#2022005- Subject-specific MR-based Multimodal Automatic 3D Pre-Surgical and Real-Time Guidance System for Neural intervention
Abigail Livnie, Zion Zibly, David Mesika, Reut Raizman
| Categories | Medical Imaging |
| Development Stage |
The system is already fully operated and implemented within Sheba Medical Center. |
| Patent Status |
pending |
Background and need
Magnetic resonance imaging–guided focused ultrasound (MRgFUS) thalamotomy is a novel, non-invasive, image-guided procedure in which thalamic tissue is ablated with submillimeter precision. This ablation is currently FDA-approved for essential tremor (ET) and tremor dominant Parkinson’s disease and is performed unilaterally. When successful, the procedure achieves contralateral tremor suppression with improvement of patients' manual function and quality of life.
The target of the ablation is the ventral-intermediate nucleus (VIM) of the thalamus. To date, neurosurgeons conducting MRgHIFU procedures determine the surgical target based on stereotactic, atlas driven, indirect targeting using a T1-weighed (T1w) and proton density (PD) MRI scans. These scans have a very low intrinsic contrast between the target (VIM), adjacent nuclei and adjacent white-matter tracts. Therefore, pre-planning is done via using manual pinpointing of the specific brain landmarks. Due to individual differences and variations between patients' brains, in size and parcellation, this targeting methodology leads to a lengthy trial and error phase during the operation.
Finally, the variance of target ablations can cause damage to adjacent nuclei, leading to adverse side effects such as ataxia, gait disturbance, damage to senses of smell and taste and other adverse side effects.
Invention
A rapid, personalized MR-based multimodal automatic surgical guidance system forpre-surgical as well as real-time planning. and the technology allows long-term efficacy, reduce time in surgery and reduce unwanted adverse effects.
