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Statistical study of parameters for deep brain stimulation automatic preoperative planning of electrodes trajectories

International Journal of Computer Assisted Radiology and Surgery volume 10, pages 1973–1983 (2015)Cite this article

Abstract

Purpose

Automatic methods for preoperative trajectory planning of electrodes in deep brain stimulation are usually based on the search for a path that resolves a set of surgical constraints to propose an optimal trajectory. The relative importance of each surgical constraint is usually defined as weighting parameters that are empirically set beforehand. The objective of this paper is to analyze the use of these parameters thanks to a retrospective study of trajectories manually planned by neurosurgeons. For that purpose, we firstly retrieved weighting factors allowing to match neurosurgeons manually planned choice of trajectory on each retrospective case; secondly, we compared the results from two different hospitals to evaluate their similarity; and thirdly, we compared the trends to the weighting factors empirically set in most current approaches.

Methods

To retrieve the weighting factors best matching the neurosurgeons manual plannings, we proposed two approaches: one based on a stochastic sampling of the parameters and the other on an exhaustive search. In each case, we obtained a sample of combinations of weighting parameters with a measure of their quality, i.e., the similarity between the automatic trajectory they lead to and the one manually planned by the surgeon as a reference. Visual and statistical analyses were performed on the number of occurrences and on the rank means.

Results

We performed our study on 56 retrospective cases from two different hospitals. We could observe a trend of the occurrence of each weight on the number of occurrences. We also proved that each weight had a significant influence on the ranking. Additionally, we observed no influence of the medical center parameters, suggesting that the trends were comparable in both hospitals. Finally, the obtained trends were confronted to the usual weights chosen by the community, showing some common points but also some discrepancies.

Conclusion

The results tend to show a predominance of the choice of a trajectory close to a standard direction. Secondly, the avoidance of the vessels or sulci seems to be sought in the surroundings of the standard position. The avoidance of the ventricles seems to be less predominant, but this could be due to the already reasonable distance between the standard direction and the ventricles. The similarity of results between two medical centers tends to show that it is not an exceptional practice. These results suggest that manual planning software may introduce a bias in the planning by proposing a standard position.

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Acknowledgments

The authors thank the French National Research Agency (ANR) for funding this work through the ACouStiC project grant (ANR 2010 BLAN 0209 02).

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Affiliations

  1. ICube, Université de Strasbourg/CNRS (UMR 7357), 300 bd Sébastien Brant, BP 10413, 67412, Illkirch, France

    Caroline Essert & Antonio Capobianco

  2. ICM CENIR, CNRS (UMR 7225)/INSERM (U975)/UPMC/Hôpital Pitié-Salpêtrière, 47 boulevard de l’Hôpital, 75013, Paris, France

    Sara Fernandez-Vidal & Eric Bardinet

  3. LTSI, INSERM (UMR 1099)/Université Rennes 1, CS34317, 35043, Rennes, France

    Claire Haegelen & Pierre Jannin

  4. Department of Neurosurgery, Rennes University Hospital, 35000, Rennes, France

    Claire Haegelen

  5. Department of Neurosurgery, Sorbonne Universités, UPMC Université Paris 6, INSERM, CNRS, INRIA, ICM AP-HP, Hôpital Pitié-Salpêtrière, 47 boulevard de l’Hôpital, 75013, Paris, France

    Carine Karachi

  6. INRIA Rennes Bretagne-Atlantique/IRISA/INSA Rennes, France, Campus de Beaulieu, 35042, Rennes Cedex, France

    Maud Marchal

Authors
  1. Caroline Essert
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  2. Sara Fernandez-Vidal
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  3. Antonio Capobianco
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  4. Claire Haegelen
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  5. Carine Karachi
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  6. Eric Bardinet
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  7. Maud Marchal
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  8. Pierre Jannin
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Corresponding author

Correspondence to Caroline Essert.

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The authors declare that they have no conflict of interest.

Informed consent

In this paper, a retrospective study has been performed on a dataset of anonymized images, but informed consent was obtained from all individual participants included in the study.

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Essert, C., Fernandez-Vidal, S., Capobianco, A. et al. Statistical study of parameters for deep brain stimulation automatic preoperative planning of electrodes trajectories. Int J CARS 10, 1973–1983 (2015). https://doi.org/10.1007/s11548-015-1263-5

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  • DOI: https://doi.org/10.1007/s11548-015-1263-5

Keywords

  • Surgical planning
  • Trajectory optimization
  • Statistical analysis
  • Deep brain stimulation
  • Neurosurgery