A multi-modal approach to computer-assisted deep brain stimulation trajectory planning
| Autor: | Fahd Al Subaie, G. Bruce Pike, D. Louis Collins, Abbas F. Sadikot, Silvain Bériault |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Decision support system Parkinson's disease Deep brain stimulation Deep Brain Stimulation medicine.medical_treatment Neurological function Biomedical Engineering Health Informatics Health informatics Physical medicine and rehabilitation Image Interpretation Computer-Assisted medicine Humans Radiology Nuclear Medicine and imaging Hemorrhagic risk Neuronavigation Aged business.industry Brain Parkinson Disease General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Computer Graphics and Computer-Aided Design Computer Science Applications Surgery Modal Trajectory planning Therapy Computer-Assisted Female Computer Vision and Pattern Recognition business Algorithms |
| Zdroj: | International Journal of Computer Assisted Radiology and Surgery. 7:687-704 |
| ISSN: | 1861-6429 1861-6410 |
| DOI: | 10.1007/s11548-012-0768-4 |
| Popis: | Both frame-based and frameless approaches to deep brain stimulation (DBS) require planning of insertion trajectories that mitigate hemorrhagic risk and loss of neurological function. Currently, this is done by manual inspection of multiple potential electrode trajectories on MR-imaging data. We propose and validate a method for computer-assisted DBS trajectory planning.Our framework integrates multi-modal MRI analysis (T1w, SWI, TOF-MRA) to compute suitable DBS trajectories that optimize the avoidance of specific critical brain structures. A cylinder model is used to process each trajectory and to evaluate complex surgical constraints described via a combination of binary and fuzzy segmented datasets. The framework automatically aggregates the multiple constraints into a unique ranking of recommended low-risk trajectories. Candidate trajectories are represented as a few well-defined cortical entry patches of best-ranked trajectories and presented to the neurosurgeon for final trajectory selection.The proposed algorithm permits a search space containing over 8,000 possible trajectories to be processed in less than 20 s. A retrospective analysis on 14 DBS cases of patients with severe Parkinson's disease reveals that our framework can improve the simultaneous optimization of many pre-formulated surgical constraints. Furthermore, all automatically computed trajectories were evaluated by two neurosurgeons, were judged suitable for surgery and, in many cases, were judged preferable or equivalent to the manually planned trajectories used during the operation.This work provides neurosurgeons with an intuitive and flexible decision-support system that allows objective and patient-specific optimization of DBS lead trajectories, which should improve insertion safety and reduce surgical time. |
| Databáze: | OpenAIRE |
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