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Comparison of accuracy and precision between frame-based and frameless stereotactic navigation for deep brain stimulation electrode implantation

Bjartmarz, Hjalmar LU and Rehncrona, Stig LU (2007) In Stereotactic and Functional Neurosurgery 85(5). p.235-242
Abstract
The accuracy and precision of frameless neuronavigation as compared to conventional frame-based stereotaxy for implantation of deep brain stimulation (DBS) electrodes were studied in 14 patients with essential tremor. DBS electrodes were implanted bilaterally in the ventrolateral thalamus [ventrointermediate nucleus ( VIM)] in one procedure. Frameless neuronavigation was used on one side and the conventional frame-based technique on the other. Targeting was guided by MRI and CT imaging. Intraoperative stereotactic plain X-ray verified final electrode positions and electrode deviations from the planned target were measured. Clinical outcome was evaluated with the Essential Tremor Rating Scale. Thirteen of the patients were eligible for... (More)
The accuracy and precision of frameless neuronavigation as compared to conventional frame-based stereotaxy for implantation of deep brain stimulation (DBS) electrodes were studied in 14 patients with essential tremor. DBS electrodes were implanted bilaterally in the ventrolateral thalamus [ventrointermediate nucleus ( VIM)] in one procedure. Frameless neuronavigation was used on one side and the conventional frame-based technique on the other. Targeting was guided by MRI and CT imaging. Intraoperative stereotactic plain X-ray verified final electrode positions and electrode deviations from the planned target were measured. Clinical outcome was evaluated with the Essential Tremor Rating Scale. Thirteen of the patients were eligible for measuring electrode deviations and 10 of them were available for a clinical follow-up. Electrode deviations from target were larger using the frameless technique in the mediallateral (x: 1.9 +/- 1.3 mm) and anterior- posterior (y: 0.9 +/- 0.8 mm) directions as compared to the frame-based technique (x: 0.5 +/- 0.5 and y: 0.4 +/- 0.4 mm) but similar in the superior- inferior direction (z). The vector of deviation was 2.5 +/- 1.4 mm with the frameless technique and 1.2 +/- 0.6 with the frame-based technique. The differences were statistically significant (p < 0.05-0.001). The dispersion was larger with the frameless technique as represented by the larger standard deviations in all three planes. At clinical follow-ups, tremor reduction was similar irrespective of the implantation technique. It is concluded that conventional frame-based stereotaxy has higher accuracy/precision for hitting a small brain target than the frameless technique. However, the difference is relatively small and does not influence the clinical result of DBS electrode implantations in the VIM when treating tremor. Copyright (c) 2007 S. Karger AG, Basel (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
stimulation, essential tremor, neuronavigation, stereotaxy, frameless, stereotactic neurosurgery, frame-based stereotaxy, deep brain
in
Stereotactic and Functional Neurosurgery
volume
85
issue
5
pages
235 - 242
publisher
Karger
external identifiers
  • wos:000248238000005
  • scopus:34547909263
ISSN
1011-6125
DOI
10.1159/000103262
language
English
LU publication?
yes
id
e51a152b-a49f-47d2-b9d7-a254799e962a (old id 689765)
date added to LUP
2007-12-10 12:25:18
date last changed
2017-10-29 04:26:13
@article{e51a152b-a49f-47d2-b9d7-a254799e962a,
  abstract     = {The accuracy and precision of frameless neuronavigation as compared to conventional frame-based stereotaxy for implantation of deep brain stimulation (DBS) electrodes were studied in 14 patients with essential tremor. DBS electrodes were implanted bilaterally in the ventrolateral thalamus [ventrointermediate nucleus ( VIM)] in one procedure. Frameless neuronavigation was used on one side and the conventional frame-based technique on the other. Targeting was guided by MRI and CT imaging. Intraoperative stereotactic plain X-ray verified final electrode positions and electrode deviations from the planned target were measured. Clinical outcome was evaluated with the Essential Tremor Rating Scale. Thirteen of the patients were eligible for measuring electrode deviations and 10 of them were available for a clinical follow-up. Electrode deviations from target were larger using the frameless technique in the mediallateral (x: 1.9 +/- 1.3 mm) and anterior- posterior (y: 0.9 +/- 0.8 mm) directions as compared to the frame-based technique (x: 0.5 +/- 0.5 and y: 0.4 +/- 0.4 mm) but similar in the superior- inferior direction (z). The vector of deviation was 2.5 +/- 1.4 mm with the frameless technique and 1.2 +/- 0.6 with the frame-based technique. The differences were statistically significant (p &lt; 0.05-0.001). The dispersion was larger with the frameless technique as represented by the larger standard deviations in all three planes. At clinical follow-ups, tremor reduction was similar irrespective of the implantation technique. It is concluded that conventional frame-based stereotaxy has higher accuracy/precision for hitting a small brain target than the frameless technique. However, the difference is relatively small and does not influence the clinical result of DBS electrode implantations in the VIM when treating tremor. Copyright (c) 2007 S. Karger AG, Basel},
  author       = {Bjartmarz, Hjalmar and Rehncrona, Stig},
  issn         = {1011-6125},
  keyword      = {stimulation,essential tremor,neuronavigation,stereotaxy,frameless,stereotactic neurosurgery,frame-based stereotaxy,deep brain},
  language     = {eng},
  number       = {5},
  pages        = {235--242},
  publisher    = {Karger},
  series       = {Stereotactic and Functional Neurosurgery},
  title        = {Comparison of accuracy and precision between frame-based and frameless stereotactic navigation for deep brain stimulation electrode implantation},
  url          = {http://dx.doi.org/10.1159/000103262},
  volume       = {85},
  year         = {2007},
}