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Evaluation of electrode position in deep brain stimulation by image fusion (MRI and CT)

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

Imaging has an essential role in the evaluation of correct positioning of electrodes implanted for deep brain stimulation (DBS). Although MRI offers superior anatomic visualization of target sites, there are safety concerns in patients with implanted material; imaging guidelines are inconsistent and vary. The fusion of postoperative CT with preoperative MRI images can be an alternative for the assessment of electrode positioning. The purpose of this study was to assess the accuracy of measurements realized on fused images (acquired without a stereotactic frame) using a manufacturer-provided software.

Methods

Data from 23 Parkinson’s disease patients who underwent bilateral electrode placement for subthalamic nucleus (STN) DBS were acquired. Preoperative high-resolution T2-weighted sequences at 3 T, and postoperative CT series were fused using a commercially available software. Electrode tip position was measured on the obtained images in three directions (in relation to the midline, the AC-PC line and an AC-PC line orthogonal, respectively) and assessed in relation to measures realized on postoperative 3D T1 images acquired at 1.5 T.

Results

Mean differences between measures carried out on fused images and on postoperative MRI lay between 0.17 and 0.97 mm.

Conclusion

Fusion of CT and MRI images provides a safe and fast technique for postoperative assessment of electrode position in DBS.

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References

  1. Benabid AL, Pollak P, Gervason C, Hoffmann D, Gao DM, Hommel M, Perret JE, de Rougemont J (1991) Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet 337(8738):403–406

    Article  CAS  PubMed  Google Scholar 

  2. Benabid AL, Pollak P, Louveau A, Henry S, de Rougemont J (1987) Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol 50(1–6):344–346

    CAS  PubMed  Google Scholar 

  3. Volkmann J (2007) Update on surgery for Parkinson’s disease. Curr Opin Neurol 20(4):465–469. doi:10.1097/WCO.0b013e32816f76ca

    PubMed  Google Scholar 

  4. Spiegel J, Fuss G, Backens M, Reith W, Magnus T, Becker G, Moringlane JR, Dillmann U (2003) Transient dystonia following magnetic resonance imaging in a patient with deep brain stimulation electrodes for the treatment of Parkinson disease. Case report. J Neurosurg 99(4):772–774. doi:10.3171/jns.2003.99.4.0772

    Article  PubMed  Google Scholar 

  5. Henderson JM, Tkach J, Phillips M, Baker K, Shellock FG, Rezai AR (2005) Permanent neurological deficit related to magnetic resonance imaging in a patient with implanted deep brain stimulation electrodes for Parkinson’s disease: case report. Neurosurgery 57(5):E1063, discussion E1063

    Article  PubMed  Google Scholar 

  6. Larson PS, Richardson RM, Starr PA, Martin AJ (2008) Magnetic resonance imaging of implanted deep brain stimulators: experience in a large series. Stereotact Funct Neurosurg 86((2):92–100. doi:10.1159/000112430

    Article  PubMed  Google Scholar 

  7. Weise LM, Schneider GH, Kupsch A, Haumesser J, Hoffmann KT Postoperative MRI examinations in patients treated by deep brain stimulation using a non-standard protocol. Acta Neurochir (Wien) 152 (12):2021–2027. doi:10.1007/s00701-010-0738-y

  8. Pinsker MO, Herzog J, Falk D, Volkmann J, Deuschl G, Mehdorn M (2008) Accuracy and distortion of deep brain stimulation electrodes on postoperative MRI and CT. Zentralbl Neurochir 69(3):144–147. doi:10.1055/s-2008-1077075

    Article  CAS  PubMed  Google Scholar 

  9. Ferroli P, Franzini A, Marras C, Maccagnano E, D’Incerti L, Broggi G (2004) A simple method to assess accuracy of deep brain stimulation electrode placement: pre-operative stereotactic CT + postoperative MR image fusion. Stereotact Funct Neurosurg 82(1):14–19. doi:10.1159/000076655-76655

    Article  PubMed  Google Scholar 

  10. O’Gorman RL, Jarosz JM, Samuel M, Clough C, Selway RP, Ashkan K (2009) CT/MR image fusion in the postoperative assessment of electrodes implanted for deep brain stimulation. Stereotact Funct Neurosurg 87(4):205–210. doi:10.1159/000225973

