Optimization of postoperative computerized tomographic imaging in patients with the implanted responsive neurostimulation system.
The Responsive Neurostimulation System is currently under investigation as a neurosurgical option for medically refractory epilepsy. The device produces significant metallic artifact on conventional axial CT scans, resulting in limited diagnostic imaging options for implanted patients. We have developed a strategy to overcome this technical difficulty utilizing optimized patient positioning, thin-slice image acquisition, and postprocessing image reconstruction with commercially available software. Significant improvements were noted in the severity of device-related metallic streak artifact on reconstructed axial images. In addition, thin-section data were successfully used to generate detailed three-dimensional reconstructions, providing for improved visualization of the stimulator and the intracranial position of attached electrodes.
Waziri
Allen
A
Department of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, NY, USA. aew2001@columbia.edu
Mehta
Hasit
H
Goodman
Robert R
RR
D046690:Deep Brain Stimulation / Q000295:instrumentation* / Q000379:methods; D004569:Electroencephalography / Q000295:instrumentation / Q000379:methods; D006801:Humans; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods; D011182:Postoperative Care / Q000295:instrumentation* / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods