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--- activities:theme1:projects:dbs:index [2012/10/10 12:14]
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+++ activities:theme1:projects:dbs:index [2016/01/04 13:47] (current)
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 <html> <div class="pageTitle"> Model based computer assisted surgery for Deep Brain Stimulation </div></html>
-====== Members ======
+====== Participants ======
+[[http://www.anr-acoustic.org/|{{ :activities:theme1:projects:dbs:acoustic5.png?150|}}]]
   * [[members:pierre.jannin:index|Pierre Jannin]] - Leader
-  * [[members:claire.haegelen:index|Claire Haegelen]] - Medical expert - PhD student
+  * [[members:claire.haegelen:index|Claire Haegelen]] - Neurosurgeon - Medical expert - PhD (2010-2014)
   * [[members:florent.lalys:index|Florent Lalys]] - Post Doc
-  * [[members:tiziano.dalbis:index|Florent Lalys]] - Software
+  * [[members:yulong.zhao:index|Yulong Zhao]] - Post Doc
+  * [[members:tiziano.dalbis:index|Tiziano D'Albis]] - Software
+  * [[members:gregory.laheurte:index|G. Laheurte]] - Software
   * [[members:xavier.morandi:index|Xavier Morandi]] - Medical expert
   * Former contributors: [[members:caroline.essert:index|Caroline Essert]]
+  * M.Sc.: C. Nicolas, C. Baumgarten, M. Mehri
+  * Visiting guest researchers: R. Zelmann, Y. Xiao (Mc Gill Univ, Montréal, Canada)
+====== Awards ======
-See also the [[http://www.anr-acoustic.org/|ACouStiC web site]]: ANR Blanc grant for 4 years starting in 2011 - PI: P. Jannin
+  * 2014 Best Paper Award at the International Conference of Computer Assisted Radiology and Surgery in Fukuoka (Japan)
+  * The [[http://www.anr-acoustic.org/|ANR ACouStiC project]] was awarded with the 2013 Grand Prix des trophées “Loading the Future”
 ====== General purpose ======
-Stimulation is a minimally invasive therapy, which was developed for various diseases more than 20 years ago and is currently emerging as a powerful tool with increasing potential. We will address common aspects related to stimulation procedures, such as model supported surgical planning, intraoperative imaging for helping implantation in the OR, and postoperative assessment based on images and clinical scores. Parkinson Disease (PD) prevalence is about 1% in adults over 60 years old. High frequency Deep Brain Stimulation (DBS), also considered as a brain pacemaker, has been demonstrated as an efficient minimally invasive surgical treatment for treating Parkinson or motor related diseases and recently severe neuropsychological diseases. It was originally developed in France by Pr. Benabid (Grenoble).
+High frequency and continuous electrical stimulation of deep brain structures (DBS) has been demonstrated as an efficient minimally invasive surgical treatment for treating motor related diseases and recently severe neuropsychological diseases. The quality of the clinical improvement, as well as the existence of motor, neuropsychological or psychiatric side effects strongly depend on the location of the electrodes. To improve targeting and post operative evaluation for better outcome and reduced side effects, we studied and implemented an approach based on numeric and symbolic models for helping decision making process in deep brain stimulation surgery, in the context of the ANR project ACouStiC (PI: P. Jannin).
-====== Description ======
+====== Results ======
 {{ :activities:theme1:projects:dbs:test.jpeg?495x380 }}
 \\
-As demonstrated in the literature, the quality of the clinical improvement, as well as the existence of motor, neuropsychological or psychiatric post operative side effects strongly depend on the location of the electrode, and therefore on the quality of the surgical planning. \\
-\\
+We first developed a software environment allowing to fully automatically, i.e. without user interaction, compute a pre-operative patient specific model from his/her multimodal medical images and from anatomical atlases (allowing segmentation of anatomical targets not visible in the medical images) (Figure 1). This software also includes visualisation and interaction modules with few interaction and increase of automation to ease planning phase. The software was installed at two surgical centers for pre-clinical evaluation and is protected by APP.
