Download PDF
J Neurol Surg A Cent Eur Neurosurg 2013; 74(03): 175-182
DOI: 10.1055/s-0032-1333124
Technical Note
Georg Thieme Verlag KG Stuttgart · New York

Rapid and Accurate Anatomical Localization of Implanted Subdural Electrodes in a Virtual Reality Environment

Carlo Serra
1   Klinik für Neurochirurgie, Unispital Zurich, Zurich, Switzerland
,
Hans-Jőrgen Huppertz
2   Department of Medizinische Bildverarbeitung, Swiss Epilepsy Center, Zurich, Switzerland
,
R.A. Kockro
3   Department of Neurosurgery, Klinik Hirslanden, Zurich, Switzerland
,
Thomas Grunwald
4   Abteilung für Klinische Neurophysiologie, Swiss Epilepsy Center, Zurich, Switzerland
,
Oliver Bozinov
1   Klinik für Neurochirurgie, Unispital Zurich, Zurich, Switzerland
,
Niklaus Krayenbühl
1   Klinik für Neurochirurgie, Unispital Zurich, Zurich, Switzerland
,
René-Ludwig Bernays
1   Klinik für Neurochirurgie, Unispital Zurich, Zurich, Switzerland
› Author Affiliations
Further Information

Publication History

14 June 2012

11 August 2012

Publication Date:
19 March 2013 (online)

    Permissions and Reprints

Abstract

Background An accurate and rapid anatomical localization of implanted subdural electrodes is essential in the invasive diagnostic process for epilepsy surgery.

Objective To demonstrate our experience with a three-dimensional (3D) virtual reality simulation software (Dextroscope®, Bracco Imaging, Milano, Italy) in the postoperative localization of subdural electrodes.

Methods Postoperative thin-slice computed tomography (CT) scans were coregistered to preoperative 3D magnetic resonance (MR) images in the Dextroscope environment in 10 patients. Single-electrode contacts were segmented and their positions in relation to specific brain anatomic structures were obtained by 3D reconstruction within the Dextroscope environment. The spatial accuracy was tested by comparing the positions of the electrode contacts as visible in the 3D reconstruction with intraoperative photographs. Image processing time was also recorded.

Results The 3D stereoscopic reconstruction provided an accurate representation of the implanted electrodes with highly detailed visualization of the underlying anatomy. The mean absolute difference between 3D reconstruction and intraoperative photographs was 2.4 mm ± 2.2 mm. The processing time to obtain the 3D reconstructions did not exceed 15 minutes.

Conclusions The results indicate that the 3D virtual reality simulation software used in our series is a useful tool for rapid and precise localization of subdural electrodes implanted for invasive electroencephalography (EEG) recordings.

