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Puiggrós IV, Moreno EG, Dotu CO, Agustí MQI, Díaz FL. Diagnostic Efficacy of High-Resolution Computed Tomography Densitometry for Diagnosing Otosclerosis. Otol Neurotol 2023; 44:e697-e701. [PMID: 37733986 DOI: 10.1097/mao.0000000000004012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
OBJECTIVES The purpose of this study is to evaluate the reliability of temporal bone density measurements for diagnosing otosclerosis. MATERIALS AND METHODS A retrospective case-control study is presented. Bone density was measured in Hounsfield units (HUs) by using high-resolution computed tomography in eight regions of interest (ROI) where otosclerotic foci are usually localized. The density of 113 otosclerotic ears was compared with that of 33 nonotosclerotic ears to determine sensitivity and specificity. Furthermore, the binormal receiver operating characteristic curve of each ROI's density was calculated to estimate the diagnostic value for osteosclerosis. In addition, the radiological density of seven cases-where radiological visual examination exhibited no findings but surgery confirmed stapes fixation-was compared with nonotosclerotic controls. RESULTS ROI densities were significantly lower in otosclerotic patients compared with nonotosclerotic controls. The area under the curve of the fissula ante fenestram (FAF) presented the highest diagnostic performance: 1,871 HU cut-off value (area under the curve = 0.986), 96.64% sensitivity, and 100% specificity. Significantly lower densities in the FAF area were observed in the seven cases with negative radiology but intraoperatively confirmed otosclerosis. CONCLUSION The high-resolution computed tomography density of the FAF is a reliable measurement for diagnosing otosclerosis. A value less than 1,871 HU exhibited the highest sensitivity and specificity in a European Caucasian population.
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Affiliation(s)
- Ignacio Viza Puiggrós
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Clinic de Barcelona
| | | | - César Orús Dotu
- Division of Otology, Department of Otolaryngology, Hospital de la Santa Creu i Sant Pau
| | - Miquel Quer I Agustí
- Division of Otology, Department of Otolaryngology, Hospital de la Santa Creu i Sant Pau
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Computed Tomography Density as a Bio-marker for Histologic Grade of Otosclerosis: A Human Temporal Bone Pathology Study. Otol Neurotol 2022; 43:e605-e612. [PMID: 35761453 DOI: 10.1097/mao.0000000000003535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS Computed tomography (CT) density measurement can be used to objectively distinguish otosclerosis from normal bone and to determine histologic grades of otosclerosis. BACKGROUND Otosclerosis can be seen on CT as subtle radiolucent areas. An objective radiologic measurement that corresponds to known otosclerosis pathology may improve diagnostic accuracy, and could be used as a radiologic biomarker for otosclerosis grade. METHODS A blinded, randomized evaluation of both histologic grade on histopathology slides and CT density measurement was performed on 78 human temporal bone specimens (31 with otosclerosis and 47 controls) that had undergone high-resolution multi-detector CT before histologic processing. Assessments were performed at 11 regions of interest (ROIs) in the otic capsule for each specimen. RESULTS The CT density measurement mean (Hounsfield Units) ± standard deviation for all ROIs (Nos. 1-9) was 2245 ± 854 for grade 0 (no otosclerosis, n = 711), 1896 ± 317 for grade 1 (inactive otosclerosis, n = 109), and 1632 ± 255 for grades 2 and 3 combined (mixed/active otosclerosis, n 35). There was a strong inverse correlation of CT density to histologic grade at ROIs Nos. 1-5 (ANOVA, p < 0.0001). The inter-rater reliability for CT density was very good (correlation coefficient 0.87, p < 0.05). ROC curves suggested a cut-off of 2,150HU to distinguish otosclerosis from normal bone, and 1,811HU to distinguish low grade from mixed/high grade otosclerosis. CONCLUSIONS In human temporal bone specimens, CT density may be used to distinguish normal bone from bone involved by otosclerosis. A higher histologic grade (i.e., indicating a more active otosclerotic focus) correlated with lower density.
