Multicenter validation of automated trajectories for selective laser amygdalohippocampectomy

Epilepsia
Vejay N VakhariaJohn S Duncan

Abstract

Laser interstitial thermal therapy (LITT) is a novel minimally invasive alternative to open mesial temporal resection in drug-resistant mesial temporal lobe epilepsy (MTLE). The safety and efficacy of the procedure are dependent on the preplanned trajectory and the extent of the planned ablation achieved. Ablation of the mesial hippocampal head has been suggested to be an independent predictor of seizure freedom, whereas sparing of collateral structures is thought to result in improved neuropsychological outcomes. We aim to validate an automated trajectory planning platform against manually planned trajectories to objectively standardize the process. Using the EpiNav platform, we compare automated trajectory planning parameters derived from expert opinion and machine learning to undertake a multicenter validation against manually planned and implemented trajectories in 95 patients with MTLE. We estimate ablation volumes of regions of interest and quantify the size of the avascular corridor through the use of a risk score as a marker of safety. We also undertake blinded external expert feasibility and preference ratings. Automated trajectory planning employs complex algorithms to maximize ablation of the mesial hippocampal head ...Continue Reading

References

May 30, 2013·Brain : a Journal of Neurology·Silvia B BonelliJohn S Duncan
Jul 16, 2013·Trends in Cognitive Sciences·Elissa M AminoffMoshe Bar
Jul 24, 2014·IEEE Transactions on Medical Imaging·Ninon BurgosSebastien Ourselin
Apr 8, 2015·International Journal of Computer Assisted Radiology and Surgery·Maria A ZuluagaSébastien Ourselin
Apr 17, 2015·IEEE Transactions on Medical Imaging·M Jorge CardosoSebastien Ourselin
Jul 15, 2015·Journal of Medical Imaging·Marc ModatSébastien Ourselin
Jun 4, 2016·Journal of Neurosurgery·Rachel PruittAshesh D Mehta
Dec 28, 2016·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Hena WaseemFernando L Vale
Apr 16, 2017·Seizure : the Journal of the British Epilepsy Association·Christian HoppeChristian E Elger
Jun 18, 2017·International Journal of Computer Assisted Radiology and Surgery·Rachel SparksSebastien Ourselin
Sep 20, 2017·Operative Neurosurgery·Walter J JermakowiczJonathan R Jagid
Nov 25, 2017·Epilepsy & Behavior : E&B·Gabrielle T PetitoWilliam O Tatum
Dec 1, 2017·Journal of Neurology, Neurosurgery, and Psychiatry·James X TaoPeter C Warnke
Feb 9, 2018·Annals of Neurology·Robert E GrossDaniel L Drane
Jul 7, 2018·PloS One·Walter J JermakowiczJonathan R Jagid

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Citations

Apr 1, 2020·Epilepsia·Christian DorferArthur Cukiert
Oct 20, 2020·Medical Image Analysis·Davide ScorzaElena De Momi
Oct 24, 2020·APL Bioengineering·Alice SegatoElena De Momi
Mar 6, 2021·Current Opinion in Neurology·Vejay N VakhariaMartin Tisdall

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Methods Mentioned

BETA
surgical resection

Clinical Trials Mentioned

NCT02820740
NCT02844465

Software Mentioned

MTLE LITT
LITT
Stata
Freesurfer
EpiNav
SPSS

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