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Automatic preoperative planning of DBS electrode placement using anatomo-clinical atlases and volume of tissue activated

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Deep brain stimulation (DBS) is a procedure requiring accurate targeting and electrode placement. The two key elements for successful planning are preserving patient safety by ensuring a safe trajectory and creating treatment efficacy through optimal selection of the stimulation point. In this work, we present the first approach of computer-assisted preoperative DBS planning to automatically optimize both the safety of the electrode’s trajectory and location of the stimulation point so as to provide the best clinical outcome.

Methods

Building upon the findings of previous works focused on electrode trajectory, we added a set of constraints guiding the choice of stimulation point. These took into account retrospective data represented by anatomo-clinical atlases and intersections between the stimulation region and sensitive anatomical structures causing side effects. We implemented our method into automatic preoperative planning software to assess if the algorithm was able to simultaneously optimize electrode trajectory and the stimulation point.

Results

Leave-one-out cross-validation on a dataset of 18 cases demonstrated an improvement in the expected outcome when using the new constraints. The distance to critical structures was not reduced. The intersection between the stimulation region and structures sensitive to stimulation was minimized.

Conclusions

Introducing these new constraints guided the planning to select locations showing a trend toward symptom improvement, while minimizing the risks of side effects, and there was no cost in terms of trajectory safety.

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Acknowledgements

This work was funded by the French National Research Agency (ANR) through the ACouStiC Project Grant (ANR 2010 BLAN 0209 02).

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Authors and Affiliations

  1. ICube Laboratory, CNRS, UMR 7357, Université de Strasbourg, Strasbourg, France

    Olga Dergachyova & Caroline Essert

  2. INSERM, U1099, Rennes, 35000, France

    Olga Dergachyova, Yulong Zhao, Claire Haegelen & Pierre Jannin

  3. Université de Rennes 1, LTSI, Rennes, 35000, France

    Olga Dergachyova, Yulong Zhao, Claire Haegelen & Pierre Jannin

  4. CHU Rennes, Service de Neurochirurgie, Rennes, 35000, France

    Claire Haegelen

Authors
  1. Olga Dergachyova
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  2. Yulong Zhao
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  3. Claire Haegelen
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  4. Pierre Jannin
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  5. Caroline Essert
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Correspondence to Olga Dergachyova.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Dergachyova, O., Zhao, Y., Haegelen, C. et al. Automatic preoperative planning of DBS electrode placement using anatomo-clinical atlases and volume of tissue activated. Int J CARS 13, 1117–1128 (2018). https://doi.org/10.1007/s11548-018-1724-8

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  • DOI: https://doi.org/10.1007/s11548-018-1724-8

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