3D X-ray based visualization of directional deep brain stimulation lead orientation

Area of Science:

• Neurosurgery
• Medical Imaging
• Biomedical Engineering

Background:

• Accurate orientation of directional deep brain stimulation (DBS) electrodes is essential for effective, image-guided stimulation parameter adjustments.
• Current methods for determining electrode orientation may lack precision or clinical applicability.

Purpose of the Study:

• To develop and validate a rotational X-ray based examination for precise determination of implanted DBS electrode orientation.
• To provide a reliable tool for visualizing electrode alignment in relation to the anterior-commissure–posterior-commissure (ACPC) line for clinical routine.

Main Methods:

• A rotational X-ray examination was developed to assess electrode orientation.
• The method identifies the patient's 0° axis and the electrode's rotation using the "iron sights"-sign.
• This allows for the exact determination of the electrode's orientation relative to the ACPC-line.

Main Results:

• The developed rotational X-ray approach reliably determines the orientation of directional DBS electrodes.
• The "iron sights"-sign facilitates precise identification of electrode rotation and alignment.
• The method provides exact orientation data in relation to the established ACPC-line.

Conclusions:

• The presented imaging approach is a reliable diagnostic tool for visualizing implanted DBS electrode orientation.
• This technique enables image-based adjustments of stimulation settings, optimizing therapeutic outcomes.
• The method is suitable for integration into routine clinical practice for deep brain stimulation procedures.