Real-time MRI means safer brain surgeries

Certain areas of the brain become obscured from view during surgery. Sometimes doctors rely on patients to stay awake during brain operations.

A new system for visualizing the brain provides live MRI images -- allowing surgeons to monitor progress during operations previously considered to be extremely difficult or even impossible. Technology Review reports.

Typically, neurosurgeons use an MRI before a surgery to plan the trajectory of the operation, based on the brain’s position relative to a guidance frame that’s screwed onto the patient’s skull.

But the brain can shift before the surgery actually begins, making the images inaccurate and forcing doctors to stop surgery. Often, neurosurgeons end up relying on patients to be awake during brain operations to provide behavioral clues that tools have been inserted into the intended location.

Real-time MRI technology would be especially helpful when small objects -- like biopsy needles, implants, or tubes to deliver drugs -- must be placed at precise locations in the brain.

Some neurosurgeons say the most useful system on the market is offered by Memphis-based MRI Interventions. Their ClearPoint system works with conventional MRI scanners.

  • A platform (pictured below) for guiding surgical tools or implants into the brain is affixed to the skull and provides a grid-based system for determining the trajectory.
  • Material in the platform makes the device visible to the MRI scanner.
  • Software shows surgeons where their tools are relative to the patient’s brain, and that’s displayed on an MRI-compatible monitor.
  • This gives surgeons a view of what’s happening inside the skull -- and if the brain has shifted -- without interfering with the imaging procedure.

MRI Interventions has installed 25 of its real-time MRI guidance systems: two in Europe and 23 in the U.S. Here's a video of how it works.

In addition to treating and diagnosing patients, doctors are also using the system to deliver experimental treatments for brain cancer. Not to mention, the new technology means that keeping patients awake during the operation is no longer necessary.

[Technology Review]

Images: MRI Interventions

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