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International Journal of Computer Assisted Radiology and Surgery

Erschienen in:

14.07.2017 | Original Article

Retrospective evaluation and SEEG trajectory analysis for interactive multi-trajectory planner assistant

verfasst von: Davide Scorza, Elena De Momi, Lisa Plaino, Gaetano Amoroso, Gabriele Arnulfo, Massimo Narizzano, Luis Kabongo, Francesco Cardinale

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 10/2017

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Abstract

Purpose

Focal epilepsy is a neurological disease that can be surgically treated by removing area of the brain generating the seizures. The stereotactic electroencephalography (SEEG) procedure allows patient brain activity to be recorded in order to localize the onset of seizures through the placement of intracranial electrodes. The planning phase can be cumbersome and very time consuming, and no quantitative information is provided to neurosurgeons regarding the safety and efficacy of their trajectories. In this work, we present a novel architecture specifically designed to ease the SEEG trajectory planning using the 3D Slicer platform as a basis.

Methods

Trajectories are automatically optimized following criteria like vessel distance and insertion angle. Multi-trajectory optimization and conflict resolution are optimized through a selective brute force approach based on a conflict graph construction. Additionally, electrode-specific optimization constraints can be defined, and an advanced verification module allows neurosurgeons to evaluate the feasibility of the trajectory.

Results

A retrospective evaluation was performed using manually planned trajectories on 20 patients: the planning algorithm optimized and improved trajectories in 98% of cases. We were able to resolve and optimize the remaining 2% by applying electrode-specific constraints based on manual planning values. In addition, we found that the global parameters used discards 68% of the manual planned trajectories, even when they represent a safe clinical choice.

Conclusions

Our approach improved manual planned trajectories in 98% of cases in terms of quantitative indexes, even when applying more conservative criteria with respect to actual clinical practice. The improved multi-trajectory strategy overcomes the previous work limitations and allows electrode optimization within a tolerable time span.

Vorheriger Artikel 3D intra-operative ultrasound and MR image guidance: pursuing an ultrasound-based management of brainshift to enhance neuronavigation

Nächster Artikel Statistical shape modelling to aid surgical planning: associations between surgical parameters and head shapes following spring-assisted cranioplasty

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Titel: Retrospective evaluation and SEEG trajectory analysis for interactive multi-trajectory planner assistant
verfasst von: Davide Scorza
Elena De Momi
Lisa Plaino
Gaetano Amoroso
Gabriele Arnulfo
Massimo Narizzano
Luis Kabongo
Francesco Cardinale
Publikationsdatum: 14.07.2017
Verlag: Springer International Publishing
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 10/2017
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-017-1641-2

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Abstract

Purpose

Methods

Results

Conclusions

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