In the treatment of Parkinson's disease some cases require the ablation of a specific region in the basal ganglia. The accurate localization of this region inside the patient's brain is essential and because direct visual anatomical information for such deep brain structures is not available, the surgeon has to rely on other sources of information such as MRI, CT and x-ray of the patient's brain. However these imaging techniques do not provide sufficient anatomical information, requiring the use of a subcortical brain atlas book to assist in the localization of the different structures. This way of proceeding is cumbersome and results in a certain lack of accuracy in the localization of the different brain structures.; We developed a method that aids the surgeon to obtain the sufficient anatomical information in a simpler and more accurate manner. We provide him with a segmentation of the patient's MRI scan based on the Schaltenbrand and Wahren subcortical atlas. To achieve such segmentation a volumetric version of the atlas was obtained and was then mapped to a model brain MRI using landmark matching. Using an automated tool for the three-dimensional registration of two MRI volumes the deformation transformation between the model brain MRI and the patient's brain MRI was obtained. By applying this same transformation to the volumetric atlas, we obtain a superposition of a volumetric subcortical atlas onto the MRI of the patient's brain in the stereotactic space. This method results in a more accurate localization of the surgical lesion, thus reducing the number of additional interventions which are often necessary when the results of the first procedure are shown to be unsatisfactory. The whole guidance system is now used routinely at the Montreal Neurological Institute and is part of the standard surgical procedure.
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