From the April 2018 issue of HealthCare Business News magazine


The improved patient outcomes contributed to a boost in Brigham and Women’s reputation, becoming one of the most active tumor resection practices in the world.

However, the applications for iMRI at Brigham and Women’s have hardly stopped at low grade gliomas. The solution now has applications in seemingly countless procedures, many of which Brigham and Women’s pioneered. This extensive list includes craniotomies, brain biopsies, laser thermal ablation, cryoablation, microwave ablation, prostate biopsies, parathyroid operations, asleep deep brain stimulation (DBS), cardiac ablation, breast and spine procedures and more.


“Intraoperative MRI has brought every conceivable advantage to bear for surgeons,” said Dr. Golby. While there are a number of considerations for hospitals introducing a suite of this magnitude, Dr. Golby has long been convinced of its value and incomparable effect on surgical precision and patient outcomes. “After over 25 years of using it, it’s not at all an open question.”

Regardless of the type of tumor resection, no patient wants to hear that they have to come back for a second surgery. Dr. Golby explains that breast tumors, for example, can present challenges for surgeons as the preoperative imaging must be done with the patient in prone position (face down), while the surgery is done with the patient supine (face up). Often, postoperative imaging can reveal the need for a second surgery. With intraoperative imaging, surgeons can more confidently perform gross total resection, leaving clean margins to the surrounding tissue and greatly reducing the chance of a follow-up surgery.

Treating movement disorders more comfortably and effectively
One of the latest applications of iMRI at Brigham and Women’s is for the treatment of Parkinson’s disease and essential tremors through asleep deep brain stimulation (DBS). Garth Rees Cosgrove, M.D., FRCSC, is the director of epilepsy and functional neurosurgery for the hospital, and after 30 years of treating various movement disorders, he claims that he will never go back to performing DBS without intraoperative MRI capabilities.

Prior to practicing at Brigham and Women’s with iMRI, Dr. Cosgrove would perform DBS while the patient was awake, using local anesthesia to access the brain and implant a neurostimulator. For a significant percentage of surgeons, this is still how the surgery is performed. Dr. Cosgrove identifies a number of disadvantages to this method that asleep DBS with intraoperative MRI addresses.

April 2018 Magazine

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