Kathryn Holloway1, Alen Docef. 1. Department of Neurosurgery, Virginia Commonwealth University and Parkinson's Disease Research, Education, and Clinical Care Center at the McGuire VAMC, Richmond, Virginia 23298, USA. khollowa@vcu.edu
Abstract
BACKGROUND: Deep brain stimulation (DBS) surgery has an average accuracy of 2 to 3 mm (range, 0-6 mm). Intraoperative detection of track location may be useful in interpreting physiological results and thus limit the number of brain penetrations as well as decrease the incidence of reoperations. The O-arm has been used to identify the DBS lead position; however, early results have indicated a significant discrepancy with lead position on postoperative imaging. OBJECTIVE: This prospective study was conducted to determine the accuracy and reliability of fiducial and track localization and to assess the accuracy of O-arm image-based registration. The computed tomography (CT) image was considered the gold standard, and so for this study, the locations of all objects on the O-arm image were compared with their CT location. METHODS: Thirty-three DBS surgeries were performed using the O-arm to image each track with detailed analysis of fiducial and track localization accuracy. Twenty-one subsequent surgeries were performed using O-arm registration. Only the final lead position was assessed in these individuals. RESULTS: The measurement error of the system was 0.7 mm, with a maximum error of 1.9 mm. Twenty-two percent of the parallel tracks through the BenGun exceeded this error and demonstrated the ability of the O-arm to detect these skewed tracks. The accuracy of final lead position was 2.04 mm in procedures with registration based on an O-arm image. This was not significantly different from CT-based registration at 2.16 mm. CONCLUSION: The O-arm was able to detect skewed tracks and provide registration accuracy equivalent to a CT scan.
BACKGROUND: Deep brain stimulation (DBS) surgery has an average accuracy of 2 to 3 mm (range, 0-6 mm). Intraoperative detection of track location may be useful in interpreting physiological results and thus limit the number of brain penetrations as well as decrease the incidence of reoperations. The O-arm has been used to identify the DBS lead position; however, early results have indicated a significant discrepancy with lead position on postoperative imaging. OBJECTIVE: This prospective study was conducted to determine the accuracy and reliability of fiducial and track localization and to assess the accuracy of O-arm image-based registration. The computed tomography (CT) image was considered the gold standard, and so for this study, the locations of all objects on the O-arm image were compared with their CT location. METHODS: Thirty-three DBS surgeries were performed using the O-arm to image each track with detailed analysis of fiducial and track localization accuracy. Twenty-one subsequent surgeries were performed using O-arm registration. Only the final lead position was assessed in these individuals. RESULTS: The measurement error of the system was 0.7 mm, with a maximum error of 1.9 mm. Twenty-two percent of the parallel tracks through the BenGun exceeded this error and demonstrated the ability of the O-arm to detect these skewed tracks. The accuracy of final lead position was 2.04 mm in procedures with registration based on an O-arm image. This was not significantly different from CT-based registration at 2.16 mm. CONCLUSION: The O-arm was able to detect skewed tracks and provide registration accuracy equivalent to a CT scan.
Authors: Xiaoxuan Zhang; Ali Uneri; J Webster Stayman; Corinna C Zygourakis; Sheng-Fu L Lo; Nicholas Theodore; Jeffrey H Siewerdsen Journal: Med Phys Date: 2019-06-30 Impact factor: 4.071
Authors: Carlos E Restrepo; David B Clarke; P Daniel McNeely; Matthew D Cooper; Murray Hong; Ron Hill; Lutz M Weise Journal: Acta Neurochir (Wien) Date: 2021-01-14 Impact factor: 2.216
Authors: Rozemarije A Holewijn; Maarten Bot; Pepijn van den Munckhof; P Richard Schuurman Journal: Oper Neurosurg (Hagerstown) Date: 2020-09-01 Impact factor: 2.703