Portable Intraoperative MRI for Neurosurgery

用于神经外科的便携式术中 MRI

• 批准号: 10728737
• 负责人: Haidong Peng
• 金额: $ 48.46万
• 依托单位: NEURO42, INC.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10728737
• 关键词: 3D Print; Address; Air; Air Movements; Beds; Boundary Elements; Brain; Brain Diseases; Brain region; Callback; Charge; Clinical Management; Collaborations; Computer software; Conventional Surgery; Dedications; Development; Diagnosis; Diameter; Diffusion; Diffusion Magnetic Resonance Imaging; Electromagnetics; Elements; Equipment; Excision; Generations; Image; Image-Guided Surgery; In Situ; Interruption; Lesion; Magnetic Resonance Imaging; Magnetism; Maps; Measurement; Mechanics; Metabolism; Methods; Modeling; Modification; Morphologic artifacts; Nature; Neurologic; Neuronavigation; Neurosurgical Procedures; Operating Rooms; Operative Surgical Procedures; Partner in relationship; Patients; Phase; Physiologic pulse; Planet Earth; Positioning Attribute; Procedures; RF coil; Radiation exposure; Repeat Surgery; Resolution; Robotics; Roentgen Rays; San Francisco; Secure; Services; Stream; Structure; Surgeon; System; T2 weighted imaging; Testing; Time; Tissue Differentiation; Tissues; Twin Multiple Birth; Update; Validation; Variant; Weight; biomedical imaging; brain surgery; cost; design; design and construction; detection method; diffusion weighted; experience; fiberglass; flexibility; human subject; image guided; image reconstruction; light weight; monitoring device; neuroimaging; neurosurgery; notch protein; novel; phase 1 designs; polycarbonate; portability; prevent; reconstruction; simulation; software development; tool; transmission process; ultrasound; user friendly software

Magnetic Resonance Imaging (MRI) is the gold-standard method for the detection and diagnosis of brain disease and surgical planning. Neurosurgery is closely guided by preoperative neuroimaging with MRI which can accurately localize and delineate lesions, map functionally critical brain regions, or probe tissue metabolism to guide clinical management. While the preoperative images are regularly consulted in the OR, the surgeon’s ability to navigate with these maps is degraded by tissue deformation and brain shifts that occur during surgery. Dedicated intraoperative MRI suites have been constructed to address this but are relatively rare due to the cost of equipment and installation and the excessive time they add to the surgical procedure. The latter results from the need to either reposition the patient (with conventional scanners or even the latest generation of low-field portable brain scanners) or evacuate non-MR compatible equipment and then re- establish them with a track-driven high-field scanner such as the IMRIS system. To address this, we develop a portable, ultra-compact, low-field MRI scanner for intraoperative imaging. The scanner will be integrated with a commercially available low-profile stereotactic (Mayfield-like) frame that is necessary for most neurological surgeries. The size, weight, power, and cooling requirements of the scanner allow its integration into a standard operating room without special facility modifications. It is designed to rapidly engage and disengage from the patient to minimize time delays associated with imaging. The low-field and self-shielded nature of the “Halbach dome” magnet eliminate the need to evacuate ferromagnetic equipment from the vicinity further minimizing delays. Rapid intraoperative imaging with this system could directly guide the procedure by providing images to neuro-navigation software that identify tissue distortion (brain-shift) relative to high-resolution pre-operative images to allow more accurate and complete surgical resections with decreased repeat surgeries (call-backs). To efficiently mate with the stereotactic frame, we develop optimized RF coils that incorporate gaps and notches for the frame which has itself been made RF compatible. We also integrate an advanced electromagnetic interference (EMI) mitigation solution that obviates the need for an RF-shielded room (used in typical MRI suites) to allow for in situ operating room imaging. We will develop the critical acquisition sequences for neurosurgical guidance, e.g., T2, FLAIR, and DWI, and a user-friendly software solution for console control and ai-based image reconstruction. Finally, the new scanner will be validated with bench measurements and imaging tests in anthropomorphic phantoms and healthy subjects.

磁共振成像（MRI）是用于检测和诊断脑病和手术计划的金标准方法。神经外科通过MRI进行术前神经影像的指导，可以准确地定位和描绘病变，地图在功能上关键的大脑区域或探针组织代谢来指导临床管理。虽然在OR中定期咨询术前图像，但外科医生使用这些地图导航的能力会因组织变形和手术过程中发生的脑移位而降低。已经建造了专用的术中MRI套件来解决此问题，但由于设备和安装的成本以及它们添加到外科手术程序中的时间，相对较少。后者是由于需要重新定位患者（使用常规的扫描仪，甚至是最新一代的低野便携式脑扫描仪）或撤离非MR兼容设备，然后使用轨道驱动的高档扫描仪（例如IMRIS系统）重新建立患者。为了解决这个问题，我们开发了用于术中成像的便携式，超紧凑，低场MRI扫描仪。该扫描仪将与大多数神经系统手术所必需的市售低调的立体定位（类似Mayfield）框架集成。扫描仪的尺寸，重量，功率和冷却​​要求允许将其集成到没有特殊设施修改的标准手术室中。它旨在迅速与患者脱离与成像相关的时间延迟。 “ Halbach Dome”磁铁的低场和自固定性质消除了从附近撤离铁磁设备的需求，进一步最小化了延迟。使用该系统快速的术中成像可以通过为相对于高分辨率术前图像识别组织失真（换挡）的神经运动软件的图像来直接指导该过程，从而允许使用改进的重复手术（呼叫呼叫）进行更准确和完整的外科手术切除术。为了有效地与立体定向框架配合，我们开发了优化的RF线圈，这些线圈结合了框架的差距和凹口，该框架本身已使RF兼容。我们还集成了高级电磁干扰（EMI）缓解解决方案，该解决方案消除了对RF屏蔽的房间（典型MRI套件使用）的需求，以允许原位手术室成像。我们将开发用于神经外科指导的关键采集序列，例如T2，Flair和DWI，以及用于控制台控制和基于AI的图像重建的用户友好软件解决方案。最后，新的扫描仪将通过拟人化幻象和健康受试者的基准测量和成像测试来验证。