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Roman Rodionov, Aidan O’Keeffe, Mark Nowell, Michele Rizzi, Vejay N. Vakharia, Victoria Wykes, Sofia H. Eriksson, Anna Miserocchi, Andrew W. McEvoy, Sebastien Ourselin, and John S. Duncan

A pproximately 25% of individuals with refractory focal epilepsy who may benefit from epilepsy surgery require intracranial electrodes to localize and delineate the epileptogenic zone. The electrode implantation follows the formulation of a strategy devised by the multidisciplinary team. The safety of stereoelectroencephalography (SEEG) depends on the planned trajectories and the accuracy of implementation of the plan. With a highly accurate implantation technique, plans that may be considered too risky if implantation is not accurate may still be performed. The

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Julie Dubourg, Moncef Berhouma, Michael Cotton, and Mahmoud Messerer

can also determine the covariates that may influence results. The process leading to publication of a meta-analysis should be transparent and reproducible. Unlike metaanalyses of randomized controlled treatment trials, the methodology of a meta-analysis of diagnostic test accuracy is less known and understood. Despite the existence for more than 10 years of more and more methodological work, 11 , 14 , 16 , 35 , 59 many uncertainties remain, and there is no consensus indicating the best statistical method to synthesize results from studies of diagnostic tests

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Eric M. Thompson, Gregory J. Anderson, Colin M. Roberts, Matthew A. Hunt, and Nathan R. Selden

F rameless stereotactic guidance uses 3D coordinates from CT or MR imaging to localize and target specific anatomical areas of the brain with precise accuracy. Frameless stereotaxy is particularly important in identifying lesions that are deep within the brain, lie near eloquent structures, or are not readily apparent using direct or magnified vision. 1 Many epileptogenic lesions, although not directly visible, are often accurately identified on high quality and often high-Tesla MR images. 6 Thus, MR imaging–based stereotaxis is often an indispensible

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Ludvic Zrinzo, Arjen L. J. van Hulzen, Alessandra A. Gorgulho, Patricia Limousin, Michiel J. Staal, Antonio A. F. De Salles, and Marwan I. Hariz

D eep brain stimulation is a well-established procedure used in the treatment of a variety of chronic neurological conditions. 8 , 11 , 22 , 27 Functional neurosurgeons take great pains to improve the accuracy of electrode placement in the brain. 1 , 2 Stereotactic anatomical targeting is an essential first step in every functional procedure. 4 , 16 , 17 Improved accuracy at this stage is highly desirable since this is likely to result in superior clinical outcomes and should minimize the need for multiple passes within the brain with the increased risk

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Daniel von Langsdorff, Philippe Paquis, and Denys Fontaine

R obotic neurosurgery has been developed for nearly 25 years and offers neurosurgeons many advantages, especially increased accuracy. 10 Accuracy is a key point for stereotactic neurosurgical procedures, particularly for implantations of deep brain stimulation (DBS) electrodes. The Neuromate robot (Renishaw) is a commercially available neurosurgical robot used in many centers around the world for stereotactic and endoscopic procedures ( Fig. 1A ). According to the manufacturer, its accuracy is better than 1 mm and its reproducibility is 0.15 mm, leading

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Peter W. A. Willems, Herke Jan Noordmans, Jan Willem Berkelbach van der Sprenkel, Max A. Viergever, and Cees A. F. Tulleken

new type of instrument holder mounted to a robotic microscope (the MKM system), which was developed to provide these advantages, and we present the results of a phantom-based accuracy study in which we compared the MKM system with the BRW stereotactic frame (BRW; Radionics, Burlington, MA). Materials and Methods Frameless Stereotactic Equipment and Procedure Navigation System The MKM system consists of an operating microscope that is mounted to a six-axis motor-driven robot and a computer workstation. The microscope can be repositioned by the surgeon

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Satoshi Yamaguchi, Tetsuya Nagayama, Kuniki Eguchi, Masaaki Takeda, Kazunori Arita, and Kaoru Kurisu

MDCTA for preoperative examination for SDAVFs. 6 , 11 , 14 , 15 However, the pitfalls of interpreting MDCTA findings have rarely been mentioned in the literature. In this paper, we retrospectively reviewed the accuracy and drawbacks of MDCTA in the preoperative examination of SDAVFs. Methods The protocol of this study was approved by the ethical committee of our institute. Between 2006 and 2008 we treated 10 patients with SDAVF or SEDAVF ( Table 1 ). Cases 1–3 were documented in a preliminary report. 14 There were 8 men and 2 women whose mean age was 63 years

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Peter A. Woerdeman, Peter W. A. Willems, Herke J. Noordmans, Cornelis A. F. Tulleken, and Jan Willem Berkelbach van der Sprenkel

neurosurgical practice because of its invasiveness. 1 Three alternatives to implanted fiducial markers are available: adhesive fiducial markers, anatomical landmarks, and surface matching. Unfortunately, sparse comparative data are available regarding the application accuracy of these alternatives. 4 , 7 , 10 , 14 The aim of this study was to determine and compare the application accuracy of these three patient-to-image registration strategies using current navigation software. Clinical Material and Methods Image Acquisition and Stereotactic Equipment This study

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Pierre Bourdillon, Claude-Edouard Châtillon, Alexis Moles, Sylvain Rheims, Hélène Catenoix, Alexandra Montavont, Karine Ostrowsky-Coste, Sebastien Boulogne, Jean Isnard, and Marc Guénot

as the ability to reach targets obliquely, free of the orthogonal constraints; digitalization of the stereoscopy; and multimodal unification of the stereotactic space, along with increased safety with the application of these advances in SEEG. 9–11 , 23 , 25 Nevertheless, the robotic 3D approach has never been compared, in terms of accuracy, to the Talairach orthogonal procedure. The aim of our study was to provide this direct comparison. Methods Patients All patients who had been successfully treated with an SEEG procedure performed after 2012 were eligible. All

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Junyoung Ahn, Daniel D. Bohl, Ehsan Tabaraee, Khaled Aboushaala, Islam M. Elboghdady, and Kern Singh

postoperative pain management and minimize the side effects of narcotic analgesia. The most intuitive way for a treatment team to determine if a patient is taking preoperative narcotics is to ask the patient. However, little is known about the accuracy of self-reported narcotic utilization. The purpose of this study is to determine what proportion of patients accurately self-report preoperative narcotic utilization and, among patients who use narcotics preoperatively, to compare postoperative narcotic consumption between patients who do and do not accurately report