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European Radiology
Published in: European Radiology 1/2011

01-01-2011 | Magnetic Resonance

Optimal MRI methods for direct stereotactic targeting of the subthalamic nucleus and globus pallidus

Authors: Ruth L. O’Gorman, Karin Shmueli, Keyoumars Ashkan, Michael Samuel, David J. Lythgoe, Asal Shahidiani, Stephen J. Wastling, Michelle Footman, Richard P. Selway, Jozef Jarosz

Published in: European Radiology | Issue 1/2011

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Abstract

Objective

Reliable identification of the subthalamic nucleus (STN) and globus pallidus interna (GPi) is critical for deep brain stimulation (DBS) of these structures. The purpose of this study was to compare the visibility of the STN and GPi with various MRI techniques and to assess the suitability of each technique for direct stereotactic targeting.

Methods

MR images were acquired from nine volunteers with T2- and proton density-weighted (PD-W) fast spin echo, susceptibility-weighted imaging (SWI), phase-sensitive inversion recovery and quantitative T1, T2 and T2* mapping sequences. Contrast-to-noise ratios (CNR) for the STN and GPi were calculated for all sequences. Targeting errors on SWI were evaluated on magnetic susceptibility maps. The sequences demonstrating the best conspicuity of DBS target structures (SWI and T2*) were then applied to ten patients with movement disorders, and the CNRs for these techniques were assessed.

Results

SWI offers the highest CNR for the STN, but standard PD-W images provide the best CNR for the pallidum. Susceptibility maps indicated that the GPi margins may be shifted slightly on SWI, although no shifts were seen for the STN.

Conclusion

SWI may improve the visibility of the STN on pre-operative MRI, potentially improving the accuracy of direct stereotactic targeting.
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Metadata
Title
Optimal MRI methods for direct stereotactic targeting of the subthalamic nucleus and globus pallidus
Authors
Ruth L. O’Gorman
Karin Shmueli
Keyoumars Ashkan
Michael Samuel
David J. Lythgoe
Asal Shahidiani
Stephen J. Wastling
Michelle Footman
Richard P. Selway
Jozef Jarosz
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 1/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1885-5

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