BrainLAB Curve™ brings new level of integration, visualization to brain tumor surgery

Mayfield Clinic neurosurgeons Norberto Andaluz, MD, left, and John M. Tew, MD, trained last week on the new BrainLAB Curve™ image-guidance system (shown at right) at University Hospital. Dr. Andaluz is holding a z-touch® infrared device while Dr. Tew is holding a Softtouch® pointer with infrared spheres. The surgeons can use the hand-held devices to align the patient with MRI brain scans that appear on the nearby monitor, giving them a 3D view of the patient’s brain and the tumor’s location.

Mayfield Clinic neurosurgeons this week adopted a significant upgrade to image-guidance technology that is now available in the operating theater at UC Health’s University Hospital in Cincinnati. The technology builds on Mayfield’s evolving use of multiple types of brain imaging to plan the safest and most effective path to a brain tumor or other malformation.

The new technology, the BrainLAB Curve™, marks a high point in visual clarity and integration of all available information, enabling surgeons to see more clearly than ever before. The BrainLAB Curve™ differentiates itself from previous technologies by enabling the integration of 1) multiple types of brain scans; 2) brain scans taken at multiple diagnostic or hospital sites; and 3) multiple types of surgical technologies.The new technology, available to patients at the Brain Tumor Center at the University of Cincinnati Neuroscience Institute, is a beautifully engineered package of image-guidance equipment that:

•    takes neuro-navigation to a new level of precision, allowing surgeons to move through safe corridors in the brain while avoiding eloquent areas and critical white-matter tracts, veins, and arteries;
•    provides surgeons with crystalline, high definition 3D images of the brain and its landmarks on two touchscreen monitors;
•    allows surgeons to track their surgical movements  with the simple touch of a fingertip; the monitors, with smartphone-like glass, use “surface wave acoustic technology,” enabling the screens to activate instantly at the sound or feel of a human touch
•    simplifies pre-op planning for patients and eliminates the need for them to arrive at the hospital the day before for the placement of navigation fiducials on their head.

The installation of the BrainLAB Curve™ at University Hospital is the first in the Ohio-Kentucky-Indiana region.

“The new state-of-the-art Curve™ technology is one more reason why patients served by the Mayfield Clinic receive the best care available anywhere in the world,” said Ronald E. Warnick, MD, Chairman of the Mayfield Clinic and Medical Director of the UC Brain Tumor Center. “Mayfield and the Brain Tumor Center share a commitment to provide our neurosurgeons with the best available technology for complex brain tumor surgery. The Curve™ will allow our surgeons to integrate all available brain imaging to carefully plan the operation. The GPS tracking technology will help the surgeon locate deep tumors, map a safe corridor to the tumor, avoid eloquent brain areas, and determine when the tumor has been completely removed.”

“We have entered a new world of visualization,” said Christopher McPherson, MD, a Mayfield Clinic neurosurgeon and Director of the Division of Surgical Neuro-Oncology at the UC College of Medicine. “We now have two high-definition screens with larger, flat-panel monitors, which improve the way we and the entire operating room team can visualize this technology. In addition, the Curve™ allows us to integrate multiple different technologies: We can integrate our microscope view, our endoscope view, and pictures from prior scans — all of which can be used together.”

Equally important, the new system eliminates the need for patients to arrive a day ahead of their surgery for scanning with special markers – called fiducials — that appear in the scans and are used as a point of reference. “The technology has improved to the point where we can perform our image-guided surgery without fiducials,” Dr. McPherson said. “Before, patients had to wear these markers on their head from the time of their MRI to the time of surgery.”

Said John M. Tew, MD, a Mayfield neurosurgeon and Clinical Director of the UC Neuroscience Institute: “It is a significant upgrade that provides major improvement in accuracy. That translates into shorter operations, shorter hospital stays, and lower treatment costs, which will improve outcomes and patient satisfaction.”

— Cindy Starr