Inside the Advanced Multimodality Image Guided Operating Suite

The Advanced Multimodality Image Guided Operating (AMIGO) suite, encompassing 5,700 square feet, is divided into three separate yet integrated procedure rooms. The suite is designed so that multidisciplinary medical teams can move effortlessly throughout to access any of the advanced imaging and surgical technologies available, whether before, during, or after the procedure. AMIGO is one of the first operating suites in the world to integrate the use of this wide variety of advanced imaging technologies, including cross-sectional digital imaging systems such as CT and MRI; real-time anatomical imaging, such as x-ray and ultrasound; and molecular imaging, such as beta probes (detects malignant tissue by measuring sensitivity to beta radiation), PET/CT, and targeted optical imaging (imaging based on the nature of light).

MRI Room

The Magnetic Resonance Imaging (MRI) room of AMIGO includes a high-performance scanner that is used to image patients before, during, and after therapy. This room is fully outfitted with MRI-compatible materials and devices, including a patient transfer board that is used to safely and efficiently move the patient, anesthesia system, and patient-monitoring devices between the MRI room, PET/CT room, and the operating room. The ceiling-mounted MRI also can be easily slid into the operating room and over a patient who is already on the operating table.

MRI’s exceptional ability to provide detailed anatomical, functional, and metabolic information has made it a valuable technology for guiding the intra-operative removal of brain tumors, and we apply similar image-guidance principles to the removal of breast cancer, prostate cancer, and other malignancies. Specifically, the AMIGO MRI room is used for:

  • biopsies
  • needle insertion-based procedures, such as prostate brachytherapy (internal radiotherapy)
  • laser removal of brain tumors
  • minimally invasive removal of soft tissue tumors by using freezing or heating technologies
  • cerebrovascular and endovascular interventions, including x-ray and MRI-guided cardiac tissue removal to prevent arrhythmias.

Operating Room

The center of the image-guided operating suite, the operating room (OR), is outfitted with a state-of-the-art, electronically controlled operating table. It is mounted with a MRI-compatible anesthesia delivery system, and surrounded by advanced mobile imaging and therapy devices, including:

  • surgical navigation systems, which track hand-held tools or other surgical devices and project images based on the location of the devices
  • C-Arm X-Ray (for mobile, low-exposure x-ray imaging)
  • 3D ultrasound
  • a near-infared imaging system

All images and data related to the procedure are collected and prioritized by using video integration technology and then displayed on large LCD monitors that cover the walls of all three rooms in the suite, enabling surgical teams to view all available information at a glance.

Procedures performed in the OR will include open surgeries of the brain and breast, cerebrovascular and endovascular interventions, spine surgery, skull base surgery, and endoscopic and laparoscopic surgeries.

PET/CT Room

Positron emission tomography (PET) produces clear details of metabolic activity and promises to become the method of choice for introducing molecular imaging agents – which produce images according to molecular changes in the body – into therapy. Within the PET/CT (computed tomography) room, researchers test novel molecular imaging agents to determine the extent of cancer before and after therapy.

The inclusion of PET imaging into the suite, along with the use of short half-life isotopes made in our hospital’s cyclotron, is one of the most innovative features of AMIGO. Using this technology, physicians can precisely target tumor tissue before starting a procedure and then verify the complete removal or destruction of tumors by depicting any residual cancer tissue before concluding the procedure. The combined use of MRI and CT with PET enables clinicians to integrate anatomical, functional, and metabolic information to enhance their decision-making during tumor removals.

AMIGO Suite Overview Video

Narrated by Steven Seltzer, MD, Chair, Department of Radiology at Brigham and Women’s Hospital, this video provides an inside look at the AMIGO suite.

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