Minimally invasive precision brain access using prospective stereotaxy and a trajectory guide

Area of Science:

• Neurosurgery
• Medical Imaging
• Neurology

Background:

• Accurate targeting of brain structures is crucial for neurosurgical procedures like biopsies and deep brain stimulator (DBS) implantations.
• Minimally invasive techniques are sought to improve patient outcomes and reduce complications.

Purpose of the Study:

• To evaluate the capabilities of MR-guided prospective stereotaxy for accessing brain structures.
• To assess the efficacy and accuracy of this technique for biopsy and electrode implantation.

Main Methods:

• Prospective stereotaxy with a trajectory guide and real-time MR guidance was used for biopsy and DBS electrode implantation.
• Imaging was employed for path planning, guide orientation, and monitoring device insertion.
• Technical success, targeting accuracy, and complication rates were assessed.

Main Results:

• 187 MR-guided brain biopsies were performed, all diagnostic, with a low complication rate.
• 42 DBS electrode insertions showed an average targeting accuracy of 1.2 mm +/- 0.7 mm.
• 90% of electrode insertions required only a single brain penetration, indicating high precision.

Conclusions:

• MR-guided prospective stereotaxy, coupled with a trajectory guide, is effective for precise brain targeting.
• The technique demonstrates efficiency and accuracy for both biopsy and deep brain stimulator electrode placement.