Flat Panel Angiography in the Cross-Sectional Imaging of the Temporal Bone: Assessment of Image Quality and Radiation Dose Compared with a 64-Section Multisection CT Scanner

Conte, Giorgio; Scola, Elisa; Calloni, Sonia Francesca; Brambilla, Roberto; Campoleoni, Mauro; Lombardi, Luciano; Berardino, Federica Di; Zanetti, Diego; Gaini, Lorenzo; Triulzi, F.; Sina, C.

doi:10.3174/ajnr.a5302

Cited by 16 publications

(12 citation statements)

References 18 publications

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“…This is in accordance with Rathgeb et al, who was among the first to evaluate a good clinical observer variability of the planning software [27]. FpVCT without secondary reconstruction is considered a precise method for assessing the parameters of the inner ear with the same or even less radiation dose than conventional methods [18,19]. This might reduce the risk of radiogenic damage in the long term [36,37] while increasing diagnostic image quality [18,19,22].…”

Section: Discussionsupporting

confidence: 68%

“…The first application of fpVCT in patients revealed a proper resolution regarding the critical structures for cochlear implantation [17]. Other studies first showed a significantly higher overall image quality compared to MSCT and a reduction of the effective dose of approximately 40% compared to 64-section- [18] and 128-section-MSCT [19]. Further advantages of fpVCT are portability-enabling the intraoperative use and reduced metallic artifacts, allowing postoperative position analyses, and more accurate frequency mapping of the electrode contacts [20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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Implementation of secondary reconstructions of flat-panel volume computed tomography (fpVCT) and otological planning software for anatomically based cochlear implantation

Müller-Graff¹,

Ilgen²,

Schendzielorz³

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose For further improvements in cochlear implantation, the measurement of the cochlear duct length (CDL) and the determination of the electrode contact position (ECP) are increasingly in the focus of clinical research. Usually, these items were investigated by multislice computed tomography (MSCT). The determination of ECP was only possible by research programs so far. Flat-panel volume computed tomography (fpVCT) and its secondary reconstructions (fpVCTSECO) allow for high spatial resolution for the visualization of the temporal bone structures. Using a newly developed surgical planning software that enables the evaluation of CDL and the determination of postoperative ECP, this study aimed to investigate the combination of fpVCT and otological planning software to improve the implementation of an anatomically based cochlear implantation. Methods Cochlear measurements were performed utilizing surgical planning software in imaging data (MSCT, fpVCT and fpVCTSECO) of patients with and without implanted electrodes. Results Measurement of the CDL by the use of an otological planning software was highly reliable using fpVCTSECO with a lower variance between the respective measurements compared to MSCT. The determination of the inter-electrode-distance (IED) between the ECP was improved in fpVCTSECO compared to MSCT. Conclusion The combination of fpVCTSECO and otological planning software permits a simplified and more reliable analysis of the cochlea in the pre- and postoperative setting. The combination of both systems will enable further progress in the development of an anatomically based cochlear implantation.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Implementation of secondary reconstructions of flat-panel volume computed tomography (fpVCT) and otological planning software for anatomically based cochlear implantation

Müller-Graff¹,

Ilgen²,

Schendzielorz³

et al. 2021

Eur Arch Otorhinolaryngol

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“…Multisection computed-tomography (MSCT) is the traditional technique of choice when cholesteatoma is clinically suspected, providing a spatial resolution of 0.4 x 0.4 mm in plane and 0.5 mm in slice thickness. In the last years the use of flat-panel CT (FPCT) has taken place in clinical practice, being preferred for its higher spatial resolution and lower radiation dose 910 . Typically, PBC appears as an expansive soft-tissue mass in the apical portion of the petrous bone, with large areas of bone reabsorption (Fig.…”

