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The benefits of intraoperative MR Q&A with Dr. John Huston

par Lauren Dubinsky, Senior Reporter | April 09, 2019
MRI Operating Room
From the April 2019 issue of HealthCare Business News magazine

We are also using it for laser or thermal ablation of the medial temporal lobe in patients with seizures. MR-guided focused ultrasound is an additional application. It is approved for essential tremor treatment and we are also using it for tremor-predominant Parkinson’s disease.

We have used the MR/OR suite a lot for deep brain stimulation, but for efficiency reasons we are not using it as often currently.

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HCB News: I know that an MR magnet needs to be in a shielded space; does this create unique challenges for surgical operations?
JH: Not at all, because the rooms are adjacent but separate and we have the MR room RF-shielded. We have developed a culture of safety, where we’re working together to make sure that there are no potential projectiles in the MR space.

By dividing it as we have, the surgeons can use all of their equipment. Some of it is MR-compatible, but in general once that door is shut the clinicians can use the OR as if it’s any other OR.

HCB News: How would you describe the process of bringing new providers into the intraoperative suite? Is there a steep learning curve?
JH: Much of what we are doing is an evolution of what has been done. For example, we have been using image guidance for treatment of a lesion for many years, so it’s taking that experience from the ultrasound or CT environment into the MR world.

We would never do that just because we want to do it with MR. However, there are lesions that you only see with MR, so in order to find the lesion it has to be done in the MR environment.

I think that there are some things that are transformational – and that would include focused ultrasound. With this we can give a test dose to see if that reduces the patient’s tremor before we treat. Then we can increase heating to the level of treatment and have the final result. The advantages of that are that there is no radiation and the results are immediate.

We have a very cooperative relationship with our neurosurgeons. As they brought deep brain stimulation into this space, it was very easy to work with them. It’s more an attitude and a willingness to incorporate new techniques and technology. Once people have that willingness, then the practice changes.

HCB News: Would you say intraoperative MR leads to greater collaboration between radiologists and surgeons?
JH: That has been the case in our practice. By nature, our practice is collaborative. For instance, when we do a placement of a laser, that involves a neuroradiologist working side by side with a neurosurgeon. When we treat with the focused ultrasound, it’s the same thing.

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