A neurosurgeon’s dream comes true

Prof. Dr. Mitsunori Matsumae (above, sitting bottom left and in right side photo), originator of the MRXO project.
Where can a surgeon easily access an Achieva 1.5T MR, a Brilliance 40 slice CT and an Allura Xper FD20 X-ray angio system during a surgical procedure?  The answer – in the newly installed MRXO surgical suite at Tokai University Hospital, Kangawaga, Japan

Realizing a need
“I am a neurosurgeon,” says Prof. Dr. Mitsunori Matsumae, Neurosurgeon-in-Chief and Prime Surgeon at Tokai University.  “I would love to have an MR in the operating room to monitor the progress of my surgical interventions.  Intra-operative MR imaging can be very beneficial in helping to reduce the risk of unexpected events during a procedure.  But I know an arrangement like this is not practical.”

More often than not imaging systems like MR, CT and X-ray are scattered throughout the institution – often far from surgical suites.  Moving a patient across the hall or across campus for an examination while in the midst of surgery is unrealistic.

Prof. Matsumae had a vision of the ideal setup. “My thought was to bring the systems I need to a single location.”  And so was born the MRXO concept (which stands for the integration of MR, CT, X-ray and a high-end operating table).  Now doctors at Tokai University can plan their interventions using this new hybrid interventional suite.  And intra-operative imaging can be a regular part of their procedures.

Operating room of the future
The unique layout of the MRXO suite allows patients on a fully outfitted surgical table to be transported in just minutes to MR, CT or X-ray, whichever modality is most appropriate at the moment.

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A) Achieva I/T 1.5T system     B) FD20 cardiovascular system

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Schematic of Tokai University’s MRXO setup. Left: MR scanner, center: cath lab and surgery spot, right: CT scanner. Electric sliding doors allow both combined and individual use of the separate systems.

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C) Bridge connecting surgery table to MR system  D) CT system

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Centrally located, the specially designed surgical table shares a room with the X-ray angio system.  To the left and right, behind shielded sliding doors sit the MR and CT bays.  The doors can be quickly opened for any intra-operative examination.  Closed, they allow each system to be used independently, thereby maximizing flexibility and economic efficiency.

Finding the best location for the hybrid suite was another important decision.  “Our MRXO suite is located right next to the ER,” notes Prof. Matsumae.  “That way, even while surgery is in progress, we’re getting maximum use from the imaging systems not employed during the procedure.”

Demonstrable results
Only weeks after installation, Prof. Matsumae had the opportunity to test the setup during a challenging neurosurgical procedure.

The MR scanner was used at several stages during the resection of a major left brain tumor.  By quickly transferring the patient from the operating table to the MR scanner, he was able to ensure that the entire tumor had been removed, that no healthy brain tissue had been damaged and that no complications resulted.

A cost effective arrangement
Central to Prof. Matsumae’s bold vision is the requirement that the configuration serve a dual purpose:

1. To have imaging services available during neurosurgical and radiological interventions
2. To have those same imaging services available to the entire institution Tokai University has proven this balance can be achieved.  Weekly, one or two cases of neurosurgery and two cases of radiological intervention are performed in the MRXO suite.  During that same time period, the number of routine exams includes:
   • 40 diagnostic CT scans
   • 16 diagnostic MRI scans
   • 1 case using X-ray angiography

Coordinated efforts
This highly successful MRXO project is another example of an innovative solution based on the foresight of one of Philips’ customers.

In this instance the synergistic efforts of Prof. Matsumae, Philips Medical Systems and a Japanese company (who developed the surgery table) show that patient management can be positively influenced through the thoughtful arrangement of imaging equipment.

“MRXO is an excellent and highly innovative system in neurosurgery, and a major contribution to medical science,” concludes Prof. Matsumae.  “It is a customer’s dream come true.”

http://www.optigo.com/main/news/publications/articles/surgery/dreamcomestrue.asp