Epilepsy is potentially curable with resective surgery if the epileptogenic zone (EZ) can be identified. If non-invasive imaging is unable to elucidate the EZ, intracranial electrodes may be implanted to identify the EZ as well as map cortical function. In current clinical practice, each electrode trajectory is determined by time-consuming manual inspection of preoperative imaging to find a path that avoids blood vessels while traversing appropriate deep and superficial regions of interest (ROIs). We present anatomy-driven multiple trajectory planning (ADMTP) to find safe trajectories from a list of user-defined ROIs within minutes rather than the hours required for manual planning.
Electrode trajectories are automatically computed in three steps: (1) Target Point Selection to identify appropriate target points within each ROI; (2) Trajectory Risk Scoring to quantify the cumulative distance to critical structures (blood vessels) along each trajectory, defined as the skull entry point to target point. (3) Implantation Plan Computation: to determine a feasible combination of low-risk trajectories for all electrodes.
ADMTP was evaluated on 20 patients (190 electrodes). ADMTP lowered the quantitative risk score in 83% of electrodes. Qualitative results show ADMTP found suitable trajectories for 70% of electrodes; a similar portion of manual trajectories were considered suitable. Trajectory suitability for ADMTP was 95% if traversing sulci was not included in the safety criteria. ADMTP is computationally efficient, computing between 7 and 12 trajectories in 54.5 (17.3–191.9) s.
ADMTP efficiently compute safe and surgically feasible electrode trajectories.
Beare R, Lehmann G (2005) Finding regional extrema—methods and performance. Insight J. http://hdl.handle.net/1926/153
Fujii T, Emoto H, Sugou N, Mito T, Shibata I (2003) Neuropath plannerautomatic path searching for neurosurgery. Int Congress Ser 1256:587–596 CrossRef
Hartigan JA, Wong MA (1979) Algorithm AS 136: a k-means clustering algorithm. J R Stat Soc Ser C (Appl Stat) 28(1):100–108
Sparks R, Zombori G, Rodionov R, Zuluaga MA, Diehl B, Wehner T, Miserocchi A, McEvoy AW, Duncan JS, Ourselin S (2016) Efficient anatomy driven automated multiple trajectory planning for intracranial electrode implantation. In: 19th international conference medical image computing and computer-assisted intervention—MICCAI 2016, Athens, Greece, October 17–21, 2016, Proceedings, Part I. Springer, pp 542–550
Sparks R, Zombori G, Rodionov R, Nowell M, Vos SB, Zuluaga MA, Diehl B, Wehner T, Miserocchi A, McEvoy AW, Duncan JS, Ourselin S (2017) Automated multiple trajectory planning algorithm for the placement of stereo-electroencephalography (SEEG) electrodes in epilepsy treatment. Int J Comput Assist Radiol Surg 12(1):123–136 CrossRefPubMed
Trope M, Shamir RR, Joskowicz L, Medress Z, Rosenthal G, Mayer A, Levin N, Bick A, Shoshan Y (2015) The role of automatic computer-aided surgical trajectory planning in improving the expected safety of stereotactic neurosurgery. Int J Comput Assist Radiol Surg 10(7):1127–1140
Vaillant M, Davatzikos C, Taylor RH, Bryan RN (1997) A path-planning algorithm for image-guided neurosurgery. In: Troccaz J, Grimson E, Mösges R (eds) CVRMed-MRCAS’97: first joint conference computer vision, virtual reality and robotics in medicine and medical robotics and computer-assisted surgery Grenoble, France, March 19–22, 1997 proceedings. Springer, Berlin, pp 467–476
Zombori G, Rodionov R, Nowell M, Zuluaga MA, Clarkson MJ, Micallef C, Diehl B, Wehner T, Miserochi A, McEvoy AW, Duncan JS, Ourselin S (2014) A computer assisted planning system for the placement of SEEG electrodes in the treatment of epilepsy. In: Information processing in computer-assisted interventions: 5th international conference, IPCAI 2014, Fukuoka, Japan, June 28, 2014. Proceedings, vol 8498, Springer, pp 118–127
Zuluaga MA, Rodionov R, Nowell M, Achhala S, Zombori G, Mendelson AF, Cardoso MJ, Miserocchi A, McEvoy AW, Duncan JS, Ourselin S (2015) Stability, structure and scale: improvements in multi-modal vessel extraction for SEEG trajectory planning. Int J Comput Assist Radiol Surg 10(8):1227–1237 CrossRefPubMedPubMedCentral
- Anatomy-driven multiple trajectory planning (ADMTP) of intracranial electrodes for epilepsy surgery
Sjoerd B. Vos
Andrew W. McEvoy
John S. Duncan
- Springer International Publishing
International Journal of Computer Assisted Radiology and Surgery
A journal for interdisciplinary research, development and applications of image guided diagnosis and therapy
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
Neu im Fachgebiet Radiologie
Meistgelesene Bücher aus der Radiologie
e.Med Kampagnen-Visual, Mail Icon II