Comparison of photon-counting CT and conventional CT for cochlear implant preoperative planning

Accurate cochlear measurements are crucial for personalized cochlear implantation, requiring high-quality imaging for precise cochlear duct length (CDL) assessment. Photon-counting computed tomography (PC-CT) is an advanced imaging technique that enhances image quality while reducing radiation exposure. The aim of this study was to compare PC-CT and conventional CT in cochlear measurements using cochlear implant planning software in patients with a unilateral cochlear implant. This prospective study was conducted at a tertiary referral center. All patients had a previous conventional temporal bone CT before cochlear implantation and a PC-CT of the temporal bone for the post implant evaluation. Image analysis for both PC-CT and CT was performed with the OTOPLAN version 3.0 software manually and independently by three different otologist experts in the field. Ten cochleae were evaluated. The mean full CDL was 35.81 ± 1.22 mm in CT and 35.99 ± 1.94 mm in PC-CT (P = 0.77) Inter-observer reliability was poor for CT with an intra-correlation coefficient of 0.16 and moderate for PC-CT with an intra-correlation coefficient of 0.71. This study demonstrated the advantages of PC-CT over conventional CT by improving the reliability and reproducibility of CDL measurements in patients.