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Pham N, Raslan O, Strong EB, Boone J, Dublin A, Chen S, Hacein-Bey L. High-Resolution CT Imaging of the Temporal Bone: A Cadaveric Specimen Study. J Neurol Surg B Skull Base 2022; 83:470-475. [PMID: 36091630 PMCID: PMC9462966 DOI: 10.1055/s-0041-1741006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 11/12/2021] [Indexed: 02/02/2023] Open
Abstract
Objective Super-high and ultra-high spatial resolution computed tomography (CT) imaging can be advantageous for detecting temporal bone pathology and guiding treatment strategies. Methods Six temporal bone cadaveric specimens were used to evaluate the temporal bone microanatomic structures utilizing the following CT reconstruction modes: normal resolution (NR, 0.5-mm slice thickness, 512 2 matrix), high resolution (HR, 0.5-mm slice thickness, 1,024 2 matrix), super-high resolution (SHR, 0.25-mm slice thickness, 1,024 2 matrix), and ultra-high resolution (UHR, 0.25-mm slice thickness, 2,048 2 matrix). Noise and signal-to-noise ratio (SNR) for bone and air were measured at each reconstruction mode. Two observers assessed visualization of seven small anatomic structures using a 4-point scale at each reconstruction mode. Results Noise was significantly higher and SNR significantly lower with increases in spatial resolution (NR, HR, and SHR). There was no statistical difference between SHR and UHR imaging with regard to noise and SNR. There was significantly improved visibility of all temporal bone osseous structures of interest with SHR and UHR imaging relative to NR imaging ( p < 0.001) and most of the temporal bone osseous structures relative to HR imaging. There was no statistical difference in the subjective image quality between SHR and UHR imaging of the temporal bone ( p ≥ 0.085). Conclusion Super-high-resolution and ultra-high-resolution CT imaging results in significant improvement in image quality compared with normal-resolution and high-resolution CT imaging of the temporal bone. This preliminary study also demonstrates equivalency between super-high and ultra-high spatial resolution temporal bone CT imaging protocols for clinical use.
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Affiliation(s)
- Nancy Pham
- Department of Radiology, University of California, Los Angeles, California, United States,Address for correspondence Nancy Pham, MD Department of Radiology, University of California757 Westwood Plaza, Suite 1621D, Los Angeles, CA 90095-7532United States
| | - Osama Raslan
- Department of Radiology, University of California, Davis, Sacramento, California, United States
| | - Edward B. Strong
- Department of Otolaryngology, University of California, Davis, Sacramento, California, United States
| | - John Boone
- Department of Radiology, University of California, Davis, Sacramento, California, United States
| | - Arthur Dublin
- Department of Radiology, University of California, Davis, Sacramento, California, United States
| | - Shuai Chen
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, California, United States
| | - Lotfi Hacein-Bey
- Department of Radiology, University of California, Davis, Sacramento, California, United States
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Measuring the density of the fissula antefenestram and the section of the basal turn of the cochlea: are they useful in the radiological diagnosis of otosclerosis? J Otol 2022; 17:84-89. [PMID: 35949553 PMCID: PMC9349010 DOI: 10.1016/j.joto.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/22/2021] [Accepted: 01/03/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction The role of objective parameters in terms of improvement of the accuracy of high-resolution computed tomography (HRCT) of the temporal bone in the diagnosis of otosclerosis remains unclear. Objectives To investigate the relationship between the density of the fissula antefenestram (FAF) and of the width of the transversal section of the basal turn of the cochlea (BTC), and the diagnosis of otosclerosis. Methods This is a retrospective study in which preoperative HRCT data from ears of patients submitted to stapedotomy due to otosclerosis (case group) were evaluated. For the control group, normal hearing ears having undergone HRCT for other purposes were included. Case and control HRCT images were objectively assessed by an experienced blinded radiologist. During this evaluation, measurements of the relative radiological density of the FAF and of the transversal section of the BTC were obtained. The results were compared between the groups. Also, a receiver operating characteristic curve was created and the area under the curve (AUC) was calculated for each variable. Significance level was set at .05. Results 40 ears were included in each group. Case ears presented reduced values for the relative radiological density on the FAF (p-value<0.0001). Moreover, ears with otosclerosis (p-value: 0.022) presented lower transversal section of the BTC. The AUC for these variables reached 0.929 and 0.646, respectively. Conclusions Otosclerotic ears present reduced radiological density on the FAF and narrower BTC. The relative density of the FAF also shows a great diagnostic power in the context of this disease.
