General Algorithm Applicability in Determining DBS Lead Orientation: Adapting 2D and 3D X-Ray Techniques for...

Area of Science:

• Neurosurgery
• Medical Imaging
• Biomedical Engineering

Background:

• Advancements in deep brain stimulation (DBS) utilize directional leads with segmented contacts for precise brain region targeting.
• Diverse manufacturer markers for lead orientation necessitate adaptable determination techniques.
• Focus on adapting 2017 Cologne research group techniques for lead orientation.

Purpose of the Study:

• To adapt and evaluate 2D and 3D X-ray-based techniques for Medtronic SenSight™ lead orientation.
• To assess the feasibility and consistency of adapted algorithms using a retrospective patient study.
• To compare the agreement between 2D and 3D methods for lead orientation determination.

Main Methods:

• Adapted 2017 2D and 3D X-ray techniques, originally for C-shaped markers, to the dual-marker of the Medtronic SenSight™ lead.
• Conducted a retrospective patient study to evaluate algorithm feasibility and consistency.
• Utilized Bland-Altman analysis and intraclass correlation coefficient (ICC) for agreement assessment.

Main Results:

• Favorable concordance observed between 2D and 3D methods, with no significant systematic errors (mean difference 0.79°, limits of agreement -19.8° to 21.4°).
• High reliability demonstrated by an intraclass correlation coefficient of 0.99 (p < 0.001).
• Algorithms showed significant agreement between the two orientation determination methods.

Conclusions:

• The adapted 2D and 3D algorithms successfully determined the orientation of the Medtronic SenSight™ lead marker.
• Findings confirm the adaptability of these algorithms to different lead markers.
• Techniques are viable using both low-dose intraoperative 2D X-ray and standard CT imaging.