Comparative evaluation of flat-panel volume CT protocols for high-resolution visualization of middle ear anatomy

Sep 30, 2026

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Comparative evaluation investigates image quality and radiation dose across six flat-panel volume CT (fpVCT) protocols with different scan times and technical parameters for visualizing middle ear structures in human skull specimens. A scoring system delineates 28 anatomical structures and narrows to eight for detailed comparison. Protocols 14s I and 8s I achieve the highest quality; 8s I also optimizes the image-quality-to-radiation balance following the ALADA principle. Shorter protocols reduce dose but may fail clinical image-quality thresholds, and 8s I is recommended as standard, with 4s I as a radiation-minimizing alternative.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

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Results

Preparation of various imaging protocol

[www. nature.com/scientificreports](www. nature.com/scientificreports) OPEN Comparative evaluation of flatpanel volume CT protocols for high-resolution visualization of middle ear anatomy in human skull specimens Franz-Tassilo Müller-Graff1􀀍, Jan von Düring1, Bjoern Spahn1, Stefan Weick2, Anne Richter2, Jan-Peter Grunz3, Tilmann Neun4, Stephan Hackenberg1 & Kristen Rak1 This study evaluates the imaging quality and radiation dose of six flat-panel volume CT protocols with varying technical parameters, including examination time (“Artis Icono” angiography system (Siemens Healthcare AG, Erlangen, Germany): 14s DCT HEAD MICRO CARE (14s I), 14s DCT HEAD MICRO CARE 4 (14s II), 8s DCT HEAD 70kV CARE 1 (8s I), 8s DCT HEAD 70kV CARE 3 (8s II), 4s DCTHEAD CARE FB (4s I), 4s DCT HEAD CARE FB 2 (4s II)) for middle ear visualization in human skull specimens. A scoring system assessed the delineation of 28 anatomical structures, narrowed to eight for detailed evaluation. Protocols 14s I and 8s I achieved the highest image quality, exceeding the clinical threshold. 8s I protocol demonstrated an optimal balance between image quality and radiation safety, adhering to theALADA principle (“as low as diagnostically acceptable”). While 14s I offered superior detail, it involved higher radiation exposure without substantial further image improvement, indicating a saturation effect. Shorter protocols, such as 4s I, offered radiation-sparing advantages but did not consistently meet clinical image quality standards. Protocol 8s I is recommended as the standard for middle ear imaging, with 4s I as a potential alternative for cases requiring minimized radiation exposure and reduced motion artifact susceptibility. Keywords Imaging protocols, Cumulative score, Reference structures, Gray-scale profile, Phantom dosimetry, Dose quantification, Ionization chamber, Secondary reconstruction of flat-panel volume CT (fpVCTSECO) Modern imaging techniques such as digital volume tomography (DVT) and computed tomography (CT) play a crucial role in the diagnosis of middle ear pathologies1–4. Unlike multi-slice CT (MSCT), DVT systems employ a conical beam geometry, commonly referred to as Cone Beam CT (CBCT)5,6. The imaging capabilities of CBCT can be enhanced by incorporating flat-panel detectors, leading to significant improvements in imaging quality7. This combination is termed “flat-panel volume CT” (fpVCT)8–10. Secondary reconstructions from fpVCT (fpVCTSECO) have been shown to further enhance resolution and provide more accurate measurements, particularly in the context of cochlear implantation11–13. However, a wide range of parameters such as voltage, amperage, and scan time in fpVCT can significantly affect both image quality and radiation dose. Higher voltage levels improve image contrast but also increase radiation exposure14, 15, while longer scan times may result in greater motion artifacts. Pre-programmed fpVCT protocols define these key parameters, ultimately influencing image quality. Despite this, there is a limited 1Department of Oto-Rhino-Laryngology, Head and Neck Surgery and the Comprehensive Hearing Center, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany. 2Department of Radiotherapy and Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany. 3Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany. 4Institute for Diagnostic and Interventional Neuroradiology, University Hospital Wuerzburg, Wuerzburg, Germany. 􀀍 email: [Mueller_F7@ukw.de](Mueller_F7@ukw.de) [www. nature.com/scientificreports/](www. nature.com/scientificreports/) body of research comparing the advantages and disadvantages of different fpVCT protocols for various clinical scenarios16–19. Previous studies have compared fpVCT to MSCT for middle ear imaging, though caution is required when generalizing these results to clinical practice. Many studies have been conducte

FAQs

What does the study compare among flat-panel volume CT protocols?

It compares imaging quality and radiation dose across six fpVCT protocols using different technical parameters for middle ear visualization in human skull specimens.

How is image quality evaluated?

A scoring system assesses the delineation of anatomical structures, narrowing from 28 assessed structures to eight for more detailed evaluation.

Which protocol is recommended and why?

Protocol 8s I is recommended as the standard for middle ear imaging because it provides an optimal balance between high image quality and radiation safety according to the ALADA principle.

Sep 30, 2026

Upload by Levi