Hunsche Stefan, Hellerbach Alexandra, Eichner Markus, Panknin Christoph, Faby Sebastian, Wirths Jochen, Visser-Vandewalle Veerle, Treuer Harald, Fedders Dieter
Department of Stereotactic and Functional Neurosurgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany.
Computed Tomography, Siemens Healthineers AG, Forchheim, Germany.
Stereotact Funct Neurosurg. 2025;103(1):55-62. doi: 10.1159/000541151. Epub 2024 Sep 25.
Photon-counting detector computed tomography (PCD-CT) represents the next generation of CT technology, offering enhanced capabilities for detecting the orientation of directional leads in deep brain stimulation (DBS). This study aims to refine PCD-CT-based lead orientation determination using an automated method applicable to devices from various manufacturers, addressing current methodological limitations and improving neurosurgical precision.
An automated method was developed to ascertain the orientation of directional DBS leads using PCD-CT data and grayscale model fitting for devices from Boston Scientific, Medtronic, and Abbott. A phantom study was conducted to evaluate the precision and accuracy of this method, comparing it with the stripe artifact method across different lead alignments relative to the CT gantry axis.
Except for the Medtronic Sensight™ lead, where detection was occasionally unfeasible if aligned normal to the z-axis of the CT gantry, a clinically very unlikely alignment, the lead orientation could be automatically determined regardless of its position. The accuracy and precision of this automated method was comparable to those of the stripe artifact method.
PCD-CT enables the automatic determination of lead orientation from leading manufacturers with an accuracy comparable to the stripe artifact method, and it offers the added benefit of being independent of the clinically occurring orientation of the head and, consequently, the lead relative to the CT gantry axis.
光子计数探测器计算机断层扫描（PCD-CT）代表了下一代CT技术，在检测深部脑刺激（DBS）中定向电极的方向方面具有更强的能力。本研究旨在使用一种适用于不同制造商设备的自动化方法来优化基于PCD-CT的电极方向确定，解决当前方法的局限性并提高神经外科手术的精度。
开发了一种自动化方法，利用PCD-CT数据和灰度模型拟合来确定波士顿科学公司、美敦力公司和雅培公司设备的定向DBS电极的方向。进行了一项体模研究，以评估该方法的精度和准确性，并将其与条纹伪影法在相对于CT机架轴的不同电极排列情况下进行比较。
除了美敦力Sensight™电极外，如果其与CT机架的z轴垂直对齐（临床上极不可能的对齐方式），偶尔无法进行检测，其他情况下无论电极位置如何，都可以自动确定电极方向。这种自动化方法的准确性和精度与条纹伪影法相当。
PCD-CT能够自动确定主要制造商生产的电极方向，其准确性与条纹伪影法相当，并且具有独立于临床上头部出现的方向以及因此电极相对于CT机架轴的方向的额外优势。