-The main objective of our project, funded by a ANR Blanc grant for 4 years starting in 2011 ([[http://www.anr-acoustic.org/|Acoustic]] ), is to develop an innovative strategy based on models for helping decision-making process during surgical planning and post operative assessment in DBS for increasing the accuracy and precision of DBS. Two types of models will be made available to the surgeon: patient specific models and generic models. We will study methods for building 1) patient specific models from multimodal medical images dedicated to DBS and 2) generic anatomo-clinical models that gather location of the electrodes and clinical scores from a population of patients. Histological atlases will also be available thanks to collaboration with the CRICM (Centre de Recherche de l'Institut du Cerveau et de la Moelle) – UPMC / INSERM UMR_S975 / CNRS UMR 7225 Pitié-Salpêtrière Hospital in Paris. Dedicated linear and non-linear image registration methods will be developed with the CRICM. Strategies for building the anatomo-clinical atlases will be studied as well as strategies for extracting rules from these models defining optimal targets for DBS. \\
+In order to improve decision making, we introduced the concept of anatomo-clinical atlases, which consists of analysing retrospective data of previously implanted DBS patients. In opposition to classical works using anatomical and electro-physiological data [39,41,42,43,44], we studied the correlation between stimulated areas and clinical scores. By non-linear registration of images to compensate anatomical differences between individuals (Figure 2), we were able to compute 3D atlases highlighting areas with best clinical results according to different clinical scores. We introduced the concept of such atlas for outcome prediction. This work resulted into two patent submissions (in review). The first clinical evaluations seem to show better outcome and decrease of operating time, resulting in fewer infections.
+See also the [[http://www.anr-acoustic.org/|ACouStiC web site]]: ANR Blanc grant for 4 years starting in 2011 - PI: P. Jannin
+  * Valorisation: Two submitted patents and 2 APP protected software (pyDBS and Park MedAtlis)
+<html>
+<center><iframe width="420" height="315" src="http://www.youtube.com/embed/6_i1IXhV23U" frameborder="0" allowfullscreen></iframe></center>
+</html>
 \\
-Secondly, the project will develop methods for automatic computation of optimal electrodes trajectories from these models, taken into account the rules expressed by the surgeons, the knowledge available in the atlases, and the patient specific data and information thanks to collaboration with the IGG team (Geometrical and Graphical Informatics) of LSIIT (Image Sciences, Computer Sciences and Remote Sensing Laboratory) from the University of Strasbourg. For better accuracy and precision, we will also simulate the possible deformations of the final electrode and anatomical structures during surgery and integrate this simulation into the trajectory computation thanks to collaborations with the ALCOVE INRIA team in Lille. \\
-\\
-Additionally, an important effort will be assigned on the validation of the proposed tools. We will validate the proposed deformation models with rigorous studies on realistic physical phantoms. We will validate the image registration method on retrospective clinical data sets. We will quantitatively and  ualitatively validate the computation of optimal trajectories in a large population of retrospective clinical data sets available in two clinical centers associated to this project. \\
-\\
-One studied  hypothesis will be that multimodal patient specific models have an impact in process of care based decisions and help reducing operative time, assessed by surgical process models, and post operative readjustments by better planning of possible trajectories. Another hypothesis will be that generic models such as anatomo clinical atlases have an impact in outcome-based decisions and help reducing post operative clinical side effects by better targeting and prediction of the outcome (PhD of Claire Haegelen). Local collaboration with the Unité de Recherche Universitaire 490 "Comportement et Noyaux Gris Centraux" directed by Pr. M Vérin will allow us to perform similar studies for DBS for neuropsychological diseases such as OCD and severe depression.
-{{ :activities:theme1:projects:dbs:vue-globale2.png?600 |}}
+{{ :activities:theme1:projects:dbs:vue-globale2.png?600| }} \\
-{{ :activities:theme1:projects:dbs:3d_mri_electrode_big.png?600| }}
 ====== Main Collaborators ======
   * [[http://anr-acoustic.org|Participants of the ACouStiC project]]
+  * iCUBE Univ. Strasbourg,
+  * Inria Lille
+  * ICM (Centre de Recherche de l'Institut du Cerveau et de la Moelle) – UPMC / INSERM UMR_S975 / CNRS UMR 7225 Pitié-Salpêtrière Hospital in Paris
+  * Unité de Recherche Universitaire 490 "Comportement et Noyaux Gris Centraux" directed by Pr. M Vérin
   * [[http://www.bic.mcgill.ca|Pr. Louis Collins MNI McGill University Canada]]
+{{ :activities:theme1:projects:dbs:3d_mri_electrode_big.png?300| }}
+====== Publications ======
+<html>
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