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BAYKARA S, BAYKARA M, MERMİ O, YILDIRIM H, ATMACA M. Magnetic resonance imaging histogram analysis of corpus callosum in a functional neurological disorder. Turk J Med Sci 2021; 51:140-147. [PMID: 32892546 PMCID: PMC7991863 DOI: 10.3906/sag-2004-252] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/29/2020] [Indexed: 02/02/2023] Open
Abstract
Background/aim The aim of the present study was to examine and compare the corpus callosum (CC) via histogram analysis (HA) on T1-weighted MR images of patients diagnosed with Functional Neurological Disorder (FND) and healthy controls. Materials and methods The study group included 19 female patients diagnosed with FND, and the control group included 20 healthy subjects. All participants were scanned with a 1.5 T MR scanner. A high-resolution structural image of the entire brain was obtained with sagittal 3D spiral fast spin echo T1-weighted images. Gray level intensity, standard deviation of the histogram, entropy, uniformity, skewness, and kurtosis values were determined with texture analysis. A student’s t-test was used to compare the group data. P < 0.05 was accepted as statistically significant. Results It was determined that the mean gray level intensity, standard deviation of the histogram, entropy calculated by the maximum, median and variance and size M percentage values were higher in patients with FND. Kurtosis and size U percentages values were lower in patients with FND. Conclusion In the present study, analysis of CC with T1-weighted MR image HA demonstrated significant differences between FND patients and healthy controls. The study findings indicated that HA is a beneficial technique for demonstrating textural variations between the CCs of patients with FND and healthy controls using MR images.
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Affiliation(s)
- Sema BAYKARA
- Department of Psychiatry, Faculty of Medicine, Fırat University, ElazığTurkey
| | - Murat BAYKARA
- Department of Radiology, Faculty of Medicine, Fırat University, ElazığTurkey
| | - Osman MERMİ
- Department of Psychiatry, Faculty of Medicine, Fırat University, ElazığTurkey
| | - Hanefi YILDIRIM
- Department of Radiology, Faculty of Medicine, Fırat University, ElazığTurkey
| | - Murad ATMACA
- Department of Psychiatry, Faculty of Medicine, Fırat University, ElazığTurkey
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Cakmak V, Cakmak P. Does otosclerosis affect the dimensions of the facial canal and cochlear aquaduct? Eur Arch Otorhinolaryngol 2021; 278:1845-1852. [PMID: 33550475 DOI: 10.1007/s00405-021-06655-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/27/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE Our aim was to evaluate the relationship of the dimensions of the facial canal (FC) and cochlear aqueduct (CA) in otosclerosis (OS) with the type and severity of OS. METHODS Two radiologists retrospectively evaluated temporal bone high-resolution computed tomography (HRCT) images obtained from 48 healthy individuals and 94 OS patients between January 2015 and July 2020. In the study group, the CA width, funnel base width, and funnel length, in addition to the FC transverse length, were measured in the axial plane. The CA length was measured in the coronal plane on HRCT images. The FC craniocaudal length was measured in the same plane as the fissula ante fenestram (FAF) in coronal reformatted HRCT images. Grading of OS was based on otosclerotic plaque density and new bone formation extending toward the tympanic cavity at the FAF level. RESULTS In the OS patients, the CA width and FC craniocaudal and FC transverse diameters were significantly decreased on both sides compared to those in the control group (p < 0.001). In fenestral OS, the FC craniocaudal and transverse widths on both sides were statistically significantly lower than the FC widths in the control group (p < 0.0001). A statistically negative correlation was found in the FC craniocaudal (r = - 0.831/- 0.818) and transverse (r = - 0.742/- 0.750) measurements on both sides in accordance with an increase in the otosclerotic plaque density (p < 0.0001). CONCLUSION The presence of narrowing in the FC and CA adjacent to the FAF supports the role of autoimmunity theory in the etiology of OS.
