Imaging Of Cochlea Research Articles

Automatic cochlear multimodal 3D image segmentation and analysis using atlas–model-based method

Objectives To propose an automated fast cochlear segmentation, length, and volume estimation method from clinical 3D multimodal images which has a potential role in the choice of cochlear implant type, surgery planning, and robotic surgeries. Methods: Two datasets from different countries were used. These datasets include 219 clinical 3D images of cochlea from 3 modalities: CT, CBCT, and MR. The datasets include different ages, genders, and types of cochlear implants. We propose an atlas–model-based method for cochlear segmentation and measurement based on high-resolution μCT model and A-value. The method was evaluated using 3D landmarks located by two experts. Results: The average error was 0.61 ± 0.22 mm and the average time required to process an image was 5.21 ± 0.93 seconds (P<0.001). The volume of the cochlea ranged from 73.96 mm 3 to 106.97 mm 3 , the cochlear length ranged from 36.69 to 45.91 mm at the lateral wall and from 29.12 to 39.05 mm at the organ of Corti. Discussion: We propose a method that produces nine different automated measurements of the cochlea: volume of scala tympani, volume of scala vestibuli, central lengths of the two scalae, the scala tympani lateral wall length, and the organ of Corti length in addition to three measurements related to A-value. Conclusion: This automatic cochlear image segmentation and analysis method can help clinician process multimodal cochlear images in approximately 5 seconds using a simple computer. The proposed method is publicly available for free download as an extension for 3D Slicer software.

In vivo real-time imaging reveals megalin as the aminoglycoside gentamicin transporter into cochlea whose inhibition is otoprotective

Aminoglycosides (AGs) are commonly used antibiotics that cause deafness through the irreversible loss of cochlear sensory hair cells (HCs). How AGs enter the cochlea and then target HCs remains unresolved. Here, we performed time-lapse multicellular imaging of cochlea in live adult hearing mice via a chemo-mechanical cochleostomy. The invivo tracking revealed that systemically administered Texas Red-labeled gentamicin (GTTR) enters the cochlea via the stria vascularis and then HCs selectively. GTTR uptake into HCs was completely abolished in transmembrane channel-like protein 1 (TMC1) knockout mice, indicating mechanotransducer channel-dependent AG uptake. Blockage of megalin, the candidate AG transporter in the stria vascularis, by binding competitor cilastatin prevented GTTR accumulation in HCs. Furthermore, cilastatin treatment markedly reduced AG-induced HC degeneration and hearing loss invivo. Together, our invivo real-time tracking of megalin-dependent AG transport across the blood-labyrinth barrier identifies new therapeutic targets for preventing AG-induced ototoxicity.

Optimal path generation in scala tympani and path planning for robotic cochlear implant of perimodiolar electrode.

In this study, a new idea of the optimal path generation method was proposed and a path planning strategy for robotic cochlear implant of perimodiolar electrode was designed. The centerline of scala tympani channel was taken as the optimal implant path of the perimodiolar electrode, which aimed to reduce the damage of the electrode to the cochlea during implantation. First, the three-dimensional cochlear model was reconstructed based on the micro-computed tomography images of cochlea, and it was re-segmented to obtain the cross sections of the scala tympani at different angles. Then, the image processing method was used to determine the central point of the scala tympani cross sections. The cubic B-spline interpolation method was used to fit these discrete central points to generate the optimal path. Finally, the coordinate information of the optimal path was combined with the stylet extraction state of perimodiolar electrode to conduct the path planning for robotic cochlear implant, and the result was sent to the robot for kinematic inverse solution to obtain the robot motion trajectory. The robotic cochlear implant experiment was performed with the model of scala tympani. The results showed that the maximum implant force based on path planning was 0.084 N, and the maximum implant force without path planning was 0.134 N. The optimal path generation and the path planning method effectively help to reduce the damage of the electrode to the cochlea.

