使用DiODe算法确定分段脑深部刺激导联实际方向的变化:不同导联设计和医疗机构的回顾性研究。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2023-01-01 Epub Date: 2023-09-15 DOI:10.1159/000531644
Kaylee R Henry, Milina Michelle Miulli, Noa B Nuzov, Mark J Nolt, Joshua M Rosenow, Behzad Elahi, Julie Pilitsis, Laleh Golestanirad
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引用次数: 0

摘要

导语:定向深部脑刺激(DBS)导线在过去十年中得到了广泛应用。理解定向导线提供的不对称刺激需要精确了解导线相对于其解剖目标的精确方向。最近,DiODe算法被开发用于根据术后计算机断层扫描(CT)图像上的伪影自动确定导线的方位角。但是,手动DiODe结果取决于用户。这项研究分析了两个最常见的DBS系统,即Boston Scientific的Vercise和Abbott的Infinity,以及两个独立的医疗机构的导联轮换程度以及DiODe计算的用户一致性。方法:对104例在西北纪念医院(NMH)或奥尔巴尼医疗中心(AMC)接受前向单侧/双侧定向DBS植入术的患者的数据进行回顾性分析。植入导线的实际方向由三名个人用户在导线DBS和患者术后CT图像中使用DiODe算法独立计算。对偏离预期方向和用户一致性进行了评估。结果:无论DBS导线设计(p<;0.05)或机构(p<;0.05)如何,所有导线都明显偏离了预期的0°方向(p&lgt;0.001)。然而,Boston Scientific导线在两个机构都显示出向左的植入偏移(NMH时p=0.014,AMC时p=0.029)。波士顿科学公司28%(NMH)和39%(AMC)以及雅培公司76%(NMH和53%(AMC。结论:我们的研究结果表明,在DBS系统和两个医疗机构中,与预期的手术方向相比,存在显著的导联轮换;然而,只有在《波士顿科学报》的报道中才看到对单一方向的偏见。此外,这些结果还对手动细化用DiODe计算的方位角时出现的用户错误提出了疑问。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Variations in Determining Actual Orientations of Segmented Deep Brain Stimulation Leads Using the DiODe Algorithm: A Retrospective Study Across Different Lead Designs and Medical Institutions.

Introduction: 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, manual DiODe results are user-dependent. This study analyzed the extent of lead rotation as well as the user agreement of DiODe calculations across the two most common DBS systems, namely, Boston Scientific's Vercise and Abbott's Infinity, 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. The deviation from the intended orientation and user agreement were assessed.

Results: All leads significantly deviated from the intended 0° orientation (p < 0.001), regardless of DBS lead design (p < 0.05) or institution (p < 0.05). However, the Boston Scientific leads showed an implantation bias toward the left at both institutions (p = 0.014 at NMH, p = 0.029 at AMC). A difference of 10° between at least two users occurred in 28% (NMH) and 39% (AMC) of all Boston Scientific and 76% (NMH) and 53% (AMC) of all Abbott 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 toward a single direction was only seen in the 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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来源期刊
Accounts of Chemical Research
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.
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