Fast Automated Stereo-EEG Electrode Contact Identification and Labeling Ensemble

Abstract

<b><i>Introduction:</i></b> Stereotactic electroencephalography (SEEG) has emerged as the preferred modality for intracranial monitoring in drug-resistant epilepsy (DRE) patients being evaluated for neurosurgery. After implantation of SEEG electrodes, it is important to determine the neuroanatomic locations of electrode contacts (ECs), to localize ictal onset and propagation, and integrate functional information to facilitate surgical decisions. Although there are tools for coregistration of preoperative MRI and postoperative CT scans, identification, sorting, and labeling of SEEG ECs is often performed manually, which is resource intensive. We report development and validation of a software named Fast Automated SEEG Electrode Contact Identification and Labeling Ensemble (FASCILE). <b><i>Methods:</i></b> FASCILE is written in Python 3.8.3 and employs a novel automated method for identifying ECs, assigning them to respected SEEG electrodes, and labeling. We compared FASCILE with our clinical process of identifying, sorting, and labeling ECs, by computing localization error in anteroposterior, superoinferior, and lateral dimensions. We also measured mean Euclidean distances between ECs identified by FASCILE and the clinical method. We compared time taken for EC identification, sorting, and labeling for the software developer using FASCILE, a first-time clinical user using FASCILE, and the conventional clinical process. <b><i>Results:</i></b> Validation in 35 consecutive DRE patients showed a mean overall localization error of 0.73 ± 0.15 mm. FASCILE required 10.7 ± 5.5 min/patient for identifying, sorting, and labeling ECs by a first-time clinical user, compared to 3.3 ± 0.7 h/patient required for the conventional clinical process. <b><i>Conclusion:</i></b> Given the accuracy, speed, and ease of use, we expect FASCILE to be used frequently for SEEG-driven epilepsy surgery. It is freely available for noncommercial use. FASCILE is specifically designed to expedite localization of ECs, assigning them to respective SEEG electrodes (sorting), and labeling them and not for coregistration of CT and MRI data as there are commercial software available for this purpose.

Efficient volume-based localization and automatic labeling of intracranial depth electrodes

“…Narizzano et al integrated the 3D slicer platform SEEG assistant ( 27 ) in another tool that enables the 3D visualization of the depth electrodes. Narizzano et al ’s tool, which uses fast automated stereo-EEG electrode contact identification and labeling ensemble (FASCILE) written in Python, had a <1 mm localization error and was used to manually identify, sort, and label electrode contacts in ~10 min ( 28 ). Other techniques, such as EpiTools ( 29 ) and toolbox by Wang et al ( 14 ), have adopted similar workflows for depth electrode reconstruction.…”

Neuronal Circuits Supporting Development of Visual Naming Revealed by Intracranial Coherence Modulations

“…The same warping was then applied to the CT scan already co-registered to the MRI, with SPM12 toolbox in MATLAB. The electrode contacts were identified and labeled from the normalized CT scan, and assigned to a parcel within the MICCAI atlas, using the FASCILE software ( Ervin et al, 2021b ).…”