Abstract
BackgroundThe purpose of this study was to develop an effective method of reducing metal artifacts in cochlear implant (CI) electrodes.MethodsThe temporal bones of 30 patients (34 ears) after CI were examined with 320-detector row computed tomography, which was evaluated by two senior radiologists using a double-blind method. Noise, artifact index, signal-to-noise ratio, and the subjective image quality score were compared before versus after using single-energy metal artifact reduction (SEMAR). The electrode position, single electrode visibility, and electrode count were evaluated using SEMAR combined with either multi-planar reconstruction (MPR) or maximum intensity projection.ResultsThe two radiologists’ measurements had good consistency. SEMAR significantly reduced the image noise and artifacts index and significantly improved the signal-to-noise ratio and subjective image quality score (P < 0.01). The combination of SEMAR with MPR was conducive to accurate assessment of electrode position and single-electrode visibility. The combination of SEMAR with MIP facilitated accurate and intuitive matching of the assessed electrode count with the number of electrodes implanted during the operation (P = 0.062).ConclusionSEMAR significantly reduces metal artifacts generated by CI electrodes and improves the quality of computed tomography images. The combination of SEMAR with MPR and maximum intensity projection is beneficial for evaluating the position and number of CI electrodes.
Highlights
The purpose of this study was to develop an effective method of reducing metal artifacts in cochlear implant (CI) electrodes
Evaluation of images processed by single-energy metal artifact reduction (SEMAR) combined with multi-planar reconstruction (MPR) or maximum intensity projection (MIP) To further evaluate the accuracy of electrode positioning in the cochlea, we performed MPR on the computed tomography (CT) images
We found that images processed with SEMAR combined with MPR clearly elucidated the inner ear’s fine structure, which is conducive to accurate assessment of the electrode position in the cochlea and its effect on the modiolus and bone spiral plate (Fig. 5)
Summary
The purpose of this study was to develop an effective method of reducing metal artifacts in cochlear implant (CI) electrodes. Cochlear implants (CIs) are currently the most effective treatment for patients with severe-to-profound sensorineural hearing loss, and they have been widely used worldwide. In addition to the cause, duration, and extent of hearing loss and the development of speech function before implantation, the electrode position in the cochlea can play an essential role in the postoperative effects of CIs [1,2,3]. Because electrodes cannot be observed in the cochlea by naked eye after implantation, methods to evaluate the electrode position after CI are needed. The main methods to perform such evaluation are currently X-ray, computed tomography (CT), and other imaging examinations. Methods to reduce or remove artifacts around metal implants are clinically important. The application of energy spectrum CT [8] and various post-processing technologies [9] after artifact removal has provided some solutions, but the results of such artifact removal remain unsatisfactory
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