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  • 3D Position of STN in T2 weighed MR images compared to Stereotactic Atlases for functional neurosurgery planning.

    Final Number:

    Erich Talamoni Fonoff PhD; William Omar Contreras Lopez PhD; PR Dos reis; Alho EJL PhD; A Alaninos MD; Manoel Jacobsen Almeida de Oliveira Teixeira PhD

    Study Design:

    Subject Category:
    Image Guided Applications

    Meeting: 2014 ASSFN Biennial Meeting

    Introduction: Currently there are several standard atlases available that are used to localize the STN in functional MRI studies and clinical procedures such as deep brain stimulation (DBS). However, current atlases are based on low sample sizes and restricted age ranges (Schaltenbrand and Wahren, 1977, Morel 2007), and hence the use of these atlases effectively ignores substantially individual differences in brain structural and the changes associated with aging. Here we aimed to compare the position and the volumen of STN observed in the T2 weighted MR images in comparison the same structure in the Schaltenbrand and Morel atlases.

    Methods: 10 parkinson patients who underwent STN DBS, received anatomical 3D reconstruction of MRI T2 modified sequence fusioned with stereotomography, atlas integration, volumetric and spatial comparation of the STN related to the AC-PC using the Schaltenbrand and Wahren, 1977, and Morel 2007 atlases.

    Results: We found an important anatomical variation related with patient age, which induces an error on the atlas interpretation, the mean variation on the caudal part of the STN was of 2,5 mm. It was also adquired a convergence zone common to all used atlases with an important relevance for future DBS implant studies. STN was always medially related to propose STN by the Schaltenbrand atlas and lateral related to Morel atlas.

    Conclusions: : Our series found Morel atlas to be more accurate in relation to patient image T2 modified series than Schaltenbrand in which we found a lateral posterior deviation. The comparison between patients concludes that no target should be base only on atlas anatomy but the sume of MER, an anatomical atlas and atlas based coordinates from the MCP. We may also advice to mostly relay on the MRI image.

    Patient Care: Practicians should be awared that the use of these atlases effectively ignores substantially individual differences in brain structural and the changes associated with aging during their surgery planning, which may avoid undesired electrodes misplacements.

    Learning Objectives: By the conclusion of this session, participans should be aware of the important anatomical variation between MRI patient image and current available software planning human stereotactic atlases.


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