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Title: Intraoperative O-Arm Corroboration Of Electrode Placement In Frame Based Deep Brain Stimulation: Potential To Be Used As Primary Imaging Modality
e-poster Number: INSIM1
Category: Neurosurgery
Author Name: Sanjeev Srivastava
Institute: Artemis Hospital
Co-Author Name: Aditya Gupta
Abstract :
OBJECTIVE
To analyse the utility of intraoperative O-arm in assessing the accuracy of DBS electrode placement.
MATERIALS AND METHODS
In patients planned for bilateral STN-DBS for refractory Parkinsons disease, preoperatively CT Head and preoperative O Arm images (with Leksell Frame in place) were fused with preoperative MRI for targeting independently. Difference in stereotactic target plan point coordinates and the actual electrode tip coordinates on postoperative O Arm images and postoperative CT images were calculated for both sides independently.
RESULTS
Between January 2018 to January 2019, among 13 bilateral DBS electrode placement patients, average difference between the proposed target coordinates and actual electrode tip coordinates on standard CT and O-Arm (with MRI fusion) preoperatively and postoperatively for each side was calculated on each axis. The median difference between preoperative coordinates on O-Arm images and postoperative actual lead placement coordinates on postoperative O-Arm images and postoperative CT images was non significant (0.65mm for left STN and 0.7mm for right STN).
CONCLUSION:
Intraoperative O-arm images can be reliably and accurately used to place electrodes for STN-DBS for refractory Parkinsons disease. Further it is fast, less cumbersome, and offers one-third radiation dose as compared to a standard frame based CT Head. It does not require the patient to be shifted to a separate suite, as is required for a CT scan. It offers to be a technology of the future. With more experience, we are planning to replace CT imaging with O-Arm Imaging for Deep Brain Stimulation protocols as the primary imaging modality.
