Accuracy of intraoperative computed tomography during deep brain stimulation procedures: Comparison with postoperative magnetic resonance imaging

Maarten Bot*, Pepijn Van Den Munckhof, Roy Bakay, Glenn Stebbins, Leo Verhagen Metman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

43 Scopus citations

Abstract

Objective: To determine the accuracy of intraoperative computed tomography (iCT) in localizing deep brain stimulation (DBS) electrodes by comparing this modality with postoperative magnetic resonance imaging (MRI). Background: Optimal lead placement is a critical factor for the outcome of DBS procedures and preferably confirmed during surgery. iCT offers 3-dimensional verification of both microelectrode and lead location during DBS surgery. However, accurate electrode representation on iCT has not been extensively studied. Methods: DBS surgery was performed using the Leksell stereotactic G frame. Stereotactic coordinates of 52 DBS leads were determined on both iCT and postoperative MRI and compared with intended final target coordinates. The resulting absolute differences in X (medial-lateral), Y (anterior-posterior), and Z (dorsal-ventral) coordinates (ΔX, ΔY, and ΔZ) for both modalities were then used to calculate the euclidean distance. Results: Euclidean distances were 2.7 ± 1.1 and 2.5 ± 1.2 mm for MRI and iCT, respectively (p = 0.2). Conclusion: Postoperative MRI and iCT show equivalent DBS lead representation. Intraoperative localization of both microelectrode and DBS lead in stereotactic space enables direct adjustments. Verification of lead placement with postoperative MRI, considered to be the gold standard, is unnecessary.

Original languageEnglish (US)
Pages (from-to)183-188
Number of pages6
JournalStereotactic and Functional Neurosurgery
Volume95
Issue number3
DOIs
StatePublished - Jul 1 2017

Keywords

  • Deep brain stimulation
  • Intraoperative computed tomography
  • Movement disorders
  • Stereotactic neurosurgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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