Magnetic Resonance Imaging versus Computed Tomography for Target Localization in Functional Stereotactic Neurosurgery

Magnetic Resonance Imaging versus Computed Tomography for Target Localization in Functional... AbstractOBJECTIVE:To determine whether magnetic resonance imaging (MRI), compared with computed tomography (CT), provides consistent and accurate target localization for ventrolateral thalamotomy and posteroventral pallidotomy.METHODS:For 93 procedures (78 pallidotomies and 15 thalamotomies) in 83 patients, coordinates for the anterior commissure, posterior commissure, and stereotactic target were calculated from MRI- and CT-derived images and compared.RESULTS:The mean differences for the target were -0.41 mm on the xaxis (P < 0.001), 0.06 mm on the yaxis (P = 0.412), and -0.34 mm on the z axis (P < 0.01). The mean absolute differences were 0.53 mm on the x axis (median, 0.50 mm; range, 0.00-2.00 mm), 0.46 mm on the yaxis (median, 0.50 mm; range, 0.00-2.00 mm), and 0.78 mm on the zaxis (median, 0.50 mm; range, 0.00-6.00 mm). The mean three-dimensional distance between MRI- and CT-derived coordinates for the anterior commissure was 1.65 mm, with a distance of more than 4 mm in two cases (2%). The mean three-dimensional distance for the posterior commissure was 1.65 mm, with a distance of more than 4 mm in two cases (2%). The mean three-dimensional distance for the target was 1.25 mm (median, 1.14 mm; range, 0.00-6.27 mm), with a distance of more than 4 mm in one case (1%).CONCLUSION:Statistically significant but relatively small differences between MRI- and CT-derived target coordinates were found. In some cases (approximately 2% of this series), the differences between MRI- and CT-derived coordinates may be relatively large (greater than 4 mm and up to 8 mm). However, given the superior anatomic resolution of MRI and the nature of the stereotactic procedures under consideration, we conclude that MRI, when validated within an institution, may be used alone for target localization in pallidotomy and thalamotomy. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Magnetic Resonance Imaging versus Computed Tomography for Target Localization in Functional Stereotactic Neurosurgery

Magnetic Resonance Imaging versus Computed Tomography for Target Localization in Functional Stereotactic Neurosurgery

Magnetic Resonance Imaging versus Computed Tomography for Target Localization in Functional Stereotactic Neurosurgery Paul E. Holtzheimer III, B.S., David W . Roberts, M.D., Terrance M. Darcey, Ph.D. Dartm outh M e d ic a l Sch o o l (P E H ) and Sections of N eurosurgery ( D W R ) and N e u ro lo g y (T M D ), D artm o uth -H itchco ck M e d ic a l Center, Lebanon, N e w H a m p sh ire O BJECTIVE: To determine whether magnetic resonance imaging (M RI), compared with computed tomography (CT), provides consistent and accurate target localization for ventrolateral thalamotomy and posteroventral pallidotomy. METHODS: For 93 procedures (78 pallidotomies and 15 thalamotomies) in 83 patients, coordinates for the anterior commis­ sure, posterior commissure, and stereotactic target were calculated from MRI- and CT-derived images and compared. RESULTS: The mean differences for the target were —0.41 mm on the xaxis (P < 0.001), 0.06 mm on the yaxis (P = 0.412), and —0.34 mm on the z axis (P < 0.01). The mean absolute differences were 0.53 mm on the x axis (median, 0.50 mm; range, 0.00-2.00 mm), 0.46 mm on the yaxis (median, 0.50 mm; range, 0.00-2.00 mm), and 0.78 mm on the zaxis (median, 0.50 mm; range, 0.00-6.00 mm). The mean three-dimensional distance between MRI- and CT-derived coordinates for the anterior commissure was 1.65 mm, with a distance of more than 4 mm in two cases (2 % ). The mean three-dimensional distance for the posterior commissure was 1.65 mm, with a distance of more than 4 mm in two cases (2 % ). The mean three-dimensional distance for the target was 1.25 mm (median, 1.14 mm; range, 0.00-6.27 mm), with a distance of more than 4 mm in one case (1 % ). C O N C LU SIO N : Statistically significant but relatively small differences between MRI- and CT-derived target coordinates were found. In some cases (approximately 2 % of this series), the differences between MRI- and CT-derived coordi­ nates may be relatively large (greater...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199908000-00018
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:To determine whether magnetic resonance imaging (MRI), compared with computed tomography (CT), provides consistent and accurate target localization for ventrolateral thalamotomy and posteroventral pallidotomy.METHODS:For 93 procedures (78 pallidotomies and 15 thalamotomies) in 83 patients, coordinates for the anterior commissure, posterior commissure, and stereotactic target were calculated from MRI- and CT-derived images and compared.RESULTS:The mean differences for the target were -0.41 mm on the xaxis (P < 0.001), 0.06 mm on the yaxis (P = 0.412), and -0.34 mm on the z axis (P < 0.01). The mean absolute differences were 0.53 mm on the x axis (median, 0.50 mm; range, 0.00-2.00 mm), 0.46 mm on the yaxis (median, 0.50 mm; range, 0.00-2.00 mm), and 0.78 mm on the zaxis (median, 0.50 mm; range, 0.00-6.00 mm). The mean three-dimensional distance between MRI- and CT-derived coordinates for the anterior commissure was 1.65 mm, with a distance of more than 4 mm in two cases (2%). The mean three-dimensional distance for the posterior commissure was 1.65 mm, with a distance of more than 4 mm in two cases (2%). The mean three-dimensional distance for the target was 1.25 mm (median, 1.14 mm; range, 0.00-6.27 mm), with a distance of more than 4 mm in one case (1%).CONCLUSION:Statistically significant but relatively small differences between MRI- and CT-derived target coordinates were found. In some cases (approximately 2% of this series), the differences between MRI- and CT-derived coordinates may be relatively large (greater than 4 mm and up to 8 mm). However, given the superior anatomic resolution of MRI and the nature of the stereotactic procedures under consideration, we conclude that MRI, when validated within an institution, may be used alone for target localization in pallidotomy and thalamotomy.

Journal

NeurosurgeryOxford University Press

Published: Aug 1, 1999

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