| Relevance of image fusion for target point determination in functional neurosurgery. | |
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MedLine Citation:
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PMID: 12111500 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: For the treatment of medically refractory movement disorders such as Parkinson's disease, essential tremor and primary dystonia, deep brain stimulation (DBS) has become one of the main treatment options. The targets for implantation of the stimulation electrodes are various nuclei within the basal ganglia or the thalamic and subthalamic area. Accurate target localisation is of major importance for outcome and patient safety. The goal of this study was to evaluate the role of image fusion in the determination of target co-ordinates. METHOD: We conducted a retrospective study on 10 patients in whom 17 DBS electrodes had been implanted. Coordinates of the anterior and posterior commissures and of the DBS targets were compared on pre- and postoperative computerised tomography (CT) and fused CT/magnetic resonance scans. The targets as defined on the images were further compared with the targets derived intra-operatively with microelectrode recordings (MER) and macrostimulation. FINDINGS: The achievable mean target accuracy was of the order of the diameter of the DBS electrode and of the accuracy of the image fusion algorithm, i.e. about 1 mm. However, the maximal differences were between 1.8 mm and 3.2 mm. INTERPRETATION: Image fusion is a helpful tool for accurate determination of target point co-ordinates in DBS. In combination with intraoperative, electrophysiological recordings and stimulation which are still considered to be the most reliable localisation methods, image fusion may help to discern the anatomical and functional three-dimensionality of the target nuclei. Image fusion may reduce the number of trajectories needed for intraoperative electrophysiological determination of the optimal electrode localisation and thus lower the risk of complications. |
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Authors:
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F Duffner; H Schiffbauer; S Breit; S Friese; D Freudenstein |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Acta neurochirurgica Volume: 144 ISSN: 0001-6268 ISO Abbreviation: Acta Neurochir (Wien) Publication Date: 2002 May |
Date Detail:
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Created Date: 2002-07-11 Completed Date: 2002-09-24 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0151000 Medline TA: Acta Neurochir (Wien) Country: Austria |
Other Details:
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Languages: eng Pagination: 445-51 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Eberhard-Karls-University, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Brain / anatomy & histology*, physiology Electric Stimulation Therapy / methods* Electrodes Female Humans Image Processing, Computer-Assisted Magnetic Resonance Imaging Male Middle Aged Movement Disorders / therapy* Reference Values Reproducibility of Results Retrospective Studies Sensitivity and Specificity Stereotaxic Techniques Tomography, X-Ray Computed |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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