Intraoperative MRI

This method allows the surgeon to obtain actual MRI images in the operating room before, during, and after surgery. We were the first institution in North America and only the second in the world to use the innovative Pole Star N-10 intraoperative MRI system, developed by Odin Medical Technologies in Israel.

This system also includes a surgical navigation tool which actually has a link to our own surgical navigation lowered down on the page, kind of thus providing a complete system for intraoperative imaging and guidance for brain surgery.

Intraoperative MRI allows the surgeon to monitor the progress of a procedure, for instance tumor removal. The possibility of a surgical cure is increased as no surprises are left for MRI scan done the day after surgery, as in the past. The potential dangers of brain shift, whereby during surgery the brain can move and render inaccurate coordinates obtained from preoperative imaging, is overcome by the freshening of images obtained during surgery.

For image guided surgery we were the first to describe the method whereby via intraoperative MRI, a non-invasive way to map critical brain areas (such as those responsible for movement, sensation, vision, and speech) can be mapped on to a computer in the operating room. Using surgical navigation again that link, we can precisely map out in the operating room not just the location of a lesion, such as a tumor but also the most critical areas of the brain that must be avoided during surgery. Our functional imaging laboratory , also develops ways of mapping, not just the surface of the brain, but the critical pathways known as white matter that connect the brain to other parts of the body. We also reported the first series of incorporation of functional MRI for stereotactic radiosurgery. Thus we can ploy functional image guidance not just for open surgery, but for non-invasive treatment of a variety of intracranial lesions.

The Department of Radiology at NJ Medical School in conjunction with our neighbors at Rutgers University in Newark have formed whatever is called Center for Advanced Imaging. Included here are a cutting edge three Tesla MRI scanner that will allow us to obtain brain images of unparalleled quality as well as to perform functional MRI for non-invasive brain mapping with greater speed and detail than ever before. A cutting edge CT-PET scanner will provide yet another means of obtaining functional imaging of the brain. A dedicated team of Radiologists and MR Physicists work to incorporate these methods and develop, with us, ways of bringing a full benefit into the neurosurgical operating room.

Stereotactic Radiosurgery
Stereotactic Radiosurgery is a method of treating lesions in the brain and at the skull base, with a highly concentrated dose of x-rays, by aiming radiation beams only at the target and not the surrounding brain, a very powerful dose can be delivered while making a risk of complications minimal. We use the latest Radiosurgical planning system developed by Radionics Incorporated, known as X-Knife RT. We have two linear accelerators litigated to the use of Radiosurgery. We have had our links here to publications as well. We have described work incorporating functional imaging into the Radiosurgical treatment planning. As a result we cannot only target the area of interest, but avoid radiation to critical parts of the brain. SRS is used to treat patients with a large variety of conditions, including gliomas, meningiomas, acoustic neuromas, other schwannomas, trigeminal neuralgia, and arterial venous malformations. As part of our Radiosurgery Program we have established a multi-center trial to evaluate an aggressive treatment program aimed at patients with primary brain tumors. Individuals entered into the study will undergo surgery with removal of the tumor, implantation of Gliadel link, chemotherapy wafers, Fractionated radiotherapy, and stereotactic radiosurgery as part of up front treatment.