Apparatus and methods of optimal placement of deep brain stimulator

• US 7,167,760 B2
• Filed: 04/28/2004
• Issued: 01/23/2007
• Est. Priority Date: 04/28/2003
• Status: Active Grant

• Current Assignee: Vanderbilt University
• Original Assignee: Vanderbilt University
• Inventors: Fitzpatrick, J. Michael, Konrad, Peter E., Dawant, Benoit M.
• Primary Examiner(s): Pezzuto; Robert E.
• Assistant Examiner(s): Bustamante; Erik J
• Application Number:
  US10/833,504
• Publication Number:
  US 20050004617A1
• Time in Patent Office: 1,000 Days
• Field of Search: 382/131, 607/115, 607/116, 607/32, 607/373, 607/45, 378/4, 600/378, 600/544, 600/545, 606/129
• US Class Current: 607/116
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003

Abstract

A method of optimal placement of a deep brain stimulator in a targeted region of a brain of a living subject for optimal deep brain stimulation. In one embodiment, the method includes the steps of nonmanually selecting an initial optimal position from, refining the nonmanually selected initial optimal position to determine a final position, and placing the deep brain stimulator at the final position in the targeted region of the brain of the living subject.

Claims

1. A method for optical placement of a deep brain stimulator in a targated region of a brain of a living subject, comprising the steps of nonmanually selecting an initial optimal position from which a final position for optimal placement of a deep brain stimulator in the targrted region is determinated, wherein the step of nonmanually selecting the initial optimal position comprises the steps of:

a. choosing an image volume as a common volume of reference from a set of image volumes, the set of image volumes having N image volumes each being acquired pre-operatively from a brain of a living subject having a deep brain stimulator placed in a target, N being an integer greater than 2;

b. registering each of the remaining N−

1 image volumes to the chosen common volume of reference by a nonrigid registration algorithm so as to create an atlas;

c. mapping spatial coordinates of the deep brain stimulator in each of the remaining N−

1 image volumes onto atlas coordinates in the atlas by a transformation that registers the corresponding image volume to the atlas;

d. computing a centroid of all the mapped atlas coordinates as an optimal target position of the deep brain stimulator in the atlas; and

e. projecting the optimal target position of the deep brain stimulator in the atlas onto the pre-operatively acquired image volume by an inverse of the transformation that registers the pre-operatively acquired image volume to the atlas so as to identify the initial optimal position of the deep brain stimulator in the targeted region of the brain of the living subject.

2. The method of claim 1, wherein the spatial coordinates of the deep brain stimulator are acquired intra-operatively by a guidance system that translates physical coordinates of the deep brain stimulator into coordinates of the pre-operative image volume.

3. The method of claim 1, wherein the spatial coordinates of the deep brain stimulator are acquired post-operatively by CT scans.

4. The method of claim 1, wherein the nonrigid registration algorithm for registering a source image volume to a target image volume comprises a demons algorithm that computes a transformation that minimizes the voxel-by-voxel intensity difference between the source image volume and the target image volume.

5. The method of claim 1, wherein the nonrigid registration algorithm for registering a source image volume to a target image volume comprises an adaptive base algorithm.

6. The method of claim 5, wherein the adaptive base algorithm comprises the steps of:

a. defining a source image corresponding to one of the remaining N−

1 image volumes;

b. defining a target image corresponding to the atlas;

c. creating an image pyramid for each of the source image and the target image, respectively, each image pyramid having M levels, wherein each level of the image pyramid has a resolution and is segmented with a corresponding scale so as to form a grid, each pyramid being formed such that level i of the pyramid has lower resolution and larger scale than level (i−

1), i=1, . . . , M, M being an integer greater than 1;

d. defining a deformation field, v(x), that registers the source image volume to the target image volume;

e. initializing the deformation field, v(x)=v_M(x);

f. computing the deformation field, v_i(x), at level i of the image pyramids, wherein the deformation field v_i(x) at the level i is a sum of the deformation field at level (i+1) and a linear combination of a set of radial basis functions spaced on the grid of level i so as to register the source image volume to the target image volume at level i, and wherein the computing starts at level (M−

1);

g. identifying regions of misregistration resulted from step (f);

h. optimizing each of the regions of misregistration independently from each other by modifying the region of support and radial basis functions corresponding to the region in the deformation field v_i(x); and

i. iterating steps (f)–

(h) at a next level (i−

1) of the image pyramids till level 1 is reached so as to construct a final deformation field in the form of;

v(x)=v₁(x)+ . . . +v_M(x).