Keywords

Dextroscope - subdural - electrodes - epilepsy - neurosurgery
 

  • References

  • 1 Clusmann H, Schramm J, Kral T , et al. Prognostic factors and outcome after different types of resection for temporal lobe epilepsy. J Neurosurg 2002; 97: 1131-1141
    CrossrefPubMedGoogle Scholar
  • 2 Kovalev D, Spreer J, Honegger J, Zentner J, Schulze-Bonhage A, Huppertz HJ. Rapid and fully automated visualization of subdural electrodes in the presurgical evaluation of epilepsy patients. AJNR Am J Neuroradiol 2005; 26: 1078-1083
    PubMedGoogle Scholar
  • 3 Kamida T, Anan M, Shimotaka K, Abe T, Fujiki M, Kobayashi H. Visualization of subdural electrodes with fusion CT scan/MRI during neuronavigation-guided epilepsy surgery. J Clin Neurosci 2010; 17: 511-513
    CrossrefPubMedGoogle Scholar
  • 4 Wagner S, Kuss J, Meyer T, Kirsch M, Morgenstern U. An integrated tool for automated visualization of subdural electrodes in epilepsy surgery evaluation. Int J CARS 2009; 4: 609-616
    CrossrefPubMedGoogle Scholar
  • 5 Tao JX, Hawes-Ebersole S, Baldwin M, Shah S, Erickson RK, Ebersole JS. The accuracy and reliability of 3D CT/MRI co-registration in planning epilepsy surgery. Clin Neurophysiol 2009; 120: 748-753
    CrossrefPubMedGoogle Scholar
  • 6 Sebastiano F, Di Gennaro G, Esposito V , et al. A rapid and reliable procedure to localize subdural electrodes in presurgical evaluation of patients with drug-resistant focal epilepsy. Clin Neurophysiol 2006; 117: 341-347
    CrossrefPubMedGoogle Scholar
  • 7 Darcey TM, Roberts DW. Technique for the localization of intracranially implanted electrodes. J Neurosurg 2010; 113: 1182-1185
    CrossrefPubMedGoogle Scholar
  • 8 Dalal SS, Edwards E, Kirsch HE, Barbaro NM, Knight RT, Nagarajan SS. Localization of neurosurgically implanted electrodes via photograph-MRI-radiograph coregistration. J Neurosci Methods 2008; 174: 106-115
    CrossrefPubMedGoogle Scholar
  • 9 Mahvash M, König R, Wellmer J, Urbach H, Meyer B, Schaller K. Coregistration of digital photography of the human cortex and cranial magnetic resonance imaging for visualization of subdural electrodes in epilepsy surgery. Neurosurgery 2007; 61 (5) (Suppl. 02) 340-344 , discussion 344–345
    CrossrefPubMedGoogle Scholar
  • 10 Wellmer J, von Oertzen J, Schaller C , et al. Digital photography and 3D MRI-based multimodal imaging for individualized planning of resective neocortical epilepsy surgery. Epilepsia 2002; 43: 1543-1550
    CrossrefPubMedGoogle Scholar
  • 11 Miller KJ, Makeig S, Hebb AO, Rao RP, denNijs M, Ojemann JG. Cortical electrode localization from X-rays and simple mapping for electrocorticographic research: The “Location on Cortex” (LOC) package for MATLAB. J Neurosci Methods 2007; 162: 303-308
    CrossrefPubMedGoogle Scholar
  • 12 Serra C, Picozzi P, Franzin A , et al. How to assess active contact coordinates in deep brain stimulation surgery? Comparison of three methods for determining the position of the active contact. Stereotact Funct Neurosurg 2010; 88: 67-74
    CrossrefPubMedGoogle Scholar
  • 13 Anil SM, Kato Y, Hayakawa M, Yoshida K, Nagahisha S, Kanno T. Virtual 3-dimensional preoperative planning with the dextroscope for excision of a 4th ventricular ependymoma. Minim Invasive Neurosurg 2007; 50: 65-70
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Liu XD, Xu QW, Che XM, Yang DL. Trigeminal neurinomas: clinical features and surgical experience in 84 patients. Neurosurg Rev 2009; 32: 435-444
    CrossrefPubMedGoogle Scholar
  • 15 Wong GK, Zhu CX, Ahuja AT, Poon WS. Stereoscopic virtual reality simulation for microsurgical excision of cerebral arteriovenous malformation: case illustrations. Surg Neurol 2009; 72: 69-72 , discussion 72–73
    CrossrefPubMedGoogle Scholar
  • 16 Wong GK, Zhu CX, Ahuja AT, Poon WS. Craniotomy and clipping of intracranial aneurysm in a stereoscopic virtual reality environment. Neurosurgery 2007; 61: 564-568 , discussion 568–569
    CrossrefPubMedGoogle Scholar
  • 17 Stadie AT, Kockro RA, Reisch R , et al. Virtual reality system for planning minimally invasive neurosurgery. Technical note. J Neurosurg 2008; 108: 382-394
