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Patel V, Tao S, Zhou X, Lin C, Westerhold E, Grewal S, Middlebrooks EH. Real-Time Optimal Synthetic Inversion Recovery Image Selection (RT-OSIRIS) for Deep Brain Stimulation Targeting. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024:10.1007/s10278-024-01117-7. [PMID: 38639807 DOI: 10.1007/s10278-024-01117-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Abstract
Deep brain stimulation (DBS) is a method of electrical neuromodulation used to treat a variety of neuropsychiatric conditions including essential tremor, Parkinson's disease, epilepsy, and obsessive-compulsive disorder. The procedure requires precise placement of electrodes such that the electrical contacts lie within or in close proximity to specific target nuclei and tracts located deep within the brain. DBS electrode trajectory planning has become increasingly dependent on direct targeting with the need for precise visualization of targets. MRI is the primary tool for direct visualization, and this has led to the development of numerous sequences to aid in visualization of different targets. Synthetic inversion recovery images, specified by an inversion time parameter, can be generated from T1 relaxation maps, and this represents a promising method for modifying the contrast of deep brain structures to accentuate target areas using a single acquisition. However, there is currently no accessible method for dynamically adjusting the inversion time parameter and observing the effects in real-time in order to choose the optimal value. In this work, we examine three different approaches to implementing an application for real-time optimal synthetic inversion recovery image selection and evaluate them based on their ability to display continually-updated synthetic inversion recovery images as the user modifies the inversion time parameter. These methods include continuously computing the inversion recovery equation at each voxel in the image volume, limiting the computation only to the voxels of the orthogonal slices currently displayed on screen, or using a series of lookup tables with precomputed solutions to the inversion recovery equation. We find the latter implementation provides for the quickest display updates both when modifying the inversion time and when scrolling through the image. We introduce a publicly available cross-platform application built around this conclusion. We also briefly discuss other details of the implementations and considerations for extensions to other use cases.
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Affiliation(s)
- Vishal Patel
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.
| | - Shengzhen Tao
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | - Xiangzhi Zhou
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | - Chen Lin
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Sanjeet Grewal
- Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA
| | - Erik H Middlebrooks
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
- Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA
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Remore LG, Tariciotti L, Fiore G, Pirola E, Borellini L, Cogiamanian F, Ampollini AM, Schisano L, Gagliano D, Borsa S, Pluderi M, Bertani GA, Barbieri S, Locatelli M. The role of SWI sequence during the preoperative targeting of the subthalamic nucleus for deep brain stimulation in Parkinson's disease: A retrospective cohort study. World Neurosurg X 2024; 22:100342. [PMID: 38469384 PMCID: PMC10926353 DOI: 10.1016/j.wnsx.2024.100342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/21/2024] [Indexed: 03/13/2024] Open
Affiliation(s)
- Luigi Gianmaria Remore
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan LA STATALE, Milan, Italy
| | - Leonardo Tariciotti
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan LA STATALE, Milan, Italy
| | - Giorgio Fiore
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan LA STATALE, Milan, Italy
| | - Elena Pirola
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Linda Borellini
- Department of Neuropathophysiology, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Filippo Cogiamanian
- Department of Neuropathophysiology, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Luigi Schisano
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Gagliano
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan LA STATALE, Milan, Italy
| | - Stefano Borsa
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mauro Pluderi
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulio Andrea Bertani
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sergio Barbieri
- Department of Neuropathophysiology, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Locatelli
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- “Aldo Ravelli” Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
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Ferreira F, Akram H, Ashburner J, Zrinzo L, Zhang H, Lambert C. Ventralis intermedius nucleus anatomical variability assessment by MRI structural connectivity. Neuroimage 2021; 238:118231. [PMID: 34089871 PMCID: PMC8960999 DOI: 10.1016/j.neuroimage.2021.118231] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/14/2021] [Accepted: 06/01/2021] [Indexed: 12/11/2022] Open
Abstract
The ventralis intermedius nucleus (Vim) is centrally placed in the dentato-thalamo-cortical pathway (DTCp) and is a key surgical target in the treatment of severe medically refractory tremor. It is not visible on conventional MRI sequences; consequently, stereotactic targeting currently relies on atlas-based coordinates. This fails to capture individual anatomical variability, which may lead to poor long-term clinical efficacy. Probabilistic tractography, combined with known anatomical connectivity, enables localisation of thalamic nuclei at an individual subject level. There are, however, a number of confounds associated with this technique that may influence results. Here we focused on an established method, using probabilistic tractography to reconstruct the DTCp, to identify the connectivity-defined Vim (cd-Vim) in vivo. Using 100 healthy individuals from the Human Connectome Project, our aim was to quantify cd-Vim variability across this population, measure the discrepancy with atlas-defined Vim (ad-Vim), and assess the influence of potential methodological confounds. We found no significant effect of any of the confounds. The mean cd-Vim coordinate was located within 1.88 mm (left) and 2.12 mm (right) of the average midpoint and 3.98 mm (left) and 5.41 mm (right) from the ad-Vim coordinates. cd-Vim location was more variable on the right, which reflects hemispheric asymmetries in the probabilistic DTC reconstructed. The method was reproducible, with no significant cd-Vim location differences in a separate test-retest cohort. The superior cerebellar peduncle was identified as a potential source of artificial variance. This work demonstrates significant individual anatomical variability of the cd-Vim that atlas-based coordinate targeting fails to capture. This variability was not related to any methodological confound tested. Lateralisation of cerebellar functions, such as speech, may contribute to the observed asymmetry. Tractography-based methods seem sensitive to individual anatomical variability that is missed by conventional neurosurgical targeting; these findings may form the basis for translational tools to improve efficacy and reduce side-effects of thalamic surgery for tremor.
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Affiliation(s)
- Francisca Ferreira
- EPSRC Centre for Doctoral Training in Intelligent, Integrated Imaging in Healthcare (i4health), University College London, Gower Street, London WC1E 6BT, United Kingdom; Functional Neurosurgery Unit, Department of Clinical and Motor Neurosciences, UCL Institute of Neurology, Queen Square, WC1N 3BG London, United Kingdom; Wellcome Centre for Human Neuroimaging, 12 Queen Square, London WC1N 3AR, United Kingdom.
| | - Harith Akram
- Functional Neurosurgery Unit, Department of Clinical and Motor Neurosciences, UCL Institute of Neurology, Queen Square, WC1N 3BG London, United Kingdom
| | - John Ashburner
- Wellcome Centre for Human Neuroimaging, 12 Queen Square, London WC1N 3AR, United Kingdom
| | - Ludvic Zrinzo
- Functional Neurosurgery Unit, Department of Clinical and Motor Neurosciences, UCL Institute of Neurology, Queen Square, WC1N 3BG London, United Kingdom
| | - Hui Zhang
- EPSRC Centre for Doctoral Training in Intelligent, Integrated Imaging in Healthcare (i4health), University College London, Gower Street, London WC1E 6BT, United Kingdom; Department of Computer Science and Centre for Medical Image Computing, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Christian Lambert
- Wellcome Centre for Human Neuroimaging, 12 Queen Square, London WC1N 3AR, United Kingdom
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