U 41 Research resource for Image guided therapy

U 41: Research resource for Image guided therapy PI: Ferenc Jolesz © 2005 Surgical Planning Laboratory, ARR Slide 1

U 41 Image guided therapy • Background & Significance – IGT technology growth – Clinical imaging growth • Aim – Advance and propagate novel image guided procedures • To dev and implement IGT technologies and allow rapid deployment in clinic © 2005 Surgical Planning Laboratory, ARR Slide 2

U 41 program outline • Technology Research & Development cores • Admin core • Biostatistics & Validation core • Collaborations – Internal (11) – External (8) © 2005 Surgical Planning Laboratory, ARR Slide 3

Program outline • 5 TRD cores – Computational • Leader: Ron Kikinis – Imaging • Leader: Larry Panych – MRI-guided therapy • Leader: Clare Tempany – Image guided Brain tumor surgery • Leader: Alex Golby – Focused Ultrasound • Leader: Kullervo Hynynen © 2005 Surgical Planning Laboratory, ARR Slide 4

Training & Dissemination • Leaders: John Carrino & Nancy Drinan • Continuous activities on site – First Monday seminars • • R 25 training grant Visiting fellowships Post docs, doctoral students Graduate and undergraduate students © 2005 Surgical Planning Laboratory, ARR Slide 5

Collaborations • Technology based – Advancing imaging and image processing into the OR of the future • AMIGO • Testing utility of IG – Interventional Radiology – Surgery – Cancer therapy – Cardiology (FUS ablation) © 2005 Surgical Planning Laboratory, ARR Slide 6

U 41 Collaborative projects • Internal (11) NIH funded grants – d 2. 1 G CT R 01 AG 19513 MR guided prostate diagnosis and brachytherapy • External (8) NIH grants with BWH collaborators – d 2. 1 p Christos Davatzikos 1 R 01 CA 104976 Targeted prostate biopsy using mathematical optimization © 2005 Surgical Planning Laboratory, ARR Slide 7

External collaborations Major groups • GE – Doumoulin/Pelc • 3 projects stem from the Engineering research center for computed surgical systems and technology (CISST ERC)of Johns Hopkins – Targeted biopsy (Christos Davatzikos) – Transrectal prostate therapy robot in closed MRI scanner (Gabor Fichtinger) © 2005 Surgical Planning Laboratory, ARR Slide 8

MRI guided therapy core • Neurosurgery • Prostate program • Interventional radiology – Tumor ablation program (SGS 0 – Spine interventions (JC) © 2005 Surgical Planning Laboratory, ARR Slide 9

TRD core and collaborative interactions: An example • Prostate intervention – Paradigm shift • Improved image quality – Higher field strength magnets • Magnet design issues – Closed bore systems • MRT core • Internal collaboration • External collaboration © 2005 Surgical Planning Laboratory, ARR Slide 10

Prostate Image guided diagnosis & therapy Detection Staging Brachytherapy FEM Based Deformation Prostate biopsy Mutual Information Overlaid Choline/Citrate image Treatment monitoring MR Robotics SPL Infrastructure High Performance Computing Gigabit network Terabyte storage © 2005 Surgical Planning Laboratory, ARR Slide 11

Optimized biopsy project right left Probability of cancer occurrence shown in green (left) and its adaptation (middle) to a stack of segmented intra-operative MR images obtained at the BWH (right). Optimal biopsy sites are transferred to the patient's space. © 2005 Surgical Planning Laboratory, ARR * NIH R 01 PI: Davatzikos et al Slide 12

Validation methods • Pre-clinical – IGT technology-imaging system , guidance and monitoring techniques-organ/disease specific • IGT Procedural – Image registration & segmentation • DICE-Statistical analysis of registration matching • Staple-analysis of expert and automated methods – Procedure Feasibility • Safe and effective • Treatment specific -Cancer specific goals – Patient safety, toxicity profiles, Cancer control-long and short term outcomes © 2005 Surgical Planning Laboratory, ARR Slide 13

3 T endorectal coil MRI © 2005 Surgical Planning Laboratory, ARR Slide 14 Bob Lenkinsky & Neil Rofsky BIDMC

Open vs Closed bore magnet design © 2005 Surgical Planning Laboratory, ARR Slide 15

1. Tempany CMC, Mc. Neil BJ. Advances in biomedical imaging. JAMA 2000; 285(5): 562 -567. © 2005 Surgical Planning Laboratory, ARR Slide 16