Automatic Detection of Directional Lead Orientation in Deep Brain Stimulation using Photon-Counting Detector Computed...

Area of Science:

• Medical Imaging
• Neurosurgery
• Biomedical Engineering

Background:

• Photon-counting detector computed tomography (PCD-CT) is an advanced imaging technology.
• PCD-CT offers improved capabilities for determining the orientation of directional leads in deep brain stimulation (DBS).
• Current methods for lead orientation determination have limitations.

Purpose of the Study:

• To refine PCD-CT-based lead orientation determination using an automated method.
• To develop a method applicable to DBS devices from multiple manufacturers.
• To enhance precision in neurosurgery.

Main Methods:

• Developed an automated method using PCD-CT data and grayscale model fitting.
• Applied the method to DBS leads from Boston Scientific, Medtronic, and Abbott.
• Evaluated method precision and accuracy in a phantom study, comparing it to the stripe artifact method.

Main Results:

• The automated method successfully determined lead orientation for most tested devices, irrespective of position.
• Detection was occasionally unfeasible only for a clinically unlikely alignment of the Medtronic Sensight™ lead.
• Accuracy and precision were comparable to the established stripe artifact method.

Conclusions:

• PCD-CT facilitates automatic determination of lead orientation for major DBS manufacturers.
• The automated method's accuracy is comparable to the stripe artifact method.
• PCD-CT offers independence from patient head orientation relative to the CT gantry.