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Erschienen in: International Journal of Computer Assisted Radiology and Surgery 10/2015

01.10.2015 | Original Article

Improving recorded volume in mesial temporal lobe by optimizing stereotactic intracranial electrode implantation planning

verfasst von: R. Zelmann, S. Beriault, M. M. Marinho, K. Mok, J. A. Hall, N. Guizard, C. Haegelen, A. Olivier, G. B. Pike, D. L. Collins

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 10/2015

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Abstract

Purpose

Intracranial electrodes are sometimes implanted in patients with refractory epilepsy to identify epileptic foci and propagation. Maximal recording of EEG activity from regions suspected of seizure generation is paramount. However, the location of individual contacts cannot be considered with current manual planning approaches. We propose and validate a procedure for optimizing intracranial electrode implantation planning that maximizes the recording volume, while constraining trajectories to safe paths.

Methods

Retrospective data from 20 patients with epilepsy that had electrodes implanted in the mesial temporal lobes were studied. Clinical imaging data (CT/A and T1w MRI) were automatically segmented to obtain targets and structures to avoid. These data were used as input to the optimization procedure. Each electrode was modeled to assess risk, while individual contacts were modeled to estimate their recording capability. Ordered lists of trajectories per target were obtained. Global optimization generated the best set of electrodes. The procedure was integrated into a neuronavigation system.

Results

Trajectories planned automatically covered statistically significant larger target volumes than manual plans \(({p}<0.001)\). Median volume coverage was \(419\,\hbox { mm}^{3}\) for automatic plans versus \(23\,\hbox { mm}^{3}\) for manual plans. Furthermore, automatic plans remained at statistically significant safer distance to vessels \(({p}<0.05)\) and sulci \(({p}<0.001)\). Surgeon’s scores of the optimized electrode sets indicated that 95 % of the automatic trajectories would be likely considered for use in a clinical setting.

Conclusions

This study suggests that automatic electrode planning for epilepsy provides safe trajectories and increases the amount of information obtained from the intracranial investigation.

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Metadaten
Titel
Improving recorded volume in mesial temporal lobe by optimizing stereotactic intracranial electrode implantation planning
verfasst von
R. Zelmann
S. Beriault
M. M. Marinho
K. Mok
J. A. Hall
N. Guizard
C. Haegelen
A. Olivier
G. B. Pike
D. L. Collins
Publikationsdatum
01.10.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Computer Assisted Radiology and Surgery / Ausgabe 10/2015
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-015-1165-6

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