1
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Wang Z, Song J, Lin K, Hong W, Mao S, Wu X, Zhang J. Automated detection of otosclerosis with interpretable deep learning using temporal bone computed tomography images. Heliyon 2024; 10:e29670. [PMID: 38655358 PMCID: PMC11036044 DOI: 10.1016/j.heliyon.2024.e29670] [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: 04/25/2023] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024] Open
Abstract
Objective This study aimed to develop an automated detection schema for otosclerosis with interpretable deep learning using temporal bone computed tomography images. Methods With approval from the institutional review board, we retrospectively analyzed high-resolution computed tomography scans of the temporal bone of 182 participants with otosclerosis (67 male subjects and 115 female subjects; average age, 36.42 years) and 157 participants without otosclerosis (52 male subjects and 102 female subjects; average age, 30.61 years) using deep learning. Transfer learning with the pretrained VGG19, Mask RCNN, and EfficientNet models was used. In addition, 3 clinical experts compared the system's performance by reading the same computed tomography images for a subset of 35 unseen subjects. An area under the receiver operating characteristic curve and a saliency map were used to further evaluate the diagnostic performance. Results In prospective unseen test data, the diagnostic performance of the automatically interpretable otosclerosis detection system at the optimal threshold was 0.97 and 0.98 for sensitivity and specificity, respectively. In comparison with the clinical acumen of otolaryngologists at P < 0.05, the proposed system was not significantly different. Moreover, the area under the receiver operating characteristic curve for the proposed system was 0.99, indicating satisfactory diagnostic accuracy. Conclusion Our research develops and evaluates a deep learning system that detects otosclerosis at a level comparable with clinical otolaryngologists. Our system is an effective schema for the differential diagnosis of otosclerosis in computed tomography examinations.
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Affiliation(s)
- Zheng Wang
- School of Computer Science, Hunan First Normal University, Changsha, 410205, China
- Key Laboratory of Informalization Technology for Basic Education in Hunan Province, Changsha, 410205, China
| | - Jian Song
- Department of Otorhinolaryngology, Xiangya Hospital Central South University, Changsha, Hunan, China
- Province Key Laboratory of Otolaryngology Critical Diseases, Changsha, Hunan, China
| | - Kaibin Lin
- School of Computer Science, Hunan First Normal University, Changsha, 410205, China
- Key Laboratory of Informalization Technology for Basic Education in Hunan Province, Changsha, 410205, China
| | - Wei Hong
- School of Computer Science, Hunan First Normal University, Changsha, 410205, China
- Key Laboratory of Informalization Technology for Basic Education in Hunan Province, Changsha, 410205, China
| | - Shuang Mao
- Department of Otorhinolaryngology, Xiangya Hospital Central South University, Changsha, Hunan, China
- Province Key Laboratory of Otolaryngology Critical Diseases, Changsha, Hunan, China
| | - Xuewen Wu
- Department of Otorhinolaryngology, Xiangya Hospital Central South University, Changsha, Hunan, China
- Province Key Laboratory of Otolaryngology Critical Diseases, Changsha, Hunan, China
| | - Jianglin Zhang
- Department of Dermatology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University. The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China
- Candidate Branch of National Clinical Research Center for Skin Diseases, Shenzhen, 518020, Guangdong, China
- Department of Geriatrics, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University. The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China
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Stein T, Rau A, Russe MF, Arnold P, Faby S, Ulzheimer S, Weis M, Froelich MF, Overhoff D, Horger M, Hagen F, Bongers M, Nikolaou K, Schönberg SO, Bamberg F, Weiß J. Photon-Counting Computed Tomography - Basic Principles, Potenzial Benefits, and Initial Clinical Experience. ROFO-FORTSCHR RONTG 2023; 195:691-698. [PMID: 36863367 DOI: 10.1055/a-2018-3396] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND Photon-counting computed tomography (PCCT) is a promising new technology with the potential to fundamentally change today's workflows in the daily routine and to provide new quantitative imaging information to improve clinical decision-making and patient management. METHOD The content of this review is based on an unrestricted literature search on PubMed and Google Scholar using the search terms "Photon-Counting CT", "Photon-Counting detector", "spectral CT", "Computed Tomography" as well as on the authors' experience. RESULTS The fundamental difference with respect to the currently established energy-integrating CT detectors is that PCCT allows counting of every single photon at the detector level. Based on the identified literature, PCCT phantom measurements and initial clinical studies have demonstrated that the new technology allows improved spatial resolution, reduced image noise, and new possibilities for advanced quantitative image postprocessing. CONCLUSION For clinical practice, the potential benefits include fewer beam hardening artifacts, radiation dose reduction, and the use of new contrast agents. In this review, we will discuss basic technical principles and potential clinical benefits and demonstrate first clinical use cases. KEY POINTS · Photon-counting computed tomography (PCCT) has been implemented in the clinical routine. · Compared to energy-integrating detector CT, PCCT allows the reduction of electronic image noise. · PCCT provides increased spatial resolution and a higher contrast-to-noise ratio. · The novel detector technology allows the quantification of spectral information. CITATION FORMAT · Stein T, Rau A, Russe MF et al. Photon-Counting Computed Tomography - Basic Principles, Potenzial Benefits, and Initial Clinical Experience. Fortschr Röntgenstr 2023; 195: 691 - 698.
