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Placement of deep brain stimulator electrodes using real‐time high‐field interventional magnetic resonance imaging
Author(s) -
Martin Alastair J.,
Larson Paul S.,
Ostrem Jill L.,
Keith Sootsman W.,
Talke Pekka,
Weber Oliver M.,
Levesque Nadja,
Myers Jeffrey,
Starr Philip A.
Publication year - 2005
Publication title -
magnetic resonance in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.696
H-Index - 225
eISSN - 1522-2594
pISSN - 0740-3194
DOI - 10.1002/mrm.20675
Subject(s) - magnetic resonance imaging , interventional magnetic resonance imaging , nuclear magnetic resonance , electrode , materials science , functional magnetic resonance imaging , biomedical engineering , medicine , radiology , physics , quantum mechanics
A methodology is presented for placing deep brain stimulator electrodes under direct MR image guidance. The technique utilized a small, skull‐mounted trajectory guide that is optimized for accurate alignment under MR fluoroscopy. Iterative confirmation scans are used to monitor device alignment and brain penetration. The methodology was initially tested in a human skull phantom and proved capable of achieving submillimeter accuracy over a set of 16 separate targets that were accessed. The maximum error that was obtained in this preliminary test was 2 mm, motivating use of the technique in a clinical study. Subsequently, a total of eight deep brain stimulation electrodes were placed in five patients. Satisfactory placement was achieved on the first pass in seven of eight electrodes, while two passes were required with one electrode. Mean error from the intended target on the first pass was 1.0 ± 0.8 mm (range = 0.1–1.9 mm). All procedures were considered technical successes and there were no intraoperative complications; however, one patient did develop a postoperative infection. Magn Reson Med, 2005. © 2005 Wiley‐Liss, Inc.