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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/12819

Title: Middle Ear Cholesteatoma: Non-Echo-planar Diffusion-weighted MR Imaging versus Delayed Gadolinium-enhanced T1-weighted MR Imaging-Value in Detection
Authors: De Foer, Bert
Vercruysse, Jean-Philippe
Bernaerts, Anja
Meersschaert, Joke
Kenis, Christoph
Pouillon, Marc
De Beuckeleer, Luc
Michiels, Johan
Bogaerts, Kris
Deckers, Filip
Somers, Thomas
Hermans, Robert
Offeciers, Erwin
Casselman, Jan W.
Issue Date: 2010
Publisher: RADIOLOGICAL SOC NORTH AMERICA
Citation: RADIOLOGY, 255(3), p. 866-872
Abstract: Purpose: To retrospectively compare non-echo-planar (non-EP) diffusion-weighted (DW) imaging, delayed gadolinium-enhanced T1-weighted magnetic resonance (MR) imaging, and the combination of both techniques in the evaluation of patients with cholesteatoma. Materials and Methods: This institutional review board-approved study, for which the need to obtain informed consent was waived, included 57 patients clinically suspected of having a middle ear cholesteatoma without a history of surgery and 63 patients imaged before "second-look" surgery. Four blinded radiologists evaluated three sets of MR images: a set of delayed gadolinium-enhanced T1-weighted images, a set of non-EP DW images, and a set of both kinds of images. Overall sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV), as well as intra- and inter-observer agreement, were assessed and compared among methods. To correct for the correlation between different readings, a generalized estimating equations logistic regression model was fitted. Results were compared with surgical results, which were regarded as the standard of reference. Results: Sensitivity, specificity, NPV, and PPV were significantly different between the three methods (P<.005). Sensitivity and specificity, respectively, were 56.7% and 67.6% with the delayed gadolinium-enhanced T1-weighted images and 82.6% and 87.2% with the non-EP DW images. Sensitivity for the combination of both kinds of images was 84.2%, while specificity was 88.2%. The overall PPV was 88.0% for delayed gadolinium-enhanced T1-weighted images, 96.0% for non-EP DW images, and 96.3% for the combination of both kinds of images. The overall NPV was 27.0% for delayed gadolinium-enhanced T1-weighted images, 56.5% for non-EP DW images, and 59.6% for the combination of both kinds of images. Conclusion: MR imaging for detection of middle ear cholesteatoma can be performed by using non-EP DW imaging sequences alone. Use of the non-EP DW imaging sequence combined with a delayed gadolinium-enhanced T1-weighted sequence yielded no significant increases in sensitivity, specificity, NPV, or PPV over the use of the non-EP DW imaging sequence alone. (c) RSNA, 2010
Notes: [De Foer, B; Bernaerts, A; Kenis, C; Pouillon, M; De Beuckeleer, L; Deckers, F; Casselman, JW] Sint Augustinus Hosp, Dept Radiol, B-2610 Antwerp, Belgium. [Vercruysse, JP; Somers, T; Offeciers, E] Sint Augustinus Hosp, Univ Dept ENT, B-2610 Antwerp, Belgium. [Casselman, JW] Sint Jan Hosp AV, Dept Radiol, Brugge, Belgium. [Meersschaert, J; Hermans, R] Univ Hosp Leuven, Dept Radiol, Louvain, Belgium. [Bogaerts, K] Katholieke Univ Leuven, Interuniv Inst Biostat & Stat Bioinformat, Louvain, Belgium. [Bogaerts, K] Univ Hasselt, Hasselt, Belgium. [Michiels, J] Siemens NV, Healthcare Sector, Brussels, Belgium.
URI: http://hdl.handle.net/1942/12819
DOI: 10.1148/radiol.10091140
ISI #: 000278038500026
ISSN: 0033-8419
Category: A1
Type: Journal Contribution
Validation: ecoom, 2011
Appears in Collections: Research publications

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