ACouStiC developed an assistance tool in a high tech and very risky discipline, Deep Brain Stimulation, used to treat severely incapacitating illnesses such as Parkinson’s disease or obsessive compulsive disorders. In more precise terms, ACouStiC studied, developed and validated software tools to help prepare, perform and evaluate surgical interventions. The operation involves implanting electrodes in deep brain structures to stimulate very precise anatomical structures. The results are immediate and spectacular. For example, for patients with Parkinson’s disease, shaking and rigidity of the limbs reduce or disappear completely: the patients regain an almost normal quality of life. Except that there can also be some secondary effects. For Parkinson’s disease, the target is the size of an almond in the middle of the brain, a small part of this almond having to be stimulated only. And when stimulating this area, the areas around it may also be stimulated, resulting in clinical side effects. This is why a great precision is needed. The more precise the stimulation is, the better the clinical results are. But there is no consensus about the exact target location. Tools are needed to better understand areas that give the best clinical results when stimulated.

A 3D Model of the Brain

To improve this precision and improve understanding, ACouStiC worked from different medical imaging modalities to calculate, for each patient, a 3D model of his or her brain. «We process a maximum amount of information to define the best implantation area and to determine the intervention route that will be the least dangerous for the patient». The tool also carries out a statistical process to refine the decision-making assistance from the operational history. Another objective is to shorten the operating time because the patient stays awake while their brain is being operated on. «If we can simplify the whole process, it will then benefit as many patients as possible». One publication from the partners presenting some developments of the project received the 2014 Best Paper Award at the International Conference of Computer Assisted Radiology and Surgery in Fukuoka (Japan). The whole project was awarded with the 2013 Grand Prix des trophées “Loading the Future”.

The main objective of this project is to develop an innovative strategy based on models for helping decision-making process during surgical planning in Deep Brain Stimulation. Models will rely on different levels involved in the decision-making process; namely multimodal images, information, and knowledge. Two types of models will be made available to the surgeon: patient specific models and generic models. The project will develop methods for 1) building these models and 2) automatically computing optimal electrodes trajectories from these models taking into account possible simulated deformations occurring during surgery.

The project belongs to the multidisciplinary domain of computer-assisted surgery (CAS). Computer assisted surgery aims at helping the surgeon with methods, tools, data, and information all along the surgical workflow. More specifically, the project addresses surgical planning and surgical simulation in Image Guided Surgery. It is related to the exponentially growing surgical treatment of Deep Brain Stimulation (DBS), originally developed in France by Pr. Benabid (Grenoble). The key challenges for this research project are 1) to identify, extract, gather, and make available the information and knowledge required by the surgeon for targeting deep brain structures for stimulation and 2) to realistically simulate the possible trajectories.