Diffusion-Weighted Magnetic Resonance Imaging of Cholesteatoma Using PROPELLER at 1.5T: A Single-Centre Retrospective Study

• Published in: Canadian Association of Radiologists journal Vol. 68; no. 2; pp. 116 - 121
• Main Authors: Clarke, Sharon E., MD, PhD, Mistry, Dipan, MD, AlThubaiti, Talal, MD, Khan, M. Naeem, MBBS, FRCPC, Morris, David, MBBS, FRCS (Eng), Bance, Manohar, MB, MSc
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA Elsevier Inc 01.05.2017; SAGE Publications; SAGE PUBLICATIONS, INC
• Subjects: Adult; Aged; Cholesteatoma; Cholesteatoma, Middle Ear - diagnostic imaging; Diffusion; Diffusion Magnetic Resonance Imaging - methods; Female; Hearing loss; Humans; Image Processing, Computer-Assisted; Magnetic resonance imaging; Male; NMR; Nuclear magnetic resonance; Predictive Value of Tests; Radiology; Retrospective Studies; Sensitivity and Specificity; Surgery; Temporal bone; Young Adult; Temporal bone; Cholesteatoma; Magnetic resonance imaging; Diffusion
• ISSN: 0846-5371; 1488-2361
• DOI: 10.1016/j.carj.2016.05.002

Abstract Purpose The purpose of this study was to evaluate the sensitivity, specificity, and positive and negative predictive values of the diffusion-weighted periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique in the detection of cholesteatoma at our institution with surgical confirmation in all cases. Methods A retrospective review of 21 consecutive patients who underwent diffusion-weighted PROPELLER magnetic resonance imaging (MRI) on a 1.5T MRI scanner prior to primary or revision/second-look surgery for suspected cholesteatoma from 2009-2012 was performed. Results Diffusion-weighted PROPELLER had a sensitivity of 75%, specificity of 60%, positive predictive value of 86%, and negative predictive value of 43%. In the 15 patients for whom the presence or absence of cholesteatoma was correctly predicted, there were 2 cases where the reported locations of diffusion restriction did not correspond to the location of the cholesteatoma observed at surgery. Conclusion On the basis of our retrospective study, we conclude that diffusion-weighted PROPELLER MRI is not sufficiently accurate to replace second look surgery at our institution.