Document Detail


Assessing accuracy of the magnetic resonance imaging-computed tomography fusion images to evaluate the electrode positions in subthalamic nucleus after deep-brain stimulation.
MedLine Citation:
PMID:  20495435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Accurate evaluation of the electrode position in subthalamic nucleus (STN) after deep-brain stimulation (DBS) has rarely been verified before.
OBJECTIVE: We superimposed the postoperative thin-sliced computed tomography (CT) on the preoperative magnetic resonance imaging (MRI), and the positional information of the implanted electrodes with electrophysiological data was reflected on MRI. The accuracy of this method was assessed by comparing STN demarcated on this method (M-STN) with the electrophysiologically defined STN (E-STN) and with STN on the Schaltenbrand-Wahlen atlas (SW-STN).
METHODS: In 16 patients, T2-weighted MRI was obtained before surgery and STN boundary was demarcated. Seven days after surgery, the position of the implanted electrodes was localized on thin-sliced CT and superimposed on the preoperative MRI. Their accordance with E-STN and compatibility of M-STN or SW-STN with E-STN were statistically assessed.
RESULTS: In all patients, postoperative CT corresponded well with the preoperative MRI. Between inside and outside the boundaries of M-STN, the mean amplitude levels of multiunit neuronal activities were significantly different on both the rostral and caudal sides (P < .0001), and the marginal errors between M- and E-STN were 0.388 +/- 0.755 mm (mean +/- standard deviation) at the rostral margin and 0.271 +/- 0.738 mm at the caudal margin. Statistical comparison disclosed that M-STN was more similar to E-STN than SW-STN on the axial and coronal images.
CONCLUSION: M-STN corresponded well with the high-amplitude area on the electrophysiological data, and the MRI-CT fusion method allowed sufficiently accurate assessment of the electrode position after DBS surgery.
Authors:
Masahiro Shin; Marcello Faria Penholate; Jean-Pascal Lefaucheur; Jean-Marc Gurruchaga; Pierre Brugieres; Jean-Paul Nguyen
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  66     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1193-202; discussion 1202     Citation Subset:  IM    
Affiliation:
Service de Neurochirurgie, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France. SHIN-NSU@h.u-tokyo.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Deep Brain Stimulation / instrumentation,  methods*
Electrodes, Implanted
Female
Humans
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Neuronavigation / methods
Parkinson Disease / physiopathology,  surgery
Predictive Value of Tests
Prosthesis Implantation / methods
Sensitivity and Specificity
Stereotaxic Techniques
Subthalamic Nucleus / anatomy & histology,  radiography*,  surgery*
Tomography, X-Ray Computed / methods*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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