Neurosurgery involves many complex procedures and requires precision far beyond most people’s imagination.

Today, neurosurgeons have many tools that make surgery easier to plan and perform, including computerized brain mapping, vascular x-ray images and non-invasive surgical options. Even with state-of-the-art alternatives, neurosurgery patients often face multiple operations to ensure complete removal of tumors or correction of other problems.

The availability of a revolutionary surgical imaging system may help change all that.

Barnes-Jewish Hospital and Washington University School of Medicine are currently developing plans for an integrated neurosurgical suite to house an Intraoperative Magnetic Resonance Imaging (iMRI) system—an MRI device within the surgical setting that provides scan images of the surgical site during the operation. This allows the surgeon precise removal of an entire tumor without the need, risk or expense of a second surgical procedure.

The iMRI system transcends traditional MRI technology by bringing it into the operating room. A ceiling mounted track suspends the magnet, allowing it to move between two operating rooms and permitting two surgeons to use the system almost simultaneously. The use of the device during surgery provides images to surgeons in the operating environment within minutes. Other features include the capacity to accommodate large patients and those positioned on their side for surgery as well as the ability to compare the MRI images with image-guided surgery mapping systems.

Ralph Dacey, MD, chairman of neurosurgery at Washing-ton University School of Medicine, is excited about the project. "Ultimately it all comes down to patient safety and better patient outcomes," says Dacey. "Reducing the need for multiple operations makes it safer; improving the imaging quality and availability improves our patient's outcomes and satisfaction."

The addition of the iMRI is timely too. Barnes-Jewish Hospital is currently planning the construction of two new neurosurgery rooms. In order to incorporate the iMRI system into the suite, elaborate provisions will need to be made that ensure the operating room's compatibility with the presence of a high strength magnetic held. Enhancing the operating rooms with this equipment would make Barnes-Jewish the first in St. Louis and the sixth in the country to have a fully integrated surgical suite.

Barnes-Jewish Hospital Leads in Neurology and Neurosurgery Services
Barnes-Jewish Hospital's neurology and neurosurgery services are already ranked as the best in Missouri and in the top eight in the country by U.S.News & World Report. In conjunction with Washington University neurologists and neuroradiologists, surgeons at Barnes-Jewish treat the full range of neurovascular disorders.

Barnes-Jewish Hospital currently has four dedicated neurosurgery operating rooms equipped ill perform any neurological surgical procedure. The hospital's neurointensive care unit is one of the largest and most sophisticated in the country and provides comprehensive post-surgical care from specialized physicians, nurses and clinical staff.

Many specialized procedures are offered by Washington University neurosurgeons at Barnes-Jewish including:

• Gamma Knife—a revolutionary new treatment and the only one available within 250 miles of St. Louis

• Stereotactic Neurosurgery—computer assisted guidance for brain surgery

• Surgical Navigation—computer systems that plan precise approaches to surgery

• Cavitron—surgical device that disintegrates and aspirates brain tumors

• Intraoperative Angiography—use of blood vessel x-rays during surgery to enhance outcomes for aneurysms and arteriovenous malformation surgery

• Movement Disorder Surgery—surgical implantation of stimulators to treat Parkinson's Disease and certain types of tremors

• Cortical Mapping EE—system that maps essential function locations in the brain

Neurosurgeons are constantly working to refine techniques and provide better patient outcomes. The addition of an iMRI would be an unparalleled addition to the already outstanding neurosurgical services offered at Barnes-Jewish Hospital.

Funding the Project
A fundraising campaign for the new equipment is already under way at the Barnes-Jewish Hospital Foundation. The project includes the iMRI equipment itself, the construction of the surgical suite that will house the equipment and development of nonmetallic surgical instruments and supplies that are compatible with the magnetic resonance technology.

A portion of the project is being discounted by IMRIS, the provider of this new technology. They are making the investment because they believe they can have the greatest impact at Barnes-Jewish with the first application in neurosurgery and other applications to quickly follow.

Several local donors have already made generous gifts totaling more than $1 million to lead the way in funding the purchase of the equipment.

From the Barnes-Jewish Hospital Foundation’s CORNERSTONES Magazine Winter 2006