ESM-CT: a precise method for localization of DBS electrodes in CT images

•Precise DBS electrode position is critical to study structure-function relationship.•We developed a precise method for determining DBS electrode position using CT scans.•Our semi-automated method (ESM-CT) is robust to resampling with good reproducibility.•Head angle at time of image acquisition aff...

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Bibliographic Details
Published in:Journal of neuroscience methods 2018-10, Vol.308, p.366-376
Main Authors: Milchenko, Mikhail, Snyder, Abraham Z., Campbell, Meghan C., Dowling, Joshua L., Rich, Keith M., Brier, Lindsey M., Perlmutter, Joel S., Norris, Scott A.
Format: Article
Language:English
Subjects:
Aged
Brain shift
Contact localization
Deep brain stimulation (DBS)
Deep Brain Stimulation - instrumentation
Deep Brain Stimulation - methods
Electrodes, Implanted
Female
Humans
Image Processing, Computer-Assisted - methods
Male
Middle Aged
Parkinson Disease - physiopathology
Parkinson Disease - therapy
Reproducibility of Results
Subthalamic nucleus (STN)
Tomography, X-Ray Computed - methods
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Summary:•Precise DBS electrode position is critical to study structure-function relationship.•We developed a precise method for determining DBS electrode position using CT scans.•Our semi-automated method (ESM-CT) is robust to resampling with good reproducibility.•Head angle at time of image acquisition affects calculated DBS electrode position. Deep brain stimulation (DBS) of the subthalamic nucleus produces variable effects in Parkinson disease. Variation may result from different electrode positions relative to target. Thus, precise electrode localization is crucial when investigating DBS effects. We developed a semi-automated method, Electrode Shaft Modeling in CT images (ESM-CT) to reconstruct DBS lead trajectories and contact locations. We evaluated methodological sensitivity to operator-dependent steps, robustness to image resampling, and test-retest replicability. ESM-CT was applied in 56 patients to study electrode position change (and relation to time between scans, postoperative subdural air volume, and head tilt during acquisition) between images acquired immediately post-implantation (DBS-CT) and months later (DEL-CT). Electrode tip localization was robust to image resampling and replicable to within ∼ 0.2 mm on test-retest comparisons. Systematic electrode displacement occurred rostral-ventral-lateral between DBS-CT and DEL-CT scans. Head angle was a major explanatory factor (p 
ISSN:0165-0270
1872-678X
DOI:10.1016/j.jneumeth.2018.09.009