Intraoperative X-Ray to Measure Distance between DBS Leads: A Reliability Study
Identifieur interne : 001084 ( Main/Exploration ); précédent : 001083; suivant : 001085Intraoperative X-Ray to Measure Distance between DBS Leads: A Reliability Study
Auteurs : Leo Verhagen Metman [États-Unis] ; Julie G. Pilitsis [États-Unis] ; Glenn T. Stebbins [États-Unis] ; Maarten Bot [États-Unis] ; Roy A. E. Bakay [États-Unis]Source :
- Movement disorders [ 0885-3185 ] ; 2012.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Background: Many factors can jeopardize the accuracy of deep brain stimulation (DBS) lead placement. Confirmation of lead placement while the patient is still in the operating room would be advantageous. Intraoperative MRI or CT can identify placement errors, but these modalities can be cost- or time prohibitive. Intraoperative fluoroscopy may give information on the accuracy of the Y coordinate, but the accuracy of the X coordinate usually cannot be confirmed. When an object of known dimensions is present in the brain, such as a unilateral DBS lead, its dimensions can be used to calculate unknown distances. The objective of this study was to determine if intraoperative AP skull x-ray accurately predicts the distance between DBS electrodes using postoperative MRI as the gold standard. Methods: The distance between 32 pairs of DBS leads was measured by 2 independent raters under blinded conditions on intraoperative AP x-ray and postoperative axial and coronal MRI. Variable x-ray magnification was accounted for using the formula: actual distance between 2 leads = (measured distance between DBS leads)/ (average measured length of electrodes) x 7.5 mm. Results: The mean (± SD) distance on x-ray was 22.62 ± 2.23 mm, on axial MRI 22.78 ± 1.90 mm, and on coronal MRI 22.79 ± 2.00 mm. ANOVA revealed no difference based on method (P = .887) or raters (P = .940). The intraclass correlation coefficient showed excellent interrater reliability, Conclusions: Intraoperative AP x-ray accurately predicts the distance between DBS leads. The technique is especially useful when the location of the first DBS lead relative to the midline is known, such as during staged bilateral procedures or lead replacement procedures.
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Pilitsis</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Neurosurgery, Albany Medical College</s1><s2>Albany, New York</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Stebbins, Glenn T" sort="Stebbins, Glenn T" uniqKey="Stebbins G" first="Glenn T." last="Stebbins">Glenn T. Stebbins</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurological Sciences, Rush University Medical Center</s1><s2>Chicago, Illinois</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Bot, Maarten" sort="Bot, Maarten" uniqKey="Bot M" first="Maarten" last="Bot">Maarten Bot</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurological Sciences, Rush University Medical Center</s1><s2>Chicago, Illinois</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Bakay, Roy A E" sort="Bakay, Roy A E" uniqKey="Bakay R" first="Roy A. E." last="Bakay">Roy A. E. Bakay</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Neurosurgery, Rush University Medical Center</s1><s2>Chicago, Illinois</s2><s3>USA</s3><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Illinois</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Deep brain stimulation</term><term>Intraoperative</term><term>Nervous system diseases</term><term>Nuclear magnetic resonance imaging</term><term>Parkinson disease</term><term>Reliability</term><term>Skull</term><term>Subthalamic nucleus</term><term>X ray</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Peropératoire</term><term>Rayon X</term><term>Fiabilité</term><term>Crâne</term><term>Noyau sousthalamique</term><term>Imagerie RMN</term><term>Stimulation cérébrale profonde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Many factors can jeopardize the accuracy of deep brain stimulation (DBS) lead placement. Confirmation of lead placement while the patient is still in the operating room would be advantageous. Intraoperative MRI or CT can identify placement errors, but these modalities can be cost- or time prohibitive. Intraoperative fluoroscopy may give information on the accuracy of the Y coordinate, but the accuracy of the X coordinate usually cannot be confirmed. When an object of known dimensions is present in the brain, such as a unilateral DBS lead, its dimensions can be used to calculate unknown distances. The objective of this study was to determine if intraoperative AP skull x-ray accurately predicts the distance between DBS electrodes using postoperative MRI as the gold standard. Methods: The distance between 32 pairs of DBS leads was measured by 2 independent raters under blinded conditions on intraoperative AP x-ray and postoperative axial and coronal MRI. Variable x-ray magnification was accounted for using the formula: actual distance between 2 leads = (measured distance between DBS leads)/ (average measured length of electrodes) x 7.5 mm. Results: The mean (± SD) distance on x-ray was 22.62 ± 2.23 mm, on axial MRI 22.78 ± 1.90 mm, and on coronal MRI 22.79 ± 2.00 mm. ANOVA revealed no difference based on method (P = .887) or raters (P = .940). The intraclass correlation coefficient showed excellent interrater reliability, Conclusions: Intraoperative AP x-ray accurately predicts the distance between DBS leads. The technique is especially useful when the location of the first DBS lead relative to the midline is known, such as during staged bilateral procedures or lead replacement procedures.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Illinois</li><li>État de New York</li></region></list><tree><country name="États-Unis"><region name="Illinois"><name sortKey="Metman, Leo Verhagen" sort="Metman, Leo Verhagen" uniqKey="Metman L" first="Leo Verhagen" last="Metman">Leo Verhagen Metman</name></region><name sortKey="Bakay, Roy A E" sort="Bakay, Roy A E" uniqKey="Bakay R" first="Roy A. E." last="Bakay">Roy A. E. Bakay</name><name sortKey="Bot, Maarten" sort="Bot, Maarten" uniqKey="Bot M" first="Maarten" last="Bot">Maarten Bot</name><name sortKey="Pilitsis, Julie G" sort="Pilitsis, Julie G" uniqKey="Pilitsis J" first="Julie G." last="Pilitsis">Julie G. Pilitsis</name><name sortKey="Stebbins, Glenn T" sort="Stebbins, Glenn T" uniqKey="Stebbins G" first="Glenn T." last="Stebbins">Glenn T. Stebbins</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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