3D Multimodal Visualization of Subdural Electrodes with Cerebellum Removal to Guide Epilepsy Resective Surgery Procedures

Abstract

Patients with medically refractory epilepsy may benefit from surgical resection of the epileptic focus. Subdural electrodes are implanted to accurately locate the seizure onset and locate the eloquent areas to be spared. However, the visualization of the subdural electrodes may be limited by the current methods. The aim of this work was to assist physicians in the localization of subdural electrodes in relation to anatomical landmarks using co-registration methods and by removing the cerebellum from MRI images. Three patients with refractory epilepsy were studied, in whom subdural electrodes were implanted. All electrodes were correctly localized in a 3D view over the cortex and their visualization was improved by the removal of cerebellum. This method promises to be useful in the optimization of the surgical plan.