Connectivity-augmented Surgical Targeting: Individualization of a 3D Atlas of the Human Thalamus
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Transcript of Connectivity-augmented Surgical Targeting: Individualization of a 3D Atlas of the Human Thalamus
Connectivity-augmented Surgical Targeting: Individualization of a Mean, 3D Atlas of the Human Thalamus
A. JAKAB1,3, R. BLANC1, A. MOREL2, E. BERENYI3, G. SZEKELY1
1. Computer Vision Laboratory, ETH, Zurich
2. Center for Clinical Research, University Hospital Zurich
3. Department of Biomedical Laboratory and Imaging Science, University of Debrecen
Mittwoch, 12. April 2023 2D-ITET / COMPUTER VISION LABORATORY
Transcranial MR-guided Focused Ultrasound Surgery
(1st Study on TcMRgFUS thalamotomy – Kinderspital, Zurich) Deep brain stimulation
New demands
Image-guided interventions in the thalamus
Higher precision of structural imaging,
intraprocedural
New information on internal structure
(nuclei) and function (connection)
Direct targeting, individual maps
State of the art imaging of the thalamus with DTI
Mittwoch, 12. April 2023 3D-ITET / COMPUTER VISION LABORATORY
Diffusion tensor imaging and probabilistic
tractography visualizes cortico-thalamic
connections
Top right images> Behrens et al. Non-
invasive mapping of connections
between human thalamus and cortex
using diffusion imaging Nature
Neuroscience 6, 750 - 757 (2003)
Clinical, 1.5T 3DT1
Gross, structural information
STUDY OBJECTIVES
(1) To develop a target map generation tool for image-guided neurosurgery
(2) Fit a 3D thalamus atlas to the patient’s geometry, refined by functional information (e.g. locations of specific cortico-thalamic connectivities)
(3) Assess the feasibility by observing ultrahigh-field MRI and postmortem MRI images with intrathalamic contrast
Mittwoch, 12. April 2023 4D-ITET / COMPUTER VISION LABORATORY
Methods – data and image preparation
Mittwoch, 12. April 2023 5D-ITET / COMPUTER VISION LABORATORY
A Krauth, R Blanc, A Poveda, D Jeanmonod, A Morel, G Székely (2010)A mean three-dimensional atlas of the human thalamus: Generation from multiple histological data. Neuroimage. 49(3). 2053-2062.
3D THALAMUS ATLAS – 7 thalami1. Healhy Controls (n=40)
2. 3DT1+DTI tractography
3. Use STATISTICAL SHAPE MODELS to deform the thalamus to patient space
4. How to deform the thalamus:
1. Outline, warping
2. Inside – match DTI points
5. Validation
1. Nuclei vs. tractography
2. Postmortem hi-res images(n=4)
Results – aligned maps and intrathalamic landmarks
Mittwoch, 12. April 2023 6D-ITET / COMPUTER VISION LABORATORY
Black outlines: SSM-matched thalamus atlas Red spot: somatosensory connections, VPL
Results – Comparison to ACPC matching
Mittwoch, 12. April 2023 7D-ITET / COMPUTER VISION LABORATORY
Blue: SSM-based target map
Red: ACPC aligned thalamus atlas
Comparison on 1.5 T clinical imaging and CORTICOTHALAMIC TRACTOGRAPHY
VL nucleus(VLa, VLpv)
Somatomotor connections
Somatomotor connections
Results – Comparison to ACPC matching
Mittwoch, 12. April 2023 8D-ITET / COMPUTER VISION LABORATORY
Blue: SSM-based target map
Red: ACPC aligned thalamus atlas
Comparison on 7.0 T post mortem imagingCENTROMEDIAN NUCLEUS
Results – spatial accuracy (qualitative)
Mittwoch, 12. April 2023 9D-ITET / COMPUTER VISION LABORATORY
Post-mortem high-res. MRI (protondensity-weighted)
Mittwoch, 12. April 2023 10D-ITET / COMPUTER VISION LABORATORY
Name of the structure tested
Alignment method Mean distance (mm)
Median distance (mm)
Thalamus outline ACPC reg. with scaling 1.44 ± 0.44 1.24 ± 0.44
Thalamus outline Rigid reg. of surface 1.16 ± 0.11 1.07 ± 0.13
Thalamus outline SSM matching of outline
0.83 ± 0.1 0.56 ± 0.09
Thalamus outline Hybrid SSM matching (internal landmarks)
1.07 ± 0.18 0.83 ± 0.17
Postmortem nuclei (AV, MDmc, MDpc)
SSM matching of outline
0.79 ± 0.22 0.59 ± 0.14
Results – spatial accuracy (quantitative)
CONCLUSIONS(1) We aligned a 3D mean thalamus atlas to the patient’s geometry with feasible accuracy (< 1mm)
(2) Comparison with the conventional ACPC matching method shows superiority
(3) Nonlinear deformation of the thalamus makes the shape more individual = follows individual variability
(4) DTI corticothalamic tractography can be implemented in the method
(5) Such target maps can be used for image-guided neurosurgery
Mittwoch, 12. April 2023 11D-ITET / COMPUTER VISION LABORATORY
Thank you for your attention…
Acknowledgements:
Anne Morel – thalamus cyto work
Rémi Blanc – SSM programming
Klaas Pruesmann – 7T imaging lab