Validation of Active Shape Model Techniques for Intracochlear Anatomy Segmentation in Computed Tomography Images

Purpose: Cochlear implants (CIs) have been shown to be highly effective restorative devices for patients suffering from severe-to-profound hearing loss. Hearing outcomes with CIs depend on electrode positions with respect to intracochlear anatomy. Intracochlear anatomy can only be directly visualized using high-resolution modalities, such as micro-computed tomography (mu CT), which cannot be used in vivo. However, active shape models (ASM) have been shown to be robust and effective for segmenting intracochlear anatomy in large scale datasets of patient computed tomographies (CTs). We present an extended dataset of mu CT specimens and aim to evaluate the ASM's performance more comprehensively than has been previously possible. Approach: Using a dataset of 16 manually segmented cochlea specimens on mu CTs, we found parameters that optimize mean CT segmentation performance and then evaluate the effect of library size on the ASM. The optimized ASM was further evaluated on a clinical dataset of 134 CT images to assess method reliability Results: Optimized parameters lead to mean CT segmentation performance to 0.36 mm point-to-point error, 0.10 mm surface error, and 0.83 Dice score. Larger library sizes provide diminishing returns on segmentation performance and total variance captured by the ASM. We found our method to be clinically reliable with the main performance limitation that was found to be the candidate search process rather than model representation. Conclusions: We have presented a comprehensive validation of the ASM for use in intracochlear anatomy segmentation. These results are critical to understand the limitations of the method for clinical use and for future development. (c) 2023 Society of Photo-Optical Instrumentation Engineers (SPIE)