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Three-dimensional visualization of subdural electrodes for presurgical planning. Neurosurgery 2011 Mar;68(1 Suppl Operative):152-60; discussion 160-1 PMID: 21206319 PMCID: PMC4339031

Pubmed ID

21206319

Abstract

BACKGROUND: Accurate localization and visualization of subdural electrodes implanted for intracranial electroencephalography in cases of medically refractory epilepsy remains a challenging clinical problem.

OBJECTIVE: We introduce a technique for creating accurate 3-dimensional (3D) brain models with electrode overlays, ideal for resective surgical planning.

METHODS: Our procedure uses postimplantation magnetic resonance imaging (MRI) and computed tomographic (CT) imaging to create 3D models of compression-affected brain combined with intensity-thresholded CT-derived electrode models using freely available software. Footprints, or "shadows," beneath electrodes are also described for better visualization of sulcus-straddling electrodes. Electrode models were compared with intraoperative photography for validation.

RESULTS: Realistic representations of intracranial electrode positions on patient-specific postimplantation MRI brain renderings were reliably created and proved accurate when compared with photographs. Electrodes placed interhemispherically were also visible with our rendering technique. Electrode shadows were useful in locating electrodes that straddle sulci.

CONCLUSION: We present an accurate method for visualizing subdural electrodes on brain compression effected 3D models that serves as an ideal platform for surgical planning.

Author List

LaViolette PS, Rand SD, Raghavan M, Ellingson BM, Schmainda KM, Mueller W

Authors

Peter LaViolette PhD Associate Professor in the Radiology department at Medical College of Wisconsin
Manoj Raghavan MD, PhD Professor in the Neurology department at Medical College of Wisconsin
Scott D. Rand MD, PhD Professor in the Radiology department at Medical College of Wisconsin
Kathleen M. Schmainda PhD Professor in the Radiology department at Medical College of Wisconsin




Scopus

2-s2.0-79951772694   7 Citations

MESH terms used to index this publication - Major topics in bold

Electrodes, Implanted
Epilepsy
Female
Humans
Imaging, Three-Dimensional
Magnetic Resonance Imaging
Male
Middle Aged
Preoperative Care
Software
Subdural Space
Tomography, X-Ray Computed
jenkins-FCD Prod-256 97250b83e4554f37bec91ca291f44ff4aedcc508