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Intraoperative brain shift degrades the accuracy of surgical navigation based on preoperative images.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We extended a model\u2010based image updating scheme to address intraoperative brain shift in DBS surgery and improved its accuracy in deep\u00a0brain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated 10 patients, retrospectively, who underwent bilateral DBS surgery and classified them into groups of large and small deformation based on a 2 mm subsurface movement threshold and brain shift index of 5%. In each case, sparse brain deformation data were used to estimate whole brain displacements and deform preoperative CT (preCT) to generate updated CT (uCT). Accuracy of uCT was assessed using target registration errors (TREs) at the Anterior Commissure (AC), Posterior Commissure (PC), and four calcification points in the sub\u2010ventricular area by comparing their locations in uCT with their ground truth counterparts in postoperative CT (postCT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the large deformation group, TREs were reduced from 2.5 mm in preCT to 1.2 mm in uCT (53% compensation); in the small deformation group, errors were reduced from 1.25 to 0.74 mm (41%). Average reduction of TREs at AC, PC and pineal gland were significant, statistically (<jats:italic>p<\/jats:italic> \u2a7d 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>With more rigorous validation of model results, this study confirms the feasibility of improving the accuracy of model\u2010based image updating in compensating for intraoperative brain shift during DBS procedures by assimilating deep brain sparse\u00a0data.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16578","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T17:34:30Z","timestamp":1688751270000},"page":"7904-7920","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Model\u2010based image updating in deep brain stimulation with assimilation of deep brain sparse 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