A Pipeline for 3D Multimodality Image Integration and Computer-assisted Planning in Epilepsy Surgery

Area of Science:

• Neurosurgery
• Medical Imaging
• Software Development

Background:

• Epilepsy surgery planning is complex and often underutilizes 3D multimodality image integration (3DMMI).
• Current image integration techniques can be technically demanding, limiting their clinical application.

Purpose of the Study:

• To present a user-friendly, single software platform for 3DMMI, 3D visualization, and surgical planning in epilepsy.
• To describe a reproducible pipeline for image integration and stereoencephalography (SEEG) planning.
• To introduce an automated tool for generating SEEG implantation plans.

Main Methods:

• Image acquisition, co-registration, manual segmentation, and brain/vessel extraction.
• Development of a software platform for 3D visualization and manual SEEG planning.
• Implementation of an automated multi-trajectory planner for SEEG plan generation.
• Export functionality for plans and models to neuronavigation systems.

Main Results:

• A step-by-step pipeline for 3DMMI and SEEG planning is detailed.
• Preliminary results indicate the automated planner is rapid, safe, and effective for SEEG planning.
• The software facilitates the export of surgical plans to commercial neuronavigation systems.

Conclusions:

• The developed software platform simplifies 3DMMI and surgical planning for epilepsy.
• This tool supports clinical decision-making throughout the epilepsy surgery pathway.
• Dissemination of the software and pipeline can enhance the adoption of 3DMMI in other centers.