Diagnostic performance of multishot echo-planar imaging (RESOLVE) and non-echo-planar imaging (HASTE) diffusion-weighted imaging in cholesteatoma with an emphasis on signal intensity ratio measurement.

PURPOSE: To evaluate the diagnostic efficacy of multishot echo-planar imaging (EPI) [RESOLVE (RS)] and non-EPI (HASTE) diffusion-weighted imaging (DWI) in detecting cholesteatoma (CHO), and to explore the role of signal intensity (SI) ratio measurements in addressing diagnostic challenges. METHODS: We analyzed RS-EPI and non-EPI DWI images from 154 patients who had undergone microscopic middle ear surgery, with pathological confirmation of their diagnoses. Two radiologists, referred to as Reader A and Reader B, independently reviewed the images without prior knowledge of the outcomes. Their evaluation focused on lesion location, T1-weighted (T1W) signal characteristics, and contrast enhancement in temporal bone magnetic resonance imaging. Key parameters included lesion hyperintensity, size, SI, SI ratio, and susceptibility artifact scores across both imaging modalities. RESULTS: Of the patients, 62.3% (96/154) were diagnosed with CHO, whereas 37.7% (58/154) were found to have non-CHO conditions. In RS-EPI DWI, Reader A achieved 89.6% sensitivity, 79.3% specificity, 87.8% positive predictive value (PPV), and 82.1% negative predictive value (NPV). Non-EPI DWI presented similar results with sensitivities of 89.6%, specificities of 86.2%, PPVs of 91.5%, and NPVs of 83.3%. Reader B's results for RS-EPI DWI were 82.3% sensitivity, 84.5% specificity, 89.8% PPV, and 74.2% NPV, whereas, for non-EPI DWI, they were 86.5% sensitivity, 89.7% specificity, 93.3% PPV, and 80% NPV. The interobserver agreement was excellent (RS-EPI, κ: 0.84; non-EPI, κ: 0.91). The SI ratio measurements were consistently higher in non-EPI DWI (Reader A: 2.51, Reader B: 2.46) for the CHO group compared with RS-EPI. The SI ratio cut-off (>1.98) effectively differentiated hyperintense lesions between CHO and non-CHO groups, demonstrating 82.9% sensitivity and 100% specificity, with an area under the curve of 0.901 (95% confidence interval: 0.815-0.956; P < 0.001). Susceptibility artifact scores averaged 1.18 ± 0.7 (Reader A) and 1.04 ± 0.41 (Reader B) in RS-EPI, with non-EPI DWI recording a mean score of 0. CONCLUSION: Both RS-EPI and non-EPI DWI exhibited high diagnostic accuracy for CHO. While RS-EPI DWI cannot replace non-EPI DWI, their combined use improves sensitivity. SI ratio measurement in non-EPI DWI was particularly beneficial in complex diagnostic scenarios. CLINICAL SIGNIFICANCE: This study refines CHO diagnostic protocols by showcasing the diagnostic capabilities of both RS-EPI and non-EPI DWI and highlighting the utility of SI measurements as a diagnostic tool. These findings may reduce false positives and aid in more accurate treatment planning, offering substantial insights for clinicians in managing CHO.

The dietary acrylamide intake adversely affects the serum trace element status.

Acrylamide is an organic chemical which occurs in foods widespreadly consumed in diets worldwide. The purpose of this study was to evaluate the serum trace element levels (Fe, Cu, Zn, Mn, Cr, Se, Co, Ni, V, As, Mg, P, Li, K, Al) in Wistar rats exposed to acrylamide. Acrylamide was administered to the treatment groups at 2 and 5 mg/kg body weight (bw)/day via drinking water for 90 days. Inductively coupled plasma mass spectrometry was used for the determination of serum trace element concentrations. Serum Zn, Se, Co, V and Mg concentrations of 5 mg/kg bw/day acrylamide-treated male rats were lower, whereas serum As concentration was higher than the same parameters of the controls rats. Similarly, serum Zn, Se, Co, V and Mg concentrations were decreased in 5 mg/kg bw/day acrylamide-treated female rats compared with control rats. On the other hand, there were no significant differences between serum Fe, Cu, Mn, Cr, Ni, P, Li, K and Al concentrations of all groups. The results from this study provide evidence that dietary acrylamide intake adversely affects the serum trace elements status.

The effects of acrylamide on the frequency of megakaryocytic emperipolesis and the mitotic activity of rat bone marrow cells.

BACKGROUND: Although the pathophysiological importance of emperipolesis is not known exactly, it has been reported to increase significantly in cases of various cancer types, different tumours and thrombosis disorders. In this study the effects of acrylamide on the frequency of megakaryocytic emperipolesis and the mitotic activity in rat bone marrow cells were determined. For this purpose, two separate experiments were performed with Sprague-Dawley rats gavaged with 0, 30, 45 and 60 mg acrylamide kg⁻¹ body weight (BW) for five consecutive days. In the second experiment, 3 mg colchicine kg⁻¹ BW was injected intraperitoneally 2 h before cervical dislocation. Bone marrow samples were taken 24 h after the last application in both experiments. RESULTS: It was found that only the highest dose of acrylamide significantly decreased the incidence of megakaryocytic emperipolesis and that the types of bone marrow cells engulfed by megakaryocytes were mostly neutrophil granulocytes. Neither megakaryocytes nor engulfed cells showed any morphological degeneration. In the mitotic activity experiment, doses of 45 and 60 mg acrylamide kg⁻¹ BW decreased the mitotic activity of bone marrow cells in comparison with the control group. CONCLUSION: It was concluded that the decrease in megakaryocytic emperipolesis frequency might be a consequence of the decrease in mitotic activity in bone marrow cells.