Computer-aided placement of deep brain stimulators: From planning to intraoperative guidance
Computer-aided placement of deep brain stimulators: From planning to intraoperative guidance
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DOI：
10.1109/tmi.2005.856752
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发表时间：
2005-11-01
影响因子：
10.6
通讯作者：
Dawant, BM
中科院分区：
文献类型：
--
作者：
D'Haese, PF;Cetinkaya, E;Dawant, BM
在目前的实践中，用于治疗帕金森病和特发性震颤患者运动障碍的深部脑刺激器（DBS）的最佳放置是一个迭代过程。术前根据磁共振图像上识别的解剖标志选择目标。该点用作初始位置，在术中使用微电极记录和宏观刺激进行细化。在本文中，我们报告了我们目前在开发计算机辅助术前目标点选择和术中调整这些点的系统方面取得的进展。该系统由可用于自动选择术前目标的最佳目标点可变形图集、电生理图集和术中界面组成。我们获得的结果表明，目标点的自动预测是可以实现的目标。我们的结果还表明，电生理信息可用于解析解剖图像中不可见的结构，从而改善术前和术中指导。我们的术中系统已达到工作原型阶段，我们将我们的系统和当前临床使用的方法的定位精度以及到达目标所需的路径数量进行比较。
In current practice, optimal placement of deep-brain stimulators (DBSs) used to treat movement disorders in patients with Parkinson's disease and essential tremor is an iterative procedure. A target is chosen preoperatively based on anatomical landmarks identified on magnetic resonance images. This point is used as an initial position that is refined intraoperatively using both microelectrode recordings and macrostimulation. In this paper, we report on our current progress toward developing a system for the computer-assisted preoperative selection of target points and for the intraoperative adjustment of these points. The system consists of a deformable atlas of optimal target points that can be used to select automatically the preoperative target, of an electrophysiological atlas, and of an intraoperative interface. Results we have obtained show that automatic prediction of target points is an achievable goal. Our results also indicate that electrophysiological information could be used to resolve structures not visible in anatomic images, thus improving both preoperative and intraoperative guidance. Our intraoperative system has reached the stage of a working prototype and we compare targeting accuracy as well as the number of paths needed to reach the targets with our system and with the method in current clinical use.