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Affiliation(s)
- Vefa Cakmak
- Department of Radiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
| | - Pinar Cakmak
- Department of Radiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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Fujima N, Andreu-Arasa VC, Onoue K, Weber PC, Hubbell RD, Setty BN, Sakai O. Utility of deep learning for the diagnosis of otosclerosis on temporal bone CT. Eur Radiol 2021; 31:5206-5211. [PMID: 33409781 DOI: 10.1007/s00330-020-07568-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/24/2020] [Accepted: 11/26/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Diagnosis of otosclerosis on temporal bone CT images is often difficult because the imaging findings are frequently subtle. Our aim was to assess the utility of deep learning analysis in diagnosing otosclerosis on temporal bone CT images. METHODS A total of 198 temporal bone CT images were divided into the training set (n = 140) and the test set (n = 58). The final diagnosis (otosclerosis-positive or otosclerosis-negative) was determined by an experienced senior radiologist who carefully reviewed all 198 temporal bone CT images while correlating with clinical and intraoperative findings. In deep learning analysis, a rectangular target region that includes the area of the fissula ante fenestram was extracted and fed into the deep learning training sessions to create a diagnostic model. Transfer learning was used with the deep learning model architectures of AlexNet, VGGNet, GoogLeNet, and ResNet. The test data set was subsequently analyzed using these models and by another radiologist with 3 years of experience in neuroradiology following completion of a neuroradiology fellowship. The performance of the radiologist and the deep learning models was determined using the senior radiologist's diagnosis as the gold standard. RESULTS The diagnostic accuracies were 0.89, 0.72, 0.81, 0.86, and 0.86 for the subspecialty trained radiologist, AlexNet, VGGNet, GoogLeNet, and ResNet, respectively. The performances of VGGNet, GoogLeNet, and ResNet were not significantly different compared to the radiologist. In addition, GoogLeNet and ResNet demonstrated non-inferiority compared to the radiologist. CONCLUSIONS Deep learning technique may be a useful supportive tool in diagnosing otosclerosis on temporal bone CT. KEY POINTS • Deep learning can be a helpful tool for the diagnosis of otosclerosis on temporal bone CT. • Deep learning analyses with GoogLeNet and ResNet demonstrate non-inferiority when compared to the subspecialty trained radiologist. • Deep learning may be particularly useful in medical institutions without experienced radiologists.
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Affiliation(s)
- Noriyuki Fujima
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA
- Research Center for Cooperative Projects, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - V Carlota Andreu-Arasa
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA
| | - Keita Onoue
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA
| | - Peter C Weber
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Richard D Hubbell
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Bindu N Setty
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA
| | - Osamu Sakai
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA.
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
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Mangia LRL, Coelho LODM, Carvalho B, de Oliveira AKP, Hamerschmidt R. Imaging Studies in Otosclerosis: An Up-to-date Comprehensive Review. Int Arch Otorhinolaryngol 2020; 25:e318-e327. [PMID: 33968239 PMCID: PMC8096512 DOI: 10.1055/s-0040-1715149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/21/2020] [Indexed: 11/06/2022] Open
Abstract
Introduction
Otosclerosis is a primary osteodystrophy of the otic capsule, frequently responsible for acquired hearing loss in adults. Although the diagnostic value of imaging investigations in otosclerosis is debatable, they might still be employed with different goals within the context of the disease.
