Robot-guided stereoelectroencephalography without a computed tomography scan for referencing: Analysis of accuracy.

OBJECTIVE: Recent studies with robot-guided stereotaxy use computed tomography (CT) scans for referencing. We will provide evidence that using preoperative MRI datasets referenced with a laser scan of the patient's face is sufficient for sEEG implantation.

METHODS: In total, 40 sEEG electrodes were implanted in five patients by the robotic surgical assistant (ROSA). The postoperative CT scan for identifying electrode positions was fused with the preoperative MRI-based planning data. The accuracy was determined by the target point error (TPE) and the entry point error (EPE), applying the Euclidean distance.

RESULTS: The mean TPE amounted to 2.96 mm, the mean EPE to 2.53 mm. The accuracy was improved in 1.5 T MRI: the mean TPE amounted to 1.72 mm, the EPE to 0.97 mm. No complications, haemorrhages, infections, etc., were observed.

CONCLUSIONS: Robot-guided sEEG based on 3 T MRI reduces radiation exposure for the patient and can still be performed safely.