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Affiliation(s)
- Thomas Stein
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
| | - Alexander Rau
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
| | - Maximilian Frederik Russe
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
| | - Philipp Arnold
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
| | - Sebastian Faby
- Computed Tomography, Siemens Healthcare GmbH, Forchheim, Germany
| | - Stefan Ulzheimer
- Computed Tomography, Siemens Healthcare GmbH, Forchheim, Germany
| | - Meike Weis
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Germany
| | - Matthias F Froelich
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Germany
| | - Daniel Overhoff
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Germany
| | - Marius Horger
- Department of Radiology, University Hospitals Tübingen, Germany
| | - Florian Hagen
- Department of Radiology, University Hospitals Tübingen, Germany
| | - Malte Bongers
- Department of Radiology, University Hospitals Tübingen, Germany
| | | | - Stefan O Schönberg
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
| | - Jakob Weiß
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
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Bassiouni M, Bauknecht HC, Muench G, Olze H, Pohlan J. Missed Radiological Diagnosis of Otosclerosis in High-Resolution Computed Tomography of the Temporal Bone-Retrospective Analysis of Imaging, Radiological Reports, and Request Forms. J Clin Med 2023; 12:jcm12020630. [PMID: 36675559 PMCID: PMC9860545 DOI: 10.3390/jcm12020630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Objectives: Several studies reported low detection rates of otosclerosis in high-resolution computed tomography (HRCT), especially when the scans were reviewed by non-specialized general radiologists. In the present study, we conducted a retrospective review of the detection of otosclerosis in HRCT by general radiologists and the impact of inadequately filled radiological request forms on the detection rate. Methods: Retrospective analysis of hospital records, HRCT reports, and radiological referral notes of 40 patients who underwent stapedotomy surgery for otosclerosis. HRCT imaging data sets were retrospectively reviewed by a blinded experienced neuroradiologist, whose reading served as the gold standard. Results: General radiologists reading HRCT scans had an overall detection rate of otosclerosis of 36.1% in this cohort (13 of 36 available HRCT reports). The neuroradiologist had a much higher detection rate of 82.5% (33 of 40 cases). Interobserver agreement between the general radiologists and the subspecialist neuroradiologist was poor (Cohen’s kappa κ = 0.26). General radiologists missed the diagnosis in 15 of the 33 CT-positive scans, corresponding to a missed diagnosis rate of 45.4%. There was a highly significant association between a missed diagnosis and the lack of an explicitly mentioned clinical suspicion of otosclerosis in the request forms (Pearson’s chi-squared test, p < 0.005). Conclusion: The diagnosis of otosclerosis is frequently missed by radiologists on HRCT scans of the temporal bone in a clinical setting. Possible reasons include a relative lack of experience of general radiologists with temporal bone imaging as well as the failure of clinicians to unambiguously communicate their suspicion of otosclerosis.
