Anticipation of brain shift in Deep Brain Stimulation automatic planning.

Deep Brain Stimulation is a neurosurgery procedure consisting in implanting an electrode in a deep structure of the brain. This intervention requires a preoperative planning phase, with a millimetric accuracy, in which surgeons decide the best placement of the electrode depending on a set of surgical rules. However, brain tissues may deform during the surgery because of the brain shift phenomenon, leading the electrode to mistake the target, or moreover to damage a vital anatomical structure. In this paper, we present a patient-specific automatic planning approach for DBS procedures which accounts for brain deformation. Our approach couples an optimization algorithm with FEM based brain shift simulation. The system was tested successfully on a patient-specific 3D model, and was compared to a planning without considering brain shift. The obtained results point out the importance of performing planning in dynamic conditions.