Figure 2: Design the “curved lead pathway” on MR images.
From: The “curved lead pathway” method to enable a single lead to reach any two intracranial targets
(a–c) The “curved lead pathways” passing through the right STN and right GPi. a. The axial image of the AC-PC plane. The lead pathway plane (black pentagon) passes through the point (12, −3, 0) (black triangle) and forms a 49.4 degree angle with the medium sagittal plan (black dovetail arrow). (b) Reconstruct the lead path plane on the MRI-workstation of the device (Siemens Verio 3.0 T, Siemens AG, Erlangen, Germany). The lead pathway plane is orthogonal to the AC-PC plane, and passes through the right GPi (hollow arrow) and STN (black arrow). (c) Identify the “curved lead pathway” on the “lead pathway plane”. When r = 5 cm, “curved lead pathway” is indicated by the white dovetail arrow head. When r = 6 cm, the “curved lead pathway” is indicated by the white dovetail arrow, and the estimated locations of the positioning base and poles are indicated by the white triangle and white pentagon, respectively. (d–f) The “curved lead pathways” passing through the bilateral STN. (d) The lead pathway plane, which is orthogonal to the sagittal plane and perpendicular to the AC-PC plane, passes through the bilateral STN (white arrow). (e) Identify the “curved lead pathway” on the “lead pathway plane”. When r = 5 cm, the “lead pathway” is indicated by the white dovetail arrow head. When r = 6, “curved lead pathway” is indicated by the white dovetail arrow, and the estimated location of the positioning base and poles are indicated by the white triangle and white pentagon, respectively. The lead pathway passes through the parietal lobe. (f) Adjust the safe entry point of the lead by adjusting the location of the positioning frame. When the plane of the bottom frame (the XOY plane) is parallel to the AC-PC plane, the “lead pathway plane” is indicated by the solid white line, and the lead entry point is located at the parietal bone. If the bottom frame is leaned forward for 30–40°, the approximate position of the “lead pathway plane” is indicated by the dash line, and the lead entry point is located at the frontal bone.
