Session Information
Date: Monday, June 5, 2017
Session Title: Surgical Therapy: Parkinson’s Disease
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: To compare dorsal and ventral subthalamic nucleus (STN) borders as seen on 3-Tesla (3T) T2-weighted (T2) and Susceptibility Weighted Images (SWI) with borders obtained during microelectrode recording (MER) in patients undergoing deep brain stimulation (DBS) for Parkinson’s disease (PD).
Background: Clear representation of the STN and delineation of its dorsal and ventral borders is key in determining the location for lead placement in DBS for PD. Magnetic resonance imaging (MRI) can visualize the STN. Which sequence most accurately corresponds with the electrophysiological STN (MER-STN) remains a matter of debate. CT/MRI fusion allows for comparison between the MER-STN and the STN visualized on preoperative MRI (MRI-STN).
Methods: Intraoperative CT (iCT) was performed after each MER track before removing the microelectrode. iCT images were merged with preoperative images using planning software, allowing for projection of MER tracks on T2 and SWI sequences. Dorsal and ventral borders of each track were determined and compared to MRI-STN borders. Distances between T2 MRI-STN, SWI MRI-STN, and MER-STN borders were calculated.
Results: A total of 125 tracks were evaluated in 45 patients. Dorsal MRI-STN borders showed MER-STN activity in 67% (T2) and 57% (SWI) of tracks. For Ventral MRI-STN borders this was 27% (T2) and 23% (SWI). Comparing MRI-STN to MER-STN, distances of 1.9 ± 1.4 mm (T2) and 2.5 ± 1.8 mm (SWI) were found between dorsal borders. Distances of 1.9 ± 1.6 mm (T2) and 2.1 ± 1.8 mm (SWI) were found between ventral borders. MER-STN started and ended more dorsally than respective dorsal and ventral MRI-STN borders on both sequences.
Conclusions: Border discrepancies between MRI-STN and MER-STN were found, most notably when comparing the ventral border, with T2 performing better than SWI. We suggest that a cautious approach should be taken when relying solely on MR imaging for delineation of the STN, particularly its important ventral border.
To cite this abstract in AMA style:
S. Bus, P. Van den Munckhof, M. Bot, G. Pal, B. Ouyang, S. Sani, L. Verhagen-Metman. Correspondence between MRI borders of the subthalamic nucleus and its electrophysiological borders: a comparison study using intraoperative CT. [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/correspondence-between-mri-borders-of-the-subthalamic-nucleus-and-its-electrophysiological-borders-a-comparison-study-using-intraoperative-ct/. Accessed June 15, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/correspondence-between-mri-borders-of-the-subthalamic-nucleus-and-its-electrophysiological-borders-a-comparison-study-using-intraoperative-ct/