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International Journal of Computer Assisted Radiology and Surgery
Published in: International Journal of Computer Assisted Radiology and Surgery 7/2018

20-03-2018 | Original Article

Automatic preoperative planning of DBS electrode placement using anatomo-clinical atlases and volume of tissue activated

Authors: Olga Dergachyova, Yulong Zhao, Claire Haegelen, Pierre Jannin, Caroline Essert

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 7/2018

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Abstract

Purpose

Deep brain stimulation (DBS) is a procedure requiring accurate targeting and electrode placement. The two key elements for successful planning are preserving patient safety by ensuring a safe trajectory and creating treatment efficacy through optimal selection of the stimulation point. In this work, we present the first approach of computer-assisted preoperative DBS planning to automatically optimize both the safety of the electrode’s trajectory and location of the stimulation point so as to provide the best clinical outcome.

Methods

Building upon the findings of previous works focused on electrode trajectory, we added a set of constraints guiding the choice of stimulation point. These took into account retrospective data represented by anatomo-clinical atlases and intersections between the stimulation region and sensitive anatomical structures causing side effects. We implemented our method into automatic preoperative planning software to assess if the algorithm was able to simultaneously optimize electrode trajectory and the stimulation point.

Results

Leave-one-out cross-validation on a dataset of 18 cases demonstrated an improvement in the expected outcome when using the new constraints. The distance to critical structures was not reduced. The intersection between the stimulation region and structures sensitive to stimulation was minimized.

Conclusions

Introducing these new constraints guided the planning to select locations showing a trend toward symptom improvement, while minimizing the risks of side effects, and there was no cost in terms of trajectory safety.
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Metadata
Title
Automatic preoperative planning of DBS electrode placement using anatomo-clinical atlases and volume of tissue activated
Authors
Olga Dergachyova
Yulong Zhao
Claire Haegelen
Pierre Jannin
Caroline Essert
Publication date
20-03-2018
Publisher
Springer International Publishing
Published in
International Journal of Computer Assisted Radiology and Surgery / Issue 7/2018
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-018-1724-8

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