High-resolution Imaging of the Human Cochlea through the Round Window by means of Optical Coherence Tomography

The human cochlea is deeply embedded in the temporal bone and surrounded by a thick otic capsule, rendering its internal structure inaccessible for direct visualization. Clinical imaging techniques fall short of their resolution for imaging of the intracochlear structures with sufficient detail. As a result, there is a lack of knowledge concerning best practice for intracochlear therapy placement, such as cochlear implantation. In the past decades, optical coherence tomography (OCT) has proven valuable for non-invasive, high-resolution, cross-sectional imaging of tissue microstructure in various fields of medicine, including ophthalmology, cardiology and dermatology. There is an upcoming interest for OCT imaging of the cochlea, which so far was mostly carried out in small animals. In this temporal bone study, we focused on high-resolution imaging of the human cochlea. The cochlea was approached through mastoidectomy and posterior tympanotomy, both standard surgical procedures. A commercially available spectral-domain OCT imaging system was used to obtain high-resolution images of the cochlear hook region through the intact round window membrane in four cadaveric human temporal bones. We discuss the qualitative and quantitative characteristics of intracochlear structures on OCT images and their importance for cochlear implant surgery.

Endoscopic optical coherence tomography enables morphological and subnanometer vibratory imaging of the porcine cochlea through the round window.

A highly phase stable hand-held (HH) endoscopic system has been developed for optical coherence tomography and vibrometry. Designed to transit the ear canal to the middle ear space and peer through the round window (RW), it is capable of imaging the vibratory function of the cochlear soft tissues with subnanometer scale sensitivity. A side-looking, 9cm long rigid endoscope with a distal diameter of 1.2mm, was able to fit within the RW niche and provide imaging access. The phase stability was achieved in part by fully integrating a Michelson interferometer into the HH device. Ex vivo imaging of a domestic pig demonstrated the system's ability for functional vibratory imaging of the cochlea via the RW.

Application of Curved MPR Algorithm to High Resolution 3 Dimensional T2 Weighted CISS Images for Virtual Uncoiling of Membranous Cochlea as an Aid for Cochlear Morphometry.

With the use of various surgical techniques, types of implants, the preoperative assessment of cochlear dimensions is becoming increasingly relevant prior to cochlear implantation. High resolution CISS protocol MRI gives a better assessment of membranous cochlea, cochlear nerve, and membranous labyrinth. Curved Multiplanar Reconstruction (MPR) algorithm provides better images that can be used for measuring dimensions of membranous cochlea. To ascertain the value of curved multiplanar reconstruction algorithm in high resolution 3-Dimensional T2 Weighted Gradient Echo Constructive Interference Steady State (3D T2W GRE CISS) imaging for accurate morphometry of membranous cochlea. Fourteen children underwent MRI for inner ear assessment. High resolution 3D T2W GRE CISS sequence was used to obtain images of cochlea. Curved MPR reconstruction algorithm was used to virtually uncoil the membranous cochlea on the volume images and cochlear measurements were done. Virtually uncoiled images of membranous cochlea of appropriate resolution were obtained from the volume data obtained from the high resolution 3D T2W GRE CISS images, after using curved MPR reconstruction algorithm mean membranous cochlear length in the children was 27.52 mm. Maximum apical turn diameter of membranous cochlea was 1.13 mm, mid turn diameter was 1.38 mm, basal turn diameter was 1.81 mm. Curved MPR reconstruction algorithm applied to CISS protocol images facilitates in getting appropriate quality images of membranous cochlea for accurate measurements.

In Vivo Imaging of Mouse Cochlea by Optical Coherence Tomography

Cochlear pathology can be evaluated in living animals using optical coherence tomography (OCT). The current imaging methods available for the detailed analysis of cochlear pathology in a clinical setting provide only limited information. Thus, a cochlear imaging modality with high definition is needed for improving the diagnosis of cochlear pathology. OCT has been used in other fields for obtaining high-resolution subsurface images, and its use could potentially be extended to the analysis of cochlear pathogenesis. Slc26a4(-/-) mice, which generate endolymphatic hydrops, and their littermates were used in this study. Auditory function was monitored by the auditory brainstem responses (ABR). After the mice were placed under general anesthesia, OCT images of the cochlea were captured. The cochlea was subsequently dissected out and histologically evaluated. Three or 7 days later, the wild-type mice cochleae were visualized again. In ABR assessments, Slc26a4(-/-) mice showed severe hearing loss, while no significant hearing loss was found in Slc26a4(+/-) or Slc26a4(+/+) mice. OCT demonstrated normal morphology in the cochlea of both Slc26a4(+/-) and Slc26a4(+/+) mice, including the location of Reissner's membrane. Meanwhile, in Slc26a4(-/-) mice, obvious dislocation of Reissner's membrane was observed, indicating severe endolymphatic hydrops. These findings in the OCT images were consistent with the histologic results for the cochlear morphology, as observed with hematoxylin and eosin staining. Three or 7 days later, wild-type cochleae were successfully visualized using OCT, and no otitis media or labyrinthitis was observed. OCT can be applied in the detection of endolymphatic hydrops in living mice, indicating the potential of OCT for cochlear imaging analyses for clinical use in the near future.

