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Background: Deep brain stimulation (DBS) electrode placement utilizing a frame-based technique requires registration of the stereotactic frame with computed tomography (CT) or magnetic resonance (MR) imaging. This traditionally has been accomplished with a conventional CT scanner. In recent years, intraoperative CT has become more prevalent.
Objective: To compare the coordinates obtained with intraoperative CT and conventional CT for registration of the stereotactic frame for DBS.
Methods: Patients undergoing DBS electrode placement between 2015 and 2017, who underwent both conventional and intraoperative CT for registration of the stereotactic frame, were included for analysis. The coordinates for the stereotactic target, anterior commissure, and posterior commissure for each CT method were recorded. The mean, maximum, minimum, and standard deviation of the absolute difference for each of the paired coordinates was calculated. Paired t-tests were performed to test for statistical significance of the difference. The directional difference as well as the vector error between the paired coordinates was also calculated.
Results: The mean absolute difference between conventional and intraoperative CT for the coordinate pairs was less than 0.279 mm or 0.211 degrees for all coordinate pairs analyzed. This was not statistically significant for any of the coordinate pairs. Moreover, the maximum absolute difference between all coordinate pairs was 1.04 mm.
Conclusion: Intraoperative CT imaging provides stereotactic frame registration coordinates that are similar to those obtained by a standard CT scanner. This may save time and hospital resources by obviating the need for the patient to go to the radiology department for a CT scan.
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http://dx.doi.org/10.1093/ons/opaa361 | DOI Listing |
J Contemp Brachytherapy
October 2024
Radiation Oncology, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy.
Purpose: This systematic review aimed to assess the feasibility, safety, and efficacy of using modern external beam radiotherapy (EBRT) techniques, such as intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic body radiotherapy (SBRT) as alternative approaches to brachytherapy (BRT) in adjuvant treatment of endometrial cancer (EC).
Material And Methods: A systematic review was conducted following PRISMA guidelines. The research question was framed using the PICO method, focusing on patients with EC [P] and comparing modern EBRT techniques (IMRT, VMAT, SBRT) [I] vs.
Br J Neurosurg
December 2024
Department of Neurosurgery, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP, UK.
Background: We assessed the accuracy and performed a directional analysis of robot-assisted implantation of stereoelectroencephalography (SEEG) depth electrodes in children using the frameless neurolocate 3D registration module.
Methods: Thirteen children with epilepsy undergoing stereotactic robot-assisted insertion of SEEG electrodes were included. Six children were operated on with standard frame-based registration while 7 with the use of the frameless neurolocate registration module.
Stereotact Funct Neurosurg
December 2024
Introduction Cerebellar deep brain stimulation (DBS) is gaining traction as a potential treatment for movement disorders and stroke and there is renewed interest in the cerebellum as a target for neuromodulation. Despite the safety and accuracy of frame-based approaches to the posterior fossa, unconventional stereotactic frame placement may be necessary to allow for low posterior fossa trajectories. Current literature lacks a comprehensive protocol detailing inverted frame placement and targeting.
View Article and Find Full Text PDFJ Med Imaging Radiat Sci
December 2024
Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Introduction: Non-invasive frameless systems have paved its way for stereotactic radiotherapy treatments compared to gold standard invasive rigid frame-based systems as they are comfortable to patients, do not have risk of pain, bleeding, infection, frame slippage and have similar treatment efficacy.
Aim And Objective: To estimate immobilisation accuracy (interfraction and intrafraction) and PTV margins with double shell positioning system (DSPS) using daily image guidance for stereotactic radiotherapy in patients with brain tumors.
Materials And Method: A prospective study was done in 19 cranial tumor patients with KPS ≥70, immobilized by the DSPS with mouth bite and treated with LINAC based image guided stereotactic radiotherapy.
Neurosurg Focus
December 2024
1Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin.
Objective: Robotics in neurosurgery is becoming increasingly prevalent. The integration of intraoperative imaging for patient registration into workflows of newer robotic systems enhances precision and has further driven their widespread adoption. In this study, the authors report on a lightweight, table-mounted robotic system integrating robotic cone-beam CT (CB-CT) for automated patient registration in cranial biopsies and stereotactic electroencephalography (sEEG).
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