Al-Jaberi Fadil, Moeskes Matthias, Skalej Martin, Fachet Melanie, Hoeschen Christoph
Chair of Medical Systems Technology, Institute for Medical Technology, Faculty of Electrical Engineering and Information Technology, Otto von Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany.
Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
Brain Sci. 2025 May 19;15(5):521. doi: 10.3390/brainsci15050521.
This study aimed to develop a semi-automated registration method for aligning preoperative non-contrast T2-weighted MRI with postoperative high-resolution cone-beam CT (DynaCT) in patients undergoing directional deep brain stimulation (dDBS) surgery targeting the subthalamic nucleus (STN). The aim was to facilitate image-guided programming of DBS devices and postoperative verification of the alignment of segmented contacts. A dataset of ten patients undergoing bilateral dDBS implantation was retrospectively collected, including DynaCT (acquired postoperatively) and non-contrast T2-weighted MRI (obtained preoperatively). A semi-automated registration method was used, employing manual initialization due to dissimilar anatomical information between DynaCT and T2-weighted MRI. Image visualization, initial alignment using a centered transformation initializer, and single-resolution image registration involving the Simple Insight Toolkit (SimpleITK) library were performed. Manual landmark-based alignment based on anatomical landmarks and evaluation metrics such as Target Registration Error (TRE) assessed alignment accuracy. The registration method successfully aligned all images. Quantitative evaluation revealed an average of the mean TRE of 1.48 mm across all subjects, indicating satisfactory alignment quality. Multiplanar reformations (MPRs) based on electrode-oriented normal vectors visualized segmented contacts for accurate electrode placement. The developed method demonstrated successful registration between preoperative non-contrast T2-weighted MRI and postoperative DynaCT, despite dissimilar anatomical information. This approach facilitates accurate alignment crucial for DBS programming and postoperative verification, potentially reducing the programming time of the DBS. The study underscores the importance of image quality, manual initialization and semi-automated registration methods for successful multimodal image registration in dDBS procedures targeting the STN.
本研究旨在开发一种半自动配准方法，用于在接受定向丘脑底核（STN）深部脑刺激（dDBS）手术的患者中，将术前非增强T2加权磁共振成像（MRI）与术后高分辨率锥形束CT（DynaCT）进行对齐。目的是便于DBS设备的图像引导编程以及术后对分割触点对齐情况的验证。回顾性收集了10例接受双侧DBS植入患者的数据集,包括DynaCT（术后获取）和非增强T2加权MRI（术前获得）。由于DynaCT和T2加权MRI之间的解剖信息不同，采用了半自动配准方法并进行手动初始化。进行了图像可视化、使用中心变换初始化器进行初始对齐以及涉及Simple Insight Toolkit（SimpleITK）库的单分辨率图像配准。基于解剖标志的手动标志点对齐以及诸如目标配准误差（TRE）等评估指标评估了对齐精度。配准方法成功对齐了所有图像。定量评估显示，所有受试者的平均TRE平均值为1.48毫米，表明对齐质量令人满意。基于电极方向法向量的多平面重建（MPR）可视化了分割的触点，以实现准确的电极放置。尽管解剖信息不同，但所开发的方法在术前非增强T2加权MRI和术后DynaCT之间实现了成功配准。这种方法有助于实现对DBS编程和术后验证至关重要的精确对齐，可能会减少DBS的编程时间。该研究强调了图像质量、手动初始化和半自动配准方法对于针对STN的dDBS手术中成功进行多模态图像配准的重要性。