Volumetric label-free imaging and 3D reconstruction of mammalian cochlea based on two-photon excitation fluorescence microscopy

The visualization of the delicate structure and spatial relationship of intracochlear sensory cells has relied on the laborious procedures of tissue excision, fixation, sectioning and staining for light and electron microscopy. Confocal microscopy is advantageous for its high resolution and deep penetration depth, yet disadvantageous due to the necessity of exogenous labeling. In this study, we present the volumetric imaging of rat cochlea without exogenous dyes using a near-infrared femtosecond laser as the excitation mechanism and endogenous two-photon excitation fluorescence (TPEF) as the contrast mechanism. We find that TPEF exhibits strong contrast, allowing cellular and even subcellular resolution imaging of the cochlea, differentiating cell types, visualizing delicate structures and the radial nerve fiber. Our results further demonstrate that 3D reconstruction rendered with z-stacks of optical sections enables better revealment of fine structures and spatial relationships, and easily performed morphometric analysis. The TPEF-based optical biopsy technique provides great potential for new and sensitive diagnostic tools for hearing loss or hearing disorders, especially when combined with fiber-based microendoscopy.

A micro-tomography method based on X-ray diffraction enhanced imaging for the visualization of micro-organs and soft tissues

Diffraction enhanced imaging (DEI) is one of the phase contrast imaging methods using the monochromatic X-ray from synchrotron, which provides information on the out-of-plane angular deviation of X-ray. DEI allows the investigation of micro-structures inside weakly absorbing samples at high spatial resolution without serious radiation exposure. Tomographic techniques can be applied readily to phase contrast images. The combination of DEI and tomography allows for a reconstruction of refractive index gradient distribution inside weakly absorbing samples with micrometer resolution, particularly suited for the 3D observation of micro-organisms and tissues. The existing phase contrast tomography methods based on DEI use phase contrast images as projections, such images contain not only the phase information, but also the absorption information. A novel method (DEI in the tomography mode) was developed to greatly increase the proportion of refraction information in phase contrast images by computing the difference between the two sets of images acquired at different angles of the rocking curve to adopt the projections with a complete set (2 π) for reconstruction. The reconstructed images of cochlea of a guinea pig showed the spatial structures and the micro-features inside the samples. The new method reveals higher spatial resolution compared to the conventional phase contrast tomography methods and is more suitable to the investigation of micro-structures of micro-organisms and tissue materials.

Flat-Panel Volume Computed Tomography for Cochlear Implant Electrode Array Examination in Isolated Temporal Bone Specimens

Flat-panel based volume computed tomography could improve cochlear implant electrode evaluation in comparison with multislice computed tomography. Flat-panel based volume computed tomography offers higher spatial resolution and less metal artifacts than multislice computed tomography. Both characteristics could improve the evaluation of challenging but important questions in cochlear implantation assessment, such as an exact imaging of cochlea, osseous spiral lamina, electrode array position, and single electrode contacts. These questions are not currently fully answered by multislice computed tomography. Four isolated temporal bone specimens were scanned in a current multislice computed tomography scanner and in two experimental flat-panel based volume computed tomography scanners before and after cochlea implantation. To compare flat-panel based volume computed tomography and multislice computed tomography, four features were rated according to the following criteria: 1) visibility of the cochlea; 2) visibility of the osseous spiral lamina; 3) discernibility of individual electrode contacts; and 4) the ability to determine the electrode array position relative to scala tympani and scala vestibuli. Layer-by-layer microgrinding pictures were used as the ground truth for verification of imaging findings. Flat-panel based volume computed tomography was superior to multislice computed tomography in all four features rated. The cochlea and facial nerve canal were much better delineated in flat-panel based volume computed tomography. The osseous spiral lamina and single electrode contacts were only visible in flat-panel based volume computed tomography. Assessment of implant position with regard to the cochlear spaces was considerably improved by flat-panel based volume computed tomography. Cochlear implantation assessment could be improved by flat-panel based volume computed tomography and, therefore, would be highly beneficial for cochlea implantation research and for clinical evaluation. However, these first results were shown by scanning isolated temporal bone specimens; scanning whole human skull bases might be more challenging.