7. The method of claim 6, further comprising the step of:

optimizing a constraint scheme for enforcing a Jacobian matrix of the deformation field to remain uniformly invertible throughout a domain of the source image volume and a corresponding domain of the target image volume so as to generate topologically correct transformations between the source image volume and the target image volume.

8. The method of claim 1, wherein the atlas is a common volume of reference in which the position of each deep brain stimulator can be recorded.

9. A method for optical placement of a deep brain stimulator in a targated region of a brain of a living subject, comprising the steps of:

i. nonmanually selecting an initial optimal position in the targeted region;

ii. finding a final position from the nonmanually selected initial optimal position; and

iii. placing the deep brain simulator at the final position;

wherein the step of nonmanually selecting the initial optimal position comprises the steps of;

a. choosing an image volume as a common volume of reference from a set of image volumes, the set of image volumes having N image volumes each being acquired pre-operatively from a brain of a living subject having a deep brain stimulator placed in a target, N being an integer greater than 2;

b. registering each of the remaining N−

1 image volumes to the chosen common volume of reference by a nonrigid registration algorithm so as to create an atlas;

c. mapping spatial coordinates of the deep brain stimulator in each of the remaining N−

1 image volumes onto atlas coordinates in the atlas by a transformation that registers the corresponding image volume to the atlas;

d. computing a centroid of all the mapped atlas coordinates as an optimal target position of the deep brain stimulator in the atlas; and

e. projecting the optimal target position of the deep brain stimulator in the atlas onto the pre-operatively acquired image volume by an inverse of the transformation that registers the pre-operatively acquired image volume to the atlas so as to identify the initial optimal position of the deep brain stimulator in the targeted region of the brain of the living subject.

10. The method of claim 9, wherein the spatial coordinates of the deep brain stimulator are acquired intra-operatively by a positioning drive that translates physical coordinates of the deep brain stimulator into coordinates of the pre-operative image volume.

11. The method of claim 9, wherein the spatial coordinates of the deep brain stimulator are acquired post-operatively by CT scans.

12. The method of claim 9, wherein the nonrigid registration algorithm comprises a demons algorithm that computes a transformation that minimizes the voxel-by-voxel intensity difference between the images.

13. The method of claim 9, wherein the nonrigid registration algorithm comprises an adaptive base algorithm.

14. The method of claim 13, wherein the adaptive base algorithm comprises the steps of:

a. defining a source image corresponding to one of the remaining N−

1 image volumes;

b. defining a target image corresponding to the atlas;

c. creating an image pyramid for each of the source image and the target image, respectively, each image pyramid having M levels, wherein each level of the image pyramid has a resolution and is segmented with a corresponding scale so as to form a grid, each pyramid being formed such that level i of the pyramid has lower resolution and larger scale than level (i−

1), i=1, . . . , M, M being an integer greater than 1;

d. defining a deformation field, v(x), that registers the source image volume to the target image volume;

e. initializing the deformation field, v(x)=v_M(x);

f. computing the deformation field, v_i(x), at level i of the image pyramids, wherein the deformation field v_i(x) at the level i is a sum of the deformation field at level (i+1) and a linear combination of a set of radial basis functions spaced on the grid of level i so as to register the source image volume to the target image volume at level i, and wherein the computing starts at level (M−

1);

g. identifying regions of misregistration resulted from step (f);

h. optimizing each of the regions of misregistration independently from each other by modifying the region of support and radial basis functions corresponding to the region in the deformation field v_i(x); and

i. iterating steps (f)–

(h) at a next level (i−

1) of the image pyramids till level 1 is reached so as to construct a final deformation field in the form of;

v(x)=v₁(x)+ . . . +v_M(x).