Objectives
The present paper aims to review the most recent literature on the use of imaging studies in otosclerosis for the most varied purposes, from routine application and differential diagnosis to prognostic prediction and investigation of surgical failure.
Data Synthesis
The diagnosis of otosclerosis is usually clinical, but computed tomography (CT) is paramount in particular cases for the differential diagnosis. The routine use, however, is not supported by strong evidence. Even so, there is growing evidence of the role of this method in surgical planning and prediction of postoperative prognosis. In specific scenarios, for example when superior semicircular canal dehiscence (SSCD) syndrome is suspected or in surgical failure, CT is crucial indeed. Magnetic resonance imaging (MRI), however, has limited – although important – indications in the management of individuals with otosclerosis, especially in the evaluation of postoperative complications and in the follow-up of medical treatment in active ostosclerosis.
Conclusion
Imaging studies have a broad range of well-established indications in otosclerosis. Besides, although the routine use of CT remains controversial, the most recent papers have shed light into new potential benefits of imaging prior to surgery.
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Affiliation(s)
- Lucas Resende Lucinda Mangia
- Department of Otolaryngology and Head and Neck Surgery, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | | | - Bettina Carvalho
- Department of Otolaryngology and Head and Neck Surgery, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | | | - Rogerio Hamerschmidt
- Department of Otolaryngology and Head and Neck Surgery, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
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An evaluation of magnetic resonance imaging with histogram analysis in patients with idiopathic subjective tinnitus. North Clin Istanb 2019; 6:59-63. [PMID: 31180375 PMCID: PMC6526986 DOI: 10.14744/nci.2018.72593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 01/08/2018] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Tinnitus is defined as the perception of sound in the ears without any acoustic stimulus. It has still not been determined whether tinnitus originates peripherally, centrally, or from several locations. The aim of the study was to determine any possible cochlear pathology in patients with normal hearing and tinnitus of unspecified etiology. METHODS The study included 22 patients who presented at the clinic with the complaint of idiopathic subjective tinnitus that had been ongoing for at least 1 year. A total of 44 ears were included; 28 with tinnitus and 16 healthy ears. Unilateral tinnitus was determined in 16 patients and bilateral in six patients. The temporal magnetic resonance imaging (MRI) and audiogram results of the patients were retrieved from the hospital records. The MRI histogram measurement was made automatically and calculated for each ear separately. RESULTS Entropy was found to be significantly higher in the control group and distribution was lower (p>0.01). In the tinnitus group, distribution was found to be broader, and kurtosis was statistically significantly greater (p<0.001). CONCLUSION MRI histogram analysis can be considered as a method to be used in the clinical evaluation of the determination of possible cochlear pathology in ears with tinnitus.
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Wichova H, Alvi S, Boatright C, Ledbetter L, Staecker H, Lin J. High-Resolution Computed Tomography of the Inner Ear: Effect of Otosclerosis on Cochlear Aqueduct Dimensions. Ann Otol Rhinol Laryngol 2019; 128:749-754. [PMID: 30971097 DOI: 10.1177/0003489419842579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The cochlear aqueduct is a bony duct connecting the scala tympani with the subarachnoid space. Given the pathophysiology of otosclerosis, including bone resorption and new bone deposition, we hypothesize that the cochlear aqueduct in otosclerotic ears is narrowed. METHODS A retrospective review of patients with otosclerosis who have undergone high-resolution computed tomography (HRCT) of the temporal bone was completed. The control cohort included 20 patients with the diagnosis of noise-induced hearing loss, without the diagnosis of otosclerosis. Uniform measurements of cochlear aqueduct dimensions were performed using the axial plane. RESULTS The otosclerosis cohort included 25 males and 52 females with mean age of 52.2 ± 17.6 years. The control group included 10 males and 10 females with mean age of 64.0 ± 18.5 years. The mean cochlear aqueduct length, width mid canal, aperture base, aperture widest diameter, and funnel diameter in millimeters were 12.19 ± 1.66, 0.68 ± 0.28, 4.21 ± 1.67, 3.23 ± 1.47, and 2.70 ± 1.05 in the ears with otosclerotic foci and 11.57 ± 1.66, 0.69 ± 0.29, 2.56 ± 1.59, 2.77 ± 1.67, and 2.58 ± 1.03 in control group, respectively. Statistical difference was seen in length of cochlear aqueduct, aperture base, and aperture widest diameters (P = .017, <.001, .007). CONCLUSIONS The length of the cochlear aqueduct and the funnel width are statistically longer in the otosclerotic population compared to control. The width of the cochlear aqueduct is not statistically different.
