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Deep Brain Stimulation Lead Localization Variability Comparing Intraoperative MRI Versus Postoperative Computed

Alexander G Yearley1,2, Melissa Chua2, Andreas Horn3

  • 1Harvard Medical School, Boston, Massachusetts, USA.

Operative Neurosurgery (Hagerstown, Md.)
|August 16, 2023
PubMed
Summary

Comparing deep brain stimulation (DBS) lead localization using postoperative CT scans versus intraoperative MRI reveals minimal errors, especially soon after surgery. This comparison is crucial for accurate electrode placement in DBS therapy.

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Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Deep brain stimulation (DBS) lead localization typically uses postoperative CT scans.
  • Intraoperative MRI provides an alternative imaging dataset for electrode localization.
  • Comparing these modalities is essential for refining DBS procedures.

Purpose of the Study:

  • To compare the accuracy of DBS lead localization between postoperative CT scans and intraoperative MRI.
  • To quantify trajectory and vector errors in DBS electrode placement using different imaging techniques.

Main Methods:

  • Retrospective analysis of patients undergoing MRI-guided DBS using the ClearPoint platform.
  • Coregistration of postoperative CT scans with intraoperative MRI using Brainlab Elements software.
  • Quantification of DBS electrode trajectory and vector errors between the two imaging modalities.

Main Results:

  • Mean trajectory error was 0.78 mm and mean vector error was 1.57 mm between CT and MRI.
  • Trajectory and vector errors showed a trend towards increase with longer intervals between imaging.
  • DBS electrodes targeting the subthalamic nucleus had greater trajectory errors than those targeting the globus pallidus.

Conclusions:

  • Commercially available software demonstrates largely concordant DBS lead localizations between intraoperative MRI and postoperative CT.
  • Localization accuracy is highest in the immediate postoperative period, with errors increasing over time.
  • The findings support the use of intraoperative MRI for accurate DBS lead localization.