An initial experience with intraoperative O-Arm for deep brain stimulation surgery: can it replace post-operative MRI?
| Autor: | Castellanos A Mínguez, Velasco B Iañez, Pérez M J Navarro, Ortiz G García, Majed Jouma Katati, Sevilla F Escamilla, Vidal A Jover, Sabido J de la Cruz |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Neuronavigation Neurology Movement disorders Deep brain stimulation Adolescent medicine.medical_treatment Deep Brain Stimulation Neuroimaging 03 medical and health sciences 0302 clinical medicine Imaging Three-Dimensional Tremor medicine Humans 030212 general & internal medicine Prospective cohort study Neuroradiology business.industry Parkinson Disease General Medicine Gold standard (test) Middle Aged Magnetic Resonance Imaging Surgery Computer-Assisted Dystonic Disorders Female Neurology (clinical) Radiology medicine.symptom business Tomography X-Ray Computed 030217 neurology & neurosurgery |
| Zdroj: | Acta neurologica Belgica. 120(2) |
| ISSN: | 2240-2993 |
| Popis: | Deep brain stimulation (DBS) is used to treat movement disorders, severe psychiatric disorders, and neuropathic pain, among other diseases. Advanced neuroimaging techniques allow direct or indirect localization of the target site, which is verified in many centers by the intraoperative recording of unitary neuronal activity. Intraoperative image acquisition technology (e.g., O-Arm) is increasingly used for accurate electrode positioning throughout the surgery. The aim of our study is to analyze the initial experience of our team in the utilization of O-Arm for planning DBS and monitoring its precision and accuracy throughout the procedure. The study included 13 patients with movement disorders. All underwent DBS with the intraoperative O-arm image acquisition system (iCT) and Medtronic StealthStation S7 cranial planning system, placing a total of 25 electrodes. For each patient, we calculated the difference between real and theoretic x, y, z coordinates, using the paired Student's t test to evaluate absolute and directional differences and the one-sample Student's t test to analyze differences in Euclidean distances. No statistically significant differences were found in absolute, directional, or Euclidean distances between intended and actual x, y, and z coordinates, based on iCT scan. Our experience confirms that utilization of the O-Arm system in DBS provides accurate and precise verification of electrode placements throughout the procedure. Recent studies found no significant differences between iCT and postoperative MRI, the current gold standard. Further prospective studies are warranted to test the elimination of postoperative MRI when this system is used. |
| Databáze: | OpenAIRE |
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