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A Quantitative Assessment of the Accuracy and Reliability of O-arm Images for Deep Brain Stimulation Surgery.
MedLine Citation:
PMID:  22986604     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Deep brain stimulation surgery has an average accuracy of 2-3 mm (range 0-6 mm). Intra-operative detection of track location may be useful in interpreting physiologic results and thus limit the number of brain penetrations, as well as decrease the incidence of reoperations. The O-arm has been utilized to identify DBS lead position; however, early results have indicated a significant discrepancy with lead position on postoperative imaging. OBJECTIVE:: This prospective study was conducted to determine the accuracy and reliability of fiducial and track localization and to assess the accuracy of O-arm image based registration. The CT image was considered the gold standard, and so for this study, the locations of all objects on the O-arm image were compared with their CT location. METHODS:: 33 DBS surgeries were performed utilizing the O-arm to image each track with detailed analysis of fiducial and track localization accuracy. 21 subsequent surgeries were performed using O-arm registration. Only the final lead position was assessed in these individuals. RESULTS:: The measurement error of the system was 0.7 mm with a maximum error of 1.9 mm. 22% of the parallel tracks through the BenGun exceeded this error and demonstrated the ability of the O-arm to detect these skewed tracks. The accuracy of final lead position was 2.04 mm in procedures with registration based on an O-arm image. This was not significantly different from CT-based registration at 2.16 mm CONCLUSION:: The O-arm was able to detect skewed tracks and provide registration accuracy equivalent to a CT scan.
Authors:
Kathryn Holloway; Alen Docef
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-14
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Neurosurgery, Virginia Commonwealth University and Parkinson's Disease Research, Education, and Clinical Care Center at the McGuire VAMC, Richmond Virginia, USA 2Department of Electrical and Computer Engineering, Virginia Commonwealth University, Richmond Virginia, USA.
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