Guiding Deep Brain Stimulation Interventions by Fusing Multimodal Uncertainty Regions

Abstract

Deep Brain Stimulation (DBS) is a surgical intervention that isknown to reduce or eliminate the symptoms of common movementdisorders, such as Parkinson’s disease, dystonia, or tremor. Dur-ing the intervention the surgeon places electrodes inside of the pa-tient’s brain to stimulate specific regions. Since these regions spanonly a couple of millimeters, and electrode misplacement has severeconsequences, reliable and accurate navigation is of great impor-tance. Usually the surgeon relies on fused CT and MRI data sets, aswell as direct feedback from the patient. More recently Microelec-trode Recordings (MER), which support navigation by measuringthe electric field of the patient’s brain, are also used. We proposea visualization system that fuses the different modalities: imagingdata, MER and patient checks, as well as the related uncertainties,in an intuitive way to present placement-related information in aconsistent view with the goal of supporting the surgeon in the finalplacement of the stimulating electrode. We will describe the designconsiderations for our system, the technical realization, present theoutcome of the proposed system, and provide an evaluation.