MRI Taking Some of the Challenge from Brain Surgery
Brain surgery will never be easy, but surgeons at The Ohio State University Medical Center are using new instrumentation that gives them an edge in the operating room when it comes to removing tumors with less risk.
The latest generation of intra-operative magnetic resonance imaging equipment is enabling surgeons to perform procedures with greater efficiency than ever before. For patients, it means improved outcomes and a significantly reduced chance they will need to return to the operating room for removal of a tumor mass that was initially overlooked.
Ohio State's $2 million investment in the intra-operative magnetic resonance imaging unit is quickly paying off for patients, according to Dr. E. Antonio Chiocca, director of neurological services at OSU Medical Center. Already, a few of the approximately one dozen patients Chiocca has performed surgery on have benefited from the technology.
"In two surgeries we realized after using the intra-operative MRI that we didn't get all of the tumor mass from around the brain," said Chiocca. "We were immediately able to go back in and remove diseased tissue that was not visual using conventional means. Had these surgeries been performed without the support of the intra-operative MRI the patients may have been sent to the recovery room and only later would we have realized there was tissue left to be removed."
Chiocca said it would then depend on the condition and willingness of the patient and the potential for success if a second surgery would be considered. "This puts considerable stress on the patient, not to mention the cost of a second surgery," he added.
The operating room was specifically designed for the MRI, with the device's magnet positioned around the head of the operating table. The MRI is used at least twice during each surgery, once at the start and again near the end. Each time, an accordion-like copper shield is pulled over the patient and the MRI is activated, creating within minutes an up-to-date "roadmap" of the brain on a nearby computer monitor.
The brain is a mass of dense tissue, which has a tendency to be almost gelatin-like in consistency. "As we work with more minimally invasive technologies, the visual field becomes more restricted and we need real-time imaging to help guide our movements," said Chiocca, who also is chairman of the department of neurological surgery and the Dardinger Family Professor of Oncologic Neurosurgery.
"Overall, the intra-operative MRI is saving patients from repetitious surgeries and bad outcomes. Now, when the surgery is over and the patient invariably asks, "Did you get it all?' I have the right answer."
David Crawford - COLUMBUS, Ohio - 614.293.3737
Medical Center Communications - http://www.medicalcenter.osu.edu/