An integrated tool for automated visualization of subdural electrodes in epilepsy surgery evaluation

Wagner, Stefan; Kuß, Julia; Meyer, Tobias; Kirsch, Matthias; Morgenstern, Ute

doi:10.1007/s11548-009-0378-y

Cited by 10 publications

(11 citation statements)

References 9 publications

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“…Several techniques have been employed to visualize electrode placement in vivo including artifact localization (Bootsveld et al, 1993; Silberbusch et al, 1998), three-dimensional reconstruction and X-ray derived location projection (Dalal et al, 2008; Winkler et al, 2000), automated template MRI transformation and projection (Kovalev et al, 2005), X-ray co-registration (Dalal et al, 2008; Miller et al, 2007; Winkler et al, 2000), curvilinear reformation (Schulze-Bonhage et al, 2002), CT/MRI co-registration (Grzeszczuk et al, 1992; Nelles et al, 2004; Tao et al, 2009), computer aided stereo-tactic model creation (Morris et al, 2004; Wagner et al, 2009) as well as digital 2D photography co-registered to 3D reconstructed MRI (Mahvash et al, 2007; Wellmer et al, 2002). …”

Section: Introductionmentioning

confidence: 99%

3D visualization of subdural electrode shift as measured at craniotomy reopening

et al. 2011

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Summary Purpose Subdural electrodes are implanted for recording intracranial EEG (iEEG) in cases of medically refractory epilepsy as a means to locate cortical regions of seizure onset amenable to surgical resection. Without the aid of imaging-derived 3D electrode models for surgical planning, surgeons have relied on electrodes remaining stationary from the time between placement and follow-up resection. This study quantifies electrode shift with respect to the cortical surface occurring between electrode placement and subsequent reopening. Methods CT and structural MRI data were gathered following electrode placement on 10 patients undergoing surgical epilepsy treatment. MRI data were used to create patient specific post-grid 3D reconstructions of cortex, while CT data were co-registered to the MRI and thresholded to reveal electrodes only. At the time of resective surgery, the craniotomy was reopened and electrode positions were determined using intraoperative navigational equipment. Changes in position were then calculated between CT coordinates and intraoperative electrode coordinates. Results Five out of ten patients showed statistically significant overall magnitude differences in electrode positions (mean: 7.2 mm), while 4 exhibited significant decompression based shift (mean: 4.7 mm), and 3 showed significant shear displacement along the surface of the brain (mean: 7.1 mm). Discussion Shift in electrode position with respect to the cortical surface has never been precisely measured. We show that in 50% of our cases statistically significant shift occurred. These observations demonstrate the potential utility of complimenting electrode position measures at the reopening of the craniotomy with 3D electrode and brain surface models derived from post-implantation CT and MR imaging for better definition of surgical boundaries.

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Section: Introductionmentioning

confidence: 99%

3D visualization of subdural electrode shift as measured at craniotomy reopening

et al. 2011

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“…The Electrode Visualization module is described in detail by Wagner et al [25]. In principle, a postimplantation CT data set is registered to a preimplantation MRI data set using the AMIRA standard module AffineRegistration, which implements the normalized mutual information metric.…”

Section: Electrode Visualizationmentioning

confidence: 99%

Autostereoscopic 3D visualization and image processing system for neurosurgery

Meyer

Kuß²,

Uhlemann³

et al. 2013

Biomedizinische Technik/Biomedical Engineering

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A demonstrator system for planning neurosurgical procedures was developed based on commercial hardware and software. The system combines an easy-to-use environment for surgical planning with high-end visualization and the opportunity to analyze data sets for research purposes. The demonstrator system is based on the software AMIRA. Specific algorithms for segmentation, elastic registration, and visualization have been implemented and adapted to the clinical workflow. Modules from AMIRA and the image processing library Insight Segmentation and Registration Toolkit (ITK) can be combined to solve various image processing tasks. Customized modules tailored to specific clinical problems can easily be implemented using the AMIRA application programming interface and a self-developed framework for ITK filters. Visualization is done via autostereoscopic displays, which provide a 3D impression without viewing aids. A Spaceball device allows a comfortable, intuitive way of navigation in the data sets. Via an interface to a neurosurgical navigation system, the demonstrator system can be used intraoperatively. The precision, applicability, and benefit of the demonstrator system for planning of neurosurgical interventions and for neurosurgical research were successfully evaluated by neurosurgeons using phantom and patient data sets.

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“…Three-dimensional (3D) reconstruction of individual electrode contact coordinates can often be accomplished by fusing preoperative magnetic resonance imaging (MRI) with postoperative computed tomography (CT) or skull X-rays that determine electrode positions relative to underlying anatomical landmarks [1,2,3,4,5,6,7,8,9]. However, when subdural strip electrodes are used temporarily and removed prior to closure, intraoperative imaging must serve as a substitute for ECOG electrode localization.…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Accuracy of ECOG Strip Electrode Localization Using Coregistration of Preoperative MRI and Intraoperative Fluoroscopy

Rowland

Miller²,

Starr³

2013

Stereotact Funct Neurosurg

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Background/Aims: Algorithms that estimate implanted cortical strip electrode coordinates using postoperative skull X-ray coregistration with preoperative magnetic resonance imaging (MRI) have been proposed. However, when cortical strip electrodes are inserted for temporary use and removed prior to closure, intraoperative imaging - either fluoroscopy or computed tomography (CT) - must be substituted. Objectives: To measure the accuracy of temporarily inserted subdural strip electrode coordinates using intraoperative fluoroscopic coregistration with preoperative MRI compared to intraoperative CT coregistration with preoperative MRI. Methods: In 5 patients undergoing movement disorder surgery, preoperative MRI was used to generate a three-dimensional cortical surface manually scaled to fit an intraoperative skull fluorogram with an in situ six-contact subdural electrode strip. Individual contact coordinates were estimated using subjacent gyral and sulcal patterns. Estimated coordinates were compared to reference coordinates obtained by preoperative MRI coregistration with intraoperative CT in the same patients. Results: Mean electrode coordinate distances between estimated and reference locations were 6.0 ± 0.8 (x-axis, mediolateral), 3.3 ± 0.5 (y-axis, anterior-posterior) and 4.0 ± 0.5 mm (z-axis, superior-inferior; n = 30). Conclusions: Localization of temporarily inserted subdural electrodes can be accomplished using preoperative MRI and intraoperative fluoroscopy. The accuracy of this approach is verified by preoperative MRI and intraoperative CT coregistration in the same patients.

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An integrated tool for automated visualization of subdural electrodes in epilepsy surgery evaluation

Cited by 10 publications

References 9 publications

3D visualization of subdural electrode shift as measured at craniotomy reopening

3D visualization of subdural electrode shift as measured at craniotomy reopening

Autostereoscopic 3D visualization and image processing system for neurosurgery

Three-Dimensional Accuracy of ECOG Strip Electrode Localization Using Coregistration of Preoperative MRI and Intraoperative Fluoroscopy

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