Radiologic imaging shows variable accuracy in diagnosing orbital inflammatory disease and assessing its activity

Abstract Radiologic orbital imaging provides important information in the diagnosis and management of orbital inflammation. However, the diagnostic value of orbital imaging is not well elucidated. This study aimed to investigate the diagnostic accuracy of orbital imaging to diagnose orbital inflamma...

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Autores principales:	Min Joung Lee, Bronwyn E. Hamilton, David Pettersson, Kimberly Ogle, Jennifer Murdock, Roger A. Dailey, John D. Ng, Eric A. Steele, Rohan Verma, Stephen R. Planck, Tammy M. Martin, Dongseok Choi, James T. Rosenbaum
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ec08eccbf0d24d918bf5c2aa5611a4e8
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spelling	oai:doaj.org-article:ec08eccbf0d24d918bf5c2aa5611a4e82021-12-02T12:40:41ZRadiologic imaging shows variable accuracy in diagnosing orbital inflammatory disease and assessing its activity10.1038/s41598-020-78830-02045-2322https://doaj.org/article/ec08eccbf0d24d918bf5c2aa5611a4e82020-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-78830-0https://doaj.org/toc/2045-2322Abstract Radiologic orbital imaging provides important information in the diagnosis and management of orbital inflammation. However, the diagnostic value of orbital imaging is not well elucidated. This study aimed to investigate the diagnostic accuracy of orbital imaging to diagnose orbital inflammatory diseases and its ability to detect active inflammation. We collected 75 scans of 52 patients (49 computed tomography (CT) scans; 26 magnetic resonance (MR) imaging scans). Clinical diagnoses included thyroid eye disease (TED) (41 scans, 31 patients), non-specific orbital inflammation (NSOI) (22 scans, 14 patients), sarcoidosis (4 scans, 3 patients), IgG4-related ophthalmic disease (IgG4-ROD) (5 scans, 3 patients), and granulomatosis with polyangiitis (GPA) (3 scans, 1 patient). Two experienced neuroradiologists interpreted the scans, offered a most likely diagnosis, and assessed the activity of inflammation, blinded to clinical findings. The accuracy rate of radiological diagnosis compared to each clinical diagnosis was evaluated. Sensitivity and specificity in detecting active inflammation were analyzed for TED and NSOI. The accuracy rate of radiologic diagnosis was 80.0% for IgG4-ROD, 77.3% for NSOI, and 73.2% for TED. Orbital imaging could not diagnose sarcoidosis. Orbital CT had a sensitivity of 50.0% and a specificity of 75.0% to predict active TED using clinical assessment as the gold standard. The sensitivity/specificity of orbital MR was 83.3/16.7% for the detection of active NSOI. In conclusion, orbital imaging is accurate for the diagnosis of IgG4, NSOI, and TED. Further studies with a large number of cases are needed to confirm this finding, especially with regard to uncommon diseases. Orbital CT showed moderate sensitivity and good specificity for identifying active TED.Min Joung LeeBronwyn E. HamiltonDavid PetterssonKimberly OgleJennifer MurdockRoger A. DaileyJohn D. NgEric A. SteeleRohan VermaStephen R. PlanckTammy M. MartinDongseok ChoiJames T. RosenbaumNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-8 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Min Joung Lee Bronwyn E. Hamilton David Pettersson Kimberly Ogle Jennifer Murdock Roger A. Dailey John D. Ng Eric A. Steele Rohan Verma Stephen R. Planck Tammy M. Martin Dongseok Choi James T. Rosenbaum Radiologic imaging shows variable accuracy in diagnosing orbital inflammatory disease and assessing its activity
description	Abstract Radiologic orbital imaging provides important information in the diagnosis and management of orbital inflammation. However, the diagnostic value of orbital imaging is not well elucidated. This study aimed to investigate the diagnostic accuracy of orbital imaging to diagnose orbital inflammatory diseases and its ability to detect active inflammation. We collected 75 scans of 52 patients (49 computed tomography (CT) scans; 26 magnetic resonance (MR) imaging scans). Clinical diagnoses included thyroid eye disease (TED) (41 scans, 31 patients), non-specific orbital inflammation (NSOI) (22 scans, 14 patients), sarcoidosis (4 scans, 3 patients), IgG4-related ophthalmic disease (IgG4-ROD) (5 scans, 3 patients), and granulomatosis with polyangiitis (GPA) (3 scans, 1 patient). Two experienced neuroradiologists interpreted the scans, offered a most likely diagnosis, and assessed the activity of inflammation, blinded to clinical findings. The accuracy rate of radiological diagnosis compared to each clinical diagnosis was evaluated. Sensitivity and specificity in detecting active inflammation were analyzed for TED and NSOI. The accuracy rate of radiologic diagnosis was 80.0% for IgG4-ROD, 77.3% for NSOI, and 73.2% for TED. Orbital imaging could not diagnose sarcoidosis. Orbital CT had a sensitivity of 50.0% and a specificity of 75.0% to predict active TED using clinical assessment as the gold standard. The sensitivity/specificity of orbital MR was 83.3/16.7% for the detection of active NSOI. In conclusion, orbital imaging is accurate for the diagnosis of IgG4, NSOI, and TED. Further studies with a large number of cases are needed to confirm this finding, especially with regard to uncommon diseases. Orbital CT showed moderate sensitivity and good specificity for identifying active TED.
format	article
author	Min Joung Lee Bronwyn E. Hamilton David Pettersson Kimberly Ogle Jennifer Murdock Roger A. Dailey John D. Ng Eric A. Steele Rohan Verma Stephen R. Planck Tammy M. Martin Dongseok Choi James T. Rosenbaum
author_facet	Min Joung Lee Bronwyn E. Hamilton David Pettersson Kimberly Ogle Jennifer Murdock Roger A. Dailey John D. Ng Eric A. Steele Rohan Verma Stephen R. Planck Tammy M. Martin Dongseok Choi James T. Rosenbaum
author_sort	Min Joung Lee
title	Radiologic imaging shows variable accuracy in diagnosing orbital inflammatory disease and assessing its activity
title_short	Radiologic imaging shows variable accuracy in diagnosing orbital inflammatory disease and assessing its activity
title_full	Radiologic imaging shows variable accuracy in diagnosing orbital inflammatory disease and assessing its activity
title_fullStr	Radiologic imaging shows variable accuracy in diagnosing orbital inflammatory disease and assessing its activity
title_full_unstemmed	Radiologic imaging shows variable accuracy in diagnosing orbital inflammatory disease and assessing its activity
title_sort	radiologic imaging shows variable accuracy in diagnosing orbital inflammatory disease and assessing its activity
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/ec08eccbf0d24d918bf5c2aa5611a4e8
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Radiologic imaging shows variable accuracy in diagnosing orbital inflammatory disease and assessing its activity

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