title: Wide-bore 1.5 T MRI-guided deep brain stimulation surgery: initial experience and technique comparison.
abstract: OBJECTIVE
  We report results of the initial experience with magnetic resonance image (MRI)-guided implantation of subthalamic nucleus (STN) deep brain stimulating (DBS) electrodes at the University of Wisconsin after having employed frame-based stereotaxy with previously available MR imaging techniques and microelectrode recording for STN DBS surgeries.
  
  
  METHODS
  Ten patients underwent MRI-guided DBS implantation of 20 electrodes between April 2011 and March 2013. The procedure was performed in a purpose-built intraoperative MRI suite configured specifically to allow MRI-guided DBS, using a wide-bore (70 cm) MRI system. Trajectory guidance was accomplished with commercially available system consisting of an MR-visible skull-mounted aiming device and a software guidance system processing intraoperatively acquired iterative MRI scans.
  
  
  RESULTS
  A total of 10 patients (5 male, 5 female)-representative of the Parkinson Disease (PD) population-were operated on with standard technique and underwent 20 electrode placements under MRI-guided bilateral STN-targeted DBS placement. All patients completed the procedure with electrodes successfully placed in the STN. Procedure time improved with experience.
  
  
  CONCLUSIONS
  Our initial experience confirms the safety of MRI-guided DBS, setting the stage for future investigations combining physiology and MRI guidance. Further follow-up is required to compare the efficacy of the MRI-guided surgery cohort to that of traditional frame-based stereotaxy.
authors.affiliation: University of Wisconsin, Department of Neurosurgery and Biomedical Engineering, Madison, WI, USA; Semmes-Murphey Clinic, Memphis, TN, USA; University of Tennessee Department of Neurosurgery, Memphis, TN, USA; University of Tennessee Department of Electrical Engineering and Computer Science, Knoxville, TN, USA. Electronic address: ksillay@uthsc.edu.
authors.forename: Karl A
authors.initials: KA
authors.lastname: Sillay
authors.affiliation: University of Wisconsin, Department of Anesthesiology, Madison, WI, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Rusy
authors.affiliation: University of Wisconsin, Department of Neurology, Madison, WI, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Buyan-Dent
authors.affiliation: University of Wisconsin, Department of Neurology, Madison, WI, USA.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Ninman
authors.affiliation: University of Wisconsin, Department of Radiology, Madison, WI, USA.
authors.forename: Karl K
authors.initials: KK
authors.lastname: Vigen
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D019300:Medical Errors; D008839:Microelectrodes; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D010300:Parkinson Disease / Q000601:surgery; D013238:Stereotaxic Techniques; D020531:Subthalamic Nucleus; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods*
keywords: Asleep DBS; Deep Brain Stimulation; Intraoperative MRI guided DBS; Neurosurgery Technique Comparison; Parkinson disease