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


CONCLUSIONS
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.
Department of Radiology, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: sharon.clarke@dal.ca.
Sharon E
SE
Clarke
Department of Radiology, Dalhousie University, Halifax, Nova Scotia, Canada.
Dipan
D
Mistry
Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Talal
T
AlThubaiti
Department of Diagnostic Imaging, IWK Health Centre, Halifax, Nova Scotia, Canada.
M Naeem
MN
Khan
Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
David
D
Morris
Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Manohar
M
Bance
D000328:Adult; D000368:Aged; D018424:Cholesteatoma, Middle Ear / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
Cholesteatoma; Diffusion; Magnetic resonance imaging; Temporal bone