Image Fusion of High-Resolution DynaCT and T2-Weighted MRI for Image-Guided Programming of dDBS

<b>Objectives:</b> This study aimed to develop a semi-automated registration method for aligning preoperative non-contrast T2-weighted MRI with postoperative high-resolution cone-beam CT (DynaCT) in patients undergoing directional deep brain stimulation (dDBS) surgery targeting the subth...

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Main Authors: Fadil Al-Jaberi, Matthias Moeskes, Martin Skalej, Melanie Fachet, Christoph Hoeschen
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/15/5/521
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author Fadil Al-Jaberi
Matthias Moeskes
Martin Skalej
Melanie Fachet
Christoph Hoeschen
author_facet Fadil Al-Jaberi
Matthias Moeskes
Martin Skalej
Melanie Fachet
Christoph Hoeschen
author_sort Fadil Al-Jaberi
collection DOAJ
description <b>Objectives:</b> This study aimed to develop a semi-automated registration method for aligning preoperative non-contrast T2-weighted MRI with postoperative high-resolution cone-beam CT (DynaCT) in patients undergoing directional deep brain stimulation (dDBS) surgery targeting the subthalamic nucleus (STN). The aim was to facilitate image-guided programming of DBS devices and postoperative verification of the alignment of segmented contacts. <b>Materials and Methods:</b> A dataset of ten patients undergoing bilateral dDBS implantation was retrospectively collected, including DynaCT (acquired postoperatively) and non-contrast T2-weighted MRI (obtained preoperatively). A semi-automated registration method was used, employing manual initialization due to dissimilar anatomical information between DynaCT and T2-weighted MRI. Image visualization, initial alignment using a centered transformation initializer, and single-resolution image registration involving the Simple Insight Toolkit (SimpleITK) library were performed. Manual landmark-based alignment based on anatomical landmarks and evaluation metrics such as Target Registration Error (TRE) assessed alignment accuracy. <b>Results:</b> The registration method successfully aligned all images. Quantitative evaluation revealed an average of the mean TRE of 1.48 mm across all subjects, indicating satisfactory alignment quality. Multiplanar reformations (MPRs) based on electrode-oriented normal vectors visualized segmented contacts for accurate electrode placement. <b>Conclusions:</b> The developed method demonstrated successful registration between preoperative non-contrast T2-weighted MRI and postoperative DynaCT, despite dissimilar anatomical information. This approach facilitates accurate alignment crucial for DBS programming and postoperative verification, potentially reducing the programming time of the DBS. The study underscores the importance of image quality, manual initialization and semi-automated registration methods for successful multimodal image registration in dDBS procedures targeting the STN.
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spelling doaj-art-ff6ad105413145148ae83ecc09c4bd1f2025-08-20T03:47:49ZengMDPI AGBrain Sciences2076-34252025-05-0115552110.3390/brainsci15050521Image Fusion of High-Resolution DynaCT and T2-Weighted MRI for Image-Guided Programming of dDBSFadil Al-Jaberi0Matthias Moeskes1Martin Skalej2Melanie Fachet3Christoph Hoeschen4Chair of Medical Systems Technology, Institute for Medical Technology, Faculty of Electrical Engineering and Information Technology, Otto von Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, GermanyInstitute for Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyNeuroradiology, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Straße 40, 06120 Halle, GermanyChair of Medical Systems Technology, Institute for Medical Technology, Faculty of Electrical Engineering and Information Technology, Otto von Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, GermanyChair of Medical Systems Technology, Institute for Medical Technology, Faculty of Electrical Engineering and Information Technology, Otto von Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany<b>Objectives:</b> This study aimed to develop a semi-automated registration method for aligning preoperative non-contrast T2-weighted MRI with postoperative high-resolution cone-beam CT (DynaCT) in patients undergoing directional deep brain stimulation (dDBS) surgery targeting the subthalamic nucleus (STN). The aim was to facilitate image-guided programming of DBS devices and postoperative verification of the alignment of segmented contacts. <b>Materials and Methods:</b> A dataset of ten patients undergoing bilateral dDBS implantation was retrospectively collected, including DynaCT (acquired postoperatively) and non-contrast T2-weighted MRI (obtained preoperatively). A semi-automated registration method was used, employing manual initialization due to dissimilar anatomical information between DynaCT and T2-weighted MRI. Image visualization, initial alignment using a centered transformation initializer, and single-resolution image registration involving the Simple Insight Toolkit (SimpleITK) library were performed. Manual landmark-based alignment based on anatomical landmarks and evaluation metrics such as Target Registration Error (TRE) assessed alignment accuracy. <b>Results:</b> The registration method successfully aligned all images. Quantitative evaluation revealed an average of the mean TRE of 1.48 mm across all subjects, indicating satisfactory alignment quality. Multiplanar reformations (MPRs) based on electrode-oriented normal vectors visualized segmented contacts for accurate electrode placement. <b>Conclusions:</b> The developed method demonstrated successful registration between preoperative non-contrast T2-weighted MRI and postoperative DynaCT, despite dissimilar anatomical information. This approach facilitates accurate alignment crucial for DBS programming and postoperative verification, potentially reducing the programming time of the DBS. The study underscores the importance of image quality, manual initialization and semi-automated registration methods for successful multimodal image registration in dDBS procedures targeting the STN.https://www.mdpi.com/2076-3425/15/5/521deep brain stimulationimage registrationsubthalamic nucleusmultimodal imagingdirectional electrodes
spellingShingle Fadil Al-Jaberi
Matthias Moeskes
Martin Skalej
Melanie Fachet
Christoph Hoeschen
Image Fusion of High-Resolution DynaCT and T2-Weighted MRI for Image-Guided Programming of dDBS
Brain Sciences
deep brain stimulation
image registration
subthalamic nucleus
multimodal imaging
directional electrodes
title Image Fusion of High-Resolution DynaCT and T2-Weighted MRI for Image-Guided Programming of dDBS
title_full Image Fusion of High-Resolution DynaCT and T2-Weighted MRI for Image-Guided Programming of dDBS
title_fullStr Image Fusion of High-Resolution DynaCT and T2-Weighted MRI for Image-Guided Programming of dDBS
title_full_unstemmed Image Fusion of High-Resolution DynaCT and T2-Weighted MRI for Image-Guided Programming of dDBS
title_short Image Fusion of High-Resolution DynaCT and T2-Weighted MRI for Image-Guided Programming of dDBS
title_sort image fusion of high resolution dynact and t2 weighted mri for image guided programming of ddbs
topic deep brain stimulation
image registration
subthalamic nucleus
multimodal imaging
directional electrodes
url https://www.mdpi.com/2076-3425/15/5/521
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