Image Guided Therapy (IGT)

Abstract on Image-Guided Therapy (IGT)

System development for image-guided therapy (IGT), or image-guided interventions (IGI), continues to be an area of active interest across academic and industry groups. This is an emerging field that is growing rapidly: major academic institutions and medical device manufacturers have produced IGT technologies that are in routine clinical use, dozens of high-impact publications are published in well regarded journals each year, and several small companies have successfully commercialized sophisticated IGT systems. In meetings between IGT investigators over the last two years, a consensus has emerged that several key areas must be addressed collaboratively by the community to reach the next level of impact and efficiency in IGT research and development to improve patient care

The History

The BWH began its IGT program in 1991. Since then, it has become an internationally recognized pioneer in real-time intraoperative 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-invasive MRI-guided focused ultrasound surgery. Opening in 2011, AMIGO continues these pioneering efforts with multimodal image guidance.

Dr. Jolesz began collaborating with a team of engineers from GE Healthcare in 1988 to build the first MRI scanner for use during surgical procedures. The system had two magnets on each side of a patient table, giving surgeons access to the patient who remained situated in the MRI scanner.

Dr. Jolesz and the Brigham and Women’s IGT team soon followed the successful development of intraoperative MRI with another landmark achievement. In 2004, the Food and Drug Administration approved the first image-guided procedure: MRI-guided focused ultrasound (MRgFUS) treatment of uterine fibroids. Developed by BWH’s IGT team, this non-invasive interventional procedure uses MRI to monitor and control high intensity ultrasound waves that are beamed onto a fibroid and destroy it with heat. Specialists have since used the technique to treat breast and brain tumors and relieve pain from bone metastasis.

BWH’s image-guided therapy program continued to lead the advancement of the field into the 21st century, accumulating vast knowledge on best practices in designing and implementing image-guidance systems, establishing clinical programs, and designing IGT research studies. This cumulative body of work drew the attention of the National Institutes of Health, which selected Brigham and Women’s Hospital to become the National Center for Image-Guided Therapy (NCIGT) in 2005.

What Is Image-guided Therapy?

Image-guided therapy, a central concept of 21st century medicine, is the use of any form of medical imaging to plan, perform, and evaluate surgical procedures and therapeutic interventions. Image-guided therapy techniques help to make surgeries less invasive and more precise, which can lead to shorter hospital stays and fewer repeated procedures.

While the number of specific procedures that use image-guidance is growing, these procedures comprise two general categories: traditional surgeries that become more precise through the use of imaging and newer procedures that use imaging and special instruments to treat conditions of internal organs and tissues without a surgical incision.

The cross-sectional digital imaging modalities Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) are the most commonly used modalities of image-guided therapy. These procedures are also supported by ultrasound, angiography, surgical navigation equipment, tracking tools, and integration software.

Content Sources:

http://europepmc.org/abstract/med/17644360
https://ncigt.org/igthistory
https://www.brighamandwomens.org/research/amigo/image-guided-therapy-at-bwh
https://web.stanford.edu/~allisono/icra2016tutorial/ICRA2016TutorialHata.pdf