Accuracy of stereotactic electrode placement in deep brain stimulation by intraoperative computed tomography

Fiegele, T.; Feuchtner, Gudrun; Sohm, Florian; Bauer, Richard; Anton, Jürgen Volker; Gotwald, Thaddaeus; Twerdy, K; Eisner, Wilhelm

doi:10.1016/j.parkreldis.2008.01.008

Cited by 62 publications

(36 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When applying correct window levels, CT offers a sharp and highly contrasted lead artifact which facilitates localization of the lead tip. When using MRI, correct sequencing, phase shift, slice thickness, and angulation must be applied and metallic distortion corrected in order to acquire electrode visualization with a clarity comparable to that of CT [22,23]. …”

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

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

“…Radiographs are obtained during the surgical procedure to confirm that the exploratory or the definitive electrodes are precisely following the predetermined trajectory. 72 More recently, the use of intraoperative CT 73 or MR imaging 52 to check electrode positioning has been described.…”

Section: Radiologic Confirmationmentioning

confidence: 99%

Neuroimaging and Deep Brain Stimulation

Dormont¹,

Seidenwurm²,

Galanaud³

et al. 2009

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

SUMMARY: Deep brain stimulation (DBS) is a new neurosurgical method principally used for the treatment of Parkinson disease (PD).Many new applications of DBS are under development, including the treatment of intractable psychiatric diseases. Brain imaging is used for the selection of patients for DBS, to localize the target nucleus, to detect complications, and to evaluate the final electrode contact position. In patients with implanted DBS systems, there is a risk of electrode heating when MR imaging is performed. This contraindicates MR imaging unless specific precautions are taken. Involvement of neuroradiologists in DBS procedures is essential to optimize presurgical evaluation, targeting, and postoperative anatomic results. The precision of the neuroradiologic correlation with anatomic data and clinical outcomes in DBS promises to yield significant basic science and clinical advances in the future. Chronic high-frequency stimulation of the ventral intermediate nucleus (VIM) of the thalamus was first described in the early 1990s by Benabid et al.1 These authors implanted chronic stimulating electrodes in the VIM connected to a subcutaneous pulse generator positioned in the thoracic region to treat disabling tremor in 26 patients with Parkinson disease (PD) and in 6 with essential tremor.1 They demonstrated the effectiveness of this technique and its ability to produce complete relief from tremor. Improvement was maintained for up to 29 months. This was the first clinical demonstration that chronic high-frequency stimulation of nuclei (deep brain stimulation [DBS]) could replace destructive lesion-producing functional neurosurgery such as thalamotomy. This new technique was reversible and led to a renaissance in functional neurosurgery.Next, the same team introduced bilateral DBS of the subthalamic nucleus (STN) in patients with disabling akineticrigid PD and severe motor fluctuations.2 This work extended data obtained in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine monkey model of PD showing that lesions and electric stimulation of the subthalamic nucleus reduced all of the major motor disturbances in this animal model. The results in patients with advanced PD were striking and were reproduced in many centers internationally. The US Food and Drug Administration approved the use of DBS for treatment of advanced PD with bilateral STN stimulation in 2002 and internal globus pallidus (GPi) stimulation in 2003. The main indication for DBS remains advanced PD, but numerous additional applications have been developed, ranging from dystonia to cluster headache, Tourette syndrome, and even psychiatric indications like obsessive-compulsive disorders (OCD) and major depression.DBS is a neurosurgical method, but the role of neuroimaging in successful DBS intervention is critical. Neuroimaging is used for the preoperative selection of patients who will have DBS and to localize the intended target nuclei. In the postoperative period, imaging detects complications that uncommonly accompany the procedure, confirms the pos...

show abstract

“…To help improve targeting accuracy, new techniques such as rapid prototyping, image fusion and advanced robotics are developed. In the early days, only frame-based stereotactic systems were used for electrode implantation [17,18,19,20]. Nowadays, various newly developed systems integrated with novel techniques such as optical navigation and interventional magnetic resonance imaging (iMRI) have entered the clinical theater, making the electrode implantation operation increasingly diverse [15,21,22,23], but the information on the targeting accuracy of different stereotactic systems is fragmented and mainly appears in various clinical reports [24,25,26,27].…”

Section: Introductionmentioning

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

View full text Add to dashboard Cite

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.

show abstract

Accuracy of stereotactic electrode placement in deep brain stimulation by intraoperative computed tomography

Cited by 62 publications

References 20 publications

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

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

Neuroimaging and Deep Brain Stimulation

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

Contact Info

Product

Resources

About