Visualization of subdural electrodes with fusion CT scan/MRI during neuronavigation-guided epilepsy surgery

Abstract

Neuronavigation in epilepsy surgery enables surgeons to accurately resect deep targets inside the brain, especially lesions that are unable to be visually differentiated from adjacent normal brain. The usefulness of visualizing subdural electrodes with postimplantation fusion CT/MRI was investigated. The use of platinum subdural electrodes made it possible to obtain postimplantation MRI. The postimplantation MRI and CT scans were fused on the surgical navigation system workstation to form three-dimensional (3D) images, and the epileptogenic regions were marked using the visualized electrodes. Immediately after a craniotomy was performed, the subdural electrodes were removed and the epileptogenic region was successfully resected using the neuronavigation guide. During neuronavigation-guided surgery to target deep brain epileptogenic lesions adjacent to eloquent areas, which are often invisible, we found visualization of the subdural electrodes with postimplantation fusion CT/MRI very useful.