A Retrospective Analysis of Factors Impacting Stereoelectroencephalography Accuracy at a Single Canadian Center
Abstract number :
3.322
Submission category :
9. Surgery / 9A. Adult
Year :
2022
Submission ID :
2205148
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:28 AM
Authors :
Greydon Gilmore, PhD – Western University; Mohamad Abbass, MD, MSc – Western University; Hari Ramakonar, MD – Western University; Jorge Burneo, MD, MSPH – Western University; Keith MacDougall, MD – Western University; Andrew Parrent, MD – Western University; David Steven, MD, MPH – Western University; Jonathan Lau, MD, PhD – Western University
Rationale: Stereoelectroencephalography (SEEG) is a stereotactic neurosurgical procedure utilized in specific cases of drug resistant epilepsy to characterize epileptogenic zones and networks (1). Accurate implantation of SEEG electrodes is essential for maximal efficacy and safety. Our center has previously demonstrated robotic implantation of SEEG electrodes is safe and reduces operative room time (2). In this study, we sought to analyze the factors contributing to the accuracy of robotically implanted SEEG electrodes.
Methods: A series of 123 patients who underwent robotic SEEG implantation were included (between 2017 to 2022). Euclidean and radial electrode trajectory distances were calculated between the planned target (based on preoperative magnetic resonance imaging) and the actual target (based on postoperative computed tomography). The effects of target location and patient factors on accuracy were investigated. The mean errors with interquartile ranges (IQR) are reported.
Results: This study included 123 patients (51.2% female, mean age 35.9 ± 13.0 years), with a mean (± standard deviation) of 11.3 ± 2.8 electrodes implanted per patient. The mean Euclidean error was 1.97 mm (IQR: 1.76-2.19 mm) and the mean radial error was 1.49 mm (IQR: 1.25-1.75 mm). Electrodes were most accurately placed in the posterior supplementary motor area (mean radial error 0.84 mm, IQR: 0.59-1.08 mm), and were least accurately placed in the temporal pole (mean radial error 2.75 mm, IQR: 1.71-3.80 mm).
Conclusions: SEEG electrodes can be placed within millimetric accuracy with robotic assistance. Factors such as target location can influence placement accuracy. Future directions include further elucidating the association between target location and accuracy, further exploring possible covariates such as trajectory angle and length. This framework can be applied prospectively to optimize SEEG implantations, enabling increasingly accurate and tailored investigations of patients with epilepsy._x000D_
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References:_x000D_
1. Brain. 2019;142(9):2688-2704._x000D_
2. Neurosurgery. 2020;87(1):E23-E30. _x000D_
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Ethical Procedures: This study was approved by the London Health Sciences Research Ethics Board at Western University (REB#114420).
Funding: None
Surgery