Section: Advancements and Open Issuesmentioning

confidence: 99%

Surgery of the lateral skull base: a 50-year endeavour

Zanoletti¹,

Mazzoni²,

Martini³

et al. 2019

Acta Otorhinolaryngol Ital

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101

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SUMMARY Disregarding the widely used division of skull base into anterior and lateral, since the skull base should be conceived as a single anatomic structure, it was to our convenience to group all those approaches that run from the antero-lateral, pure lateral and postero-lateral side of the skull base as “Surgery of the lateral skull base”. “50 years of endeavour” points to the great effort which has been made over the last decades, when more and more difficult surgeries were performed by reducing morbidity. The principle of lateral skull base surgery, “remove skull base bone to approach the base itself and the adjacent sites of the endo-esocranium”, was then combined with function preservation and with tailoring surgery to the pathology. The concept that histology dictates the extent of resection, balancing the intrinsic morbidity of each approach was the object of the first section of the present report. The main surgical approaches were described in the second section and were conceived not as a step-by-step description of technique, but as the highlighthening of the surgical principles. The third section was centered on open issues related to the tumor and its treatment. The topic of vestibular schwannoma was investigated with the current debate on observation, hearing preservation surgery, hearing rehabilitation, radiotherapy and the recent efforts to detect biological markers able to predict tumor growth. Jugular foramen paragangliomas were treated in the frame of radical or partial surgery, radiotherapy, partial “tailored” surgery and observation. Surgery on meningioma was debated from the point of view of the neurosurgeon and of the otologist. Endolymphatic sac tumors and malignant tumors of the external auditory canal were also treated, as well as chordomas, chondrosarcomas and petrous bone cholesteatomas. Finally, the fourth section focused on free-choice topics which were assigned to aknowledged experts. The aim of this work was attempting to report the state of the art of the lateral skull base surgery after 50 years of hard work and, above all, to raise questions on those issues which still need an answer, as to allow progress in knowledge through sharing of various experiences. At the end of the reading, if more doubts remain rather than certainties, the aim of this work will probably be achieved.

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“…Cone Beam Computed Tomography (CBCT) offers a low-radiation and cost-effective alternative to conventional CT, while also being superior in visualizing highdensity structures, such as the temporal bone [9]. CBCT provides a reduction of the effective dose of up to 40% of a 64-slice CT [10] and comparable radiation dose to a 128slice CT, but with higher image quality compared to both due to the higher spatial resolution [11,13]. The advantages in the visualization of CI electrodes result from their low susceptibility to metallic artifacts [14].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of artifacts of cochlear implant electrodes in cone beam computed tomography

Bevis

Effertz

Beutner

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose Cone Beam Computed Tomography (CBCT) offers a valid alternative to conventional Computed Tomography (CT). A possible radiation dose reduction with the use of CBCT in postoperative imaging of CIs is of great importance. Whether the visualization of Cochlear Implant (CI) electrodes in CBCT correlates with the radiation dose applied was investigated in this study. Methods We compared the visualization quality of Contour Advance CIs to Straight CIs from Cochlear using CBCT with varying tube parameters on whole-head specimen. Results The internal diameter of the cochlea decreases from base to apex, resulting in a significantly different intracochlear positioning of the two tested CI models. While electrodes of the Contour Advance series are located close to the modiolus, thus closer to the spiral ganglion neurons, those of the Straight series are located further away. The artifact portion of the electrode amounts to 50–70% of the radiological diameter of the electrode. An increase in artifact portion from the base (electrode #1 approx. 50%) to the apex (electrode #20 approx. 70%) of the cochlea was observed. The visualization of electrodes in the medial and apical part of the cochlea is limited due to artifact overlapping. There was no correlation between the artifact size and the applied radiation dose. Conclusion The results indicate that a reduction of the radiation dose by up to 45% of the currently applied radiation dose of standard protocols would be possible. Investigations of the effects on subjective image quality still need to be performed.

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Flat Panel Angiography in the Cross-Sectional Imaging of the Temporal Bone: Assessment of Image Quality and Radiation Dose Compared with a 64-Section Multisection CT Scanner

Cited by 16 publications

References 18 publications

Implementation of secondary reconstructions of flat-panel volume computed tomography (fpVCT) and otological planning software for anatomically based cochlear implantation

Implementation of secondary reconstructions of flat-panel volume computed tomography (fpVCT) and otological planning software for anatomically based cochlear implantation

Surgery of the lateral skull base: a 50-year endeavour

Evaluation of artifacts of cochlear implant electrodes in cone beam computed tomography

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