Validation of CT-MRI fusion for intraoperative assessment of stereotactic accuracy in DBS surgery

摘要: Deep brain stimulation is typically performed with intraoperative microelectrode recording and test for target confirmation. Recent studies have shown accurate, clinically efficacious results after lead placement without or stimulation, using interventional magnetic resonance imaging (MRI) computed tomography (CT; iCT) verification of accuracy. The latter relies on CT–MRI fusion. To validate fusion in this setting, we compared stereotactic coordinates determined intraoperatively those obtained postoperative MRI. electrodes were implanted patients under general anesthesia. Direct targeting was preoperative MRI, which merged preimplantation iCT images registration postimplantation accuracy Magnetic 6 weeks postoperatively comparison. Postoperative MRI 48 patients, 94 leads placed over a 1-year period. Vector error the targeted contact relative to initial plan 1.1 ± 0.7 mm 1.6 ± 0.7 Variance comparisons (F-tests) showed that discrepancy between iCT- MRI-determined errors attributable measurement as detected inter-rater reliability testing. In multivariate analysis, improved associated frame-based stereotaxy head bed at 0° frameless 30° (P = 0.037). Intraoperative CT can be used determine deep surgery. by accounted inherent error. © 2014 International Parkinson Movement Disorder Society