Abstract
Background An accurate and rapid anatomical localization of implanted subdural electrodes is
essential in the invasive diagnostic process for epilepsy surgery.
Objective To demonstrate our experience with a three-dimensional (3D) virtual reality simulation
software (Dextroscope®, Bracco Imaging, Milano, Italy) in the postoperative localization of subdural electrodes.
Methods Postoperative thin-slice computed tomography (CT) scans were coregistered to preoperative
3D magnetic resonance (MR) images in the Dextroscope environment in 10 patients. Single-electrode
contacts were segmented and their positions in relation to specific brain anatomic
structures were obtained by 3D reconstruction within the Dextroscope environment.
The spatial accuracy was tested by comparing the positions of the electrode contacts
as visible in the 3D reconstruction with intraoperative photographs. Image processing
time was also recorded.
Results The 3D stereoscopic reconstruction provided an accurate representation of the implanted
electrodes with highly detailed visualization of the underlying anatomy. The mean
absolute difference between 3D reconstruction and intraoperative photographs was 2.4 mm ± 2.2
mm. The processing time to obtain the 3D reconstructions did not exceed 15 minutes.
Conclusions The results indicate that the 3D virtual reality simulation software used in our
series is a useful tool for rapid and precise localization of subdural electrodes
implanted for invasive electroencephalography (EEG) recordings.
Keywords
Dextroscope - subdural - electrodes - epilepsy - neurosurgery