    Article  PubMed  Google Scholar 

  11. Shin M, Lefaucheur JP, Penholate MF, Brugieres P, Gurruchaga JM, Nguyen JP (2007) Subthalamic nucleus stimulation in Parkinson’s disease: postoperative CT-MRI fusion images confirm accuracy of electrode placement using intraoperative multi-unit recording. Neurophysiol Clin 37(6):457–466. doi:10.1016/j.neucli.2007.09.005

    Article  CAS  PubMed  Google Scholar 

  12. Yoshida F, Miyagi Y, Morioka T, Hashiguchi K, Murakami N, Matsumoto K, Nagata S, Sasaki T (2008) Assessment of contact location in subthalamic stimulation for Parkinson’s disease by co-registration of computed tomography images. Stereotact Funct Neurosurg 86(3):162–166. doi:10.1159/000120428

    Article  PubMed  Google Scholar 

  13. Yelnik J, Damier P, Demeret S, Gervais D, Bardinet E, Bejjani BP, Francois C, Houeto JL, Arnule I, Dormont D, Galanaud D, Pidoux B, Cornu P, Agid Y (2003) Localization of stimulating electrodes in patients with Parkinson disease by using a three-dimensional atlas-magnetic resonance imaging coregistration method. J Neurosurg 99(1):89–99. doi:10.3171/jns.2003.99.1.0089

    Article  PubMed  Google Scholar 

  14. van Rooijen BD, Backes WH, Schijns OE, Colon A, Hofman PA Brain imaging in chronic epilepsy patients after depth electrode (stereoelectroencephalography) implantation: magnetic resonance imaging or computed tomography? Neurosurgery 73 (3):543–549. doi:10.1227/01.neu.0000431478.79536.68

  15. Kondziolka D, Dempsey PK, Lunsford LD, Kestle JR, Dolan EJ, Kanal E, Tasker RR (1992) A comparison between magnetic resonance imaging and computed tomography for stereotactic coordinate determination. Neurosurgery 30(3):402–406, discussion 406–407

    Article  CAS  PubMed  Google Scholar 

  16. Sumanaweera TS, Adler JR Jr, Napel S, Glover GH (1994) Characterization of spatial distortion in magnetic resonance imaging and its implications for stereotactic surgery. Neurosurgery 35(4):696–703, discussion 703–694

    Article  CAS  PubMed  Google Scholar 

  17. Lee JY, Jeon BS, Paek SH, Lim YH, Kim MR, Kim C Reprogramming guided by the fused images of MRI and CT in subthalamic nucleus stimulation in Parkinson disease. Clin Neurol Neurosurg 112 (1):47–53. doi:10.1016/j.clineuro.2009.10.008

  18. Darcey TM, Roberts DW Technique for the localization of intracranially implanted electrodes. J Neurosurg 113 (6):1182–1185. doi:10.3171/2009.12.JNS091678

  19. Bondallaz P, Boex C, Rossetti AO, Foletti G, Spinelli L, Vulliemoz S, Seeck M, Pollo C Electrode location and clinical outcome in hippocampal electrical stimulation for mesial temporal lobe epilepsy. Seizure 22 (5):390–395. doi:10.1016/j.seizure.2013.02.007

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Acknowledgments

Statistical support was provided by Professor Thomas Perneger, Clinical Research Center, University of Geneva and Geneva University Hospitals.

Ethical standards and patient consent

We declare that all human studies have been approved by the Geneva Ethics Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Neuroradiology, Geneva University Hospital, Gabrielle Perret Gentil, 4, 1211, Geneva 14, Switzerland

    I. Barnaure, K. O. Lovblad & M. I. Vargas

  2. Department of Neurology, Geneva University Hospital, Geneva, Switzerland

    P. Pollak, J. Horvath, C. Boëx & P. Burkhard

  3. Department of Neurosurgery, Geneva University Hospital, Geneva, Switzerland

    S. Momjian

  4. Department of Radiology, Geneva University Hospital, Geneva, Switzerland

    J. Remuinan

Authors
  1. I. Barnaure
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  2. P. Pollak
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  3. S. Momjian
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  4. J. Horvath
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  5. K. O. Lovblad
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  6. C. Boëx
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  7. J. Remuinan
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  8. P. Burkhard
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  9. M. I. Vargas
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Corresponding author

Correspondence to M. I. Vargas.

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Barnaure, I., Pollak, P., Momjian, S. et al. Evaluation of electrode position in deep brain stimulation by image fusion (MRI and CT). Neuroradiology 57, 903–908 (2015). https://doi.org/10.1007/s00234-015-1547-z

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  • DOI: https://doi.org/10.1007/s00234-015-1547-z

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