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Affiliation(s)
- Mohamed Bassiouni
- Department of Otorhinolaryngology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Hans-Christian Bauknecht
- Institute of Neuroradiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Gloria Muench
- Department of Diagnostic Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Heidi Olze
- Department of Otorhinolaryngology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Julian Pohlan
- Department of Diagnostic Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
- Berlin Institute of Health, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- Correspondence:
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4
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Stenz NA, Hashmi S, Lehnick D, Treumann T, Linder T. [Role of computed tomography in the preoperative diagnosis of otosclerosis]. HNO 2023; 71:92-99. [PMID: 36326852 PMCID: PMC9895003 DOI: 10.1007/s00106-022-01241-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Otosclerosis is an osteodystrophy of the otic capsule and presents with progressive conductive hearing loss. Imaging studies, especially computed tomography (CT) and cone-beam CT, have gained increased relevance in the diagnosis of otosclerosis. OBJECTIVE This study investigated whether there is a correlation between the extent of otosclerosis in high-resolution or cone-beam CT and hearing loss in pure-tone audiometry. MATERIALS AND METHODS Based on an existing classification of otosclerotic foci, a classification was established. Preoperative CT scans of patients undergoing stapedotomy between 2015 and 2019 were evaluated and classified by two independent otorhinolaryngologists. The preoperative pure-tone audiograms were analysed and compared to the results of CT. RESULTS A total of 168 CT studies (i.e., 168 ears) in 156 patients with intraoperatively confirmed otosclerosis were included in our study. A correlation between the extent of the otosclerotic focus or the calculated scores and hearing loss in pure-tone audiometry (air conduction, bone conduction and air-bone-gap) could not be proven. CONCLUSION Preoperative CT is not obligatory. However, preoperative imaging using CT or cone-beam CT can be helpful to confirm the diagnosis and exclude other middle or inner ear pathologies as well as in planning of the surgical procedure in the overall context of otoscopy and audiometry. A correlation with the degree of hearing impairment could not be demonstrated and remains unclear.
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Affiliation(s)
- Nadja Angela Stenz
- Klinik für Hals‑, Nasen- Ohren- und Gesichtschirurgie (HNO), Luzerner Kantonsspital, Spitalstraße, 6004, Luzern, Schweiz.
| | - Salman Hashmi
- Klinik für Hals‑, Nasen- Ohren- und Gesichtschirurgie (HNO), Luzerner Kantonsspital, Spitalstraße, 6004, Luzern, Schweiz
| | - Dirk Lehnick
- Gesundheitswissenschaften und Medizin, Universität Luzern, Luzern, Schweiz
| | - Thomas Treumann
- Klinik für Radiologie, Luzerner Kantonsspital, Luzern, Schweiz
| | - Thomas Linder
- Klinik für Hals‑, Nasen- Ohren- und Gesichtschirurgie (HNO), Luzerner Kantonsspital, Spitalstraße, 6004, Luzern, Schweiz
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5
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Kryukov AI, Garov EV, Zelikovich EI, Sidorina NG, Zagorskaya EE, Fedorova OV, Zelenkova VN, Kurilenkov GV, Moseikina LA, Kaloshina AS, Kiselyus VE, Sudarev PA, Garova EE. [Clinical and radiological classification of otosclerosis]. Vestn Otorinolaringol 2023; 88:12-18. [PMID: 37970764 DOI: 10.17116/otorino20238805112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
The article presents various classifications of forms of otosclerosis (OS), which change with the development of diagnostic methods. At the same time, according to the literature, a unified OS classification has not yet been adopted. All existing classifications are imperfect to some extent. The classification of clinical forms of OS according to TPA data makes it possible to determine the indications for surgical treatment and to suggest its possible effect, but not the localization of OS foci. X-ray classifications of localization of OS foci indicate their diversity, distribution, and do not always correlate with the type of hearing loss. At the same time, modern diagnostics of OS should be based on audiological data, localization of foci and their density according to the results of X-ray methods of examination. Based on the examination and treatment of 1532 patients with various forms of OS, a modern clinical and radiological classification of the disease is proposed, based precisely on these provisions. This classification, in our opinion, will improve the quality of diagnosis of various forms of OS, will allow to differentiate the tactics of treating patients with this disease to stabilize hearing loss, indications for surgical treatment, suggest its effectiveness with a reduction in the risk of surgical failures and possible further rehabilitation of the patient.
