Objective: To determine placement of electrodes using the single energy metal artifact reduction (SEMAR) algorithm with a 320 multi-slice computed tomography (MSCT) volume scanner in Parkinson’s patients after deep brain stimulation (DBS) surgery.

Background: DBS of the subthalamic nucleus (STN) produces variable effects on PD in different patients. Different electrode positions and electrode accuracy may lead to changes in efficacy. Thus, precise electrode localization is essential in the stimulation management in DBS.

Method: From January 2018 to February 2020，twenty consecutive PD patients after DBS surgery who underwent a 320 MSCT scan were collected. The SEMAR algorithm was used to reduce the metal artifact of DBS lead. Postoperative CT images were co-registered to the preoperative high-resolution magnetic resonance (MRI) images using 3D slicer software (www.slicer.org). Using this algorithm, the postoperative spatial structure of 3 different atlases (BGHAT, ATAG，and Accolla-2014 atlas) realized visualization of electrode localization. Intraoperative microelectrode recording (MER) data was also collected as a comparative index of SEMAR algorithm.

Results: The SEMAR algorithm significantly reduced the metal artifact of DBS electrode. Of the total 40 DBS electrodes obtained, 28 (70%) electrodes showed at least 3 contacts located in the STN area, 9 (22.5%) electrodes showed 2 contacts in the STN, and 3 (7.5%) electrodes showed 1 contact in the STN. The STN length calculated by SEMAR algorithm was significantly corelated to the STN length in the MER.

Conclusion: The SEMAR algorithm shows promise in improving CT image quality and in ensuring an accurate evaluation of DBS electrode position, which could provide guidance for the postoperative programmed stimulation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/single-energy-metal-artefact-reduction-a-precise-method-for-localization-of-deep-brain-stimulation-electrodes-in-parkinsons-patients/