Localization of Deep Brain Stimulation Electrode by Image Registration Is Software Dependent: A Comparative Study...

Area of Science:

• Neurosurgery
• Medical Imaging
• Biomedical Engineering

Background:

• Accurate localization of deep brain stimulation (DBS) active contacts is essential for optimizing neurostimulation parameters and understanding treatment effects.
• Image registration, typically between preoperative MRI and postoperative CT scans, is used for lead localization, but accuracy varies with software.
• Numerous software programs exist for this critical registration process.

Purpose of the Study:

• To compare the accuracy of subthalamic nucleus (STN) deep brain stimulation (DBS) lead localization using four different image registration software programs.
• To evaluate potential discrepancies in active contact positioning derived from various commercial registration tools.

Main Methods:

• Co-registration and fusion of preoperative stereotactic MRI with 3-month postoperative CT scans in 27 Parkinson's disease patients (53 leads).
• Calculation and comparison of active contact localizations within the stereotactic frame space across different software programs.

Main Results:

• Significant differences (p < 0.001) in active contact coordinates were observed across the four software programs in all three spatial axes.
• A mean vectorial error of 1.17 mm (95% CI 1.09-1.25 mm) was calculated between the deepest contact locations determined by the different software.

Conclusions:

• A small but statistically significant variation exists in the calculated coordinates of DBS active contacts depending on the registration software used.
• These findings necessitate careful consideration when comparing active contact locations in research studies or when monitoring patients with implanted DBS leads.