It's been almost 15 years since IMRIS installed its first surgical theater in 2005, and a lot has changed with the company and the cutting edge capabilities of its equipment.

As part of its coverage of intraoperative imaging for our April magazine, we checked in with IMRIS CEO, Andy Flanagan, to find out what's new with the company and what we can expect in the future.

HCB News: IMRIS installed its first surgical theater in 2005, how many surgical theaters are in the current install base and has the basic technology changed over time?
Andy Flanagan: Since our first U.S. installation at Boston Children’s Hospital in 2005, we’ve grown our customer base to more than 75 facilities worldwide, in some of the most prestigious hospitals globally, including Brigham and Women’s Hospital, Massachusetts General Hospital, Cleveland Clinic, Johns Hopkins Hospital, and Beijing Tiantan Hospital.

The IMRIS Surgical Theatre has evolved to include a high-field 3T MRI, intraoperative CT, angiography, as well as new coils, head fixation devices, and most recently a new MR Neurosurgical Tabletop.

Perhaps one of the most important innovations is the way we help bring all aspects of the technology together to uniquely fit the customer’s intended use and workflows. Our services focus on a four-pillar approach – Consult, Design, Create, and Support – for the best possible value and outcomes. We take time to understand the needs of each hospital, and to help them optimize use of their space and their equipment while providing clinical staff training and equipment maintenance.

HCB News: What are some of the procedures where the IMRIS surgical theater offers the biggest advantages to outcomes?
AF: The IMRIS Surgical Theatre offers significant value to neurosurgeons in particular – for tumor resection, and movement disorder procedures like deep brain stimulation (DBS).

Brain tumors are diagnosed in tens of thousands of Americans each year and tragically they are the leading cause of cancer-related deaths in children. The IMRIS Surgical Theatre offers a few key benefits. First, the IMRIS Surgical Theatre features a moving magnet, giving surgeons a way to bring imaging to the patient rather than the other way around, avoiding the inherent risks of transporting a patient in and out of the operating room during surgery. Secondly, it allows surgeons greater precision to distinguish tumorous tissue from normal tissue that can sometimes be hard to identify with the naked eye, and greater resection rates help reduce or eliminate the need for follow-up surgeries.

For procedures like DBS to treat patients with movement disorders, the IMRIS Surgical Theatre completely changes the experience for both surgeons and patients. Traditionally, DBS is performed using local anesthesia to implant electrodes in the brain while the patient is awake. Neurosurgeons rely on the patient’s awake responses to stimulation. Some patients decline DBS procedures after learning that they need to be awake for the procedure.

IMRIS offers a solution that increases patient safety, reduces risk of infection, and improves outcomes, while bringing confidence to patients’ families. With intraoperative imaging in the IMRIS Surgical Theatre, the procedure can be performed while the patient is asleep. Neurosurgeons also have an unprecedented level of precision while performing the procedure.

HCB News: How do hospitals that invest in something like intraoperative MR see financial returns on the investment?
AF:One of the biggest returns on investment is the improvement to patient outcomes, which is the ultimate goal – saving lives. The IMRIS Surgical Theatre allows for greater utilization. It is important that the MR scanner be available for routine diagnostic scans when not in use in the operating room, and the operating room is fully utilized even when the iMRI is not necessary. There are also implications for a hospital’s reputation, recruitment, and retention efforts. The IMRIS Surgical Theatre also offers greater efficiencies. In the example of asleep DBS procedures, surgeons are able to cut hours from their surgery time and perform multiple surgeries in a single day.

HCB News: Which imaging OEMs does IMRIS partner with for the systems?
AF: IMRIS integrates all the leading vendors into our surgical theatre designs, including our modality partner, Siemens Healthineers – the leader in MR, CT, and angiography.

HCB News: You recently got FDA clearance for a multifunctional surgical theater table, how does that enhance the system?
AF: The new multifunctional magnetic resonance (MR) Neurosurgical Table was a joint development between IMRIS and Hill-Rom Surgical Solution’s Trumpf Medical, and it’s an essential component of the IMRIS Surgical Theatre. It’s built on the TruSystem® 7500 Surgical Table platform, with interchangeable tabletops to be used for a broad range of surgical procedures and disciplines. It offers improved ergonomics and allows surgeons to position the patient exactly where they need to be for optimal precision and efficiency. Boston Children’s Hospital, our first customer in 2005, is now also the first hospital to implement the new MR Neurosurgical Table.

HCB News: In 2015 IMRIS changed ownership. Can you tell us about that process and how it has impacted the company?
AF: In August 2015, we received backing from our parent company, Deerfield Management. At that time we reorganized and realigned ourselves under new leadership and with a renewed focus on neurosurgery. Since then, we’ve seen record earnings and significant growth in personnel, as well as new product developments, consulting services, and continued customer support. In 2017, our strong financial performance was driven by 67 percent growth in system bookings. We added 25 new personnel and unveiled a new corporate brand identity that better communicates our position in the industry and our focus on the human impact of our work – for physicians, hospital administrators and, most importantly, patients and their families.

Celebrating our two-year anniversary under new ownership last year was quite memorable for us. It’s been an incredible couple of years of growth. The internal alignment we now have, along with a pipeline of innovation, is energizing us to have a greater impact on both the medical experience and the human experience.

HCB News: What kind of news can we expect from IMRIS throughout the rest of the year and perhaps beyond that?
AF: Customers are inquiring about the option of a fixed MRI scanner and a stand-alone neuro-interventional angiography. If a facility is not able to undertake the construction for a moving scanner option, we want to provide the customer with an alternate solution that will provide the same high-quality imaging during the procedure. The solution would be to offer them a stationary scanner. We also have active projects in patient positioning and head fixation, and we are investigating the possibility of new types of coils.