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Utility of Non-EPI DWI MRI Imaging in Cholesteatoma: The Indian Perspective

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Abstract

The purpose of this prospective observational study was to evaluate the diagnostic performance of non–EPI-based techniques, in detecting both primary and residual/recurrent cholesteatoma in a tertiary care center. 56 patients (25 female and 31 male) aged between 6 and 59 years were prospectively evaluated for the presence or absence of cholesteatoma. This included both primary and postoperative recurrent cholesteatoma (16). All the patients underwent sequential CT scans of temporal bones and non-EPI DWI (Non-Echo Planar Diffusion-Weighted Imaging) MRI techniques. The findings were correlated with surgical findings regarding the presence or absence of cholesteatoma. The size of cholesteatoma that was diagnosed on non-EPI DWI MRI was measured. The smallest size was 6 mm and the largest one was 21 mm. The accuracy of non-EPI DWI MRI in diagnosing cholesteatoma (primary and recurrent) was 97.5%. Whereas in diagnosing recurrent cholesteatoma accuracy was 100%. Accuracy of non-EPI DWI MRI is very high in diagnosing cholesteatoma especially in recurrent cholesteatoma and can potentially replace second look surgery when intact canal wall techniques are used. The technique is best used with a CT Scan of the temporal bone to depict bony changes, anatomical variants, or complications. The combination of HRCT and non-EPI DWI needs to be employed in diagnosing primary and recurrent cholesteatoma to maximize the diagnostic benefit as they are complimentary.

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References

  1. Cholesteatoma: Practice Essentials, Background, Etiology and Pathophysiology. (2018) cited 13 May 2018. Available from: https://emedicine.medscape.com/article/860080-overview

  2. Dhepnorrarat RC, Wood B, Rajan GP (2009) Postoperative non-echo-planar diffusion-weighted magnetic resonance imaging changes after cholesteatoma surgery: implications for cholesteatoma screening. Otol Neurotol Off Publ Am Otol Soc Am Neurotol Soc Eur Acad Otol Neurotol 30(1):54–58

    Article  Google Scholar 

  3. Songu M, Altay C, Onal K, Arslanoglu S, Balci MK, Ucar M et al (2015) Correlation of computed tomography, echo-planar diffusion-weighted magnetic resonance imaging and surgical outcomes in middle ear cholesteatoma. Acta Otolaryngol (Stockh) 135(8):776–780

    Article  Google Scholar 

  4. Baráth K, Huber AM, Stämpfli P, Varga Z, Kollias S (2011) Neuroradiology of cholesteatomas. AJNR Am J Neuroradiol 32(2):221–229

    Article  Google Scholar 

  5. van Egmond SL, Stegeman I, Grolman W, Aarts MCJ (2016) A Systematic review of non-echo planar diffusion-weighted magnetic resonance imaging for detection of primary and postoperative cholesteatoma. Otolaryngol-Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg 154(2):233–240

    Article  Google Scholar 

  6. **dal M, Riskalla A, Jiang D, Connor S, O’Connor AF (2011) A systematic review of diffusion-weighted magnetic resonance imaging in the assessment of postoperative cholesteatoma. Otol Neurotol Off Publ Am Otol Soc Am Neurotol Soc Eur Acad Otol Neurotol 32(8):1243–1249

    Article  Google Scholar 

  7. Migirov L, Wolf M, Greenberg G, Eyal A (2014) Non-EPI DW MRI in planning the surgical approach to primary and recurrent cholesteatoma. Otol Neurotol Off Publ Am Otol Soc Am Neurotol Soc Eur Acad Otol Neurotol 35(1):121–125

    Article  Google Scholar 

  8. Corrales CE, Blevins NH (2013) Imaging for evaluation of cholesteatoma: current concepts and future directions. Curr Opin Otolaryngol Head Neck Surg 21(5):461–467

    Article  Google Scholar 

  9. Muzaffar J, Metcalfe C, Colley S, Coulson C (2017) Diffusion-weighted magnetic resonance imaging for residual and recurrent cholesteatoma: a systematic review and meta-analysis. Clin Otolaryngol Off J ENT-UK Off J Neth Soc Oto-Rhino-Laryngol Cervico-Facial Surg 42(3):536–543

    CAS  Google Scholar 

  10. Ayache D, Williams MT, Lejeune D, Corré A (2005) Usefulness of delayed postcontrast magnetic resonance imaging in the detection of residual cholesteatoma after canal wall-up tympanoplasty. Laryngoscope 115(4):607–610

