{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T10:04:07Z","timestamp":1775037847626,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p><jats:italic>Objectives.<\/jats:italic> Magnetic resonance imaging (MRI) and in particular diffusion-weighted imaging (DWI) have been broadly proven to be the reference imaging method to discriminate between cholesteatoma and noncholesteatomatous middle ear lesions, especially when high tissue specificity is required. The aim of this study is to define a range of apparent diffusion coefficient (ADC) values within which the diagnosis of cholesteatoma is almost certain.<jats:italic> Methods.<\/jats:italic> The study was retrospectively conducted on a cohort of 124 patients. All patients underwent first- or second-look surgery because primary or secondary acquired cholesteatoma was clinically suspected; they all had preoperative MRI examination 15 days before surgery, including DWI from which the ADC maps were calculated.<jats:italic> Results.<\/jats:italic> Average ADC value for cholesteatomas was 859,4 \u00d7 10<jats:sup>\u22126<\/jats:sup>\u2009mm<jats:sup>2<\/jats:sup>\/s (range 1545 \u00d7 10<jats:sup>\u22126<\/jats:sup>\u2009mm<jats:sup>2<\/jats:sup>\/s; IQR = 362 \u00d7 10<jats:sup>\u22126<\/jats:sup>\u2009mm<jats:sup>2<\/jats:sup>\/s; <jats:italic>\u03c3<\/jats:italic> = 276,3 \u00d7 10<jats:sup>\u22126<\/jats:sup>\u2009mm<jats:sup>2<\/jats:sup>\/s), while for noncholesteatomatous inflammatory lesions, it was 2216,3 \u00d7 10<jats:sup>\u22126<\/jats:sup>\u2009mm<jats:sup>2<\/jats:sup>\/s (range 1015 \u00d7 10<jats:sup>\u22126<\/jats:sup>\u2009mm<jats:sup>2<\/jats:sup>\/s; IQR = 372,75 \u00d7 10<jats:sup>\u22126<\/jats:sup>\u2009mm<jats:sup>2<\/jats:sup>\/s; <jats:italic>\u03c3<\/jats:italic> = 225,6 \u00d7 10<jats:sup>\u22126<\/jats:sup>\u2009mm<jats:sup>2<\/jats:sup>\/s). Interobserver agreement with Fleiss\u2019 Kappa statistics was 0,96. No overlap between two groups\u2019 range of values was found and the difference was statistically significant for <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn fontstyle=\"italic\">0.0001<\/mml:mn><\/mml:math>.<jats:italic> Conclusions.<\/jats:italic> We propose an interval of ADC values that should represent an appropriate benchmark range for a correct differentiation between cholesteatoma and granulation tissue or fibrosis of noncholesteatomatous inflammatory lesions.<\/jats:p>","DOI":"10.1155\/2018\/7945482","type":"journal-article","created":{"date-parts":[[2018,4,24]],"date-time":"2018-04-24T19:34:03Z","timestamp":1524598443000},"page":"1-6","source":"Crossref","is-referenced-by-count":15,"title":["ADC Benchmark Range for Correct Diagnosis of Primary and Recurrent Middle Ear Cholesteatoma"],"prefix":"10.1155","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2256-7281","authenticated-orcid":true,"given":"Camilla","family":"Russo","sequence":"first","affiliation":[{"name":"Dipartimento di Scienze Biomediche Avanzate, Universit\u00e0 degli Studi di Napoli \u201cFederico II\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Elefante","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche Avanzate, Universit\u00e0 degli Studi di Napoli \u201cFederico II\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella M.","family":"Di Lullo","sequence":"additional","affiliation":[{"name":"Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche, Universit\u00e0 degli Studi di Napoli \u201cFederico II\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6527-4692","authenticated-orcid":true,"given":"Barbara","family":"Carotenuto","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche Avanzate, Universit\u00e0 degli Studi di Napoli \u201cFederico II\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche Avanzate, Universit\u00e0 degli Studi di Napoli \u201cFederico II\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Cavaliere","sequence":"additional","affiliation":[{"name":"Dipartimento di Neuroscienze, Scienze Riproduttive e Odontostomatologiche, Universit\u00e0 degli Studi di Napoli \u201cFederico II\u201d, Naples, 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