Stereotactic accuracy and frame mounting: A phantom study

Onur Alptekin, Felix S Gubler*, Linda Ackermans, Pieter L Kubben, Mark L Kuijf, Ersoy Kocabicak, Yasin Temel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Frame mounting is considered one of the most critical steps in stereotactic neurosurgery. In routine clinical practice, the aim is to mount the frame as symmetrical as possible, parallel to Reid's line. However, sometimes, the frame is mounted asymmetrically often due to patient-related reasons.

Methods: In this study, we addressed the question whether an asymmetrically mounted frame influences the accuracy of stereotactic electrode implantation. A Citrullus lanatus was used for this study. After a magnetic resonance imaging scan, symmetric and asymmetric mounting of the frame, which could occur in clinical scenarios, was performed with computed tomography (CT). Three different stereotactic software packages were used to analyze the results. In addition, manual calculations were performed by two different observers.

Results: Our results show that an asymmetrically mounted frame (deviated, tilted, or rotated) does not affect the accuracy in the mediolateral axis (X-coordinate) or the anteroposterior axis (Y-coordinate). However, it can lead to a clinically relevant error in the superoinferior axis (Z-coordinate). This error was largest with manual calculations.

Conclusion: These results suggest that asymmetrical frame mounting can lead to stereotactic inaccuracy in the superoinferior axis (Z coordinate).

Original languageEnglish
Article number67
JournalSurgical Neurology International
Publication statusPublished - 24 Apr 2019

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