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Comparative Study
. 2025 Jan;55(1):103038.
doi: 10.1016/j.neucli.2024.103038. Epub 2025 Jan 13.

Refining computer-assisted SEEG planning with spatial priors - A novel comparison of implantation strategies across adult and paediatric centres

Debayan Dasgupta  1 , Aswin Chari  2 , Mehdi Khan  3 , Friederike Moeller  4 , Zubair Tahir  5 , Andrew W McEvoy  6 , Anna Miserocchi  6 , John S Duncan  7 , Rachel E Sparks  8 , Martin Tisdall  9
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Free article
Comparative Study

Refining computer-assisted SEEG planning with spatial priors - A novel comparison of implantation strategies across adult and paediatric centres

Debayan Dasgupta et al. Neurophysiol Clin. 2025 Jan.
Free article

Abstract

Objectives: Computer-assisted planning (CAP) allows faster SEEG planning and improves grey matter sampling, orthogonal drilling angles to the skull, reduces risk scores and minimises intracerebral electrode length. Incorporating prior SEEG trajectories enhances CAP planning, refining output with centre-specific practices. This study significantly expands on the previous work, compares priors libraries between two centres, and describes differences between SEEG in adults and children in these centres.

Methods: 98 adults and 61 children who underwent SEEG implantation as part of epilepsy surgery investigations were included. Priors libraries were created for each population, clustered by target regions and subdivided by cortical approaches. The libraries were coregistered and quantitatively and qualitatively compared.

Results: The average number of implanted electrodes per patient was higher in paediatric patients than adults (13.6 vs 8.0). Paediatric implantations focused more on the insula than adult implantations (38.0 % vs 13.5 %), with similar proportions of electrodes implanted in the temporal and parietal lobes, and a higher proportion of adult electrodes in the frontal and orbitofrontal regions (40.6 % vs 24.0 %). Correspondence between the priors libraries was high. We present an example of a complex insular implantation planned with paediatric spatial priors and illustrate resultant SEEG recordings.

Discussion: The use of centre-specific spatial priors allows the incorporation of surgeon-specific and unit-specific preferences into automated planning. We compare implantation styles between a paediatric and an adult centre, discussing similarities and differences. This tool allows centres to compare practice and represents an effective way to analyse implantation strategies that is agnostic to method of implantation.

Keywords: Computer-assisted planning; Epilepsy surgery; Intracranial EEG; Spatial priors; Stereoelectroencephalography (SEEG); Surgical planning.

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Conflict of interest statement

Declaration of competing interest None of the authors has any conflict of interest to disclose. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.