Alexey V Dimov1,2, Ajay Gupta2, Brian H Kopell3, Yi Wang1,2. 1. 1Meinig School of Biomedical Engineering, Cornell University, Ithaca. 2. 2Department of Radiology, Weill Medical College of Cornell University; and. 3. 3Department of Neurosurgery, Mount Sinai Health System, New York, New York.
Abstract
OBJECTIVE: Faithful depiction of the subthalamic nucleus (STN) is critical for planning deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD). Quantitative susceptibility mapping (QSM) has been shown to be superior to traditional T2-weighted spin echo imaging (T2w). The aim of the study was to describe submillimeter QSM for preoperative imaging of the STN in planning of DBS. METHODS: Seven healthy volunteers were included in this study. T2w and QSM were obtained for all healthy volunteers, and images of different resolutions were reconstructed. Image quality and visibility of STN anatomical features were analyzed by a radiologist using a 5-point scale, and contrast properties of the STN and surrounding tissue were calculated. Additionally, data from 10 retrospectively and randomly selected PD patients who underwent 3-T MRI for DBS were analyzed for STN size and susceptibility gradient measurements. RESULTS: Higher contrast-to-noise ratio (CNR) values were observed in both high-resolution and low-resolution QSM images. Inter-resolution comparison demonstrated improvement in CNR for QSM, but not for T2w images. QSM provided higher inter-quadrant contrast ratios (CR) within the STN, and depicted a gradient in the distribution of susceptibility sources not visible in T2w images. CONCLUSIONS: For 3-T MRI, submillimeter QSM provides accurate delineation of the functional and anatomical STN features for DBS targeting.
OBJECTIVE: Faithful depiction of the subthalamic nucleus (STN) is critical for planning deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD). Quantitative susceptibility mapping (QSM) has been shown to be superior to traditional T2-weighted spin echo imaging (T2w). The aim of the study was to describe submillimeter QSM for preoperative imaging of the STN in planning of DBS. METHODS: Seven healthy volunteers were included in this study. T2w and QSM were obtained for all healthy volunteers, and images of different resolutions were reconstructed. Image quality and visibility of STN anatomical features were analyzed by a radiologist using a 5-point scale, and contrast properties of the STN and surrounding tissue were calculated. Additionally, data from 10 retrospectively and randomly selected PDpatients who underwent 3-T MRI for DBS were analyzed for STN size and susceptibility gradient measurements. RESULTS: Higher contrast-to-noise ratio (CNR) values were observed in both high-resolution and low-resolution QSM images. Inter-resolution comparison demonstrated improvement in CNR for QSM, but not for T2w images. QSM provided higher inter-quadrant contrast ratios (CR) within the STN, and depicted a gradient in the distribution of susceptibility sources not visible in T2w images. CONCLUSIONS: For 3-T MRI, submillimeter QSM provides accurate delineation of the functional and anatomical STN features for DBS targeting.
Entities:
Keywords:
AC = anterior commissure; AL = anterolateral; AM = anteromedial; CNR = contrast-to-noise ratio; CR = contrast ratio; DBS = deep brain stimulation; GPi = globus pallidus internus; GRE = gradient echo; MER = microelectrode recording; PC = posterior commissure; PD = Parkinson’s disease; PL = posterolateral; PM = posteromedial; QSM = quantitative susceptibility mapping; SN = substantia nigra; STN = subthalamic nucleus; T2w = spin-echo T2-weighted; WM (or wm) = white matter; deep brain stimulation; electrode placement; functional neurosurgery; iron; quantitative susceptibility mapping; subthalamic nucleus; surgical technique
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: Kelly M Gillen; Mayyan Mubarak; Calvin Park; Gerald Ponath; Shun Zhang; Alexey Dimov; Maya Levine-Ritterman; Steven Toro; Weiyuan Huang; Stephanie Amici; Ulrike W Kaunzner; Susan A Gauthier; Mireia Guerau-de-Arellano; Yi Wang; Thanh D Nguyen; David Pitt Journal: Ann Clin Transl Neurol Date: 2021-03-11 Impact factor: 4.511