Co-registration of cone beam CT and preoperative MRI for improved accuracy of electrode localization following cochlear implantation. (4th May 2018)

• Record Type: Journal Article
• Authors: Dragovic, A. S.; Stringer, A. K.; Campbell, L.; Shaul, C.; O'Leary, S. J.; Briggs, R. J.
• Is Part Of: Cochlear implants international. Volume 19:Number 3(2018)
• Page Start: 147
• Page End: 152
• Publication Date: 2018-05-04
• Subjects: Preoperative MRI -- Co-registration -- Cone beam CT -- Electrode localization -- Cochlear implantation -- Translocation -- Scala tympani -- Scala vestibuli; Cochlear implants -- Periodicals; 617.882
• DOI: 10.1080/14670100.2017.1419548
• Languages: English
• ISSNs: 1467-0100

Abstract

Abstract : Objectives: To investigate the clinical usefulness and practicality of co-registration of Cone Beam CT (CBCT) with preoperative Magnetic Resonance Imaging (MRI) for intracochlear localization of electrodes after cochlear implantation. Methods: Images of 20 adult patients who underwent CBCT after implantation were co-registered with preoperative MRI scans. Time taken for co-registration was recorded. The images were analysed by clinicians of varying levels of expertise to determine electrode position and ease of interpretation. Results: After a short learning curve, the average co-registration time was 10.78 minutes (StdDev 2.37). All clinicians found the co-registered images easier to interpret than CBCT alone. The mean concordance of CBCT vs. co-registered image analysis between consultant otologists was 60% (17-100%) and 86% (60-100%), respectively. The sensitivity and specificity for CBCT to identify Scala Vestibuli insertion or translocation was 100 and 75%, respectively. The negative predictive value was 100%. Discussion: CBCT should be performed following adult cochlear implantation for audit and quality control of surgical technique. If SV insertion or translocation is suspected, co-registration with preoperative MRI should be performed to enable easier analysis. There will be a learning curve for this process in terms of both the co-registration and the interpretation of images by clinicians.