Manish Ranjan1, Alexandre Boutet1, David S Xu1, Christopher S Lozano1, Rajeev Kumar2, Alfonso Fasano3,4,5, Walter Kucharczyk6, Andres M Lozano1. 1. Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. 2. Marine Institute, Memorial University of Newfoundland, St. John's, Newfoundland, Canada. 3. Morton and Gloria Shulman Movement Disorders Centre and Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, UHN, Toronto, Ontario, Canada. 4. Division of Neurology, University of Toronto, Toronto, Ontario, Canada. 5. Krembil Research Institute, Toronto, Ontario, Canada. 6. Division of Neuroimaging, Department of Medical Imaging, Toronto, Ontario, Canada.
Abstract
BACKGROUND: The visualization of the subthalamic nucleus (STN) on magnetic resonance imaging (MRI) is variable. Studies of the contribution of patient-related factors and intrinsic brain volumetrics to STN visualization have not been reported previously. OBJECTIVE: To assess the visualization of the STN during deep brain stimulation (DBS) surgery in a clinical setting. METHODS: Eighty-two patients undergoing pre-operative MRI to plan for STN DBS for Parkinson disease were retrospectively studied. The visualization of the STN and its borders was assessed and scored by 3 independent observers using a 4-point ordinal scale (from 0 = not seen to 3 = excellent visualization). This measure was then correlated with the patients' clinical information and brain volumes. RESULTS: The mean STN visualization scores were 1.68 and 1.63 for the right and left STN, respectively, with a good interobserver reliability (intraclass correlation coefficient: 0.744). Older age and decreased white matter volume were negatively correlated with STN visualization (p < 0.05). CONCLUSION: STN visualization is only fair to good on routine MRI with good concordance of interindividual rating. Advancing age and decreased white matter are associated with poor visualization of the STN. Knowledge about factors contributing to poor visualization of the STN could alert a surgeon to modify the imaging strategy to optimize surgical targeting.
BACKGROUND: The visualization of the subthalamic nucleus (STN) on magnetic resonance imaging (MRI) is variable. Studies of the contribution of patient-related factors and intrinsic brain volumetrics to STN visualization have not been reported previously. OBJECTIVE: To assess the visualization of the STN during deep brain stimulation (DBS) surgery in a clinical setting. METHODS: Eighty-two patients undergoing pre-operative MRI to plan for STN DBS for Parkinson disease were retrospectively studied. The visualization of the STN and its borders was assessed and scored by 3 independent observers using a 4-point ordinal scale (from 0 = not seen to 3 = excellent visualization). This measure was then correlated with the patients' clinical information and brain volumes. RESULTS: The mean STN visualization scores were 1.68 and 1.63 for the right and left STN, respectively, with a good interobserver reliability (intraclass correlation coefficient: 0.744). Older age and decreased white matter volume were negatively correlated with STN visualization (p < 0.05). CONCLUSION: STN visualization is only fair to good on routine MRI with good concordance of interindividual rating. Advancing age and decreased white matter are associated with poor visualization of the STN. Knowledge about factors contributing to poor visualization of the STN could alert a surgeon to modify the imaging strategy to optimize surgical targeting.
Authors: Alexandre Boutet; Robert Gramer; Christopher J Steele; Gavin J B Elias; Jürgen Germann; Ricardo Maciel; Walter Kucharczyk; Ludvic Zrinzo; Andres M Lozano; Alfonso Fasano Journal: Curr Neurol Neurosci Rep Date: 2019-05-30 Impact factor: 5.081
Authors: Maija Johanna Lahtinen; Tarja Helena Haapaniemi; Mikko Tapio Kauppinen; Niina Salokorpi; Esa Raimo Heikkinen; Jani Petteri Katisko Journal: Acta Neurochir (Wien) Date: 2020-02-26 Impact factor: 2.216