    CrossrefPubMedGoogle Scholar
  • 18 Ng I, Hwang PY, Kumar D, Lee CK, Kockro RA, Sitoh YY. Surgical planning for microsurgical excision of cerebral arterio-venous malformations using virtual reality technology. Acta Neurochir (Wien) 2009; 151: 453-463 , discussion 463
    CrossrefPubMedGoogle Scholar
  • 19 Kockro RA, Serra L, Tseng-Tsai Y , et al. Planning and simulation of neurosurgery in a virtual reality environment. Neurosurgery 2000; 46: 118-135 , discussion 135–137
    PubMedGoogle Scholar
  • 20 Desai A, Jobst BC, Thadani VM , et al. Stereotactic depth electrode investigation of the insula in the evaluation of medically intractable epilepsy. J Neurosurg 2011; 114: 1176-1186
    CrossrefPubMedGoogle Scholar
  • 21 Immonen A, Jutila L, Könönen M , et al. 3-D reconstructed magnetic resonance imaging in localization of subdural EEG electrodes. Case illustration. Epilepsy Res 2003; 54: 59-62
    CrossrefPubMedGoogle Scholar
  • 22 Morris K, O'Brien TJ, Cook MJ, Murphy M, Bowden SC. A computer-generated stereotactic “Virtual Subdural Grid” to guide resective epilepsy surgery. AJNR Am J Neuroradiol 2004; 25: 77-83
    PubMedGoogle Scholar
  • 23 Winkler PA, Vollmar C, Krishnan KG, Pfluger T, Brückmann H, Noachtar S. Usefulness of 3-D reconstructed images of the human cerebral cortex for localization of subdural electrodes in epilepsy surgery. Epilepsy Res 2000; 41: 169-178
    CrossrefPubMedGoogle Scholar
  • 24 LaViolette PS, Rand SD, Raghavan M, Ellingson BM, Schmainda KM, Mueller W. Three-dimensional visualization of subdural electrodes for presurgical planning. Neurosurgery 2011; 68 (1, Suppl Operative): 152-160 , discussion 160–161
    PubMedGoogle Scholar
  • 25 Watanabe Y, Han E. Image registration accuracy of GammaPlan: a phantom study. J Neurosurg 2008; 109 (Suppl): 21-24
    PubMedGoogle Scholar
  • 26 Cohen DS, Lustgarten JH, Miller E, Khandji AG, Goodman RR. Effects of coregistration of MR to CT images on MR stereotactic accuracy. J Neurosurg 1995; 82: 772-779
    CrossrefPubMedGoogle Scholar
  • 27 Elias WJFK, Fu KM, Frysinger RC. Cortical and subcortical brain shift during stereotactic procedures. J Neurosurg 2007; 107: 983-988
    CrossrefPubMedGoogle Scholar
  • 28 Miyagi YSF, Shima F, Sasaki T. Brain shift: an error factor during implantation of deep brain stimulation electrodes. J Neurosurg 2007; 107: 989-997
    CrossrefPubMedGoogle Scholar
  • 29 Hill DL, Maurer Jr CR, Maciunas RJ, Barwise JA, Fitzpatrick JM, Wang MY. Measurement of intraoperative brain surface deformation under a craniotomy. Neurosurgery 1998; 43: 514-526 , discussion 527–528
    CrossrefPubMedGoogle Scholar
  • 30 LaViolette PS, Rand SD, Ellingson BM , et al. 3D visualization of subdural electrode shift as measured at craniotomy reopening. Epilepsy Res 2011; 94: 102-109
    CrossrefPubMedGoogle Scholar
  • 31 Chamoun RB, Nayar VV, Yoshor D. Neuronavigation applied to epilepsy monitoring with subdural electrodes. Neurosurg Focus 2008; 25: E21
    CrossrefPubMedGoogle Scholar
  • 32 Yang L, Xu QW, Che XM, Wu JS, Sun B. Clinical evaluation and follow-up outcome of presurgical plan by Dextroscope: a prospective controlled study in patients with skull base tumors. Surg Neurol 2009; 72: 682-689 , discussion 689
    CrossrefPubMedGoogle Scholar
  • 33 González Sánchez JJ, Enseñat Nora J, Candela Canto S , et al. New stereoscopic virtual reality system application to cranial nerve microvascular decompression. Acta Neurochir (Wien) 2010; 152: 355-360
    CrossrefPubMedGoogle Scholar
  • 34 Low D, Lee CK, Dip LL, Ng WH, Ang BT, Ng I. Augmented reality neurosurgical planning and navigation for surgical excision of parasagittal, falcine and convexity meningiomas. Br J Neurosurg 2010; 24: 69-74
    CrossrefPubMedGoogle Scholar
  • 35 Qiu TM, Zhang Y, Wu JS , et al. Virtual reality presurgical planning for cerebral gliomas adjacent to motor pathways in an integrated 3-D stereoscopic visualization of structural MRI and DTI tractography. Acta Neurochir (Wien) 2010; 152: 1847-1857
    CrossrefPubMedGoogle Scholar