Using MDEFT MRI Sequences to Target the GPi in DBS Surgery.

Nowacki, Andreas; Fiechter, Michael; Fichtner, Jens; Debove, Ines; Lachenmayer, Lenard; Schüpbach, Michael; Oertel, Markus Florian; Wiest, Roland; Pollo, Claudio (2015). Using MDEFT MRI Sequences to Target the GPi in DBS Surgery. PLoS ONE, 10(9), e0137868. Public Library of Science 10.1371/journal.pone.0137868

[img]
Preview
Text
10.1371_journal.pone.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (4MB) | Preview

OBJECTIVE Recent advances in different MRI sequences have enabled direct visualization and targeting of the Globus pallidus internus (GPi) for DBS surgery. Modified Driven Equilibrium Fourier Transform (MDEFT) MRI sequences provide high spatial resolution and an excellent contrast of the basal ganglia with low distortion. In this study, we investigate if MDEFT sequences yield accurate and reliable targeting of the GPi and compare direct targeting based on MDEFT sequences with atlas-based targeting. METHODS 13 consecutive patients considered for bilateral GPi-DBS for dystonia or PD were included in this study. Preoperative targeting of the GPi was performed visually based on MDEFT sequences as well as by using standard atlas coordinates. Postoperative CT imaging was performed to calculate the location of the implanted leads as well as the active electrode(s). The coordinates of both visual and atlas based targets were compared. The stereotactic coordinates of the lead and active electrode(s) were calculated and projected on the segmented GPi. RESULTS On MDEFT sequences the GPi was well demarcated in most patients. Compared to atlas-based planning the mean target coordinates were located significantly more posterior. Subgroup analysis showed a significant difference in the lateral coordinate between dystonia (LAT = 19.33 ± 0.90) and PD patients (LAT = 20.67 ± 1.69). Projected on the segmented preoperative GPi the active contacts of the DBS electrode in both dystonia and PD patients were located in the inferior and posterior part of the structure corresponding to the motor part of the GPi. CONCLUSIONS MDEFT MRI sequences provide high spatial resolution and an excellent contrast enabling precise identification and direct visual targeting of the GPi. Compared to atlas-based targeting, it resulted in a significantly different mean location of our target. Furthermore, we observed a significant variability of the target among the PD and dystonia subpopulation suggesting accurate targeting for each individual patient.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Nowacki, Andreas; Fiechter, Michael; Fichtner, Jens; Debove, Ines; Lachenmayer, Lenard; Schüpbach, Michael; Oertel, Markus Florian; Wiest, Roland and Pollo, Claudio

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

05 Oct 2015 08:19

Last Modified:

05 Oct 2015 08:19

Publisher DOI:

10.1371/journal.pone.0137868

PubMed ID:

26366574

BORIS DOI:

10.7892/boris.72164

URI:

https://boris.unibe.ch/id/eprint/72164

Actions (login required)

Edit item Edit item
Provide Feedback