{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:46:02Z","timestamp":1786124762612,"version":"build-2736575974"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T00:00:00Z","timestamp":1552348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Automatic segmentation is gaining relevancy in image-based targeting of neural structures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate its feasibility, we retrospectively analyzed the concordance of magnetic resonance imaging (MRI)-based automatic segmentation of the subthalamic nucleus (STN) and intraoperative microelectrode recordings (MERs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Electrodes (n\u00a0=\u00a060) for deep brain stimulation were implanted in the STN of patients (n\u00a0=\u00a030; median age 57 yr) with Parkinson disease (n\u00a0=\u00a029) or rapid-onset dystonia parkinsonism (n\u00a0=\u00a01). Elements (Brainlab, Munich, Germany) were used to segment the STN, using 2 volumetric T1 (\u00b1contrast) and volumetric T2 images as input. The stereotactic computed tomography was coregistered with the imaging, and the original stereotactic coordinates were imported. MERs (0.5-1 mm steps) along the anterior, central, and lateral trajectories were used to determine differences between the image-segmented STN boundary and MER-based STN entry and exit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 175 trajectories, 105 penetrated or touched (\u22640.7 mm) the STN. The overall median deviation between the segmented STN boundary and electrophysiological recordings was 1.1 mm for MER-based STN entry and 2.0 mm for STN exit. Regarding the entry point of the STN, there was no statistically significant difference between MRI-based automatic segmentation and the electrophysiological trajectories analyzed with intraoperative MER. The exit point was significantly different between both methods in the central and lateral trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>MRI-based automatic segmentation of the STN is a viable, patient-specific targeting approach that can be used alongside traditional targeting methods in deep brain stimulation to support preoperative planning and visualization of target structures and aid postoperative optimization of programming.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opz015","type":"journal-article","created":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T06:47:03Z","timestamp":1552373223000},"page":"497-502","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":17,"title":["Automatic Segmentation of the Subthalamic Nucleus: A Viable Option to Support Planning and Visualization of Patient-Specific Targeting in Deep Brain Stimulation"],"prefix":"10.1227","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1691-546X","authenticated-orcid":false,"given":"Peter C","family":"Reinacher","sequence":"first","affiliation":[{"name":"Department of Stereotactic and Functional Neurosurgery, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1lint","family":"V\u00e1rkuti","sequence":"additional","affiliation":[{"name":"Department of Functional and Stereotactic Neurosurgery, Brainlab AG, Olof Palme Stra\u00dfe 9, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie T","family":"Kr\u00fcger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Piroth","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Egger","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Roelz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker A","family":"Coenen","sequence":"additional","affiliation":[{"name":"Department of Stereotactic and Functional Neurosurgery, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,11]]},"reference":[{"issue":"2","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"370","DOI":"10.3171\/jns.2002.97.2.0370","article-title":"Implantation of deep brain stimulators into subthalmic nucleus: technical approach and magnetic imaging\u2014verified electrode locations","volume":"97","author":"Starr","year":"2002","journal-title":"J Neurosurg"},{"issue":"2","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"269","DOI":"10.3171\/jns.2002.96.2.0269","article-title":"Bilateral high-frequency stimulation in the subthalamic nucleus for the treatment of Parkinson disease: correlation of therapeutic effect with 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