Computed tomography and magnetic resonance fusion imaging in cholesteatoma preoperative assessment

Eur Arch Otorhinolaryngol. 2017 Mar;274(3):1405-1411. doi: 10.1007/s00405-016-4415-5. Epub 2016 Dec 5.


The purpose of this study is to describe a method for developing fusion imaging for the preoperative evaluation of cholesteatoma. In 33 patients diagnosed with cholesteatoma, a high-resolution temporal bone computed tomography (CT) scan without intravenous contrast and propeller diffusion-weighted magnetic resonance imaging (MRI) were performed. Both studies were then sent to the BrainLAB work station, where the images were fused to obtain a morphological and color map. Intraoperative findings coincided with fusion CT-MRI imaging in all but two patients. In addition, one false positive and one false negative case were observed. CT and diffusion-weighted MRI are complementary techniques that should be employed to assess a cholesteatoma prior to surgery in many cases. Hence, to combine the advantages of each technique, we developed a fusion image technique similar to those that are routinely employed for radiotherapy planning and positron emission tomography-CT imaging. Fusion images can prove useful in selected cases.

Keywords: Cholesteatoma; Computed tomography; Fusion; Magnetic resonance.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Cholesteatoma, Middle Ear / diagnostic imaging*
  • Cholesteatoma, Middle Ear / surgery*
  • Diffusion Magnetic Resonance Imaging*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Preoperative Care*
  • Temporal Bone / diagnostic imaging
  • Tomography, X-Ray Computed*
  • Young Adult