title: Diagnostic accuracy of susceptibility-weighted magnetic resonance imaging for the evaluation of pineal gland calcification.
abstract: OBJECTIVE
  To determine the diagnostic performance of susceptibility-weighted magnetic resonance imaging (SWMR) for the detection of pineal gland calcifications (PGC) compared to conventional magnetic resonance imaging (MRI) sequences, using computed tomography (CT) as a reference standard.
  
  
  METHODS
  384 patients who received a 1.5 Tesla MRI scan including SWMR sequences and a CT scan of the brain between January 2014 and October 2016 were retrospectively evaluated. 346 patients were included in the analysis, of which 214 showed PGC on CT scans. To assess correlation between imaging modalities, the maximum calcification diameter was used. Sensitivity and specificity and intra- and interobserver reliability were calculated for SWMR and conventional MRI sequences.
  
  
  RESULTS
  SWMR reached a sensitivity of 95% (95% CI: 91%-97%) and a specificity of 96% (95% CI: 91%-99%) for the detection of PGC, whereas conventional MRI achieved a sensitivity of 43% (95% CI: 36%-50%) and a specificity of 96% (95% CI: 91%-99%). Detection rates for calcifications in SWMR and conventional MRI differed significantly (95% versus 43%, p<0.001). Diameter measurements between SWMR and CT showed a close correlation (R2 = 0.85, p<0.001) with a slight but not significant overestimation of size (SWMR: 6.5 mm ± 2.5; CT: 5.9 mm ± 2.4, p = 0.02). Interobserver-agreement for diameter measurements was excellent on SWMR (ICC = 0.984, p < 0.0001).
  
  
  CONCLUSIONS
  Combining SWMR magnitude and phase information enables the accurate detection of PGC and offers a better diagnostic performance than conventional MRI with CT as a reference standard.
authors.affiliation: Department of Radiology, Charité, Berlin, Germany.
authors.forename: Lisa C
authors.identifier: http://orcid.org/0000-0001-5836-4542
authors.initials: LC
authors.lastname: Adams
authors.affiliation: Department of Radiology, Charité, Berlin, Germany.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Böker
authors.affiliation: Department of Radiology, Charité, Berlin, Germany.
authors.forename: Yvonne Y
authors.initials: YY
authors.lastname: Bender
authors.affiliation: Department of Radiology, Charité, Berlin, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Diederichs
authors.affiliation: Department of Radiology, Charité, Berlin, Germany.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Fallenberg
authors.affiliation: Department of Radiology, Charité, Berlin, Germany.
authors.forename: Moritz
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Department of Radiology, Charité, Berlin, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.affiliation: Department of Radiology, Charité, Berlin, Germany.
authors.forename: Marcus R
authors.initials: MR
authors.lastname: Makowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D010870:Pineal Gland / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult