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In August 1996, BWH neurosurgeons performed the world’s first intraoperative MR-guided brain tumor craniotomy, successfully removing a tumor using the most advanced imaging techniques available.
As BWH marks the 10th anniversary of this landmark procedure, Neurosurgery, Neuroradiology and Magnetic Resonance Therapy (MRT) teams last month combined to perform the hospital’s 1,000th intraoperative MR-guided craniotomy.
“This milestone is testament to how effective this operation is,” Peter Black, MD, PhD, BWH’s neurosurgeon-in-chief, said. “The concept of intraoperative imaging has revolutionized neurosurgery, with many intraoperative MRI units now around the world. The concept remains a major impetus to integrating advanced neuron-imaging for surgery. It is a great tribute to the BWH team, the administration, General Electric and the BWH neuroscience initiative that it was developed here. ”
On Aug. 25, a neurosurgery team of surgeons, radiologists, anesthetists, nurses, MRI technologists and technicians operated on a Florida resident who came to BWH with a recurring meningioma, a slow-growing tumor that was unresponsive to radiation and a standard craniotomy. During the six-hour operation, radiologists used a GE Signa SP open MRI-scanner to produce real-time, high-resolution images of the patient’s brain. Surgeons used these images to guide their incisions and ensure they successfully and completely removed an orange-sized tumor from underneath the motor cortex, the brain’s movement control center.
The operation was a success. Using this proven minimally-invasive technique, the neurosurgeons removed the tumor early enough to prevent its progression and without harming healthy brain tissue. In addition, hospital recovery time following the surgery was just three days.
Ten years ago when BWH performed the first MR-guided craniotomy, the idea of effectively removing barely visible tumors from the brain was unfathomable. To treat brain tumors, surgeons relied on standard OR navigation systems, which did not allow them to account for the tissue and fluid movement within the brain during surgery or visualize the tumor adequately as they removed it. An MR-guided craniotomy detects the brain’s fluidity and allows surgeons to alter incisions during the procedure and operate more precisely, making it the procedure of choice for many brain tumors.
As a national leader in the Neurosciences and one of only 10 U.S. hospitals with the resources and expertise to perform intraoperative MR-guided craniotomies, BWH is the first hospital in the world to perform 1,000 of them.
“This amazingly complex operation is becoming routine for us as we perform about 150 each year,” said Ferenc Jolesz, MD, vice chairman for Research and director of the Division of MRI and Image Guided Therapy Program in the Department of Radiology, who is leading the National Center of Image Guided Therapy at BWH. “People from all over the world come to us for this procedure.”