Surgical Planning Laboratory
Ron Kikinis, MD - Director
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The Surgical Planning Laboratory (SPL) is a computer-science oriented laboratory working within the strong clinical environment of the Image Guided Therapy Program. The main goal of the SPL is to develop image-processing methods for digital medical imaging data and to use these methods for surgical and other medical applications.
The SPL is the world leader in surgical planning and one of the premier labs in the field of image processing. Our compelling research activities are known not only in the medical arena, but also in engineering and computer science communities. Therefore, funding for our research is available from multiple sources. The Surgical Planning Lab has been chiefly funded to date by federal and private research grants and grants from the makers of imaging equipment and computers. Our primary funding is from NIH, and our primary industrial partner is SUN Microsystems. In fact, the SPL has been named a SUN Microsystems Center for Excellence. Several other companies may soon begin to provide substantial support for our work.
The SPL encompasses the Neuroimaging Analysis Center (NAC).
Currently, MR and CT scanners produce hundreds of megabytes of data per day per unit. Generally, this information is analyzed by a visual evaluation of cross-sectional slices and then incorporated as gray-scale images on radiological film. Technologists are engaged in image acquisition and filming, and the films are read by diagnostic radiologists. The films are also used to communicate with the referring physicians and as references during patient procedures. It is important to keep in mind, however, that the appearances of anatomical structures on such grayscale images are different from their three-dimensional realities. The mental reconstruction of flat images into three-dimensional anatomy requires highly specialized training. While radiologists have had this specialized training, their clinical partners generally have not, and therefore often have difficulty with the translation. The goal of the work in the SPL is to try to make this job easier by taking the raw imaging data, segmenting out relevant structures, and then generating 3D reconstructions.
This work has several potential applications, including, but not limited to
- making the work of radiologists more efficient by concentrating information from several slices into one rendering (such as occurs in virtual endoscopy);
- facilitating the communication with referring physicians to enhance their ability to translate imaging information into a surgical scenario;
- evaluating tumors, brain anomalies (such as those associated with schizophrenia and multiple sclerosis), and arthritic changes of the musculoskeletal system pre- and post-intervention;
- assisting surgeons in planning for surgical intervention for tumor treatment and orthopedic or reconstructive procedures; and
- assisting clinicians in the follow up of pathology.
Basic research initiatives related to those applications include
- functional mapping of the cerebral cortex;
- evaluation of normal and pathological aging;
- improved understanding of 3D anatomy for diagnosis and therapy; and
- development of interactive 3D digital atlas and related tools.
Much of our work is focused on neuroanatomy and neurological applications of these advanced imaging tools. This technology gives the physician the ability to "see," by means of special-imaging software and hardware, all of the structures within the brain that are not necessarily visible to even the most highly trained human eye. Utilizing sophisticated software, the SPL has the capability to visualize tumors in toto on a 3D plane and differentiate them from the normal surrounding structures of the brain. By correctly mapping these normal structures, the SPL paves the way for improved results for the neurosurgeon during surgery and, most importantly, a significantly improved outcome for the patient. The software that allows the complete "visualization" of these anatomic structures has been developed in the SPL. To date, Radiology has not submitted bills in conjunction with the use of this equipment and software. We stress that the use of this service, in many cases, may provide a less invasive neurosurgery, a shorter operative time, and an improved operative result (in terms amount of tumor removed), as well as a potentially shorter length of hospital stay. This could, in turn, obviate the need for additional neurosurgery due to recurrence of the tumor.
For further information contact:
Ron Kikinis, MD at kikinis@bwh.harvard.edu
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