Radiation-free automatic planning for cochlear implantation: Comparing cochlear duct lengths between CT and MRI.

OBJECTIVE: Preoperative imaging is crucial for proper Cochlear Implantation (CI) planning. Currently, no universally accepted guidelines for radiological evaluation existed before CI. While High-Resolution Computed Tomography (HRCT) reveals bony structures but may miss membranous labyrinthine abnormalities, it involves substantial radiation exposure. Conversely, Magnetic Resonance Imaging (MRI) allows visualization of fluid content without radiation exposure. This study aimed to assess the accuracy of automated preoperative cochlear measurements obtained from MRI compared to those extracted manually from HRCT and MRI scans. METHODS: This retrospective study included 55 cochlear implant ears. Preoperative CT and MRI were evaluated using OTOPLAN® to determine the A value, B value, and Cochlear Duct Length (CDL). These measurements were performed using manual (CT and MRI) and automatic (MRI) options. Interrater reliability, concordance, and comparative analyses of the three approaches were conducted. RESULTS: Our findings indicated that automated MRI measurements were comparable to the manual CT and MRI assessments. No statistically significant differences were detected among the three approaches when determining the A, B, and CDL values. Automated measurements obtained from MRI showed more concordance with CT measurements than those obtained from manual MRI, suggesting that MRI-Auto assesses cochlear parameters better than manual MRI. CONCLUSION: Automated cochlear measurements using MRI were comparable to manual assessments using CT and MRI. Moreover, when assessing cochlear metrics, MRI-Auto outperformed the manual MRI workflow. Utilizing MRI-Auto planning for CI surgery can facilitate the process and minimize risks. LEVEL OF EVIDENCE: Level 3.