Advanced Multimodality Image Guided Operating (AMIGO) Suite
Image-guided Therapy
Imaging has become essential not only for the detection and monitoring of disease but also for improving the outcome of therapy. The overall goal of Image Guided Therapy (IGT) is to help the physician improve the efficacy and reduce the morbidity of minimally invasive procedures by providing intra-operative imagebased anatomic and physiologic information in real-time. Traditional surgery is based on hand-eye coordination; IGT advances this concept by enhancing what the eye can see with multimodal imaging, and what the hand can do with robotic and therapy devices. IGT integrates therapy with intra-operative imaging and transforms invasive procedures into reduced-risk minimally invasive or non-invasive ones. In IGT, pre-operative and real-time intra-operative image information is displayed, and the technologies for imaging, guidance, and therapy are all integrated within complex therapy delivery systems. In addition, multimodal imaging guides therapies using comprehensive information derived from the different physical and biological characteristics of the tissues in ways that a single imaging modality cannot. Through this fusion of data from various imaging sources, compensations are made for any weakness of an individual modality.
The History of Image-guided Therapy at Brigham and Women’s Hospital
The BWH began its IGT program in 1991. Since then, it has become an internationally recognized pioneer in real-time intra-operative MRI-guided therapy. Using the well-known “double-doughnut” system, BWH teams performed over 3,000 surgical and interventional procedures. By 1994 the BWH IGT Program introduced non-vasive MRI-guided ocused ultrasound surgery. Constructed in 2009, AMIGO continues these pioneering efforts with multimodal image guidance.
| MRT 1991 | Focused Ultrasound Surgery 1994 | AMIGO 2009 |
AMIGO
The Advanced Multimodality Image Guided Operating (AMIGO) Suite is an innovative surgical and interventional suite that is the clinical arm of the National Center for Image Guided Therapy (NCIGT) at the Brigham and Women’s Hospital and Harvard Medical School. AMIGO is a highly integrated, 5,700 square foot suite featuring three sterile procedure rooms in which a multidisciplinary team treats patients with the benefit of intra-operative imaging. In AMIGO, real-time anatomical imaging modalities like x-ray and ultrasound are combined with CT and MRI cross sectional digital imaging systems. AMIGO also takes advantage of the most of advanced molecular imaging technologies, such as beta probes, PET/CT, and optical imaging to provide molecular image guided therapy. The use of multiple molecular probes increases the sensitivity and specificity of cancer detection by improving the ability to define tumor margins to more completely excise or thermally ablate tumors. In addition to these multiple imaging modalities, AMIGO has guidance or navigational devices that help physicians localize tumors or other targeted abnormalities that are identified on images but that may not be visible to the naked eye. AMIGO enables co-operation and collaboration between interdisciplinary teams of surgeons, interventional radiologists, imaging physicists, computer scientists, biomedical engineers, nurses and technologists in their common goal of delivering the best therapy to patients in a friendly environment.

