IGT:March 2008 IGT Workshop:BreakOutSession

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Breakout Session 1: DTI/fMRI Acquisition and Visualization for Neurosurgery

Preoperative Functional MRI and Diffusion Tensor Imaging; Acquisition and Visualization for Neurosurgery

by Steve Whalen (slides) and Lauren O'Donnell (slides)

The goal of surgical treatment for cerebral neoplasms is to maximize the extent of tumor resection while preventing or minimizing postoperative neurologic deficits. Preoperative functional MRI (fMRI) and diffusion tensor imaging (DTI) are highly effective, non-invasive methods of mapping eloquent cortical areas and critical white matter structures, so as to assess their relationship with a tumor or other pathological neural manifestations. We describe these two preoperative imaging methods as they are used in the Golby Surgical Brain Mapping Laboratory at Brigham and Women’s Hospital. The discussion of fMRI will show how we can clearly identify language, motor, and visual cortical areas preoperatively. DTI analysis will include novel whole-brain tractography segmentation by clustering. And we will also include an overview of the new Slicer3 DTI visualization software.

Breakout Session 2: Slicer Prostate Module

Application of Slicer in Prostate Intervention

by Steve Haker and Noby Hata (slides)

The goal of this breakout session is to learn the state-of-art in computer assisted prostate intervention using open-source software for navigation, registration, and visualization. We will highlight 3D Slicer (www.slicer.org) that has been essential to enable the MR-guided prostate biopsy and brachytherapy in Brigham and Women’s Hospital. The coordinates of suspicious tumor foci are specified in 3D Slicer and corresponding holes in the needle guiding template grid are computed, which effectively shortens surgery time and reduces the potential for computational errors. A key feature of the system is volumetric data fusion, allowing for target planning on high- resolution preoperative T2-weighted images mapped onto intraoperative 0.5T images. The prostate biopsy module also provides methods to control real-time image MR imaging and on-line image transfer of acquired real-time images, using Open IGT Link, a new open standard for inter-device communication in Image Guided Therapy. Development is underway to apply the Open IGT Link to control robot in prostate therapies inside a close-bore 3-tesla MRI scanner. In conclusion, the participants of this session will learn how 3D Slicer enables MRI guided prostate interventions by providing advanced image processing and computing. The participant will also learn the benefit of using open-source and open-standard in IGT research. Recommended further reading: Tempany C, et al. J Magn Reson Imaging. 2008 Feb;27(2):356-67.

Breakout Session 3: Liver Visualization

Application of Slicer 3.0 for Non-Rigid, Multi-Modality Image Registration for Thermal Ablation: Pre-procedural MRI on Intra-Procedural CT for Tumor Targeting

by Nicu Archip(*), Paul Morrison slides

The goal of this break-out session is to provide the participants with a brief overview of contemporary image-guided thermal therapies for percutaneous tumor ablation. The overview is then focused down to CT-guided RF ablation in the liver. Sample images from recent clinical cases contrast the information-rich pre-procedural MRI scan against the information-poor un-enhanced CT scan available at the time of the procedure. This clarifies for the participant, one area of need which image registration can address – targeting the lesion. The session will also provide an introduction to Slicer 3.0 and will demonstrate in this environment the registration of pre-procedural MRI scan with intra-procedural CT scan for lesion targeting with an RF electrode. Participants will appreciate how such registration techniques in moving organs can improve the depiction of tumor margins intra-procedurally to make for a more efficient and effective procedure. The same techniques have the potential of improving the treatment planning and acute assessment of treatment success.