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Vejay N Vakharia1,2,3, Rachel Sparks4, Anna Miserocchi5,6,7

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Computer-assisted planning (CAP) software significantly reduced planning time and improved safety for stereoelectroencephalography (SEEG) procedures. This prospective study validated EpiNav as a clinical decision support tool, demonstrating its successful integration into epilepsy surgery pathways.

Keywords:
Clinical decision support softwareComputer-assisted planningEpiNavEpilepsySEEG

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Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Epilepsy Research

Background:

  • Stereoelectroencephalography (SEEG) is crucial for identifying seizure onset zones in focal epilepsy.
  • Computer-assisted planning (CAP) offers potential improvements in SEEG trajectory planning.
  • Clinical validation of advanced decision support software for SEEG is needed.

Purpose of the Study:

  • To prospectively validate EpiNav, a clinical decision support software, for SEEG planning.
  • To compare the safety and efficiency of CAP-generated SEEG trajectories versus manual planning.
  • To assess the integration of CAP into the clinical workflow for SEEG implantation.

Main Methods:

  • Prospective recruitment of 13 consecutive patients undergoing SEEG.
  • Utilized EpiNav to create 3D models of brain structures and vasculature.
  • Compared CAP-generated plans with manually generated plans for risk scores and planning time.

Main Results:

  • All 13 patients received SEEG implants based on CAP-generated plans with lower mean risk scores.
  • CAP trajectories were generated 70% faster than manual plans.
  • No complications or adverse events were reported during the study.

Conclusions:

  • EpiNav successfully integrated as a clinical decision support software for SEEG.
  • CAP significantly reduces planning time and risk scores in SEEG procedures.
  • This study provides the highest level of evidence for a complex CDSS in stereotactic neurosurgery to date.