The accuracy and reliability of 3D CT/MRI co-registration in planning epilepsy surgery

被引:44
作者
Tao, James X. [1 ]
Hawes-Ebersole, Susan [1 ]
Baldwin, Maria [1 ]
Shah, Sona [1 ]
Erickson, Robert K. [1 ]
Ebersole, John S. [1 ]
机构
[1] Univ Chicago, Dept Neurol & Neurosurg, Adult Epilepsy Ctr, Chicago, IL 60637 USA
关键词
Co-registration; Epilepsy surgery; Subdural electrodes; Temporal lobe epilepsy; Intra-operative digital photography; SUBDURAL ELECTRODES; CT IMAGES; PRESURGICAL EVALUATION; TEMPORAL-LOBE; LOCALIZATION; MRI; COREGISTRATION; RECONSTRUCTION; FUSION;
D O I
10.1016/j.clinph.2009.02.002
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To investigate the accuracy and reliability of 3D CT/MRI co-registration technique for the localization of implanted subdural electrodes in the routine epilepsy presurgical evaluation, in so doing assess its usefulness in planning the tailored resection of epileptic focus. Methods: Four external anatomic fiducial makers were used for co-registration of volumetric pre-implant brain MRI and post-implant head CT using Curry 5.0 software in 19 epilepsy presurgical candidates. The location of subdural electrodes derived from the co-registration was compared to that obtained by intra-operative digital photographs by using gyral/sulcal patterns and cortical vasculature as anatomic markers. Results: The mean localization error was 4.3 +/- 2.5 mm in all 19 patients. However, the mean localization error was 3.1 +/- 1.3 mm in 13 patients with all four reliable fiducial markers; whereas the mean localization error was 6.8 +/- 2.4 mm in 6 patients with two or three reliable fiducial markers. Conclusion: Visualization of subdural electrode positions on a patient's cortex can be accurately performed in the routine clinical setting by 3D CT/MRI co-registration. However, the accuracy of co-registration is dependent upon having reliable surface fiducial markers. In practice, confirmation of location accuracy, such as with intra-operative digital photographs, is necessary for planning of tailored resective surgery. Significance: The combination of 3D CT/MRI co-registration and intra-operative digital photography techniques provides a practical and effective algorithm for the localization and validation of implanted subdural electrodes. (C) 2009 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:748 / 753
页数:6
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