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Affiliation(s)
- A I Kryukov
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
- Department of Otorhinolaryngology Academician B.S. Preobrazhensky Medical Faculty of the Pirogov Russian National Medical Research University, Moscow, Russia
| | - E V Garov
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
- Department of Otorhinolaryngology Academician B.S. Preobrazhensky Medical Faculty of the Pirogov Russian National Medical Research University, Moscow, Russia
| | - E I Zelikovich
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - N G Sidorina
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - E E Zagorskaya
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - O V Fedorova
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - V N Zelenkova
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - G V Kurilenkov
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - L A Moseikina
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - A S Kaloshina
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - V E Kiselyus
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - P A Sudarev
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - E E Garova
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
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6
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Automatic Prediction of Conductive Hearing Loss Using Video Pneumatic Otoscopy and Deep Learning Algorithm. Ear Hear 2022; 43:1563-1573. [DOI: 10.1097/aud.0000000000001217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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7
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Kataria T, Sehra R, Grover M, Sharma S, Verma N, Sharma MP. Correlation of Preoperative High-resolution Computed Tomography Temporal Bone Findings with Intra-operative Findings in Various Ear Pathologies. Indian J Otolaryngol Head Neck Surg 2022; 74:190-199. [PMID: 36032829 PMCID: PMC9411368 DOI: 10.1007/s12070-020-01950-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022] Open
Abstract
High resolution computed tomography (HRCT) is a tool which provide fine details of temporal bone and its associated pathologies which are of extreme use in making diagnosis, to evaluate extension of disease and most important to plan surgical approach. Aim of the present study was to correlate HRCT findings with operative findings in different ear pathologies. This observational, prospective study enrolled 70 patients of different ear pathologies required surgical intervention. They were subjected to HRCT temporal bone and its findings were correlated with surgical findings. Mean age of the study population was 20.3 ± 12.04 years with M: F = 1.12: 1. HRCT showed specificity and sensitivity of 100% and 92.31% respectively in detecting ossicular erosion. It was 100% sensitive and 98.51% specific in detecting LSCC erosion, 85.71% sensitive and 96.83% specific in detecting facial canal dehiscence, 100% sensitive and 98.11% specific in detecting scutum erosion, 75% sensitive and 96.97% specific to detect tegmen erosion, 100% sensitive and 97.01% specific in detecting sinus plate erosion, 100% sensitive and 95.38% specific in detecting high jugular bulb, sensitivity and specificity both are 100% in detecting labyrinthitis ossificans and 100% sensitive in detecting otosclerotic foci. HRCT findings showed a good association with operative findings in terms of sensitivity and specificity. Thus, HRCT is a acceptable tool to make diagnosis and to plan surgical approach.
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Walker BA, Thorwarth RM, Stull LL, Hoxworth JM, Deep NL, Weisskopf PA. Incidence of Concomitant Semicircular Canal Dehiscence With Otosclerosis. OTOLOGY & NEUROTOLOGY OPEN 2022; 2:e012. [PMID: 38516327 PMCID: PMC10950147 DOI: 10.1097/ono.0000000000000012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 03/23/2024]
Abstract
Objective The concurrence of otosclerosis and superior semicircular canal dehiscence (SSCD) presents a diagnostic challenge and failure to differentiate between these 2 diagnoses results in mischaracterization and unsuccessful surgery. The objective of this study is to identify the incidence of SSCD in patients who have computed tomography (CT) evidence of otosclerosis. Study Design Retrospective chart review. Setting Tertiary referral hospital. Patients Adults with CT scan of the temporal bone diagnosed with radiological unilateral or bilateral fenestral otosclerosis from January 1995 to April 2018. Methods Retrospective review of patient imaging from a multi-center tertiary-referral health system from January 1995 to April 2018. Imaging was reviewed to quantify the incidence of SSCD among patients with CT-diagnosed bilateral fenestral otosclerosis. Poor quality imaging was excluded from review. Results One-thousand two-hundred eight patients (1214 CT scans) were identified with otosclerosis, of which 373 were diagnosed with fenestral otosclerosis (663 ears) with imaging of sufficient quality for review. This population was predominantly female (57.2%) with bilateral fenestral otosclerosis (78%). Of these, 23 ears (3.5%) had definitive evidence of SSCD, with an additional 15 ears (2.3%) with possible radiographic evidence of SSCD. There was no significant difference in laterality between the SSCD and otosclerosis. Conclusions Among 373 patients with fenestral otosclerosis per CT temporal bone imaging at a tertiary referral hospital, as many as 8.3% of patients had radiographic evidence of SSCD. Given this incidence, it continues to be important to consider SSCD when diagnosing and treating otosclerosis.
