| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | Acta Neurochirurgica | ||||
| Publisher: | SPRINGER WIEN | ||||
| Place of Publication: | VIENNA | ||||
| Volume: | 147 | ||||
| Number of Issue or Book Chapter: | 11 | ||||
| Page Range: | pp. 1175-1180 | ||||
| Date: | 2005 | ||||
| Institutions: | Medicine > Lehrstuhl für Neurochirurgie Medicine > Lehrstuhl für Neurologie Medicine > Lehrstuhl für Röntgendiagnostik | ||||
| Identification Number: |
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| Keywords: | MICROELECTRODE-GUIDED PALLIDOTOMY; CHRONIC THALAMIC-STIMULATION; SUBTHALAMIC NUCLEUS; PARKINSONS-DISEASE; ELECTROPHYSIOLOGICAL GUIDANCE; TECHNICAL APPROACH; GLOBUS-PALLIDUS; TARGET; VENTRICULOGRAPHY; LOCALIZATION; stereotaxy; functional neurosurgery; deep brain stimulation; stereotactic atlas | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 70376 |
Web of ScienceAbstract
Background. In deep brain stimulation the way to define and localize the optimal target for the individual patient is still under debate. The objective of our study was to investigate the reliability of atlas derived data by comparing them with direct targeting on MR images. Method. We investigated 28 STN targets in 14 volunteers. The stereotactic coordinates of the dorso-lateral subthalamic ...
Abstract
Background. In deep brain stimulation the way to define and localize the optimal target for the individual patient is still under debate. The objective of our study was to investigate the reliability of atlas derived data by comparing them with direct targeting on MR images. Method. We investigated 28 STN targets in 14 volunteers. The stereotactic coordinates of the dorso-lateral subthalamic nucleus (STN), were determined in 5 different ways for both STNs of each individual volunteer: 1. directly, on axial T2WI spin echo slices, 2. directly, on coronal T2WI spin echo slices and after fusion of data sets: 3. indirectly, on an axial atlas plate, 4. indirectly, on a coronal atlas plate, 5. indirectly, 12 mm lateral, 3 mm posterior and 3 mm inferior to mid-AC-PC. Findings. The differences between MRI derived targets on axial vs. coronal slices were not statistically significant. After detection of the atlas derived targets the resulting x-coordinates were found more lateral than after direct detection on both, axial and coronal T2-weighted images (p < 0.001). On axial images y-coordinates were located more anterior (p=0.240) on atlas derived targets and more posterior when target localizations were compared on coronal slices (p < 0.001). z-Coordinates were more superior after atlas targeting compared to MRI targeting (p < 0.001). Differences up to 6.21 mm occurred. Conclusions. Despite the limitations concerning image distortions and slice thickness, direct target planning on MRI, regarding our results, is more reliable than targeting solely based on atlas derived data. Only MRI gives us detailed information about the individual configurations of central structures in every single patient. However, targets, which are not detectable on MRI like the nucleus ventralis intermedius have to be planned using stereotactic atlas information. In these cases intra-operative micro-electrode recording might help to better define the target region.
Metadata last modified: 19 Dec 2024 14:54
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