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) 是检测和诊断脑部疾病和手术计划的黄金标准方法，神经外科手术以 MRI 的术前神经成像密切指导，可以准确定位和描绘病变、绘制功能关键脑区域图或探测组织。虽然在手术室中定期查阅术前图像，但手术过程中发生的组织变形和大脑移位会降低外科医生使用这些图进行导航的能力。为了解决这个问题而建造了套房，但由于设备和安装的成本以及手术过程中需要重新定位患者（使用传统扫描仪甚至最新一代扫描仪）而增加了过多的时间，因此相对较少。低场便携式脑部扫描仪）或撤离非 MR 兼容设备，然后使用轨道驱动的高场扫描仪（例如 IMRIS 系统）重新建立它们。为了解决这个问题，我们开发了一种便携式、超紧凑、低功耗的设备。 - 术中现场 MRI 扫描仪该扫描仪将与大多数神经手术所需的商用低轮廓立体定向（Mayfield 式）框架集成。扫描仪的尺寸、重量、功率和冷却​​要求使其能够集成到标准手术室中。它旨在快速与患者接触和脱离，以最大程度地减少与成像相关的时间延迟。“Halbach 圆顶”磁铁的低场和自屏蔽特性消除了从附近疏散铁磁设备的需要。使用该系统进行快速术中成像可以通过向神经导航软件提供图像来直接指导手术，该软件可以识别相对于高分辨率术前图像的组织变形（脑移位），从而实现更准确和完整的手术切除。为了有效地与立体定向框架配合，我们开发了优化的射频线圈，其中包含框架本身的间隙和凹口，我们还集成了先进的电磁干扰 (EMI) 缓解解决方案。这消除了对射频屏蔽室（在典型的 MRI 套件中使用）的需求，以便进行原位手术室成像，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，以及用户-最后，新的扫描仪将通过拟人模型和健康受试者的工作台测量和成像测试进行验证。