Post-implantation 3-T MRI in patients with an epicranial stimulation device: image quality and deep learning-based electrode reconstruction

Post-implantation 3-T MRI in five patients with an implanted EASEE focal cortex stimulation system produced clear intracranial anatomy and plausible MRI-only electrode reconstructions with 9–20 mm median electrode-to-cortical gray-matter distances.

• Why it matters: The work addresses whether structural and functional MRI at 3 T remains feasible after implantation and whether electrode geometry can be estimated from MRI alone to enable downstream modeling and connectivity analyses.
• What they did: Structural and functional scans were acquired in all five patients and evaluated visually and with implant-centered versus control-region metrics (GM/WM ratios, GE-EPI intensity, T2*, relative off-resonance). A deep learning pipeline trained exclusively on synthetic data estimated electrode position from T1-weighted MPRAGE images.
• The result: No scan-related adverse events occurred, and no imaging metric differed significantly between regions (all p > 0.05), while GE-EPI signal was numerically lower in implant-centered regions. Reconstructions were anatomically plausible in all patients, but localization accuracy remains unvalidated.