Joint application of the two enabling medical technologies can exhibit benefits of intraoperative MRI for direct visualisation when navigating to treat brain tumours and neurological disorders.
IMRIS and MRI Interventions have announced that a surgical team at Brigham and Women’s Hospital (BWH) in Boston, USA, has performed the first laser ablation procedure to combine the use of MRI Interventions’ ClearPoint neurointervention system as the navigation platform with intraoperative MRI in a VISIUS surgical theatre. The combination of these two technologies provided continuous visualisation and guidance throughout a neurosurgical intervention to treat a right frontal brain tumour.
“The combination of the two technologies made for a smooth and successful operation,” said Alexandra Golby, BWH neurosurgeon and associate professor of surgery at Harvard Medical School, USA. “We had access to excellent real-time MR images within a hi-tech surgical suite and were able to use those images to guide and deliver the needed therapy to specific targets in the brain with a high degree of precision.”
The ClearPoint navigation platform enables minimally-invasive neurosurgery under continuous MR guidance, and offers surgeons a direct view of the inside of a patient’s brain during a procedure. The VISIUS surgical theatre allows use of intraoperative MRI right inside the operating room and over the operating room table.
Using the ClearPoint system with VISIUS iMRI, Golby was able to see and select the lesion of the tumour in the brain, establish a safe trajectory, and visualise the laser catheter on MR images as it was inserted to the desired location. She was then able to use real-time MR thermometry to monitor progress as the laser catheter heated the target area to the desired temperature for therapeutic destruction of the malignant tissue, preserving surrounding healthy tissue in the process. MRI is the only imaging technology that will safely allow this continuous soft tissue visualisation during surgery.
Finally, Golby was able to confirm results of the procedure using the MRI before the patient was removed from the operating table.
Installed at Brigham and Women’s Hospital in 2011, the VISIUS surgical theatre features a high-field iMRI that travels on-demand between operating and angiography rooms on ceiling rails. The multi-disciplinary suite provides truly intraoperative imaging as it does not require the patient to be moved from the operating room table for scanning during surgery, so optimal positioning for neurosurgery is not compromised and typical clinical workflow is not impacted.
In addition to focal laser ablation, the ClearPoint system has been used within a VISIUS surgical theatre to facilitate direct drug delivery in the brain and deep brain stimulator electrode placement. Brain biopsy is another potential joint application of these technologies.