Validation of CT-MRI fusion for intraoperative assessment of stereotactic accuracy in DBS surgery.
Identifieur interne : 000367 ( Main/Exploration ); précédent : 000366; suivant : 000368Validation of CT-MRI fusion for intraoperative assessment of stereotactic accuracy in DBS surgery.
Auteurs : Zaman Mirzadeh [États-Unis] ; Kristina Chapple ; Meg Lambert ; Rohit Dhall ; Francisco A. PonceSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2014.
English descriptors
- KwdEn :
- Adult, Aged, Deep Brain Stimulation (methods), Electrodes, Implanted, Female, Humans, Imaging, Three-Dimensional (methods), Magnetic Resonance Imaging (methods), Male, Middle Aged, Multimodal Imaging, Neurosurgical Procedures (methods), Postoperative Period, Reproducibility of Results, Stereotaxic Techniques, Subthalamic Nucleus (physiology), Tomography, X-Ray Computed (methods).
- MESH :
- methods : Deep Brain Stimulation, Imaging, Three-Dimensional, Magnetic Resonance Imaging, Neurosurgical Procedures, Tomography, X-Ray Computed.
- physiology : Subthalamic Nucleus.
- Adult, Aged, Electrodes, Implanted, Female, Humans, Male, Middle Aged, Multimodal Imaging, Postoperative Period, Reproducibility of Results, Stereotaxic Techniques.
Abstract
Deep brain stimulation is typically performed with intraoperative microelectrode recording and test stimulation for target confirmation. Recent studies have shown accurate, clinically efficacious results after lead placement without microelectrode recording or test stimulation, using interventional magnetic resonance imaging (MRI) or intraoperative computed tomography (CT; iCT) for verification of accuracy. The latter relies on CT-MRI fusion. To validate CT-MRI fusion in this setting, we compared stereotactic coordinates determined intraoperatively using CT-MRI fusion with those obtained on postoperative MRI. Deep brain stimulation electrodes were implanted with patients under general anesthesia. Direct targeting was performed on preoperative MRI, which was merged with preimplantation iCT images for stereotactic registration and postimplantation iCT images for accuracy confirmation. Magnetic resonance imaging was obtained 6 weeks postoperatively for comparison. Postoperative MRI was obtained for 48 patients, with 94 leads placed over a 1-year period. Vector error of the targeted contact relative to the initial plan was 1.1 ± 0.7 mm on iCT and 1.6 ± 0.7 mm on postoperative MRI. Variance comparisons (F-tests) showed that the discrepancy between iCT- and postoperative MRI-determined errors was attributable to measurement error on postoperative MRI, as detected in inter-rater reliability testing. In multivariate analysis, improved lead placement accuracy was associated with frame-based stereotaxy with the head of the bed at 0° compared with frameless stereotaxy with the head of the bed at 30° (P = 0.037). Intraoperative CT can be used to determine lead placement accuracy in deep brain stimulation surgery. The discrepancy between coordinates determined intraoperatively by CT-MRI fusion and postoperatively by MRI can be accounted for by inherent measurement error.
DOI: 10.1002/mds.26056
PubMed: 25377213
Affiliations:
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Ponce</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Deep Brain Stimulation (methods)</term><term>Electrodes, Implanted</term><term>Female</term><term>Humans</term><term>Imaging, Three-Dimensional (methods)</term><term>Magnetic Resonance Imaging (methods)</term><term>Male</term><term>Middle Aged</term><term>Multimodal Imaging</term><term>Neurosurgical Procedures (methods)</term><term>Postoperative Period</term><term>Reproducibility of Results</term><term>Stereotaxic Techniques</term><term>Subthalamic Nucleus (physiology)</term><term>Tomography, X-Ray Computed (methods)</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term><term>Imaging, Three-Dimensional</term><term>Magnetic Resonance Imaging</term><term>Neurosurgical Procedures</term><term>Tomography, X-Ray Computed</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Electrodes, Implanted</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Multimodal Imaging</term><term>Postoperative Period</term><term>Reproducibility of Results</term><term>Stereotaxic Techniques</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Deep brain stimulation is typically performed with intraoperative microelectrode recording and test stimulation for target confirmation. Recent studies have shown accurate, clinically efficacious results after lead placement without microelectrode recording or test stimulation, using interventional magnetic resonance imaging (MRI) or intraoperative computed tomography (CT; iCT) for verification of accuracy. The latter relies on CT-MRI fusion. To validate CT-MRI fusion in this setting, we compared stereotactic coordinates determined intraoperatively using CT-MRI fusion with those obtained on postoperative MRI. Deep brain stimulation electrodes were implanted with patients under general anesthesia. Direct targeting was performed on preoperative MRI, which was merged with preimplantation iCT images for stereotactic registration and postimplantation iCT images for accuracy confirmation. Magnetic resonance imaging was obtained 6 weeks postoperatively for comparison. Postoperative MRI was obtained for 48 patients, with 94 leads placed over a 1-year period. Vector error of the targeted contact relative to the initial plan was 1.1 ± 0.7 mm on iCT and 1.6 ± 0.7 mm on postoperative MRI. Variance comparisons (F-tests) showed that the discrepancy between iCT- and postoperative MRI-determined errors was attributable to measurement error on postoperative MRI, as detected in inter-rater reliability testing. In multivariate analysis, improved lead placement accuracy was associated with frame-based stereotaxy with the head of the bed at 0° compared with frameless stereotaxy with the head of the bed at 30° (P = 0.037). Intraoperative CT can be used to determine lead placement accuracy in deep brain stimulation surgery. The discrepancy between coordinates determined intraoperatively by CT-MRI fusion and postoperatively by MRI can be accounted for by inherent measurement error.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Arizona</li></region></list><tree><noCountry><name sortKey="Chapple, Kristina" sort="Chapple, Kristina" uniqKey="Chapple K" first="Kristina" last="Chapple">Kristina Chapple</name><name sortKey="Dhall, Rohit" sort="Dhall, Rohit" uniqKey="Dhall R" first="Rohit" last="Dhall">Rohit Dhall</name><name sortKey="Lambert, Meg" sort="Lambert, Meg" uniqKey="Lambert M" first="Meg" last="Lambert">Meg Lambert</name><name sortKey="Ponce, Francisco A" sort="Ponce, Francisco A" uniqKey="Ponce F" first="Francisco A" last="Ponce">Francisco A. Ponce</name></noCountry><country name="États-Unis"><region name="Arizona"><name sortKey="Mirzadeh, Zaman" sort="Mirzadeh, Zaman" uniqKey="Mirzadeh Z" first="Zaman" last="Mirzadeh">Zaman Mirzadeh</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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