Variations in determining actual orientations of segmented deep brain stimulation leads using the manually refined DiODe algorithm: a retrospective study across different lead designs and medical institutions

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2022-12-22 DOI:10.1101/2022.12.22.22283840

Kaylee R. Henry, Milina M. Miulli, Noa B. Nuzov, M. Nolt, J. Rosenow, B. Elahi, Julie Pilitsis, L. Golestanirad

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引用次数: 0

Abstract

Purpose: Directional deep brain stimulation (DBS) leads have become widely used in the past decade. Understanding the asymmetric stimulation provided by directional leads requires precise knowledge of the exact orientation of the lead in respect to its anatomical target. Recently, the DiODe algorithm was developed to automatically determine the orientation angle of leads from the artifact on postoperative computed tomography (CT) images. However, DiODe results are user-dependent. This study analyzed the significance of lead rotation as well as the user agreement of DiODe calculations across the two most common DBS systems and two independent medical institutions. Methods: Data from 104 patients who underwent an anterior-facing unilateral/bilateral directional DBS implantation at either Northwestern Memorial Hospital (NMH) or Albany Medical Center (AMC) were retrospectively analyzed. Actual orientations of the implanted leads were independently calculated by three individual users using the DiODe algorithm in Lead-DBS and patients' postoperative CT images. Deviation from the intended orientation and user agreement were assessed. Results: All leads significantly deviated from the intended 0{degrees} orientation (p<0.001), regardless of DBS lead design (p<0.05) or institution (p<0.05). However, a bias of the implantation towards a single direction was seen for the Boston Scientific leads (p=0.014 at NMH, p=0.029 at AMC). A difference of 10{degrees} between at least two users occurred in 28% (NMH) and 39% (AMC) of all Boston Scientific and 53% (AMC) and 76% (NMH) of all St. Jude leads. Conclusion: Our results show that there is a significant lead rotation from the intended surgical orientation across both DBS systems and both medical institutions, however, a bias towards a single direction was only seen in Boston Scientific leads. Additionally, these results raise questions into the user error that occurs when manually refining the orientation angles calculated with DiODe.

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使用人工改进的二极管算法确定分段脑深部刺激引线实际方向的差异:不同引线设计和医疗机构的回顾性研究

目的:定向脑深部刺激(DBS)引线在过去的十年中得到了广泛的应用。要理解定向导联提供的不对称刺激，就需要精确地了解导联相对于其解剖目标的确切方向。近年来，研究人员开发了二极管算法，用于从术后CT图像上的伪影中自动确定引线的取向角。然而，二极管的结果是用户依赖的。本研究分析了两种最常见的DBS系统和两家独立医疗机构中铅轮旋转的意义以及二极管计算的用户协议。方法:回顾性分析在西北纪念医院(NMH)或奥尔巴尼医疗中心(AMC)接受前向单侧/双侧定向DBS植入的104例患者的资料。使用Lead-DBS中的DiODe算法和患者术后CT图像，由三个独立用户独立计算植入导线的实际方向。偏离预期方向和用户协议进行了评估。结果:无论DBS导联设计(p<0.05)或机构(p<0.05)，所有导联都明显偏离预期的0{度}方向(p<0.001)。然而，波士顿科学公司的研究结果显示植入偏向单一方向(NMH时p=0.014, AMC时p=0.029)。在所有Boston Scientific的28% (NMH)和39% (AMC)以及所有St. Jude的53% (AMC)和76% (NMH)的引线中，至少两个用户之间的差异为10{度}。结论:我们的研究结果表明，在DBS系统和两家医疗机构中，都存在明显的导联旋转，偏离了预期的手术方向，然而，只在波士顿科学公司的导联中发现了偏向单一方向的现象。此外，这些结果提出了问题，用户错误时发生的手动细化与二极管计算的方向角。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.