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Affiliation(s)
- Brian A. Walker
- Department of Otorhinolaryngology, The Mayo Clinic in Arizona, Phoenix, AZ
| | - Ryan M. Thorwarth
- Department of Otorhinolaryngology, The Mayo Clinic in Arizona, Phoenix, AZ
| | - Lindsey L. Stull
- Department of Otorhinolaryngology, The Mayo Clinic in Arizona, Phoenix, AZ
| | - Joseph M. Hoxworth
- Department of Radiology, Division of Neuroradiology, The Mayo Clinic in Arizona, Phoenix, AZ
| | - Nicholas L. Deep
- Department of Otorhinolaryngology, Division of Neurotology, The Mayo Clinic in Arizona, Phoenix, AZ
| | - Peter A. Weisskopf
- Department of Otorhinolaryngology, Division of Neurotology, The Mayo Clinic in Arizona, Phoenix, AZ
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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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10
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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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11
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Karuppannan A, Barman A. Wideband absorbance tympanometry: a novel method in identifying otosclerosis. Eur Arch Otorhinolaryngol 2021; 278:4305-4314. [PMID: 33388979 DOI: 10.1007/s00405-020-06571-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 12/12/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of the study was to know whether the wideband absorbance measurements can be a useful tool to identify ears with otosclerosis. The present study analyzed WBA measurements and highlighted its effectiveness in identifying ears with otosclerosis and differentiating from healthy normal ears. METHODS The study included 42 ears with otosclerosis which were compared with an equal sample size of healthy normal ears. WBA across frequencies and wideband average absorbance (375-2000 Hz) at the peak and ambient pressure, and resonance frequency were measured and analyzed. RESULTS Results showed that WBA levels increased with an increase in frequencies up to 2000 Hz and decreased thereafter, both in the otosclerosis and healthy normal ears. The mean WBA in the otosclerosis group was significantly lower in the 250-2000 Hz frequency range than in the healthy normal ear group. The WBA values at ambient pressure reduced significantly up to 500 Hz for the healthy normal ear group and 1500 Hz for otosclerosis group, compared with peak pressure. Further, the analysis of wideband average absorbance at ambient pressure showed reduced absorbance (0.35) and higher resonance frequency (1350.33 Hz) in the otosclerosis group compared with the healthy normal ear group (0.60 and 930.14 Hz, respectively). ROC analysis indicated that WBA is suitable for identifying otosclerotic ears and also in differentiating from healthy normal ears based on WBA values from 250 to 1500 Hz. High diagnostic values of WBA (> 90% sensitivity and specificity) were observed at a frequency of 1000 Hz. CONCLUSIONS The inclusion of WBA into clinical routine test procedures could be a useful tool for detecting otosclerosis. Further research is required to validate its clinical use in combination with other middle ear measures.
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Affiliation(s)
- Arunraj Karuppannan
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Mysuru, Karnataka, India.
| | - Animesh Barman
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Mysuru, Karnataka, India
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Maxwell AK, Shokry MH, Master A, Slattery WH. Sensitivity of High-Resolution Computed Tomography in Otosclerosis Patients undergoing Primary Stapedotomy. Ann Otol Rhinol Laryngol 2020; 129:918-923. [PMID: 32432485 DOI: 10.1177/0003489420921420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the incidence of abnormal otospongiotic or otosclerotic findings on high-resolution computed tomography (HRCT) as read by local radiologists in patients with surgically-confirmed otosclerosis. STUDY DESIGN Retrospective chart review. SETTING Tertiary-referral private otology-neurotology practice. PATIENTS Adults (>18 years old) with surgically-confirmed otosclerosis between 2012 and 2017 with a HRCT performed preoperatively. INTERVENTION Preoperative HRCT then stapedotomy. MAIN OUTCOME MEASURES Positive identification and location of radiographic otosclerosis as reported by the local radiologist. We then correlated the CT with surgical location as documented at time of surgery. Audiometry, demographic data, intraoperative findings, and surgical technique were secondarily reviewed. RESULTS Of the 708 stapes surgeries were performed during the study time frame. Preoperative HRCT scans were available for 68 primary stapedotomy surgeries performed in 54 patients. Otosclerosis was reported in 20/68 (29.4%). Following a negative report by the local radiologist, a re-review by the surgeon and/or collaborating neuroradiologist confirmed otosclerosis in 12/48 additional cases (25.0%). There was an overall sensitivity of 47.1%. Intraoperatively, cases with negative reads tended to have more limited localization at the ligament (8.7%) or anterior crus (39.1%), compared with positive reads, which demonstrated more extensive involvement, with bipolar foci (30.0%) or diffuse footplate manifestations (20.0%) more common. Acoustic reflexes were characteristically absent. CONCLUSIONS While HRCT may aid in the diagnosis of otosclerosis and rule out concomitant pathology in certain cases of clinical uncertainty or unexplained symptoms, its sensitivity for otosclerosis remains low. HRCT should not be relied upon to diagnose routine fenestral otosclerosis.