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Affiliation(s)
- Helena Wichova
- 1 Department of Otolaryngology, Head & Neck Surgery, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Sameer Alvi
- 1 Department of Otolaryngology, Head & Neck Surgery, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Christine Boatright
- 2 Department of Radiology, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Luke Ledbetter
- 2 Department of Radiology, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Hinrich Staecker
- 1 Department of Otolaryngology, Head & Neck Surgery, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - James Lin
- 1 Department of Otolaryngology, Head & Neck Surgery, The University of Kansas Medical Center, Kansas City, Kansas, USA
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Otosclerosis: anatomical distribution of otosclerotic loci analyzed by high-resolution computed tomography. Eur Arch Otorhinolaryngol 2019; 276:1335-1340. [PMID: 30887165 DOI: 10.1007/s00405-019-05385-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 03/12/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE To clarify the anatomical distribution of otosclerotic loci in otosclerosis. METHODS Ninety-five patients with surgically confirmed uni- or bilateral otosclerosis were enrolled into the study. Hypodense areas observed in the otic capsule by high-resolution computed tomography (HRCT) were defined as otosclerotic loci. The location and number of lesions were examined, and the probability of lesion overlap and correlation with age/hearing parameters (air and bone conduction threshold, air-bone gaps) were tested. RESULTS Otosclerotic loci were confirmed by HRCT in 77 out of 115 operated ears. The three commonly affected sites were the anterior part of the oval window (ant-OW), anterior part of the internal auditory canal (ant-IAC), and pericochlear area (PCochA), with lesions detected in 96.1%, 46.8%, and 26.0% of ears, respectively. Only the ant-OW area was affected in 48.1% of the ears; the ant-IAC in 3.9%; and PCochA in none with significant differences (p < 0.01). The ant-OW lesions preferentially overlapped with ant-IAC (44.6%) than PCochA lesions (27.0%) (p < 0.05). Among double sites diseases, triple sites diseases occurred more commonly in the ant-OW + PCochA group (80%) than ant-OW + ant-IAC group (48.5%) (p < 0.05). There was no correlation between a number of lesions and age/hearing parameters. CONCLUSIONS Based on the probability of lesion overlap, otosclerotic lesions may initiate at ant-OW followed by ant-IAC and later PCochA. Although the number of lesions showed no immediate correlation with hearing level or age, anatomical stage of the disease estimated by the location and the number of otosclerotic loci could be useful in predicting the future hearing status.
