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PT  - JOURNAL ARTICLE
AU  - Fourez, A.-L.
AU  - Akkari, M.
AU  - Gascou, G.
AU  - Lefevre, P.-H.
AU  - Duflos, C.
AU  - Kaderbay, A.
AU  - Mondain, M.
AU  - Venail, F.
TI  - Optimal Duration of MRI Follow-up to Safely Identify Middle Ear Residual Cholesteatoma
AID  - 10.3174/ajnr.A7116
DP  - 2021 Jul 01
TA  - American Journal of Neuroradiology
PG  - 1313--1319
VI  - 42
IP  - 7
4099  - http://www.ajnr.org/content/42/7/1313.short
4100  - http://www.ajnr.org/content/42/7/1313.full
SO  - Am. J. Neuroradiol.2021 Jul 01; 42
AB  - BACKGROUND AND PURPOSE: Previous studies have demonstrated the usefulness of non-EPI DWI for detection of residual cholesteatoma. However, limited data are available to determine the suitable duration of imaging follow-up after a first MR imaging with normal findings has been obtained. The present study aimed to determine the optimal duration of non-EPI DWI follow-up for residual cholesteatoma.MATERIALS AND METHODS: A retrospective, monocentric study was performed between 2013 and 2019 and included all participants followed up after canal wall up tympanoplasty with at least 2 non-EPI DWI examinations performed on the same 1.5T MR imaging scanner. MR images were reviewed independently by 2 radiologists. Sensitivity and specificity values were calculated as a function of time after the operation. Receiver operating characteristic curves were analyzed to determine the optimal follow-up duration.RESULTS: We analyzed 47 MRIs from 17 participants. At the end of the individual follow-up period, a residual cholesteatoma had been found in 41.1% of cases. The follow-up duration ranged from 20 to 198 months (mean, 65.9 [SD, 43.9] months). Participants underwent between 2 and 5 non-EPI DWI examinations. Analyses of the receiver operating characteristic curves revealed that the optimal diagnostic value of non-EPI DWI occurred 56 months after the operation when the first MR imaging performed a mean of 17.3 (SD, 6.8) months after the operation had normal findings (sensitivity = 0.71; specificity = 0.7, Youden index = 0.43).CONCLUSIONS: Repeat non-EPI DWI is required to detect slow-growing middle ear residual cholesteatomas. We, therefore, recommend performing non-EPI DWI for at least the first 5 years after the initial operation.