A Pipeline for 3D Multimodality Image Integration and Computer-assisted Planning in Epilepsy Surgery.
Epilepsy surgery is challenging and the use of 3D multimodality image integration (3DMMI) to aid presurgical planning is well-established. Multimodality image integration can be technically demanding, and is underutilised in clinical practice. We have developed a single software platform for image integration, 3D visualization and surgical planning. Here, our pipeline is described in step-by-step fashion, starting with image acquisition, proceeding through image co-registration, manual segmentation, brain and vessel extraction, 3D visualization and manual planning of stereoEEG (SEEG) implantations. With dissemination of the software this pipeline can be reproduced in other centres, allowing other groups to benefit from 3DMMI. We also describe the use of an automated, multi-trajectory planner to generate stereoEEG implantation plans. Preliminary studies suggest this is a rapid, safe and efficacious adjunct for planning SEEG implantations. Finally, a simple solution for the export of plans and models to commercial neuronavigation systems for implementation of plans in the operating theater is described. This software is a valuable tool that can support clinical decision making throughout the epilepsy surgery pathway.
Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology; m.nowell@ucl.ac.uk.
Mark
M
Nowell
Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology.
Roman
R
Rodionov
Center of Medical Imaging and Computing, UCL.
Gergely
G
Zombori
Center of Medical Imaging and Computing, UCL.
Rachel
R
Sparks
Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology.
Michele
M
Rizzi
Center of Medical Imaging and Computing, UCL.
Sebastien
S
Ourselin
Department of Neurosurgery, National Hospital for Neurology and Neurosurgery.
Anna
A
Miserocchi
Department of Neurosurgery, National Hospital for Neurology and Neurosurgery.
Andrew
A
McEvoy
Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology.
John
J
Duncan
D004569:Electroencephalography; D004827:Epilepsy / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D064847:Multimodal Imaging; D038361:Neuronavigation; D012984:Software