Balachandran Ramya, Mitchell Jason E, Dawant Benoit M, Fitzpatrick J Michael
Department of Otolaryngology, Vanderbilt University Medical Center, Nashville TN 37232, USA.
IEEE Trans Biomed Eng. 2009 Jan;56(1):37-44. doi: 10.1109/TBME.2008.2002110.
Deep-brain-stimulation (DBS) surgery requires implanting stimulators at target positions with submillimetric accuracy. Traditional stereotactic frames can provide such accuracy, but a recent innovation called the microTargeting Platform (FHC, Inc.) replaces this large, universal frame with a single-use, miniature, and custom-designed platform. Both single-target and dual-target platforms are available for unilateral and bilateral procedures, respectively. In this paper, their targeting accuracies are evaluated in vitro. Our approach employs "virtual targets," which eliminates the problem of collision of the implant with the target. We implement virtual targets by mounting fiducial markers, which are not used in platform targeting, on an artificial skull and defining targets relative to the skull via that fiducial system. The fiducial system is designed to surround the targets, thereby reducing the overall effect of fiducial localization inaccuracies on the evaluation. It also provides the geometrical transformation from image to physical space. Target selection is based on an atlas of stimulation targets from a set of 31 DBS patients. The measured targeting error is the displacement between the phantom implant and the virtual target. Our results show that the microTargeting Platform exhibits submillimetric in vitro accuracy with a mean of 0.42 mm and a 99.9% level of 0.90 mm.
脑深部电刺激（DBS）手术需要将刺激器植入到精度在亚毫米级的目标位置。传统的立体定向框架能够提供这样的精度，但最近一项名为微靶向平台（FHC公司）的创新技术用一次性、微型且定制设计的平台取代了这种大型通用框架。单靶点和双靶点平台分别适用于单侧和双侧手术。在本文中，对它们在体外的靶向精度进行了评估。我们的方法采用“虚拟靶点”，这消除了植入物与靶点碰撞的问题。我们通过在人工颅骨上安装基准标记来实现虚拟靶点，这些基准标记在平台靶向中并不使用，并通过该基准系统相对于颅骨定义靶点。该基准系统设计为围绕靶点，从而降低基准定位不准确对评估的总体影响。它还提供从图像到物理空间的几何变换。靶点选择基于一组31例DBS患者的刺激靶点图谱。测量的靶向误差是虚拟植入物与虚拟靶点之间的位移。我们的结果表明，微靶向平台在体外表现出亚毫米级的精度，平均为0.42毫米，99.9%的水平为0.90毫米。
