Title

Ultra-High Field Template-Assisted Target Selection for Deep Brain Stimulation Surgery.

Authors

Jonathan C Lau, Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario, Canada; Biomedical Engineering Graduate Program, Western University, London, Ontario, Canada; Division of Neurosurgery, Department of Clinical Neurological Sciences, London Health Sciences Centre, University Hospital, Western University, London, Ontario, CanadaFollow
Keith W MacDougall, Division of Neurosurgery, Department of Clinical Neurological Sciences, London Health Sciences Centre, University Hospital, Western University, London, Ontario, Canada
Miguel F Arango, Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, University Hospital, Western University, London, Ontario, Canada
Terry M Peters, Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario, Canada; Biomedical Engineering Graduate Program, Western University, London, Ontario, Canada; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
Andrew G Parrent, Division of Neurosurgery, Department of Clinical Neurological Sciences, London Health Sciences Centre, University Hospital, Western University, London, Ontario, Canada
Ali R Khan, Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario, Canada; Biomedical Engineering Graduate Program, Western University, London, Ontario, Canada; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada

Document Type

Article

Publication Date

7-1-2017

Journal

World Neurosurgery

Volume

103

First Page

531

Last Page

537

URL with Digital Object Identifier

10.1016/j.wneu.2017.04.043

Abstract

BACKGROUND: Template and atlas guidance are fundamental aspects of stereotactic neurosurgery. The recent availability of ultra-high field (7 Tesla) magnetic resonance imaging has enabled in vivo visualization at the submillimeter scale. In this Doing More with Less article, we describe our experiences with integrating ultra-high field template data into the clinical workflow to assist with target selection in deep brain stimulation (DBS) surgical planning.

METHODS: The creation of a high-resolution 7T template is described, generated from group data acquired at our center. A computational workflow was developed for spatially aligning the 7T template with standard clinical data and furthermore, integrating the derived imaging volumes into the surgical planning workstation.

RESULTS: We demonstrate that our methodology can be effective for assisting with target selection in 2 cases: unilateral internal pallidum DBS for painful dystonia and bilateral subthalamic nucleus DBS for Parkinson's disease.

CONCLUSIONS: In this article, we have described a workflow for the integration of high-resolution in vivo ultra-high field templates into the surgical navigation system as a means to assist with DBS planning. The method does not require any additional cost or time to the patient. Future work will include prospectively evaluating different templates and their impact on target selection.

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