دورية أكاديمية
أعرض في EDS

Intraoperative 3D fluoroscopy accurately predicts final electrode position in deep brain stimulation surgery.

التفاصيل البيبلوغرافية
العنوان: Intraoperative 3D fluoroscopy accurately predicts final electrode position in deep brain stimulation surgery.
المؤلفون: Neto-Fernandes P; Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.; Department of Neurosurgery, Centro Hospitalar Universitário de São João, Porto, Portugal., Chamadoira C; Department of Neurosurgery, Centro Hospitalar Universitário de São João, Porto, Portugal.; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal., Silva C; Department of Neurosurgery, Centro Hospitalar Universitário de São João, Porto, Portugal.; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal., Pereira L; Department of Radiology, Centro Hospitalar Universitário de São João, Porto, Portugal., Vaz R; Department of Neurosurgery, Centro Hospitalar Universitário de São João, Porto, Portugal.; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal., Rito M; Department of Neurosurgery, Centro Hospitalar Universitário de São João, Porto, Portugal.; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal., Ferreira-Pinto MJ; Department of Neurosurgery, Centro Hospitalar Universitário de São João, Porto, Portugal. manuel.joao.pinto@ulssjoao.min-saude.pt.; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal. manuel.joao.pinto@ulssjoao.min-saude.pt.; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal. manuel.joao.pinto@ulssjoao.min-saude.pt.
المصدر: Acta neurochirurgica [Acta Neurochir (Wien)] 2024 Aug 07; Vol. 166 (1), pp. 328. Date of Electronic Publication: 2024 Aug 07.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: Austria NLM ID: 0151000 Publication Model: Electronic Cited Medium: Internet ISSN: 0942-0940 (Electronic) Linking ISSN: 00016268 NLM ISO Abbreviation: Acta Neurochir (Wien) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Wien, Springer.
مواضيع طبية MeSH: Deep Brain Stimulation*/methods , Imaging, Three-Dimensional*/methods , Electrodes, Implanted*, Humans ; Fluoroscopy/methods ; Retrospective Studies ; Male ; Female ; Middle Aged ; Aged ; Tomography, X-Ray Computed/methods ; Adult
مستخلص: Purpose: In the absence of an intraoperative CT or MRI setup, post-implantation confirmation of electrode position in deep brain stimulation (DBS) requires patient transportation to the radiology unit, prolonging surgery time. This project aims to validate intraoperative 3D fluoroscopy (3DF), a widely available tool in Neurosurgical units, as a method to determine final electrode position.
Methods: We performed a retrospective study including 64 patients (124 electrodes) who underwent DBS at our institution. Intraoperative 3DF after electrode implantation and postoperative volumetric CT were acquired. The Euclidean coordinates of the electrode tip displayed in both imaging modalities were determined and inter-method deviations were assessed. Pneumocephalus was quantified and its potential impact in determining the electrode position analyzed. Finally, 3DF and CT-imposed exposure to radiation was compared.
Results: The difference between the electrode tip estimated by 3DF and CT was 0.85 ± 0.03 mm, and not significantly different (p = 0.11 for the distance to MCP assessed by both methods), but was, instead, highly correlated (p = 0.91; p < 0.0001). Even though pneumocephalus was larger in 3DF (6.89 ± 1.76 vs 5.18 ± 1.37 mm 3 in the CT group, p < 0.001), it was not correlated with the difference in electrode position measured by both techniques (p = 0.17; p = 0.06). Radiation exposure from 3DF is significantly lower than CT (0.36 ± 0.03 vs 2.08 ± 0.05 mSv; p < 0.0001).
Conclusions: Intraoperative 3DF is comparable to CT in determining the final DBS electrode position. Being a method with fewer radiation exposure, less expensive, faster and that avoids patient transportation outside the operation room, it is a valid tool to replace postoperative CT.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Deep brain stimulation; Electrode location; Intraoperative 3D fluoroscopy; Stereotactic surgery
تواريخ الأحداث: Date Created: 20240806 Date Completed: 20240806 Latest Revision: 20240809
رمز التحديث: 20240809
مُعرف محوري في PubMed: PMC11303432
DOI: 10.1007/s00701-024-06214-8
PMID: 39107666
قاعدة البيانات: MEDLINE
الوصف
تدمد:0942-0940
DOI:10.1007/s00701-024-06214-8