Application of Advanced Imaging and Visualization to Clinical Deep Brain Stimulation

项目摘要 丘脑底脑深部电刺激（DBS）治疗帕金森病（PD）可以高度 有效改善运动症状并提高患者的生活质量。然而，DBS手术 靶向技术和术后编程实践在~20年中相对停滞 年的治疗史。尽管如此，在MRI采集方面已经取得了实质性的科学进展， 协议、患者特定DBS建模方法和3D可视化技术。因此， 这项生物工程研究基金（PAR-19-159）将应用磁共振成像、DBS 建模和全息可视化到丘脑底DBS治疗PD的临床实践。 该项目的第一步是将定量MRI的科学进展应用于临床问题， PD患者丘脑底核（subthalamic nucleus，简称FDN）的识别。磁共振指纹（MRF）是一种 全新的MR采集、重建和后处理方法。我们的团队使用MRF来 在单个固有共配准的全脑中同时获取T1、T2和T2* 的定量图 3D采集，图像分辨率为0.6 mm 3，持续时间仅约15分钟。 MRF数据提供了用于执行脑实质的体积分割的最佳可能信息。 该项目的第二步是采用患者特定的MRF数据，以及我们的双极分割， 通过全息可视化将它们与立体定向框架的坐标系集成， 神经外科医生我们的团队开发了第一个功能齐全的神经外科导航系统， Microsoft HoloLens可视化平台，该系统直接兼容Leksell立体定向 frame.这项研究将应用我们称为HoloDBS的工具来创建我们的术前手术计划。 研究对象。 本项目的第三步是将DBS的患者特定全息模型放入 编程神经学家的手。现代DBS设备由具有8个触点的电极和一个 刺激幅度、脉冲持续时间和频率的几乎无限的参数空间。本研究将 向神经科医生提供我们的患者专用DBS模型，这些模型也在HoloLens平台内运行， 然后可以使用全息可视化来帮助为患者定制治疗。

PROJECT SUMMARY Subthalamic deep brain stimulation (DBS) for the treatment of Parkinson’s disease (PD) can be highly effective at improving motor symptoms and enhancing the patient’s quality of life. However, DBS surgical targeting technology and post-operative programming practices have been relatively stagnant over the ~20 year history of the therapy. Nonetheless, substantial scientific advances have been made in MRI acquisition protocols, patient-specific DBS modeling methods, and 3D visualization technologies. Therefore, the goal of this Bioengineering Research Grant (PAR-19-159) is to apply the latest advances in MR imaging, DBS modeling, and holographic visualization to the clinical practice of subthalamic DBS for PD. The first step of this project is to apply the scientific advances of quantitative MRI to the clinical problem of subthalamic nucleus (STN) identification in patients with PD. Magnetic Resonance Fingerprinting (MRF) is a completely new approach to MR acquisition, reconstruction, and post processing. Our group has used MRF to simultaneously acquire quantitative maps of T1, T2, and T2* in a single, inherently co-registered, whole-brain 3D acquisition, with 0.6 mm3 image resolution, lasting only ~15 min. The key advantage of multi-dimensional MRF data is that provides the best possible information for performing volumetric segmentation of the STN. The second step of this project is to take the patient-specific MRF data, with our STN segmentations, and integrate them with the coordinate system of the stereotactic frame via holographic visualization for the neurosurgeon. Our group developed the first fully functional neurosurgical navigation system within the Microsoft HoloLens visualization platform and this system is directly compatible with the Leksell stereotactic frame. This study will apply that tool we call HoloDBS to the creation of the pre-operative surgical plan for our research subjects. The third step of this project is to take the patient-specific holographic model of DBS and put it into the hands of the programming neurologist. Modern DBS devices consist of electrodes with 8 contacts and a nearly infinite parameter space of stimulus amplitudes, pulse durations, and frequencies. This study will provide our patient-specific DBS models, which also run within the HoloLens platform, to the neurologist who can then use holographic visualization to help customize the treatment to patient.