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Utilization of Novel High-Resolution, MRI-Based Vascular Imaging Modality for Preoperative Stereoelectroencephalography Planning in Children: A Technical Note.

Publication ,  Journal Article
Feng, AY; Ho, AL; Kim, LH; Sussman, ES; Pendharkar, AV; Iv, M; Yeom, KW; Halpern, CH; Grant, GA
Published in: Stereotact Funct Neurosurg
2020

INTRODUCTION: Stereoelectroencephalography (SEEG) is a powerful intracranial diagnostic tool that requires accurate imaging for proper electrode trajectory planning to ensure efficacy and maximize patient safety. Computed tomography (CT) angiography and digital subtraction angiography are commonly used, but recent developments in magnetic resonance angiography allow for high-resolution vascular visualization without added risks of radiation. We report on the accuracy of electrode placement under robotic assistance planning utilizing a novel high-resolution magnetic resonance imaging (MRI)-based imaging modality. METHODS: Sixteen pediatric patients between February 2014 and October 2017 underwent SEEG exploration for epileptogenic zone localization. A gadolinium-enhanced 3D T1-weighted spoiled gradient recalled echo sequence with minimum echo time and repetition time was applied for background parenchymal suppression and vascular enhancement. Electrode placement accuracy was determined by analyzing postoperative CT scans laid over preoperative virtual electrode trajectory paths. Entry point, target point, and closest vessel intersection were measured. RESULTS: For any intersection along the trajectory path, 57 intersected vessels were measured. The mean diameter of an intersected vessel was 1.0343 ± 0.1721 mm, and 21.05% of intersections involved superficial vessels. There were 157 overall intersection + near-miss events. The mean diameter for an involved vessel was 1.0236 ± 0.0928 mm, and superficial vessels were involved in 20.13%. Looking only at final electrode target, 3 intersection events were observed. The mean diameter of an intersected vessel was 1.0125 ± 0.2227 mm. For intersection + near-miss events, 24 were measured. An involved vessel's mean diameter was 1.1028 ± 0.2634 mm. For non-entry point intersections, 45 intersected vessels were measured. The mean diameter for intersected vessels was 0.9526 ± 0.0689 mm. For non-entry point intersections + near misses, 126 events were observed. The mean diameter for involved vessels was 0.9826 ± 0.1008 mm. CONCLUSION: We believe this novel sequence allows better identification of superficial and deeper subcortical vessels compared to conventional T1-weighted gadolinium-enhanced MRI.

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Published In

Stereotact Funct Neurosurg

DOI

EISSN

1423-0372

Publication Date

2020

Volume

98

Issue

1

Start / End Page

1 / 7

Location

Switzerland

Related Subject Headings

  • Tomography, X-Ray Computed
  • Stereotaxic Techniques
  • Preoperative Care
  • Neurology & Neurosurgery
  • Male
  • Magnetic Resonance Imaging
  • Magnetic Resonance Angiography
  • Humans
  • Female
  • Electroencephalography
 

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Feng, A. Y., Ho, A. L., Kim, L. H., Sussman, E. S., Pendharkar, A. V., Iv, M., … Grant, G. A. (2020). Utilization of Novel High-Resolution, MRI-Based Vascular Imaging Modality for Preoperative Stereoelectroencephalography Planning in Children: A Technical Note. Stereotact Funct Neurosurg, 98(1), 1–7. https://doi.org/10.1159/000503693
Feng, Austin Y., Allen L. Ho, Lily H. Kim, Eric S. Sussman, Arjun V. Pendharkar, Michael Iv, Kristen W. Yeom, Casey H. Halpern, and Gerald A. Grant. “Utilization of Novel High-Resolution, MRI-Based Vascular Imaging Modality for Preoperative Stereoelectroencephalography Planning in Children: A Technical Note.Stereotact Funct Neurosurg 98, no. 1 (2020): 1–7. https://doi.org/10.1159/000503693.
Feng AY, Ho AL, Kim LH, Sussman ES, Pendharkar AV, Iv M, et al. Utilization of Novel High-Resolution, MRI-Based Vascular Imaging Modality for Preoperative Stereoelectroencephalography Planning in Children: A Technical Note. Stereotact Funct Neurosurg. 2020;98(1):1–7.
Feng, Austin Y., et al. “Utilization of Novel High-Resolution, MRI-Based Vascular Imaging Modality for Preoperative Stereoelectroencephalography Planning in Children: A Technical Note.Stereotact Funct Neurosurg, vol. 98, no. 1, 2020, pp. 1–7. Pubmed, doi:10.1159/000503693.
Feng AY, Ho AL, Kim LH, Sussman ES, Pendharkar AV, Iv M, Yeom KW, Halpern CH, Grant GA. Utilization of Novel High-Resolution, MRI-Based Vascular Imaging Modality for Preoperative Stereoelectroencephalography Planning in Children: A Technical Note. Stereotact Funct Neurosurg. 2020;98(1):1–7.
Journal cover image

Published In

Stereotact Funct Neurosurg

DOI

EISSN

1423-0372

Publication Date

2020

Volume

98

Issue

1

Start / End Page

1 / 7

Location

Switzerland

Related Subject Headings

  • Tomography, X-Ray Computed
  • Stereotaxic Techniques
  • Preoperative Care
  • Neurology & Neurosurgery
  • Male
  • Magnetic Resonance Imaging
  • Magnetic Resonance Angiography
  • Humans
  • Female
  • Electroencephalography