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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:1078-1083, May 2005
© 2005 American Society of Neuroradiology

Technical Note
BRAIN

Rapid and Fully Automated Visualization of Subdural Electrodes in the Presurgical Evaluation of Epilepsy Patients

Dimitri Kovalev^a, Joachim Spreer^b, Jürgen Honegger^c, Josef Zentner^c, Andreas Schulze-Bonhage^a and Hans-Jürgen Huppertz^a

^a Epilepsy Center, University Hospital Freiburg, Freiburg, Germany
^b Section of Neuroradiology, University Hospital Freiburg, Freiburg, Germany
^c Department of Neurosurgery, University Hospital Freiburg, Freiburg, Germany

Address correspondence to Hans-Jürgen Huppertz, MD, Epilepsiezentrum Neurochirurgische Universitätsklinik Freiburg Breisacher Strasse 64 79106 Freiburg, Germany

Summary: For rapid visualization of subdural electrodes with respect to cortical and subcortical structures, we describe a novel and fully automated method based on coregistration, normalization, optional cerebellum masking, and volume rendering of 3D MR imaging data taken before and after implantation. The key step employs the skull-stripped preimplantation image as a mask to also remove the skull in the postimplantation image. The extracted brain is presented in 3D with the electrodes directly visible by their susceptibility artifacts. Compared with alternative methods, ours is based on freely available software and does not require manual intervention.