IMRIS and MRI Interventions’ Surgical Suite Collaboration Debuts in Cook Children’s Hospital

IMRIS Inc. and MRI Interventions Inc. have collaborated to construct a real-time visualization and guidance system for brain tumor neurosurgical intervention—and the system has been used for the first time in Cook Children’s Hospital in Fort Worth, Texas. The suit is comprised of IMRIS’ Visius surgical theatre with the use of MRI Interventions’ Clearpoint neuro intervention system as the navigation platform; and the Visius intraoperative MRI (iMRI).

“This initial operation went very well,” said John Honeycutt, M.D., medical director of the Cook Children’s department of neurosurgery, who led the operation. “Access to real-time intraoperative imaging and guidance with Visius and Clearpoint technologies together allowed accurate placement of the laser catheter for thermal ablation of the tumor. Since this tumor was small, deep, and next to critical structures, having Clearpoint to assure accuracy was critical to successful ablation of the tumor with no side effects or complications. The Visius iMRI allows us to do the complete procedure in a proper operating room.”

According to MRI Interventions, the Clearpoint navigation platform is the only technology that enables minimally-invasive neurosurgery under continuous MR (magnetic resonance) guidance, offering surgeons real-time direction and a direct view of the inside of a patient’s brain during a procedure.

At Cook, the Visius iMRI is mounted on ceiling-mounted rails, which is meant to allow the scanner to movie between the operating room (OR) and the diagnostics room easily. This way, images can be accessed immediately without moving the patient.

Using the Clearpoint system with Visius iMRI, Honeycutt was able to see and select the tumor in the brain, establish a safe trajectory, and visualize the laser probe on MR images as it was inserted to the target location. He was then able to use real-time MR thermometry to monitor progress as the laser probe heated the target area to the desired temperature for therapeutic destruction of the tumor tissue, preserving surrounding healthy tissue in the process. Finally, the surgeon was able to confirm results of the procedure using the iMRI before the patient was moved from the operating table.

In addition to focal laser ablation, the Clearpoint system has been used within the Visius surgical theatre at Cook Children’s to facilitate “asleep” deep brain stimulator electrode placement (“asleep DBS”) for relief of symptoms related to pediatric dystonia. Listed among America’s Best Children’s Hospitals by US News and World Report, Cook Children’s is the only children’s hospital in Texas to offer a comprehensive movement disorder program that includes leading and innovative approaches to DBS.

IMRIS’ and MRI Interventions’ technologies also have been used jointly at other U.S. neuroscience centers to facilitate asleep DBS for Parkinson’s disease, focal laser ablation to treat brain cancer and delivery of investigational therapeutic agents directly into brain tumors.

The Clearpoint system is a navigation platform designed to allow real-time, direct visualization during minimally-invasive neurosurgical procedures. Clearpoint software works with MRI to assist surgeons in planning a target and trajectory, and the Smartframe targeting device enables the MRI-guided alignment and insertion of surgical instruments.

The Clearpoint Smartflow cannula is presently cleared by the U.S. Food and Drug Administration for injection of cytarabine, a chemotherapy drug, to the ventricles or removal of cerebrospinal fluid from the ventricles during intracranial procedures. Delivery of other therapeutic agents using the Smartflow cannula is investigational.

Memphis, Tenn.-based MRI Interventions makes platforms for minimally invasive procedures in the brain and heart.

IMRIS provides image guided therapy solutions through its Visius surgical theatre. The company is headquartered in Winnipeg, Manitoba, Canada, and its U.S. base is in the Minneapolis, Minn. area.