Multireader Comparison of Photon-Counting Detector CT Reconstructions for Evaluation of Temporal Bone Cochlear...

Area of Science:

• Medical Imaging
• Radiology
• Otolaryngology

Background:

• Photon-counting CT (PCCT) offers superior resolution and signal-to-noise ratios for cochlear implant (CI) imaging compared to conventional CT.
• Optimal PCCT reconstruction parameters for temporal bone CI imaging remain undetermined.

Purpose of the Study:

• To compare the effectiveness of six different PCCT reconstruction algorithms for temporal bone CI imaging.
• To identify the optimal PCCT reconstruction parameters for enhancing image quality in CI patients.

Main Methods:

• Twenty patients with CIs underwent temporal bone PCCT using a NAEOTOM Alpha scanner.
• Six reconstruction algorithms were applied, and two neuroradiologists rated electrode and wire visibility and overall image quality.
• Statistical analysis using a mixed effects model evaluated reconstruction differences.

Main Results:

• Sharp kernel reconstructions (Hr84 0.2mm T3D and Hr84 0.4mm T3D) consistently received the highest ratings for image quality and electrode visibility.
• Iterative metal artifact reduction (iMAR) and high-keV monoenergetic reconstructions performed poorly.
• Inter-reader agreement was substantial for electrode visibility (κ = 0.66) and image quality (κ = 0.79).

Conclusions:

• PCCT reconstruction parameters significantly affect postoperative CI image quality.
• Ultra-high-resolution reconstructions offer the best balance of artifact suppression and detail for CI imaging.
• Findings guide the selection of optimal PCCT protocols for evaluating cochlear implants.