Advanced Multimodality Image Guided Operating (AMIGO) Suite
The Advanced Multimodality Image Guided Operating Suite is the subject of intense, ongoing research. The overall goal of IGT is to integrate all the accessible information from both preoperative and intraoperative imaging into a single, complete operational therapy delivery system. While these therapy delivery systems can be tailored to different clinical applications, successful implementation depends almost entirely on interdisciplinary collaboration, an infusion of the most current surgical and radiological methods, and cutting edge biomedical engineering principles aimed at combining imaging and therapy devices. IGT is the quintessential example of a truly multidisciplinary, minimally invasive or non-invasive approach to the diagnosis and treatment of disease.
Indeed, as IGT increasingly integrates anatomical and physiological information, and multiple imaging and therapeutic technologies, patients can expect to benefit from less invasive therapy options and improved clinical outcomes - all achieved at significantly reduced costs. Therapy systems must be linked with imaging systems to form a complete therapy delivery system, the successful deployment of which depends on a multidisciplinary team comprised of surgeons, interventionalists, imaging experts, and computer scientists. Such an environment is radically different from the conventional operating room. Most notably, the surgeon's view of the surface of the operational field is complemented by images showing what is beyond the visible surface, which, in turn, leads to dramatic changes in surgical approaches and methods driven by a close integration of image-based information with surgical procedures.
Originally CT, US, and more recently MRI have been introduced into the operating room for intraoperative image-guidance. At the same time, with the advance of computerized image processing and visualization tools, image-guidance systems have been incorporated into various surgical and radiation oncology applications. These systems make use of preoperatively acquired images to create anatomical models. The models, in turn, provide localization, targeting, and visualization of the three-dimensional anatomy. Preoperative models, however, must be modified as the procedure progresses and the anatomy changes. The only feasible means of detecting physiologic motion, displacements, deformations, or surgical resection is via intraoperative or intra-procedural imaging. Monitoring of dynamic changes induced not only by motion, but a variety of other functional or physical parameters, may be altered or modified during interventional or surgical procedures.
Although the primary goal is to follow and update anatomical changes in position, other types of dynamic information (i.e., flow, perfusion, diffusion and cortical function) can also be extremely useful in optimizing this process. All of this correlated anatomical and functional information can be exploited for image guidance if a system of multi-modality imaging and integration via computerized navigational tools is available.
The AMIGO suite is the focal point of our IGT research and the setting in which we will draw on our decade of experience to change healthcare. Specifically, the hardware of the AMIGO system is comprised of a 3.0T MRI Scanner, PET/CT Scanner, Fluoro X-ray C-arm, navigation system, surgical microscope, and a sophisticated Surgical Table that moves the patient between stations.