A Surgeon Specific Automatic Path Planning Algorithm for Deep Brain Stimulation

Abstract

In deep brain stimulation surgeries, stimulating electrodes are placed at specific targets in the deep brain to treat neurological disorders. Reaching these targets safely requires avoiding critical structures in the brain. Meticulous planning is required to find a safe path from the cortical surface to the intended target. Choosing a trajectory automatically is difficult because there is little consensus among neurosurgeons on what is optimal. Our goals are to design a path planning system that is able to learn the preferences of individual surgeons and, eventually, to standardize the surgical approach using this learned information. In this work, we take the first step towards these goals, which is to develop a trajectory planning approach that is able to effectively mimic individual surgeons and is designed such that parameters, which potentially can be automatically learned, are used to describe an individual surgeon's preferences. To validate the approach, two neurosurgeons were asked to choose between their manual and a computed trajectory, blinded to their identity. The results of this experiment showed that the neurosurgeons preferred the computed trajectory over their own in 10 out of 40 cases. The computed trajectory was judged to be equivalent to the manual one or otherwise acceptable in 27 of the remaining cases. These results demonstrate the potential clinical utility of computer-assisted path planning.