Researchers from the Washington University School of Medicine in St. Louis and Medtronic, maker of a neurosurgery navigational system, have joined forces to create a software program that uses information from MRI scans to build personalized three-dimensional maps of the location of brain functions.
The project is being funded by a $3.6 million grant from the National Cancer Institute. By integrating the information—along with an anatomic map—into Medtronic’s StealthStation navigational system, researchers hope to enable neurosurgeons to better plan and safely perform surgery.
A “homegrown” version of the system has dramatically changed the way Washington University conducts neurosurgery, according to Eric Leuthardt, MD, a neurosurgeon and professor with the Department of Neurological Surgery and the Department of Biomedical Engineering, as well as co-principal investigator on the NCI grant.
Leuthardt, along with co-principal investigator and associate professor of radiology Joshua Shimony, MD, have developed a technique called resting-state functional MRI to map critical functional areas of the brain before surgery. This method of functional brain imaging is designed for those patients that cannot undergo surgeries while awake or perform tasks.
“It’s a technology that we believe is better for mapping out the brain in order to help the neurosurgeon do their surgery better,” says Shimony. “The traditional approach is to use task-based functional MRI.”
Shimony adds that a lot of the credit for Washington University’s prior work in this area belongs to Carl Hacker, PhD, who as a graduate student figured out how to automate the analysis of resting state functional data so that it could be processed by an algorithm rather than a human being.
According to Washington University, the system has reduced by a third the number of surgeries performed while patients are awake at Barnes-Jewish Hospital, the adult teaching hospital for Washington University School of Medicine, and it is proving popular among neurosurgeons on staff.
“We want to create this so that it can be scaled to the wider world,” says Leuthardt. “Having this turn-key ability using resting-state functional MRI—where basically the functional areas of the brain are identified automatically—integrated with navigation means that you have a much higher knowledge beforehand of not only where you are when you’re performing surgery, but what that particular part of the brain does.”
“It has become a game-changer for how we practice at Washington University, and I think it will become a game-changer for neurosurgeons at large when we can make this universally available,” he adds. “People really want to get access to our brain mapping capability. One of the key things we need to do is to integrate it with an established brain navigation system so that it can be available to everyone.”
The NCI grant funds the five-year collaboration between Medtronic and Washington University. Leuthardt contends that the goal is to create a solution that is clinically viable.
He says the initial phase of research will involve software integration, followed by a vetting and validation stage. Leuthardt notes that the third phase will address the user experience and ensure that the user interface is seamless.
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