Image-Guided Neurosurgery

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Physicians of the UC Neuroscience Institute have collaborated with other experts to develop sophisticated ways to precisely locate areas of the brain. When integrated with functional magnetic resonance imaging (fMRI), diffusion tensor tractography and intraoperative magnetic resonance imaging (ioMRI), image-guidance technologies allow neurosurgeons to safely navigate the brain during a craniotomy, spinal surgery or tumor biopsy.

At the University Hospital, we introduced North America’s first Hitachi intraoperativel MRI/operating room suite. Featuring two adjacent operating rooms, one containing the Hitachi AIRIS II MRI, this combination of state-of-the-art equipment and surgical facilities provides the most advanced treatment options in a setting designed for maximum efficiency.

In addition, our neurosurgeons have worked with other experts to develop three new computer systems that allow safer navigation in and around the brain. The Operating Arm System (OAS), made by Radionics, Inc., is a mechanical arm connected to a computer that has sophisticated software. The Optical Tracking System (OTS), also manufactured by Radionics, Inc., consists of a hand-held probe that emits flashes of lights that are detected by a camera system in the operating room. The Mayfield ACCISS System, made by Ohio Medical Instruments, Inc., is another sophisticated image-guided system developed with assistance from our neuroscience experts.

These image-guided systems allow very precise planning of the surgery by pinpointing the location of the tumor and allowing precise skin and bone openings. This leads to shorter operating time, improved surgical visibility, and shorter length of stay. The use of image-guided surgery has become standard procedure at hospitals that specialize in brain tumor surgery.

The Neuroscience Institute has shown the benefits of intraoperative MRI technology in clinical studies. These studies demonstrated that in patients with gliomas and pituitary tumors, conventional surgery using computer guidance frequently did not achieve adequate tumor removal. When intraoperative MRI showed the need for additional tumor removal, surgeons were able to remove the additional tissue immediately.