Computer-assisted stereoelectroencephalography planning: center-specific priors enhance planning

Area of Science:

• Neurosurgery
• Medical Imaging
• Computational Neuroscience

Background:

• Stereoelectroencephalography (SEEG) is crucial for localizing epileptic foci.
• Computer-assisted planning (CAP) aids SEEG trajectory planning.
• Improving the safety and efficiency of SEEG planning is an ongoing challenge.

Purpose of the Study:

• To refine computer-assisted planning (CAP) for SEEG implantations by incorporating spatial constraints from prior SEEG trajectories.
• To enhance the safety and reduce manual adjustments in SEEG planning.
• To evaluate if these improvements can be achieved without increasing planning time.

Main Methods:

• Retrospective validation using 159 previously implanted SEEG trajectories from 11 cases.
• Comparison between standard CAP and CAP with spatial priors (CAP + Priors).
• Assessment of planning time (T1 and T2), manual adjustments, and clinical implantability by expert neurosurgeons.

Main Results:

• Expert raters found 88.5% of trajectories implantable, with no significant difference between CAP and CAP + Priors.
• Initial automated planning time (T1) was slightly longer for CAP + Priors (6.3 min) vs. CAP (4.6 min) (p=0.03).
• No significant difference in surgeon-edited plan time (T2) between CAP and CAP + Priors (p=0.92). CAP + Priors significantly reduced the risk score and manual adjustments, particularly in the cingulate gyrus.

Conclusions:

• Incorporating spatial priors into SEEG CAP enhances trajectory planning granularity and standardization.
• This method integrates multi-center expertise, reducing trajectory risk and manual planning needs.
• The refined CAP approach improves SEEG planning efficiency and safety without substantially increasing time.