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Acta Neurochirurgica

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Open Access 01-02-2018 | Original Article - Functional

Borders of STN determined by MRI versus the electrophysiological STN. A comparison using intraoperative CT

Authors: Sander Bus, Pepijn van den Munckhof, Maarten Bot, Gian Pal, Bichun Ouyang, Sepehr Sani, Leo Verhagen Metman

Published in: Acta Neurochirurgica | Issue 2/2018

Abstract

Background

It is unclear which magnetic resonance imaging (MRI) sequence most accurately corresponds with the electrophysiological subthalamic nucleus (STN) obtained during microelectrode recording (MER, MER-STN). CT/MRI fusion allows for comparison between MER-STN and the STN visualized on preoperative MRI (MRI-STN).

Objective

To compare dorsal and ventral STN borders as seen on 3-Tesla T2-weighted (T2) and susceptibility weighted images (SWI) with electrophysiological STN borders in deep brain stimulation (DBS) for Parkinson’s disease (PD).

Methods

Intraoperative CT (iCT) was performed after each MER track. iCT images were merged with preoperative images using planning software. Dorsal and ventral borders of each track were determined and compared to MRI-STN borders. Differences between borders were calculated.

Results

A total of 125 tracks were evaluated in 45 patients. MER-STN started and ended more dorsally than respective dorsal and ventral MRI-STN borders. For dorsal borders, differences were 1.9 ± 1.4 mm (T2) and 2.5 ± 1.8 mm (SWI). For ventral borders, differences were 1.9 ± 1.6 mm (T2) and 2.1 ± 1.8 mm (SWI).

Conclusions

Discrepancies were found comparing borders on T2 and SWI to the electrophysiological STN. The largest border differences were found using SWI. Border differences were considerably larger than errors associated with iCT and fusion techniques. A cautious approach should be taken when relying solely on MR imaging for delineation of both clinically relevant STN borders.

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Title: Borders of STN determined by MRI versus the electrophysiological STN. A comparison using intraoperative CT
Authors: Sander Bus
Pepijn van den Munckhof
Maarten Bot
Gian Pal
Bichun Ouyang
Sepehr Sani
Leo Verhagen Metman
Publication date: 01-02-2018
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 2/2018
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-017-3432-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Borders of STN determined by MRI versus the electrophysiological STN. A comparison using intraoperative CT

Abstract

Background

Objective

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusions

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