In Vivo Accuracy of a Frameless Stereotactic Drilling Technique for Diagnostic Biopsies and Stereoelectroencephalography Depth Electrodes

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• 作者：Niels Verburg¹ ; ^{n.verburg@vumc.nl" class="auth_mail" title="E-mail the corresponding author} ; Johannes C. Baayen¹ ; Sander Idema¹ ; Michiel A.J. Klitsie¹ ; Steven Claus² ; Catharina S. de Jonge¹ ; W. Peter Vandertop¹ ; Philip C. de Witt Hamer¹
• 关键词：Depth electrode placement ; Diagnostic biopsies ; Frameless stereotaxy ; Stereotactic drilling
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：87
• 期：Complete
• 页码：392-398
• 全文大小：2396 K

文摘

Accurate frameless neuronavigation is highly important in cranial neurosurgery. The accuracy demonstrated in phantom models might not be representative for results in patients. Few studies describe the in vivo quantitative accuracy of neuronavigation in patients. The use of a frameless stereotactic drilling technique for stereoelectroencephalography depth electrode implantation in epilepsy patients, as well as diagnostic biopsies, provides a unique opportunity to assess the accuracy with postoperative imaging of preoperatively planned trajectories.

Methods

In 7 patients with refractory epilepsy, 89 depth electrodes were implanted using a frameless stereotactic drilling technique. Each electrode was planned on a preoperative magnetic resonance and computed tomographic scan, and verified on postoperative computed tomographic scan. After fusion of preoperative and postoperative imaging, the accuracy for each electrode was calculated as the Euclidean distance between the planned and observed position of the electrode tip.

Results

The median Euclidean distance between planned and observed electrode implantations was 3.5 mm (95% confidence interval, 2.9–3.9 mm) with a range of 1.2–13.7 mm.

Conclusions

In this study, we showed that the in vivo accuracy of our frameless stereotactic drilling technique, suitable for stereoelectroencephalography depth electrode placement and diagnostic brain biopsies, was 3.5 mm.