Accuracy of Postoperative Computed Tomography and Magnetic Resonance Image Fusion for Assessing Deep Brain Stimulation Electrodes

Thani, Nova; Bala, Arul; Swann, Gary B; Lind, Christopher R. P.

doi:10.1227/neu.0b013e318218c7ae

Cited by 59 publications

(53 citation statements)

References 29 publications

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“…Advanced image fusion algorithms are needed to minimize this error [56,57,59,60]. Another effective strategy is to develop MRI-compatible devices or high-resolution MRI systems, which has become a trend in recent years [12,13,15,25,35,41,54,61,62]. …”

Section: Discussionmentioning

confidence: 99%

Review on Factors Affecting Targeting Accuracy of Deep Brain Stimulation Electrode Implantation between 2001 and 2015

Li¹,

Zhang

Yan

et al. 2016

Stereotact Funct Neurosurg

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Background: Accurate implantation of a depth electrode into the brain is of the greatest importance in deep brain stimulation (DBS), and various stereotactic systems have been developed for electrode implantation. However, an updated analysis of depth electrode implantation in the modern era of DBS is lacking. Objective: This study aims at providing an updated review on targeting accuracy of DBS electrode implantation by analyzing contemporary DBS electrode implantation operations from the perspective of precision engineering. Methods: Eligible articles with information on targeting accuracy of DBS electrode implantation were searched in the PubMed database. Results: An average targeting error of DBS electrode implantation is reported to decrease toward 1 mm; the standard deviation of targeting error is decreasing toward 0.5 mm. Targeting accuracy is not only found to be affected by individual surgical steps, but also systematically affected by the architecture of the implantation operation. Conclusion: A systematic strategy should be adopted to further improve the targeting accuracy of depth electrode implantation. Attention should be paid to optimizing the whole electrode implantation operation, which can help minimize error accumulation or amplification throughout the serially connected procedures for DBS electrode implantation.

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Section: Discussionmentioning

confidence: 99%

Review on Factors Affecting Targeting Accuracy of Deep Brain Stimulation Electrode Implantation between 2001 and 2015

Li¹,

Zhang

Yan

et al. 2016

Stereotact Funct Neurosurg

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show abstract

“…Postoperative CT and MRI are currently the most commonly applied imaging modalities for verification of lead location. Literature describes both CT and MRI as being sufficiently accurate for postoperative determination of DBS lead location [18,19]. MRI has no radiation exposure and offers a higher resolution of surrounding anatomical structures but is more sensitive to image distortion compared to CT [20].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Stereotactic Accuracy in Patients Undergoing Deep Brain Stimulation Using Nexframe and the Leksell Frame

Bot

Munckhof

Bakay

et al. 2015

Stereotact Funct Neurosurg

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Objective: To determine and compare the accuracy of Nexframe and the Leksell stereotactic frame in deep brain stimulation (DBS) procedures. Background: The ‘frameless' Nexframe uses bone fiducials rather than a head-mounted frame, which offers potential benefits for both the patient and the surgical team. Accuracy of lead implantation and factors affecting this accuracy are of crucial importance but have not been extensively studied for the frameless system. Design/Methods: The location of 194 (Leksell frame, n = 116; Nexframe, n = 78) DBS leads was determined on postoperative MRI. Obtained stereotactic coordinates were compared with expected intraoperative target coordinates. Resulting absolute errors in the X (medial-lateral), Y (anterior-posterior), and Z (dorsal-ventral) coordinates (ΔX, ΔY, and ΔZ) were then used to calculate the vector error (VE). The vector error describes the total error in 3-D space and represents our main outcome measure. Results: The vector error (mean ± SD) was 2.8 ± 1.3 for Nexframe and 2.5 ± 1.2 for the Leksell frame (p = 0.43). For Nexframe, absolute X, Y, and Z errors were 1.4 ± 1.3, 1.7 ± 1.2, and 1.0 ± 0.9 mm. For the Leksell frame, the absolute X, Y, and Z errors were 1.4 ± 1.0, 1.2 ± 1.0, and 1.3 ± 0.9 mm. On the anterior-posterior plane (Y coordinate), the Leksell frame was more accurate than Nexframe (p = 0.04). In contrast, Nexframe was more accurate on the dorsal-ventral plane (Z coordinate) (p = 0.04). There was no difference in accuracy between the two methods on the medial-lateral plane (X coordinate). Conclusion: This comparison of Nexframe and the Leksell frame shows that both techniques have equivalent overall 3-D accuracy.

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“…Some studies have utilized the superior soft tissue imaging characteristics of MRI to image DBS electrodes during or after placement to establish the exact location of contact points 37, 38, 39. However, the presence of ferromagnetic material in the electrodes raises the concern of thermal injuries when MRI is performed, as well as generating a signal void as a result of local distortion of the magnetic field 39. For these reasons, CT generally is regarded as a safer modality for postoperative imaging.…”

Section: Discussionmentioning

confidence: 99%

Placement of Deep Brain Electrodes in the Dog Using the Brainsight Frameless Stereotactic System: A Pilot Feasibility Study

Long

Frey

Freestone

et al. 2013

Veterinary Internal Medicne

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BackgroundDeep brain stimulation (DBS) together with concurrent EEG recording has shown promise in the treatment of epilepsy. A novel device is capable of combining these 2 functions and may prove valuable in the treatment of epilepsy in dogs. However, stereotactic implantation of electrodes in dogs has not yet been evaluated.ObjectiveTo evaluate the feasibility and safety of implanting stimulating and recording electrodes in the brain of normal dogs using the Brainsight system and to evaluate the function of a novel DBS and recording device.AnimalsFour male intact Greyhounds, confirmed to be normal by clinical and neurologic examinations and hematology and biochemistry testing.Methods MRI imaging of the brain was performed after attachment of fiducial markers. MRI scans were used to calculate trajectories for electrode placement in the thalamus and hippocampus, which was performed via burr hole craniotomy. Postoperative CT scanning was performed to evaluate electrode location and accuracy of placement was calculated. Serial neurologic examinations were performed to evaluate neurologic deficits and EEG recordings obtained to evaluate the effects of stimulation.ResultsElectrodes were successfully placed in 3 of 4 dogs with a mean accuracy of 4.6 ± 1.5 mm. EEG recordings showed evoked potentials in response to stimulation with a circadian variation in time‐to‐maximal amplitude. No neurologic deficits were seen in any dog.Conclusions and Clinical ImportanceStereotactic placement of electrodes is safe and feasible in the dog. The development of a novel device capable of providing simultaneous neurostimulation and EEG recording potentially represents a major advance in the treatment of epilepsy.

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Accuracy of Postoperative Computed Tomography and Magnetic Resonance Image Fusion for Assessing Deep Brain Stimulation Electrodes

Abstract: CT/MRI coregistration is an acceptable method of identifying the anatomic location of DBS electrode and active contacts.

Cited by 59 publications

References 29 publications

Review on Factors Affecting Targeting Accuracy of Deep Brain Stimulation Electrode Implantation between 2001 and 2015

Review on Factors Affecting Targeting Accuracy of Deep Brain Stimulation Electrode Implantation between 2001 and 2015

Analysis of Stereotactic Accuracy in Patients Undergoing Deep Brain Stimulation Using Nexframe and the Leksell Frame

Placement of Deep Brain Electrodes in the Dog Using the Brainsight Frameless Stereotactic System: A Pilot Feasibility Study

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