Early Clinical Evaluation of a Computer Assisted Planning System for Deep Brain Surgeries: 1 Year of Clinical Assistance

摘要

Deep brain stimulation (DBS) is a surgical treatment involving the implantation of permanent electrodes connected to an implanted pulse generator, which sends electrical impulses to specific nuclei of the brain for treatment of movement and, more recently, of neurobehavioral disorders. A number of computer assisted surgery (CAS) systems are currently being developed to guide surgeons at various stages of DBS therapy. As these adjuncts become mature and ready for clinical application, their evaluation, in terms of clinical impact and ergonomic features, becomes a necessity. The goal of this paper is to provide an evaluation of the utility of the DBS planning system we have developed. We study how the automatically generated plans are used and modified by the end-users. The proposed criteria include the evaluation of the rigid registrations between the MR-T1 and T2 to the patient CT, the selection of the anterior and posterior commissures (AC-PC) and the target points. For each of these criteria, we check if the automatic plan was modified and, if so, by what degree. Our results show that the registrations were not modified in 95% of the cases; the AC and PC selections were modified in average by only 0.83mm and the sub-thalamic nucleus (STN) targets by 1.04mm.