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Yamashita K, Hiwatashi A, Togao O, Kikuchi K, Matsumoto N, Momosaka D, Nakatake H, Sakai Y, Honda H. Ultrahigh-resolution CT scan of the temporal bone. Eur Arch Otorhinolaryngol 2018; 275:2797-2803. [PMID: 30159727 DOI: 10.1007/s00405-018-5101-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Ultrahigh-resolution CT (U-HRCT) provides better spatial resolution than conventional multi-detector row CT (ConvCT) and could be expected to identify microstructures with its 0.25-mm collimation, 1792 channels and 160 detector rows, 0.4 × 0.5 mm focus size, and a 1024 matrix. The aim of the study was to evaluate key anatomic structures in temporal bone using U-HRCT comparing it to ConvCT. MATERIALS AND METHODS A total of 30 patients (14 males and 16 females; age range, 8-82 years; median 49 years) underwent both U-HRCT and ConvCT. All CT images were obtained with 0.5 mm section thickness and a 512 × 512 matrix, and field of view of 80 mm. Transverse scans were acquired in a plane parallel to the orbitomeatal plane in the helical mode with 120 kV. Images of the 30 temporal bones of unaffected side were reviewed by two independent neuroradiologists who rated the visibility of key anatomic structures for both U-HRCT and ConvCT. The ratings between U-HRCT and ConvCT were compared using Wilcoxon matched-pairs signed rank test. The interobserver agreement on the rating of stapedius tendon was evaluated using weighted κ statistics. RESULTS Excellent interobserver agreement was shown for U-HRCT (κ = 0.920), whereas good agreement was obtained for ConvCT (κ = 0.733). According to both observers, stapedius tendon was more clearly visualized using U-HRCT than ConvCT (p < 0.0001). All other anatomic structures were well visualized using both CT scanners. CONCLUSION The anatomy of temporal bone is more conspicuous on U-HRCT than on ConvCT because of its ultra-high-resolution detector. U-HRCT may provide beneficial information for determining surgical indication or procedures.
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Affiliation(s)
- Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Akio Hiwatashi
- Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Nozomu Matsumoto
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daichi Momosaka
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hiroshi Nakatake
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yuki Sakai
- Department of Medical Technology, Division of Radiology, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Kessler MM, Moussa M, Bykowski J, Kirsch CF, Aulino JM, Berger KL, Choudhri AF, Fife TD, Germano IM, Kendi AT, Kim JH, Luttrull MD, Nunez D, Shah LM, Sharma A, Shetty VS, Symko SC, Cornelius RS. ACR Appropriateness Criteria ® Tinnitus. J Am Coll Radiol 2017; 14:S584-S591. [DOI: 10.1016/j.jacr.2017.08.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 10/18/2022]
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Yamashita K, Hiwatashi A, Togao O, Kondo M, Kikuchi K, Inoguchi T, Maehara J, Kyuragi Y, Honda H. Additive value of "otosclerosis-weighted" images for the CT diagnosis of fenestral otosclerosis. Acta Radiol 2017; 58:1215-1221. [PMID: 28090791 DOI: 10.1177/0284185116687172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Otosclerotic foci are usually seen as minute low-density lesions and this may be attributed to relatively low sensitivity on visual assessment using computed tomography (CT). Otosclerotic foci can be detected by using the accurate region of interest (ROI) setting, while small ROI settings by less-experienced radiologists may result in false negative findings. Purpose To evaluate the diagnostic ability of our proposed method ("otosclerosis-weighted" imaging [OWI]), which is based on reversing the density, compared with conventional CT (CCT) imaging alone. Material and Methods Temporal bone CTs of consecutive patients with otosclerosis were analyzed. Gender- and age-matched control participants were also included. All CT images were obtained using a 64-detector row scanner. OWI was obtained by extracting the temporal bone region using the threshold technique and reversing the density (black to white). Four independent radiologists took part in two reading sessions. In the first session, the observers read only CCT imaging. In the second session, they read OWI along with the CCT imaging. Sensitivity was assessed for the four readers. Results Thirty temporal bones of 25 patients with otosclerosis (3 men, 22 women; mean age, 53.9 ± 9.0 years) and 30 temporal bones of 30 control participants (4 men, 26 women; mean age, 44.0 ± 16.2 years) were included. For all observers, reading with a combination of the two methods was associated with a higher sensitivity (63.3-80.0%) than with conventional CT images alone (30.0-60.0%; P < 0.05, each). Conclusion Application of our proposed method based on threshold value may help detect foci of fenestral otosclerosis.
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Affiliation(s)
- Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akio Hiwatashi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masatoshi Kondo
- Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takashi Inoguchi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Junki Maehara
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Kyuragi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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