title: Personalized mapping of the deep brain with a white matter attenuated inversion recovery (WAIR) sequence at 1.5-tesla: Experience based on a series of 156 patients.
abstract: OBJECTIVE
  Deep brain mapping has been proposed for direct targeting in stereotactic functional surgery, aiming to personalize electrode implantation according to individual MRI anatomy without atlas or statistical template. We report our clinical experience of direct targeting in a series of 156 patients operated on using a dedicated Inversion Recovery Turbo Spin Echo sequence at 1.5-tesla, called White Matter Attenuated Inversion Recovery (WAIR).
  
  
  METHODS
  After manual contouring of all pertinent structures and 3D planning of trajectories, 312 DBS electrodes were implanted. Detailed anatomy of close neighbouring structures, whether gray nuclei or white matter regions, was identified during each planning procedure. We gathered the experience of these 312 deep brain mappings and elaborated consistent procedures of anatomical MRI mapping for pallidal, subthalamic and ventral thalamic regions. We studied the number of times the central track anatomically optimized was selected for implantation of definitive electrodes.
  
  
  RESULTS
  WAIR sequence provided high-quality images of most common functional targets, successfully used for pure direct stereotactic targeting: the central track corresponding to the optimized primary anatomical trajectory was chosen for implantation of definitive electrodes in 90.38%.
  
  
  CONCLUSIONS
  WAIR sequence is anatomically reliable, enabling precise deep brain mapping and direct stereotactic targeting under routine clinical conditions.
authors.affiliation: Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: A
authors.initials: A
authors.lastname: Zerroug
authors.affiliation: Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Gabrillargues
authors.affiliation: Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
authors.forename: G
authors.initials: G
authors.lastname: Coll
authors.affiliation: Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France.
authors.forename: F
authors.initials: F
authors.lastname: Vassal
authors.affiliation: Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: B
authors.initials: B
authors.lastname: Jean
authors.affiliation: Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: E
authors.initials: E
authors.lastname: Chabert
authors.affiliation: Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: B
authors.initials: B
authors.lastname: Claise
authors.affiliation: Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
authors.forename: T
authors.initials: T
authors.lastname: Khalil
authors.affiliation: Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
authors.forename: L
authors.initials: L
authors.lastname: Sakka
authors.affiliation: Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France.
authors.forename: F
authors.initials: F
authors.lastname: Feschet
authors.affiliation: Service of neurology, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: F
authors.initials: F
authors.lastname: Durif
authors.affiliation: Service of radiology, CHU de Clermont-Ferrand, 63003 Clemront-Ferrand, France.
authors.forename: L
authors.initials: L
authors.lastname: Boyer
authors.affiliation: Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Coste
authors.affiliation: Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France. Electronic address: jjlemaire@chu-clermontferrand.fr.
authors.forename: J-J
authors.initials: JJ
authors.lastname: Lemaire
mesh_terms: D001931:Brain Mapping; D046690:Deep Brain Stimulation / Q000379:methods; D004567:Electrodes, Implanted; D005260:Female; D005917:Globus Pallidus / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D013238:Stereotaxic Techniques; D066127:White Matter / Q000503:physiopathology*
keywords: Anatomy; DBS; Deep brain; Direct targeting; MRI; Mapping