title: Automatic computation of electrode trajectories for Deep Brain Stimulation: a hybrid symbolic and numerical approach.
abstract: OBJECTIVE
  The optimal electrode trajectory is needed to assist surgeons in planning Deep Brain Stimulation (DBS). A method for image-based trajectory planning was developed and tested.
  
  
  METHODS
  Rules governing the DBS surgical procedure were defined with geometric constraints. A formal geometric solver using multimodal brain images and a template built from 15 brain MRI scans were used to identify a space of possible solutions and select the optimal one. For validation, a retrospective study of 30 DBS electrode implantations from 18 patients was performed. A trajectory was computed in each case and compared with the trajectories of the electrodes that were actually implanted.
  
  
  RESULTS
  Computed trajectories had an average difference of 6.45° compared with reference trajectories and achieved a better overall score based on satisfaction of geometric constraints. Trajectories were computed in 2 min for each case.
  
  
  CONCLUSIONS
  A rule-based solver using pre-operative MR brain images can automatically compute relevant and accurate patient-specific DBS electrode trajectories.
authors.affiliation: LSIIT / University of Strasbourg, Pôle API, Boulevard S. Brant, 67412, Illkirch, France. essert@unistra.fr
authors.forename: Caroline
authors.initials: C
authors.lastname: Essert
authors.forename: Claire
authors.initials: C
authors.lastname: Haegelen
authors.forename: Florent
authors.initials: F
authors.lastname: Lalys
authors.forename: Alexandre
authors.initials: A
authors.lastname: Abadie
authors.forename: Pierre
authors.initials: P
authors.lastname: Jannin
mesh_terms: D000465:Algorithms; D001331:Automation; D001921:Brain / Q000033:anatomy & histology / Q000601:surgery; D003657:Decision Making; D046690:Deep Brain Stimulation / Q000295:instrumentation*; D004567:Electrodes, Implanted; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D009069:Movement Disorders / Q000628:therapy*; D012189:Retrospective Studies; D012984:Software; D013238:Stereotaxic Techniques; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed