Implantation of deep brain stimulator electrodes using interventional MRI.
The authors describe a method for placement of deep brain stimulator electrodes using interventional MRI in conjunction with a skull-mounted aiming device (Medtronic Nexframe). This approach adapts the procedure to a standard-configuration 1.5-T diagnostic MRI scanner in a radiology suite. Preoperative imaging, device implantation, and postimplantation MRI are integrated into a single procedure performed under general anesthesia, providing real-time, high-resolution magnetic resonance confirmation of electrode position. The method is conceptually simpler than the current standard technique for deep brain stimulator placement, as it eliminates the stereotactic frame, the subsequent requirement for registration of the brain in stereotactic space, physiologic testing, and the need for patient cooperation. With further technical refinement, the interventional MRI method should improve the accuracy, safety, and speed of deep brain stimulator electrode placement.
Starr
Philip A
PA
Department of Neurosurgery, University of California, San Francisco, 533 Parnassus Avenue Box 0445, San Francisco, CA 94143, USA. starrp@neurosurg.ucsf.edu
Martin
Alastair J
AJ
Larson
Paul S
PS
D001921:Brain / Q000033:anatomy & histology / Q000502:physiology; D046690:Deep Brain Stimulation / Q000295:instrumentation*; D004567:Electrodes, Implanted; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000639:trends