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Choice of Neurosurgical Planning Software Affects Deep Brain Stimulation Target Coordinate Generation.

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Summary

Deep brain stimulation (DBS) planning stations show small coordinate differences, averaging less than 0.5mm. These variations, though minor, warrant careful appraisal when switching planning systems for subthalamic nucleus targeting.

Keywords:
Deep brain stimulationPlanning station softwareStereotaxic techniquesSubthalamic nucleusTarget coordinates

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Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Computational Neuroscience

Background:

  • Accurate targeting and coordinate derivation are essential for deep brain stimulation (DBS) procedures.
  • Several planning stations exist, but their comparative performance in DBS targeting is not well-established.
  • This study investigates the consistency of subthalamic nucleus (STN) targeting coordinates across different DBS planning platforms.

Purpose of the Study:

  • To compare the coordinate derivation accuracy of three different deep brain stimulation planning stations.
  • To determine if DBS planning generates consistent coordinates regardless of the planning station used.
  • To identify potential variations in targeting between Brainlab Elements, Medtronic StealthStation, and Renishaw NeuroInspire systems.

Main Methods:

  • Three DBS planning stations (Brainlab Elements v2, Medtronic StealthStation S8, Renishaw NeuroInspire v6.2.2) were utilized.
  • Six neurosurgical users planned bilateral STN DBS for 10 subjects across three imaging spaces (native T2, AC-PC, stereotactic frame).
  • A total of 3240 data points were analyzed using parametric statistical tests to assess coordinate differences.

Main Results:

  • Mean coordinate differences between planning stations were small, generally under 0.5mm across all spaces and planes.
  • Statistically significant differences were observed in specific planes (X, Y, Z) and spaces (image, AC-PC, stereotactic frame) for certain planning stations.
  • Variances in coordinates were noted, with a maximum mean difference of 1.02mm in the Z-plane within the AC-PC space.

Conclusions:

  • While coordinate differences between DBS planning stations are statistically significant, they are generally small (<0.5mm).
  • The observed variations suggest a complex interplay of factors within each planning system.
  • Users switching planning stations should prospectively evaluate lead placement and clinical outcomes, and critical appraisal of planning station methodologies is recommended for consistent targeting.