title: 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.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiology I, Strasbourg Hautepierre University Hospital, CHRU Hautepierre, avenue Molière, 67098 Strasbourg cedex, France. Electronic address: julienlincot@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Lincot
authors.affiliation: Department of Radiology I, Strasbourg Hautepierre University Hospital, CHRU Hautepierre, avenue Molière, 67098 Strasbourg cedex, France; Faculty of Medicine, Louis-Pasteur University, 67000 Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: Veillon
authors.affiliation: Department of Radiology I, Strasbourg Hautepierre University Hospital, CHRU Hautepierre, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Riehm
authors.affiliation: Department of Radiology I, Strasbourg Hautepierre University Hospital, CHRU Hautepierre, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: N
authors.initials: N
authors.lastname: Babay
authors.affiliation: Department of Radiology I, Strasbourg Hautepierre University Hospital, CHRU Hautepierre, avenue Molière, 67098 Strasbourg cedex, France; Faculty of Medicine, Louis-Pasteur University, 67000 Strasbourg, France.
authors.forename: J-F
authors.initials: JF
authors.lastname: Matern
authors.affiliation: Department of Radiology I, Strasbourg Hautepierre University Hospital, CHRU Hautepierre, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Rock
authors.affiliation: Department of Radiology, Bichat-Claude-Bernard University Hospital, 75018 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Dallaudière
authors.affiliation: Faculty of Medicine, Louis-Pasteur University, 67000 Strasbourg, France; Laboratory of Biostatistics and Medical Informatics, Louis-Pasteur University, 67000 Strasbourg, France.
authors.forename: N
authors.initials: N
authors.lastname: Meyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018424:Cholesteatoma, Middle Ear / Q000473:pathology*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: Cholesteatoma; Diffusion-weighted imaging; Middle ear masses; Non-echo planar; Temporal bone