    Article  CAS  Google Scholar 

  11. Venail F, Bonafe A, Poirrier V, Mondain M, Uziel A (2008) Comparison of echo-planar diffusion-weighted imaging and delayed postcontrast T1-weighted MR imaging for the detection of residual cholesteatoma. AJNR Am J Neuroradiol 29(7):1363–1368

    Article  CAS  Google Scholar 

  12. Cihan Yigiter A, Pinar E, Imre A, Erdogan N (2015) Value of echo-planar diffusion-weighted magnetic resonance imaging for detecting tympanomastoid cholesteatoma. J Int Adv Otol 10:11

    Google Scholar 

  13. Li PMMC, Linos E, Gurgel RK, Fischbein NJ, Blevins NH (2013) Evaluating the utility of non-echo-planar diffusion-weighted imaging in the preoperative evaluation of cholesteatoma: a meta-analysis. Laryngoscope 123(5):1247–1250

    Article  Google Scholar 

  14. Plouin-Gaudon I, Bossard D, Fuchsmann C, Ayari-Khalfallah S, Froehlich P (2010) Diffusion-weighted MR imaging for evaluation of pediatric recurrent cholesteatomas. Int J Pediatr Otorhinolaryngol 74(1):22–26

    Article  CAS  Google Scholar 

  15. Vaid S, Kamble Y, Vaid N, Bhatti S, Rawat S, Nanivadekar A et al (2013) Role of magnetic resonance imaging in cholesteatoma: the Indian experience. Indian J Otolaryngol Head Neck Surg Off Publ Assoc Otolaryngol India 65(Suppl 3):485–492

    Article  Google Scholar 

  16. Profant M, Sláviková K, Kabátová Z, Slezák P, Waczulíková I (2012) Predictive validity of MRI in detecting and following cholesteatoma. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg 269(3):757–765

    Google Scholar 

  17. Akkari M, Gabrillargues J, Saroul N, Pereira B, Russier M, Mom T et al (2014) Contribution of magnetic resonance imaging to the diagnosis of middle ear cholesteatoma: analysis of a series of 97 cases. Eur Ann Otorhinolaryngol Head Neck Dis 131(3):153–158

    Article  CAS  Google Scholar 

  18. Alvo A, Garrido C, Salas Á, Miranda G, Stott CE, Delano PH (2014) Use of non-echo-planar diffusion-weighted MR imaging for the detection of cholesteatomas in high-risk tympanic retraction pockets. AJNR Am J Neuroradiol 35(9):1820–1824

    Article  CAS  Google Scholar 

  19. Khemani S, Lingam RK, Kalan A, Singh A (2011) The value of non-echo planar HASTE diffusion-weighted MR imaging in the detection, localisation and prediction of extent of postoperative cholesteatoma. Clin Otolaryngol Off J ENT-UK Off J Neth Soc Oto-Rhino-Laryngol Cervico-Facial Surg 36(4):306–312

    CAS  Google Scholar 

  20. De Foer B, Vercruysse J-P, Bernaerts A, Deckers F, Pouillon M, Somers T et al (2008) Detection of postoperative residual cholesteatoma with non-echo-planar diffusion-weighted magnetic resonance imaging. Otol Neurotol Off Publ Am Otol Soc Am Neurotol Soc Eur Acad Otol Neurotol 29(4):513–517

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Columbia Asia Hospitals, Bengaluru, India

    S. Revanth & Anita N. Nagadi

  2. Department of Otolaryngology, Columbia Asia Hospitals, Bengaluru, India

    Sreenivasa Murthy, Vineetha Raghu & Harsha Chadaga

  3. Department of ENT/Head and Neck Surgery, People Tree Hospitals, Bengaluru, India

    Ravi Sachidananda

  4. Department of ENT, Trust Well Hospitals, Bengaluru, India

    Deepak Haldipur

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  1. S. Revanth
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  5. Vineetha Raghu
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Correspondence to Anita N. Nagadi.

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Revanth, S., Nagadi, A.N., Murthy, S. et al. Utility of Non-EPI DWI MRI Imaging in Cholesteatoma: The Indian Perspective. Indian J Otolaryngol Head Neck Surg 74 (Suppl 3), 3919–3926 (2022). https://doi.org/10.1007/s12070-021-02704-8

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