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Abstract #2041

"PICS": a novel patient-specific landmark for thalamic surgical interventions in the Posterior limb of the Internal Capsule Signal

Remi Patriat1, Jayashree Chandrasekaran1, Karianne Sretavan1, Henry Braun1, Samuel Brenny1, Yasamin Seddighi1, Meghan Hill1, Noam Harel1, and Leonardo Brito de Almeida1
1University of Minnesota, Minneapolis, MN, United States

Synopsis

Keywords: MR-Guided Interventions, MR-Guided Interventions, DBS, DiMANI, direct targeting, patient-specific, internal capsule, diffusion MRI

Motivation: Difficulties in direct visualization of thalamic subnuclei have led to inconsistent neurosurgery patient outcomes.

Goal(s): To study whether PICS, a “bright spot” in the posterior limb of the internal capsule (pLIC) in DiMANI images, could serve as a reliable landmark for directly targeting the Vim.

Approach: Using 7T DWI, we parcellate the pLIC, correlate its location with intra- and post-operative clinical data, and explore the PICS visibility in other MRI sequences.

Results: PICS is directly lateral to the Vim, comprises motor fibers associated with limbs and the trunk, and is visible on several MR contrasts.

Impact: A new MRI landmark is now visible on DiMANI, enabling patient-specific direct targeting for DBS and MR-guided focused ultrasound procedures. This will provide immediate impact by enhancing accuracy, clinical workflow efficiency and ultimately improve patient outcomes.

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