Contouring the cochlea on T2-weighted MRI

Anna Britten, MD

Director, Medical Affairs

Elekta AB

1 | Focus where it matters.

 The cochlea

• TG 263 Terminology:

- FMAID: 60202 (R); 60203 (L)

• Description: From the Greek word for snail shell, the cochlea is a hollow, spiral-shaped bone found in the inner ear
that plays a key role in hearing. It forms a cone 9mm in diameter at its base, and 5mm in length. It converts mechanical
energy in the form of vibrations (sound), into nerve impulses sent to the brain.

• TSG CTP description: Sit just anterior to the lateral aspect of the internal auditory canal, embedded in the
temporal bone, located lateral to the internal auditory meatus. They are most easily identified on the CT bone windows as
small caves in the bone measuring 4-6mm. Contour on 3 slices otherwise too small for dose calculation algorithms.

2 | Focus where it matters.

https://images.app.goo.gl/vRNfjRYQ4FTfocmx9
https://images.app.goo.gl/DQiosNjGFDFzLDHd8
 Gross and cross sectional anatomy
of the cochlea

https://images.app.goo.gl/ufDtKRDnm2SHHs5C7
https://images.app.goo.gl/RLYaLzN2YTWe4HfF9
3 | Focus where it matters.
 Cross sectional appearance on CT

https://images.app.goo.gl/RGDSb85Kj21Etytt9
https://images.app.goo.gl/ma4Yz4KC1HK3A1pD6
https://images.app.goo.gl/WUDuEAAKK27manpFA

4 | Focus where it matters.

 Cross sectional appearance on T1w and T2w MR

http://www.radiologyassistant.nl/en/p56195b237699d/rectal-cancer-mr-staging-20.html
5 | Focus where it matters. https://www.slideshare.net/rameshmutiki/mri-basics-how-to-read-and-understand-mri-sequences
 Cross sectional anatomy of the cochlea
on T2w MRI

https://images.app.goo.gl/WBdDKGicz7aPUW8s5

6 | Focus where it matters.

 Contouring the cochlea on CT (bone window)

3 = Cochlea; 1 = internal
auditory canal; 2 = inner ear
https://images.app.goo.gl/o2c33eFWBeGASt3o7
C = cochlea; IAC = internal auditory canal; Mastoid; ET =
7 | Focus where it matters.
https://images.app.goo.gl/1UToCQEDA7X6Jfb27 eustachian tube; TC = tympanic cavity; VS = vestibular
apparatus
 Contouring the cochlea on T2w MRI

CT bone window

CT bone window T2w MRI

T2w MRI
Green =R cochlea;; Pink = L cochlea
https://images.app.goo.gl/cbZF2sCnwvseRPZg9
8 | Focus where it matters. https://images.app.goo.gl/1hZBzFAnX9kKgd7bA
 Contouring the cochlea on MRI

Orange = R cochlea; Green =

L cochlea;

9 | Focus where it matters.

Contouring the cochlea on MRI

Orange = R cochlea; Green =

L cochlea;

10 | Focus where it matters.