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Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Directional deep brain stimulation (DBS) offers flexible programming by allowing stimulation steering.
  • Accurate anatomical visualization of lead orientation is crucial for interpreting DBS effects and guiding programming.

Purpose of the Study:

  • To develop and validate a robust algorithm for determining directional electrode orientation using standard postoperative CT imaging in DBS.
  • To assess the algorithm's accuracy in resolving subtle differences in lead implantation and orientation angles.

Main Methods:

  • A sequential algorithm was developed to compare CT artifacts with modeled patterns based on lead orientation markers and electrode geometry.
  • Validation involved analyzing seven ground truth phantoms and three leads with 60 distinct configurations.

Main Results:

  • The algorithm determined electrode orientation angles with an accuracy of -0.6 ± 1.5° (range: -5.4° to 4.2°).
  • This level of accuracy is sufficient to distinguish subtle variations between individual leads.

Conclusions:

  • The developed algorithm provides user-independent and highly accurate results for directional electrode orientation.
  • It is effective across all angular constellations typically encountered in clinical DBS cases.