3D transcranial ultrasound as a novel intra-operative imaging technique for DBS surgery: a feasibility study
3D transcranial ultrasound as a novel intra-operative imaging technique for DBS surgery: a feasibility study
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DOI：
10.1007/s11548-015-1191-4
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发表时间：
2015-06-01
影响因子：
3
通讯作者：
Boetzel, Kai
中科院分区：
文献类型：
--
作者：
Ahmadi, Seyed-Ahmad;Milletari, Fausto;Boetzel, Kai
由于术中MRI和CT采集的成本和开销，通常避免在脑深部电刺激（DBS）手术期间进行术中图像引导。最近，有兴趣在社会上对使用非侵入性经颅超声（TCUS）通过耳前骨窗。在这项工作中，我们调查，第一次，使用3D-TCUS成像已经植入DBS电极的可行性。作为实现这一目标的第一步，我们报告的成像方法和电极定位错误的手术室外的八个以前操作的DBS patients.We注册量术前T1-MRI评估使用3D-TCUS的可行性。US-MRI配准通过两步基于点的方法实现。首先，将3D-TCUS空间中的受试者皮肤表面的粗糙表面扫描配准到来自MRI的分割的皮肤表面点云。接下来，我们使用多对手动标记的解剖标志的刚性配准进行细化。我们验证对术后CT扫描，也登记到术前MRI。定性结果的形式给出的三维重建的例子，在2.5和3.5 MHz的TCUS图像频率，覆盖在术前T1-MRI和术后CT。在我们的US-MRI方法后，通过报告2.5和3.5 MHz下电极头端定位的准确性进行定量评价。作为基线，我们还报告了术前MRI和3D-TCUS中解剖标志对的RMSE误差。多个图像示例显示了3D-TCUS扫描的外观和质量，取决于骨窗。使用我们的配准方法，解剖点对的整体精度约为3.2 mm。与此基线相比，3D-TCUS中的电极头端定位具有约4.8 mm的平均精度和约2.3 mm的精度。虽然乍一看不足，但我们认为这些结果仍然有希望。我们的工作激发了进一步的未来工作，在改进的TCUS扫描，先进的TSC-MRI配准和计算机辅助电极检测3D-TCUS。
Intra-operative image guidance during deep brain stimulation (DBS) surgery is usually avoided due to cost and overhead of intra-operative MRI and CT acquisitions. Recently, there has been interest in the community towards the usage of non-invasive transcranial ultrasound (TCUS) through the preauricular bone window. In this work, we investigate, for the first time, the feasibility of using 3D-TCUS for imaging of already implanted DBS electrodes. As a first step towards this goal, we report imaging methods and electrode localisation errors outside of the operating room on eight previously operated DBS patients.We evaluate the feasibility of using 3D-TCUS by registering volumes to pre-operative T1-MRI. US-MRI registration is achieved through a two-step point-based approach. First, a rough surface scan of the subjects' skin surface in 3D-TCUS space is registered to a segmented skin-surface point cloud from MRI. Next, we perform a refinement using rigid registration of multiple pairs of manually marked anatomical landmarks. We validate against post-operative CT scans which are also registered to pre-operative MRI.Qualitative results are given in form of 3D reconstruction examples at 2.5 and 3.5 MHz TCUS image frequency, overlaid on pre-operative T1-MRI and post-operative CT. Quantitative evaluation is performed by reporting the accuracy of electrode tip localisation at 2.5 and 3.5 MHz after our US-MRI approach. As a baseline, we also report RMSE errors for pairs of anatomical landmarks in pre-operative MRI and 3D-TCUS.Multiple image examples show the appearance and quality of 3D-TCUS scans, depending on the bone window. Overall accuracy of anatomic point pairs lies on the order of 3.2 mm, using our registration approach. Compared to this baseline, electrode tip localisation in 3D-TCUS has a mean accuracy on the order of 4.8 mm and a precision on the order of 2.3 mm. While insufficient at first glance, we argue why these results are promising nonetheless. Our work motivates further future work in improved TCUS scanning, advanced TCUS-MRI registration and computer-aided electrode detection in 3D-TCUS.