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Each head was scanned on three high-end CT systems: SOMATOM Edge, SOMATOM Force and NAEOTOM Alpha. A total of 192 reconstructions were obtained, including various tube voltages (120\u2013150\u00a0kV), tin filtering, and slice thicknesses (0.2\u20130.6\u00a0mm). For each scanner, multiple reconstruction kernels were applied. Contrast-to-noise ratios (CNR) for bone-to-soft-tissue were calculated. Two radiologists independently assessed anatomy, implant visibility, and overall image quality on a 5-point Likert scale and scored diagnostic confidence for detecting anatomic dehiscence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PCD-CT showed significantly higher image quality scores across implant, anatomy, and general image quality compared to the Edge and Force (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). PCD-CT also produced significantly higher CNR (mean 23.5 vs. 13.8 [Edge] and 12.7 [Force]) and greater diagnostic confidence. For PCD-CT, optimal image quality was achieved using 0.2\u00a0mm slice thickness and the Hr89 kernel at 140\u00a0kV. PCD-CT scans acquired with half dose (27.5 mGy) showed no significant difference in CNRs but led to slightly lower subjective scores compared to standard-dose imaging.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PCD-CT provides superior image quality and diagnostic confidence in cochlear implant imaging compared to the Edge and Force. Optimal results are achieved using 140\u00a0kV, 0.2\u00a0mm slices, and the Hr89 kernel. 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