| Error analysis of MRI and leksell stereotactic frame target localization in deep brain stimulation surgery. | |
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MedLine Citation:
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PMID: 15695925 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Stereotactic deep brain stimulation (DBS) is the surgical treatment of choice for medication-refractory patients with Parkinson's disease and essential tremor. The subthalamic nucleus and ventral intermediate nucleus of the thalamus appear to be effective targets for electrode placement. Because these targets are small and encased in fiber tracts, their localization can be exceedingly difficult. However, the precision of electrode placement is crucial for obtaining successful results. Currently, surgeons rely on preoperative MRI or CT images to derive stereotactic coordinates for targeting sites such as the subthalamic nucleus and ventral intermediate nucleus of the thalamus coupled with microelectrode recordings during surgery for proper electrode placement. However, it has been argued that the stereotactic head frame produces detrimental artifacts during MRI. We examined MRI images taken from 11 patients undergoing repeat DBS surgery, and determined the coordinates of the previously placed electrode. We then set the Leksell G stereotactic frame to these coordinates and obtained fluoroscope-localizing images. Using MATLAB image analysis tools, we were able to quantify the 3-dimensional error in target localization by measuring the distance from the electrode tip to the targeted coordinate. The mean errors were 0.09 +/- 0.34 mm perpendicular, lateral to medial, 0.01 +/- 0.32 perpendicular, posterior to anterior, and -0.08 +/- 0.33 mm parallel to the electrode, superior to inferior. According to statistical analysis, the error was random and did not seem to move in any predictable fashion. Therefore, we conclude that preoperative MRI images can be safely used in DBS surgery, and they do not negatively affect its accuracy. |
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Authors:
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Scott L Simon; Pamela Douglas; Gordon H Baltuch; Jurg L Jaggi |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2005-02-04 |
Journal Detail:
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Title: Stereotactic and functional neurosurgery Volume: 83 ISSN: 1011-6125 ISO Abbreviation: Stereotact Funct Neurosurg Publication Date: 2005 |
Date Detail:
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Created Date: 2005-05-25 Completed Date: 2005-07-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8902881 Medline TA: Stereotact Funct Neurosurg Country: Switzerland |
Other Details:
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Languages: eng Pagination: 1-5 Citation Subset: IM |
Affiliation:
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Parkinson's Disease and Movement Disorders Center at Pennsylvania Hospital, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19107, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Deep Brain Stimulation / methods*, standards Essential Tremor / therapy* Female Humans Magnetic Resonance Imaging / instrumentation, standards* Male Middle Aged Parkinson Disease / therapy* Reproducibility of Results Stereotaxic Techniques / instrumentation, standards* |
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