Entries in surgery (1)

Monday
Jun152015

Intraoperative PET Imaging: The Advanced Multimodality Image Guided Operating Suite (AMIGO)

Several weeks ago, at the World Medical Innovation Forum, doctors and scientists from Brigham and Women’s Hospital presented their 20 million dollar AMIGO imaging suite complete with an operating room, MRI room, mass spectrometry instrumentation, and a PET/CT room for image-guided neurosurgeries. The current foci for this high-tech operating suite – which all rely heavily on the MRI functionality – are: 1) correcting preoperative brain images during surgery for navigation, 2) monitoring temperature for brain tumor thermal ablations, and 3) identifying residual tumor tissue at the end of surgery.1 More recently, mass spectrometry has been used intraoperatively in the AMIGO suite to map brain tumor margins through detection of an onco-metabolite,  2-hydroxyglutarate, which is produced in relatively large quantities by gliomas with mutations in isocitrate dehydrogenases 1 and 2.2 Considering my current research focus is development of new radiotracers, I was especially intrigued by the addition of PET imaging to this operating suite, which appears to be included for applications in tumor mapping and validating tumor excision completeness during surgery.3 Beyond tumor imaging, there are many radiotracers that provide important molecular and functional information about the brain, particularly the occupancy of neuroreceptors. Is there a place for these radiotracers in intraoperative neuroimaging?

~GV

1)      Jolesz, FA. (2011) Intraoperative imaging in neurosurgery: where will the future take us? Acta Neurochir Suppl, 109, 21-25.

2)      Agar, YR et al. (2014) Intraoperative mass spectrometry mapping of an onco-metabolite to guide brain tumor surgery. PNAS, 111, 11121-11126.

3)      http://brighamandwomens.org/Research/amigo/inside_suite.aspx. Accessed 06/15/2015