15. The method of claim 14, further comprising the step of:

optimizing a constraint scheme for enforcing a Jacobian matrix of the deformation field to remain uniformly invertible throughout a domain of the source image volume and a corresponding domain of the target image volume so as to generate topologically correct transformations between the source image volume and the target image volume.

16. The method of claim 9, wherein the atlas is a common volume of reference in which the position of each deep brain stimulator can be recorded.

17. An apparatus of optical placement of a deep brain simulator in a targeted region of a brain of a living subject, comprising a controller performing the step of nonmanually selecting an initial optimal position from which a final position for optical placement of deep brain simulator in the targeted region is determinated, wherein the controler furter performing the steps of:

a. choosing an image volume as a common volume of reference from a set of image volumes, the set of image volumes having N image volumes each being acquired pre-operatively from a brain of a living subject having a deep brain stimulator placed in a target, N being an integer greater than 2;

b. registering each of the remaining N−

1 image volumes to the chosen common volume of reference by a nonrigid registration algorithm so as to create an atlas;

c. mapping spatial coordinates of the deep brain stimulator in each of the remaining N−

1 image volumes onto atlas coordinates in the atlas by a transformation that registers the corresponding image volume to the atlas;

d. computing a centroid of all the mapped atlas coordinates as an optimal target position of the deep brain stimulator in the atlas; and

e. projecting the optimal target position of the deep brain stimulator in the atlas onto the pre-operatively acquired image volume by an inverse of the transformation that registers the pre-operatively acquired image volume to the atlas so as to identify the initial optimal position of the deep brain stimulator in the targeted region of the brain of the living subject.

18. The apparatus of claim 17, wherein the spatial coordinates of the deep brain stimulator are acquired intra-operatively by a guidance system that translates physical coordinates of the deep brain stimulator into coordinates of the pre-operative image volume.

19. The apparatus of claim 17, wherein the spatial coordinates of the deep brain stimulator are acquired post-operatively by CT scans.

20. The apparatus of claim 17, wherein the nonrigid registration algorithm comprises a demons algorithm that computes a transformation that minimizes the voxel-by-voxel intensity difference between the images.

21. The apparatus of claim 17, wherein the nonrigid registration algorithm comprises an adaptive base algorithm.

22. The apparatus of claim 21, wherein the adaptive base algorithm comprises the steps of:

a. defining a source image corresponding to one of the remaining N−

1 image volumes;

b. defining a target image corresponding to the atlas;

c. creating an image pyramid for each of the source image and the target image, respectively, each image pyramid having M levels, wherein each level of the image pyramid has a resolution and is segmented with a corresponding scale so as to form a grid, each pyramid being formed such that level i of the pyramid has lower resolution and larger scale than level (i−

1), i=1, . . . , M, M being an integer greater than 1;

d. defining a deformation field, v(x), that registers the source image volume to the target image volume;

e. initializing the deformation field, v(x)=v_M(x);

f. computing the deformation field, v_i(x), at level i of the image pyramids, wherein the deformation field v_i(x) at the level i is a sum of the deformation field at level (i+1) and a linear combination of a set of radial basis functions spaced on the grid of level i so as to register the source image volume to the target image volume at level i, and wherein the computing starts at level (M−

1);

g. identifying regions of misregistration resulted from step (f);

h. optimizing each of the regions of misregistration independently from each other by modifying the region of support and radial basis functions corresponding to the region in the deformation field v_i(x); and

iterating steps (e)–

(g) at a next level (i−

1) of the image pyramids till level 1 is reached so as to construct a final deformation field in the form of;

v(x)=v₁(x)+ . . . +v_M(x).

23. The apparatus of claim 22, wherein the adaptive base algorithm further comprises the step of:

optimizing a constraint scheme for enforcing a Jacobian matrix of the deformation field to remain uniformly invertible throughout a domain of the source image volume and a corresponding domain of the target image volume so as to generate topologically correct transformations between the source image volume and the target image volume.

24. The apparatus of claim 17, wherein the atlas is a common volume of reference in which the position of each deep brain stimulator can be recorded.