ArticleRadiology advances2026
Improved visualization of malpositioned middle ear prostheses using photon-counting detector CT: a cadaver study.
Article in Radiology advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Evaluation of middle ear prostheses requires high-resolution imaging to assess position and structural integrity. Purpose: To assess the diagnostic performance of photon-counting-detector (PCD)-CT for middle ear prosthesis imaging in cadaveric specimens. Materials and Methods: Nine different middle ear prostheses were implanted in 5 fresh-frozen whole-head specimens, both in correct anatomic position and displaced to mimic malposition. Specimens were scanned on PCD-CT (NAEOTOM Alpha, Siemens) and energy-integrating-detector (EID)-CT (SOMATOM Force, Siemens), reconstructed at 0.2 mm and 0.4 mm, respectively. Eighteen cases (9 prostheses, 2 positions) per scanner were evaluated by 2 neuroradiologists (36 readings), blinded to scanner and position, who scored prosthesis position, reader confidence, and overall image quality. Agreement with the reference standard and between readers was compared. Results: PCD-CT showed higher diagnostic confidence compared with EID-CT, while accuracy and inter-reader agreement did not demonstrate significant differences between scanners. Correct readings, PCD-CT versus EID-CT: lateral contact, 31/36 (86.1%; 95% CI, 58.3-94.4) vs 29/36 (80.6%; 95% CI, 55.6-91.7), Conclusion: PCD-CT was associated with significantly higher reader confidence and preferred image quality, without significant differences in diagnostic accuracy or inter-reader agreement. These findings suggest that PCD-CT is a promising modality for postoperative middle ear evaluations and warrants further investigations.
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