In Vitro Assessment and Comparison of a Novel Electromagnetic Tracking System for Stereotactic DBS Surgery

Area of Science:

• Neurosurgery
• Medical Device Technology
• Surgical Navigation

Background:

• Real-time guidance for deep-brain-stimulation (DBS) electrode implantation in stereotactic neurosurgery is crucial but currently lacking.
• Electromagnetic tracking (EMT) systems provide high-accuracy tool localization but are susceptible to electromagnetic distortions in surgical environments, limiting their use in stereotactic procedures.

Purpose of the Study:

• To evaluate and compare the localization performance of a novel EMT system, ManaDBS, designed for stereotactic environments, against a commercial system, NDI Aurora.
• To assess the suitability of both EMT systems for stereotactic DBS surgery by analyzing their accuracy in the presence of stereotactic equipment and during simulated implantation.

Main Methods:

• Two studies were conducted: 1) evaluating EMT system accuracy within the measurement volume with two stereotactic systems (Frame G, Elekta Vantage), and 2) simulating DBS implantation procedures to assess sensor position accuracy.
• Localization performance (position and orientation) of ManaDBS and NDI Aurora EMT systems were measured and compared under various conditions, including the presence of stereotactic frames and simulated surgical trajectories.

Main Results:

• The NDI Aurora system initially showed lower localization errors (0.66 mm, 0.89°) than ManaDBS (1.57 mm, 1.01°).
• However, Aurora's performance degraded significantly (2.34 mm, 1.03°) in the presence of stereotactic systems, while ManaDBS remained unaffected.
• Simulated DBS implantations revealed nonlinear trajectories and significant error fluctuations with Aurora, whereas ManaDBS demonstrated consistent performance.

Conclusions:

• The NDI Aurora system's susceptibility to electromagnetic distortions makes it incompatible with stereotactic DBS surgery.
• The ManaDBS system's robustness against these distortions indicates its potential suitability for DBS surgery and other stereotactic neurosurgical applications.