Khalil Bazzi1, Eugene Wong2, Nicholas Jufas3, Nirmal Patel3. 1. School of Medicine, The University of Notre Dame Australia, 160 Oxford Street, Darlinghurst, NSW, Australia. Electronic address: khalil.bazzi@outlook.com. 2. Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Westmead, NSW, Australia. 3. Kolling Deafness Research Centre, Royal North Shore Hospital and Macquarie University, Sydney, Australia; Discipline of Surgery, Sydney Medical School, University of Sydney, Australia; Sydney Endoscopic Ear Surgery (SEES) Research Group, Australia; Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
Abstract
OBJECTIVE: To examine the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) in the detection of residual and recurrent cholesteatoma in children. METHODS: A systematic review and meta-analysis was conducted as per PRISMA guidelines using the following databases from their date of inception: MEDLINE, PubMed, Embase, Cochrane Library, Web of Science. Bivariate meta-analysis using a random effects model was used to calculate summarized pooled estimates of sensitivity, specificity, and diagnostic odds ratios, using second-look surgery as the gold standard comparison. RESULTS: A total of ten articles (141 cases) were included for qualitative and quantitative analysis. Pooled sensitivity and specificity of non-echo planar imaging (non-EPI) DW-MRI were 89.4% (95%CI 51.9%-98.5%) and 92.9% (95%CI 81.4%-97.5%) respectively. DW-MRI appears limited in its ability to detect lesions less than 3 mm in size. CONCLUSION: Non-EPI DW-MRI is highly specific but carries uncertain sensitivity in the detection of residual and recurrent cholesteatoma in children. Further research is warranted to determine the specific role of DW-MRI in this patient group, namely when and how often children should be referred for imaging and in which cases the method can be used to completely replace second-look surgery.
OBJECTIVE: To examine the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) in the detection of residual and recurrent cholesteatoma in children. METHODS: A systematic review and meta-analysis was conducted as per PRISMA guidelines using the following databases from their date of inception: MEDLINE, PubMed, Embase, Cochrane Library, Web of Science. Bivariate meta-analysis using a random effects model was used to calculate summarized pooled estimates of sensitivity, specificity, and diagnostic odds ratios, using second-look surgery as the gold standard comparison. RESULTS: A total of ten articles (141 cases) were included for qualitative and quantitative analysis. Pooled sensitivity and specificity of non-echo planar imaging (non-EPI) DW-MRI were 89.4% (95%CI 51.9%-98.5%) and 92.9% (95%CI 81.4%-97.5%) respectively. DW-MRI appears limited in its ability to detect lesions less than 3 mm in size. CONCLUSION: Non-EPI DW-MRI is highly specific but carries uncertain sensitivity in the detection of residual and recurrent cholesteatoma in children. Further research is warranted to determine the specific role of DW-MRI in this patient group, namely when and how often children should be referred for imaging and in which cases the method can be used to completely replace second-look surgery.
Authors: M Wiesmueller; W Wuest; M S May; S Ellmann; R Heiss; M Saake; R Janka; M Uder; F B Laun Journal: AJNR Am J Neuroradiol Date: 2021-04-29 Impact factor: 4.966
Authors: A-L Fourez; M Akkari; G Gascou; P-H Lefevre; C Duflos; A Kaderbay; M Mondain; F Venail Journal: AJNR Am J Neuroradiol Date: 2021-04-15 Impact factor: 4.966