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Frameless Intraoperative CT-Guided Deep Brain Stimulation: A Multi-Institutional Analysis of Stereotactic Accuracy
Matthan Tharakan1, Kishore Balasubramanian1,2, Rohan Aggarwal1
1Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Stereotactic and Functional Neurosurgery
|June 29, 2026
Summary
ClearPoint Software v3.0 using intraoperative CT achieved submillimeter accuracy for deep brain stimulation lead placement in standard operating rooms. This frameless system offers a simpler workflow compared to MRI-guided stereotaxy.
Area of Science:
- Neurosurgery
- Medical Imaging
- Neurological Devices
Background:
- MRI-guided stereotaxy offers high accuracy but requires specialized MRI suites and complex workflows.
- ClearPoint Software v3.0 enables stereotactic procedures in conventional operating rooms using intraoperative CT (iCT).
Purpose of the Study:
- To evaluate the stereotactic accuracy and operative efficiency of the ClearPoint frameless iCT image-guided system for deep brain stimulation (DBS) lead implantation.
Main Methods:
- A multi-center retrospective review of 23 consecutive DBS lead placement procedures using ClearPoint Software v3.0 was conducted across 7 sites.
- Primary outcomes assessed were radial targeting error and operative duration.
Main Results:
- High targeting accuracy was achieved with a median radial error of 0.20 mm on both sides.
- Median operative duration was 203 minutes, with a median of 6 intraoperative scans and 2 adjustments per side.
Conclusions:
- The ClearPoint frameless iCT workflow demonstrated consistent submillimeter accuracy for DBS lead placement.
- This system offers favorable operative metrics in a standard operating room setting, simplifying the stereotactic procedure.
