Or is it? iMRI machines give surgeons insight
BY DR. Randy L. Jensen, MD, PhD
Brain and spine tumors – simply defined, they are abnormal growths of cells within the brain or the structures around the spinal cord. These often-complicated masses are the result of a variety of conditions and come in a variety of forms, all of which require treatment of some kind.
How brain tumors are treated is based upon several factors and may involve a team of multiple doctors. In most cases, however, the first step in brain tumor treatment is for a neurosurgeon to surgically remove as much of the tumor as possible without affecting a patient’s normal brain function.
As one might imagine, surgically removing a brain or spine tumor is no easy task, but neurosurgeons at University of Utah Hospital now have two innovative weapons in the battle against brain and spine tumors – intraoperative magnetic resonance imaging (iMRI), and surgical suites. One of these suites is located at the Huntsman Cancer Hospital and the other at the Clinical Neurosciences Center.
In most brain and spine tumor removal cases today, neurosurgeons must operate around delicate areas or multiple locations of the brain, not knowing if all of the tumor has been removed until a post-operative MRI can be conducted days following the initial procedure. This means that some residual tumor could still be present, forcing patients to undergo a second invasive surgical procedure to remove the rest of it.
Through iMRI technology, such issues can now be addressed in real-time during the surgical procedure, guaranteeing that the tumor is removed in its entirety the first time.
Both suites at the University of Utah feature 10-ton iMRI machines that are bolted to specialized overhead rails. This makes the MRI machine mobile, allowing neurosurgeons to obtain valuable pictures of the patient while he or she is still on the operating table. The resulting high-quality images can then be reviewed in real time, enabling surgeons to continue or complete the surgery as needed.
“Once neurosurgeons feel they are at an evaluation point, all metal surgical instruments are removed and the iMRI is brought into the operating room to evaluate the patient’s progress,” says Dr. William T. Couldwell, professor and chair of neurosurgery. “By having the imaging capability readily available in a surgical setting, we can reduce the number of follow-up procedures, or more clearly determine that a surgery is complete within minutes.”