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Proceedings Paper

Potential predictors for the amount of intra-operative brain shift during deep brain stimulation surgery
Author(s): Ryan Datteri; Srivatsan Pallavaram; Peter E. Konrad; Joseph S. Neimat; Pierre-François D'Haese; Benoit M. Dawant
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Paper Abstract

A number of groups have reported on the occurrence of intra-operative brain shift during deep brain stimulation (DBS) surgery. This has a number of implications for the procedure including an increased chance of intra-cranial bleeding and complications due to the need for more exploratory electrodes to account for the brain shift. It has been reported that the amount of pneumocephalus or air invasion into the cranial cavity due to the opening of the dura correlates with intraoperative brain shift. Therefore, pre-operatively predicting the amount of pneumocephalus expected during surgery is of interest toward accounting for brain shift. In this study, we used 64 DBS patients who received bilateral electrode implantations and had a post-operative CT scan acquired immediately after surgery (CT-PI). For each patient, the volumes of the pneumocephalus, left ventricle, right ventricle, third ventricle, white matter, grey matter, and cerebral spinal fluid were calculated. The pneumocephalus was calculated from the CT-PI utilizing a region growing technique that was initialized with an atlas-based image registration method. A multi-atlas-based image segmentation method was used to segment out the ventricles of each patient. The Statistical Parametric Mapping (SPM) software package was utilized to calculate the volumes of the cerebral spinal fluid (CSF), white matter and grey matter. The volume of individual structures had a moderate correlation with pneumocephalus. Utilizing a multi-linear regression between the volume of the pneumocephalus and the statistically relevant individual structures a Pearson's coefficient of r = 0.4123 (p = 0.0103) was found. This study shows preliminary results that could be used to develop a method to predict the amount of pneumocephalus ahead of the surgery.

Paper Details

Date Published: 2 March 2011
PDF: 8 pages
Proc. SPIE 7964, Medical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling, 79640T (2 March 2011); doi: 10.1117/12.878504
Show Author Affiliations
Ryan Datteri, Vanderbilt Univ. (United States)
Srivatsan Pallavaram, Vanderbilt Univ. (United States)
Peter E. Konrad, Vanderbilt Univ. (United States)
Joseph S. Neimat, Vanderbilt Univ. (United States)
Pierre-François D'Haese, Vanderbilt Univ. (United States)
Benoit M. Dawant, Vanderbilt Univ. (United States)


Published in SPIE Proceedings Vol. 7964:
Medical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling
Kenneth H. Wong; David R. Holmes, Editor(s)

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