INTRODUCTION: Subthalamic nucleus stimulation (STN-DBS) is a well stablished therapy for Parkinson’s disease (PD). Initial programing of the DBS electrodes may take up to 2 hours in order to determine the contact(s) with the best and worse therapeutic response and thresholds for side effects. Furthermore novel directional electrodes have additional contacts that increase complexity and time to the selection. New image processing techniques allows reconstruction and visualisation of the DBS electrode and adjacent structures in a tridimensional space as well as modeling of the volume of tissue activation (VTA) which in turns helps to infer which contact(s) could be best for the stimulation. METHODS: Forty-four electrodes were evaluated; directional contacts were initially reviewed as a ring. The images were processed using two different methods 1) The spatial position and distance of each electrode contact was assessed in a normalized space with respect to the STN, motor portion of the STN (mSTN) and the corticospinal tract (CST) using the open source toolbox Lead-DBS; 2) The relation of the electrode contacts with the STN was visualized using the Boston Scientific GuideTM XT clinical software which is based on automatic anatomical segmentation. Both methods were independently used to select the best (positive) and worst (negative) stimulation contacts and then compared with the final stimulation plan. RESULTS: A chi-square analysis demonstrated a significant association between the IBP and the final therapeutic configuration (p<0.05). The test sensitivity was 95%-97.3%, specificity 85.7%-83.87%, positive predictive value 86.3%-87.8%, negative predictive value 94.7%-96.3%, and accuracy 90.2%-91.2% using the research and clinical methods respectively. In a subsequent analysis the selection of the directional contact(s) was investigated in 5 patients (6 electrodes) using current steering. In 89%-78% of the cases the contact(s) selected based on the IBP was part of the final configuration. CONCLUSION: An Imaged-based programing plan could be used as an initial guide to predict the best electrode configuration in order to reduce the programing time, this may translate in better use of hospital resources, improve the patient comfort and may avoid further adjustments in programing.