Int J Comput Assist Radiol Surg - Multi-trajectories automatic planner for StereoElectroEncephaloGraphy (SEEG).

Tópicos

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Resumo

RPOSE: StereoElectroEncephaloGraphy (SEEG) is done to identify the epileptogenic zone of the brain using several multi-lead electrodes whose positions in the brain are pre-operatively defined. Intracranial hemorrhages due to disruption of blood vessels can cause major complications of this procedure ([Formula: see text]1?%). In order to increase the intervention safety, we developed and tested planning tools to assist neurosurgeons in choosing the best trajectory configuration.METHODS: An automated planning method was developed that maximizes the distance of the electrode from the vessels and avoids the sulci as entry points. The angle of the guiding screws is optimized to reduce positioning error. The planner was quantitatively and qualitatively compared with manually computed trajectories on 26 electrodes planned for three patients undergoing SEEG by four neurosurgeons. Quantitative comparison was performed computing for each trajectory using (a) the Euclidean distance from the closest vessel and (b) the incidence angle.RESULTS: Quantitative evaluation shows that automatic planned trajectories are safer in terms of distance from the closest vessel with respect to manually planned trajectories. Qualitative evaluation performed by four neurosurgeons showed that the automatically computed trajectories would have been preferred to manually computed ones in 30?% of the cases and were judged good or acceptable in about 86?% of the cases. A significant reduction in time required for planning was observed with the automated system (approximately 1/10).CONCLUSION: The automatic SEEG electrode planner satisfied the essential clinical requirements, by providing safe trajectories in an efficient timeframe.

Resumo Limpo

rpose stereoelectroencephalographi seeg done identifi epileptogen zone brain use sever multilead electrod whose posit brain preoper defin intracrani hemorrhag due disrupt blood vessel can caus major complic procedur formula see text order increas intervent safeti develop test plan tool assist neurosurgeon choos best trajectori configurationmethod autom plan method develop maxim distanc electrod vessel avoid sulci entri point angl guid screw optim reduc posit error planner quantit qualit compar manual comput trajectori electrod plan three patient undergo seeg four neurosurgeon quantit comparison perform comput trajectori use euclidean distanc closest vessel b incid angleresult quantit evalu show automat plan trajectori safer term distanc closest vessel respect manual plan trajectori qualit evalu perform four neurosurgeon show automat comput trajectori prefer manual comput one case judg good accept case signific reduct time requir plan observ autom system approxim conclus automat seeg electrod planner satisfi essenti clinic requir provid safe trajectori effici timefram

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