DOI: 10.1007/s11548-011-0651-8Online First™

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Computer Assisted Radiology and Surgery

Automatic computation of electrode trajectories for Deep Brain Stimulation: a hybrid symbolic and numerical approach

Caroline Essert, Claire Haegelen, Florent Lalys, Alexandre Abadie and Pierre Jannin

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Abstract

Purpose   

The optimal electrode trajectory is needed to assist surgeons in planning Deep Brain Stimulation (DBS). A method for image-based trajectory planning was developed and tested.

Methods   

Rules governing the DBS surgical procedure were defined with geometric constraints. A formal geometric solver using multimodal brain images and a template built from 15 brain MRI scans were used to identify a space of possible solutions and select the optimal one. For validation, a retrospective study of 30 DBS electrode implantations from 18 patients was performed. A trajectory was computed in each case and compared with the trajectories of the electrodes that were actually implanted.

Results   

Computed trajectories had an average difference of 6.45° compared with reference trajectories and achieved a better overall score based on satisfaction of geometric constraints. Trajectories were computed in 2 min for each case.

Conclusion   

A rule-based solver using pre-operative MR brain images can automatically compute relevant and accurate patient-specific DBS electrode trajectories.

Keywords  Geometric constraint solving – Deep Brain Stimulation – Path planning – Decision making – 3D models – Optimization

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