OBJECTIVE: Cerebrovascular imaging is critical for safe and accurate planning of Stereo-ElectroEncephaloGraphy (SEEG) electrode trajectory. We developed a new technique for Cone Beam Computed Tomography (CBCT) Three-Dimensional Digital Subtraction Angiography (3D DSA). METHODS: The workflow core is the acquisition of computed tomography datasets without (bone mask) and with selective injection of contrast medium in the main brain-feeding arteries, followed by dataset registration and subtraction. The images were acquired with the O-armTM 1000 System (Medtronic). Images were postprocessed with FSL software package. We retrospectively analyzed 191 3D DSA procedures and qualitatively analyzed the quality of each 3D DSA dataset. RESULTS: The quality of 3D DSA was good in 150 procedures, sufficient in 37, and poor in 4. 3D rendering of the vascular tree was helpful for both SEEG implantation and resective surgery planning. Angiography complications occurred in only one procedure that was aborted due to a major allergic reaction to contrast medium. No other complications directly related to 3D DSA occurred. Minor intracerebral hemorrhage occurred in 2/191 patients after SEEG implantation, with no permanent sequelae. CONCLUSIONS: CBCT 3D DSA is a safe diagnostic procedure for SEEG electrode trajectory planning and for 3D reconstructions of the vascular tree in multimodal scenes for resections. The high fidelity and geometric accuracy contribute to the safety of electrode implantation.
OBJECTIVE: Cerebrovascular imaging is critical for safe and accurate planning of Stereo-ElectroEncephaloGraphy (SEEG) electrode trajectory. We developed a new technique for Cone Beam Computed Tomography (CBCT) Three-Dimensional Digital Subtraction Angiography (3D DSA). METHODS: The workflow core is the acquisition of computed tomography datasets without (bone mask) and with selective injection of contrast medium in the main brain-feeding arteries, followed by dataset registration and subtraction. The images were acquired with the O-armTM 1000 System (Medtronic). Images were postprocessed with FSL software package. We retrospectively analyzed 191 3D DSA procedures and qualitatively analyzed the quality of each 3D DSA dataset. RESULTS: The quality of 3D DSA was good in 150 procedures, sufficient in 37, and poor in 4. 3D rendering of the vascular tree was helpful for both SEEG implantation and resective surgery planning. Angiography complications occurred in only one procedure that was aborted due to a major allergic reaction to contrast medium. No other complications directly related to 3D DSA occurred. Minor intracerebral hemorrhage occurred in 2/191 patients after SEEG implantation, with no permanent sequelae. CONCLUSIONS: CBCT 3D DSA is a safe diagnostic procedure for SEEG electrode trajectory planning and for 3D reconstructions of the vascular tree in multimodal scenes for resections. The high fidelity and geometric accuracy contribute to the safety of electrode implantation.
Authors: Vejay N Vakharia; Rachel Sparks; Aidan G O'Keeffe; Roman Rodionov; Anna Miserocchi; Andrew McEvoy; Sebastien Ourselin; John Duncan Journal: Epilepsia Date: 2017-03-06 Impact factor: 5.864
Authors: Davide Scorza; Elena De Momi; Lisa Plaino; Gaetano Amoroso; Gabriele Arnulfo; Massimo Narizzano; Luis Kabongo; Francesco Cardinale Journal: Int J Comput Assist Radiol Surg Date: 2017-07-14 Impact factor: 2.924
Authors: Vejay N Vakharia; Rachel Sparks; Roman Rodionov; Sjoerd B Vos; Christian Dorfer; Jonathan Miller; Daniel Nilsson; Martin Tisdall; Stefan Wolfsberger; Andrew W McEvoy; Anna Miserocchi; Gavin P Winston; Aidan G O'Keeffe; Sebastien Ourselin; John S Duncan Journal: J Neurosurg Date: 2018-04-01 Impact factor: 5.115
Authors: Beatrice Barra; Elena De Momi; Giancarlo Ferrigno; Guglielmo Pero; Francesco Cardinale; Giuseppe Baselli Journal: J Med Imaging (Bellingham) Date: 2016-11-29
Authors: Vejay N Vakharia; Rachel Sparks; Kuo Li; Aidan G O'Keeffe; Anna Miserocchi; Andrew W McEvoy; Michael R Sperling; Ashwini Sharan; Sebastien Ourselin; John S Duncan; Chengyuan Wu Journal: Epilepsia Date: 2018-03-12 Impact factor: 5.864
Authors: Vejay N Vakharia; John S Duncan; Juri-Alexander Witt; Christian E Elger; Richard Staba; Jerome Engel Journal: Ann Neurol Date: 2018-04-10 Impact factor: 10.422
Authors: Vejay N Vakharia; Rachel Sparks; Sjoerd B Vos; Andrew W McEvoy; Anna Miserocchi; Sebastien Ourselin; John S Duncan Journal: World Neurosurg X Date: 2019-08-05