Lead-DBS: A toolbox for deep brain stimulation electrode localizations and visualizations
Lead-DBS: A toolbox for deep brain stimulation electrode localizations and visualizations
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DOI：
10.1016/j.neuroimage.2014.12.002
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发表时间：
2015-02-15
期刊：
影响因子：
5.7
通讯作者：
Kuehn, Andrea A.
中科院分区：
文献类型：
--
作者：
Horn, Andreas;Kuehn, Andrea A.
为了确定脑深部电刺激（DBS）手术后的电极放置，引入了一种新型工具箱，该工具箱有助于重建导线电极轨迹和触点放置。使用该工具箱，可以根据术后磁共振（MR）或计算机断层扫描（CT）图像上的电极诱导伪影重建和可视化电极放置。正确的电极放置对于DBS的有效治疗至关重要。关于DBS电极触点和轨迹放置的术后知识是DBS效应和不良反应临床评价的有前途的工具。它可以帮助临床医生根据解剖目标区域确定最佳刺激触点，甚至可以缩短未来的测试刺激协议。在将术后MR/CT体积标准化为标准蒙特利尔神经学研究所（MNI）立体定向空间后，通过一种新算法检测电极导线（n=104），该算法迭代阈值化每个轴向切片并隔离MR/CT图像中电极伪影的质心（仅MR n=32，仅CT n=10，MR和CT n=8）。2名患者接受了4根电极导线，其他患者接受了2根双侧四极DBS电极导线，总计120根电极导线定位。在第二重建步骤中，通过使用预先手动创建的电极头端模板重建沿着导线轨迹的电极接触。该算法能够在98%的电极和69%的电极中以自动化方式稳健地完成导线重建，并在69%的电极中进行接触重建。使用额外的后续手动细化重建的接触位置，118的120电极导线和接触重建可以定位使用toolbox. Together，这里介绍的工具箱允许一个精确和快速的DBS接触重建提出了一个半自动化的过程。重建结果可以直接导出到二维和三维视图，显示DBS触点和解剖目标区域之间的关系。该工具箱以开放源代码MATLAB存储库的形式向公众提供。(C)2014爱思唯尔公司All rights reserved.
To determine placement of electrodes after deep brain stimulation (DBS) surgery, a novel toolbox that facilitates both reconstruction of the lead electrode trajectory and the contact placement is introduced. Using the toolbox, electrode placement can be reconstructed and visualized based on the electrode-induced artifacts on postoperative magnetic resonance (MR) or computed tomography (CT) images.Correct electrode placement is essential for efficacious treatment with DBS. Post-operative knowledge about the placement of DBS electrode contacts and trajectories is a promising tool for clinical evaluation of DBS effects and adverse effects. It may help clinicians in identifying the best stimulation contacts based on anatomical target areas and may even shorten test stimulation protocols in the future.Fifty patients that underwent DBS surgery were analyzed in this study. After normalizing the post-operative MR/CT volumes into standard Montreal Neurological Institute (MNI)-stereotactic space, electrode leads (n=104) were detected by a novel algorithmthat iteratively thresholds each axial slice and isolates the centroids of the electrode artifacts within the MR/CT-images (MR only n=32, CT only n=10, MR and CT n=8). Two patients received four, the others received two quadripolar DBS leads bilaterally, summing up to a total of 120 lead localizations. In a second reconstruction step, electrode contacts along the lead trajectories were reconstructed by using templates of electrode tips that had been manually created beforehand. Reconstructions that were made by the algorithm were finally compared to manual surveys of contact localizations.The algorithm was able to robustly accomplish lead reconstructions in an automated manner in 98% of electrodes and contact reconstructions in 69% of electrodes. Using additional subsequent manual refinement of the reconstructed contact positions, 118 of 120 electrode lead and contact reconstructions could be localized using the toolbox.Taken together, the toolbox presented here allows for a precise and fast reconstruction of DBS contacts by proposing a semi-automated procedure. Reconstruction results can be directly exported to two-and three-dimensional views that show the relationship between DBS contacts and anatomical target regions. The toolbox is made available to the public in form of an open-source MATLAB repository. (C) 2014 Elsevier Inc. All rights reserved.