Computer-Assisted planning for SEEG-Guided RF-TC in Pediatric Epilepsy: Improved surgical outcomes

This study aimed to evaluate the efficiency of an RF-TC Target Planning Software in enhancing outcomes of SEEG-guided RF-TC for pediatric drug-resistant epilepsy.

A retrospective analysis of 68 cases at Peking University First Hospital from May 2018 and November 2023 was conducted. Of these, software-assisted planning and manual planning were utilized in 27 and 41 patients, respectively. Surgical parameters, primarily the number of contact pairs, planning time, and postoperative results were analyzed. Statistical analysis compared seizure-free rates and other key metrics across the two planning groups.

A larger group with software-assisted planning was associated with a significantly higher number of contact pairs for RF-TC and lower planning time. The software-assisted group's seizure-free rate was 77.78 % after 23 months, compared to 29.41 % over 57.97 months for the manual planning group. Transient contralateral limb weakness was observed in 11.11 % of software-assisted cases, but full recovery was eventually noted for all patients.

The RF-TC Target Planning Software enhances the effectiveness and efficiency of SEEG-guided RF-TC by improving electrode contact pair choice, reducing planning time, and increasing postoperative seizure-free rates. In complex situations, such as hypothalamic hamartomas, the software displays its value by reducing the risk of missed electrode pairings. Notwithstanding its advantages, the software-assisted approach may raise transient postoperative neurological deficits slightly. Additional studies with expanded cohorts and extended follow-ups are necessary for a comprehensive assessment of this technique's long-term effectiveness.