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Affiliation(s)
| | | | - Adam Master
- Department of Otorhinolaryngology, Ochsner Clinic, New Orleans, LA, USA
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Bilateral Cochlear Otosclerosis; Clinic and Radiologic Findings. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2019. [DOI: 10.21673/anadoluklin.453418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Burwood GWS, Fridberger A, Wang RK, Nuttall AL. Revealing the morphology and function of the cochlea and middle ear with optical coherence tomography. Quant Imaging Med Surg 2019; 9:858-881. [PMID: 31281781 PMCID: PMC6571188 DOI: 10.21037/qims.2019.05.10] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 05/09/2019] [Indexed: 01/17/2023]
Abstract
Optical coherence tomography (OCT) has revolutionized physiological studies of the hearing organ, the vibration and morphology of which can now be measured without opening the surrounding bone. In this review, we provide an overview of OCT as used in the otological research, describing advances and different techniques in vibrometry, angiography, and structural imaging.
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Affiliation(s)
- George W. S. Burwood
- Department of Otolaryngology, Oregon Hearing Research Center/HNS, Oregon Health & Science University, Portland, OR, USA
| | - Anders Fridberger
- Department of Otolaryngology, Oregon Hearing Research Center/HNS, Oregon Health & Science University, Portland, OR, USA
- Department of Clinical and Experimental Medicine, Section for Neurobiology, Linköping University, Linköping, Sweden
| | - Ruikang K. Wang
- Department of Bioengineering and Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Alfred L. Nuttall
- Department of Otolaryngology, Oregon Hearing Research Center/HNS, Oregon Health & Science University, Portland, OR, USA
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Sanghan N, Chansakul T, Kozin ED, Juliano AF, Curtin HD, Reinshagen KL. Retrospective Review of Otic Capsule Contour and Thickness in Patients with Otosclerosis and Individuals with Normal Hearing on CT. AJNR Am J Neuroradiol 2018; 39:2350-2355. [PMID: 30467217 DOI: 10.3174/ajnr.a5892] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/29/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE Otosclerosis is commonly identified on CT as a focus of hypodensity in the otic capsule anterior to the oval window. However, otosclerosis can have a sclerotic phase approximating the density of normal bone, making diagnosis challenging. This study assesses differences in otic capsule contour and thickness anterolateral to the anterior margin of the oval window in patients with otosclerosis compared with individuals with normal hearing. MATERIALS AND METHODS Axial CT of 104 ears with clinically diagnosed otosclerosis and 108 consecutive ears of audiometrically normal individuals were retrospectively reviewed. Two radiologists independently evaluated the pattern of otosclerosis, otic capsule contour, and bone thickness on standardized axial images at the level of the oval window and cochleariform process. Measurements were made from the posterolateral margin of the cochlea to the apex of the otic capsule convex contour just anterolateral to the anterior margin of the oval window. In the absence of a convex contour, the sulcus between the oval window and the cochleariform process was identified, and measurement to the depth of the sulcus was used. Receiver operating characteristic analysis determined the best cutoff value of otic capsule thickness. RESULTS Mean otic capsule thickness (2 SDs) was 3.08 (0.93) mm and 1.82 (0.31) mm in patients with otosclerosis and individuals with normal hearing, respectively (P < .001), with excellent interobserver agreement. Otic capsule thickness of >2.3 mm had 96.2% sensitivity, 100% specificity, 100% positive predictive value, and 96.4% negative predictive value for otosclerosis. A bulging/convex contour of the otic capsule had 68.3% sensitivity, 98.1% specificity, 97.3% positive predictive value, and 76.3% negative predictive value. CONCLUSIONS Patients with otosclerosis have significantly thicker bone abutting the oval window than individuals with normal hearing.
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Affiliation(s)
- N Sanghan
- From the Department of Radiology (N.S.), Prince of Songkla University, Hadyai, Songkhla, Thailand
| | - T Chansakul
- From the Department of Radiology (N.S.), Prince of Songkla University, Hadyai, Songkhla, Thailand
| | - E D Kozin
- From the Department of Radiology (N.S.), Prince of Songkla University, Hadyai, Songkhla, Thailand
| | - A F Juliano
- From the Department of Radiology (N.S.), Prince of Songkla University, Hadyai, Songkhla, Thailand
| | - H D Curtin
- From the Department of Radiology (N.S.), Prince of Songkla University, Hadyai, Songkhla, Thailand
| | - K L Reinshagen
- From the Department of Radiology (N.S.), Prince of Songkla University, Hadyai, Songkhla, Thailand
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