compared diagnostic performances of two incremental MRI protocols including non-echo planar diffusion-weighted imaging acquired on 3T and 1.5T scanners. J Neuroradiol 2015; 42 (04) 193-201
    CrossrefPubMedSuche in Google Scholar
  • 9 De Foer B, Vercruysse JP, Bernaerts A. et al. The value of single-shot turbo spin-echo diffusion-weighted MR imaging in the detection of middle ear cholesteatoma. Neuroradiology 2007; 49 (10) 841-848
    CrossrefPubMedSuche in Google Scholar
  • 10 Lingam RK, Bassett P. A meta-analysis on the diagnostic performance of non-echoplanar diffusion-weighted imaging in detecting middle ear cholesteatoma: 10 years on. Otol Neurotol 2017; 38 (04) 521-528
    CrossrefPubMedSuche in Google Scholar
  • 11 Sharifian H, Taheri E, Borghei P. et al. Diagnostic accuracy of non-echo-planar diffusion-weighted MRI versus other MRI sequences in cholesteatoma. J Med Imaging Radiat Oncol 2012; 56 (04) 398-408
    CrossrefPubMedSuche in Google Scholar
  • 12 Fischer N, Schartinger VH, Dejaco D. et al. Readout-segmented echo-planar DWI for the detection of cholesteatomas: correlation with surgical validation. Am J Neuroradiol 2019; 40 (06) 1055-1059
    CrossrefPubMedSuche in Google Scholar
  • 13 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 (01) 20180015
    PubMedSuche in Google Scholar
  • 14 Porter DA, Heidemann RM. High resolution diffusion-weighted imaging using readout-segmented echo-planar imaging, parallel imaging and a two-dimensional navigator-based reacquisition. Magn Reson Med 2009; 62 (02) 468-475
    CrossrefPubMedSuche in Google Scholar
  • 15 Naganawa S, Yamazaki M, Kawai H, Sone M, Nakashima T, Isoda H. Anatomical details of the brainstem and cranial nerves visualized by high resolution readout-segmented multi-shot echo-planar diffusion-weighted images using unidirectional MPG at 3T. Magn Reson Med Sci 2011; 10 (04) 269-275
    CrossrefPubMedSuche in Google Scholar
  • 16 Yamashita K, Yoshiura T, Hiwatashi A. et al. Detection of middle ear cholesteatoma by diffusion-weighted MR imaging: multishot echo-planar imaging compared with single-shot echo-planar imaging. Am J Neuroradiol 2011; 32 (10) 1915-1918
    CrossrefPubMedSuche in Google Scholar
  • 17 Sheng Y, Hong R, Sha Y, Zhang Z, Zhou K, Fu C. Performance of TGSE BLADE DWI compared with RESOLVE DWI in the diagnosis of cholesteatoma. BMC Med Imaging 2020; 20 (01) 40
    CrossrefPubMedSuche in Google Scholar
  • 18 Algin O, Aydın H, Ozmen E. et al. Detection of cholesteatoma: high-resolution DWI using RS-EPI and parallel imaging at 3 tesla. J Neuroradiol 2017; 44 (06) 388-394
    CrossrefPubMedSuche in Google Scholar
  • 19 Wiesmueller M, Wuest W, May MS. et al. Comparison of readout-segmented echo-planar imaging and single-shot TSE DWI for cholesteatoma diagnostics. Am J Neuroradiol 2021; 42 (07) 1305-1312
    CrossrefPubMedSuche in Google Scholar
  • 20 Ishii K, Takahashi S, Kobayashi T, Matsumoto K, Ishibashi T. MR imaging of middle ear cholesteatomas. J Comput Assist Tomogr 1991; 15 (06) 934-937
    CrossrefPubMedSuche in Google Scholar
  • 21 Russo C, Elefante A, Di Lullo AM. et al. ADC benchmark range for correct diagnosis of primary and recurrent middle ear cholesteatoma. BioMed Res Int 2018; 2018: 7945482
    CrossrefPubMedSuche in Google Scholar
  • 22 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 (02) 504-510
    CrossrefPubMedSuche in Google Scholar
  • 23 Thiriat S, Riehm S, Kremer S, Martin E, Veillon F. Apparent diffusion coefficient values of middle ear cholesteatoma differ from abscess and cholesteatoma admixed infection. Am J Neuroradiol 2009; 30 (06) 1123-1126
    CrossrefPubMedSuche in Google Scholar
  • 24 Benson JC, Carlson ML, Lane JI. Non-EPI versus multishot EPI DWI in cholesteatoma detection: correlation with operative findings. Am J Neuroradiol 2021; 42 (03) 573-577
    CrossrefPubMedSuche in Google Scholar
  • 25 Lingam RK, Nash R, Majithia A, Kalan A, Singh A. Non-echoplanar diffusion weighted imaging in the detection of post-operative middle ear cholesteatoma: navigating beyond the pitfalls to find the pearl. Insights Imaging 2016; 7 (05) 669-678
    CrossrefPubMedSuche in Google Scholar
  • 26 Lips LMJ, Nelemans PJ, Theunissen FMD. et al. The diagnostic accuracy of 1.5 T versus 3 T non-echo-planar diffusion-weighted imaging in the detection of residual or recurrent cholesteatoma in the middle ear and mastoid. J Neuroradiol 2020; 47 (06) 433-440
    CrossrefPubMedSuche in Google Scholar
  • 27 van Egmond SL, Stegeman I, Grolman W, Aarts MC. A systematic review of non-echo planar diffusion-weighted magnetic resonance imaging for detection of primary and postoperative cholesteatoma. Otolaryngol Head Neck Surg 2016; 154 (02) 233-240
    CrossrefPubMedSuche in Google Scholar
  • 28 Plouin-Gaudon I, Bossard D, Fuchsmann C, Ayari-Khalfallah S, Froehlich P. Diffusion-weighted MR imaging for evaluation of pediatric recurrent cholesteatomas. Int J Pediatr Otorhinolaryngol 2010; 74 (01) 22-26
    CrossrefPubMedSuche in Google Scholar
  • 29 Lecler A, Lenoir M, Peron J. et al. Magnetic resonance imaging at one year for detection of postoperative residual cholesteatoma in children: is it too early?. Int J Pediatr Otorhinolaryngol 2015; 79 (08) 1268-1274
    CrossrefPubMedSuche in Google Scholar
  • 30 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 (03) 536-543
    CrossrefPubMedSuche in Google Scholar
  • 31 Horn RJ, Gratama JWC, van der Zaag-Loonen HJ, Droogh-de Greve KE, van Benthem PG. Negative predictive value of non-echo-planar diffusion weighted MR imaging for the detection of residual cholesteatoma done at 9 months after primary surgery is not high enough to omit second look surgery. Otol Neurotol 2019; 40 (07) 911-919
    CrossrefPubMedSuche in Google Scholar
  • 32 Muhonen EG, Mahboubi H, Moshtaghi O. et al. False-positive cholesteatomas on non-echoplanar diffusion-weighted magnetic resonance imaging. Otol Neurotol 2020; 41 (05) e588-e592
    CrossrefPubMedSuche in Google Scholar