{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:50:53Z","timestamp":1787021453814,"version":"build-2736575974"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJR|Open"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We aimed to compare a newer readout-segmented echoplanar imaging (RS-EPI) technique with the established single shot turbo spin echo (SS-TSE) non-EPI diffusion-weighted imaging (DWI) in detecting surgically validated cholesteatoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We retrospectively reviewed 358 consecutive MRI studies in 285 patients in which both RS-EPI and non-EPI DWI sequences were performed. Each diffusion sequence was reviewed independently and scored negative, indeterminate or positive for cholesteatoma in isolation and after reviewing the T\n                      <jats:sub>1<\/jats:sub>\n                      W sequence. Average artefacts scores were evaluated and the lesion size measured as a distortion indicator. The imaging scores were correlated with surgical validation, clinical and imaging follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 239 middle ear and central mastoid tract and 34 peripheral mastoid lesions. 102 tympanomastoid operations were performed. The positive predictive value ( PPV), post-operative PPV, primary PPV, negative predictive value were 93%, 95%, 87.5%, 70% for RS-EPI and 92.5%, 93.6%, 90%, 79% for non-EPI DWI. There was good agreement between the two techniques (k = 0.75). Non-EPI DWI is less susceptible to skull base artefacts although the mean cholesteatoma measurement difference was only 0.53\u2009mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      RS-EPI has comparable PPV with non-EPI DWI in both primary and post-operative cholesteatoma but slightly lower negative predictive value. When there is a mismatch, non-EPI DWI better predicts the presence of cholesteatoma. There is good agreement between the sequences for cholesteatoma diagnosis. The T\n                      <jats:sub>1<\/jats:sub>\n                      W sequence is very important in downgrading indeterminate DWI signal lesions to a negative score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge:<\/jats:title>\n                    <jats:p>This is, to our knowledge, the first study to compare a multishot EPI DWI technique with the established non- EPI DWI in cholesteatoma diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1259\/bjro.20180015","type":"journal-article","created":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T11:51:42Z","timestamp":1551700302000},"page":"20180015","source":"Crossref","is-referenced-by-count":10,"title":["Cholesteatoma: multishot echo-planar\n                    <i>vs<\/i>\n                    non echo-planar diffusion-weighted MRI for the prediction of middle ear and mastoid cholesteatoma"],"prefix":"10.1093","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3019-5382","authenticated-orcid":false,"given":"Cristina","family":"Dudau","sequence":"first","affiliation":[{"name":"Department of Radiology, Guy\u2019s and St Thomas\u2019 Hospital, and Department of Neuroradiology, King\u2019s College Hospital, London,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashleigh","family":"Draper","sequence":"additional","affiliation":[{"name":"GKT School of Medicine, King's College, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gkagkanasiou","sequence":"additional","affiliation":[{"name":"General &amp; VA Air Force Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Charles-Edwards","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Guy\u2019s and St Thomas\u2019 Hospital, and School of Biomedical Engineering and Imaging Sciences, King's College London, London,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irumee","family":"Pai","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Guy\u2019s and St. Thomas\u2019 Hospital, London,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Connor","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guy\u2019s and St Thomas\u2019 Hospital, and Department of Neuroradiology, King\u2019s College Hospital, London,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"b1","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1148\/radiol.2381041649","volume":"238","author":"Dubrulle F","year":"2006","journal-title":"Radiology"},{"key":"b2","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.ijporl.2009.09.035","volume":"74","author":"Plouin-Gaudon I","year":"2010","journal-title":"Int 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