BWH MRI Research Center and Image Guided Therapy Program

Overview

Brigham and Women's MRI Research Center (BWMRC)
The Brigham and Women’s MRI Research Center provides essential research MRI services to BWH researchers and other investigators from the broader scientific community. Located at 221 Longwood Avenue, the facility improves research capabilities by making functional MRI, spectroscopy, and devices for imaging pre-clinical models available in a single space.

The new center also houses a translational imaging research program, allowing for an environment more conducive to collaboration between basic science researchers working with pre-clinical models and researchers conducting MRI imaging on human subjects and patients. Because of this, the integrated MRI research programs are expected to have even more impact. Scientists who discover a breakthrough application of MRI for treating disease in pre-clinical models can rapidly share their findings with clinicians and researchers working with human subjects.

Advancing Translational Research in MRI
Magnetic Resonance Imaging (MRI) is an essential research tool for the non-invasive study of both the biological structures and functions of the human body. MRI Imaging in pre-clinical models can be used to understand disease processes and develop novel treatment approaches. Human MRI studies build upon this, allowing a unique view of virtually every organ of the body. From the study of brain function in neuropsychiatric disease to the measurement of pulmonary physiological parameters, to new image-guided therapy approaches, the use of innovative MRI methods is revolutionizing biomedical science.

Benefits to Patients
The cutting edge research at the BMRC will deeply impact a wide range of diseases and potential treatment applications. Some areas of active investigation include:

Brain diseases (psychiatric disorders, degenerative neurological diseases, neurosurgical applications, and traumatic brain injury)
Highly specialized area of the study of pulmonary function
Investigation of the chemical composition of normal and diseased tissues and organs with MR Spectroscopy
Early advanced work in musculoskeletal systems, such as cartilage imaging, could expand and improve treatments for patients experiencing joint pain
Leading work in image-guided therapy impacts multiple diseases allowing for minimally invasive treatments.

Research Equipment
The Latest in MRI Research Equipment
There are a variety of MRI scanners and advanced imaging instruments at the new facility to address the multiple needs of the Center’s investigators.

Siemens 3T Skyra MRI scanner
This Skyra has a number of features that enhance image quality, acquisition speed, and workflow productivity. These improvements allow for a greater range of novel research applications. With a 70 cm wide bore design, the Skrya can comfortably accommodate claustrophobic patients or patients with limited mobility.

NordicNeuroLab fMRI Hardware System
Sensory perception studies are the basis for many research studies that use fMRI. The BWMRC is equipped with a fully integrated array of fMRI hardware for auditory and visual stimulus presentation, response collection, and experiment synchronization.

Open-Source Xenon Polarizer XENA
The incorporation of a xenon polarizer enhances the capabilities, productivity, and collaborations of the unique BWH pulmonary functional imaging program. The polarizer makes hyperpolarized xenon, a non-toxic gas that, when inhaled by the patient, can be measured under MRI imaging. This allows assessment of lung function in addition to lung structure. These measurements provide information that is relevant to studying diseases such as emphysema, interstitial lung disease (pulmonary fibrosis) and pulmonary vascular disease.

Development of the xenon polarizer was the result of collaborations among academic researchers and represents a state-of-the-art device in the field of pulmonary imaging. Our xenon polarizer is an open-source design, based largely upon existing designs and technologies, but scaled up for human imaging applications. It is also specifically designed to be more portable than other xenon polarizers currently available. Sam Patz, PhD, provided the funding for the development and construction of the polarizer, which is to be used in conjunction with the Siemens Skyra 3T MRI magnet.

Ferroguard Beacon Ferromagnetic Detection System
Introduction of metal objects that are ferromagnetic – meaning the objects react strongly to magnetic fields – is one of the primary safety concerns of MRI. The Ferroguard Beacon Ferromagnetic Detection System is a state-of-the-art patented screening system designed to prevent patient injury and equipment damage that can occur when ferromagnetic objects are brought into the magnetic field of an MRI unit. Unlike handheld ferromagnetic screening devices, which occasionally fail due to user error, Ferroguard scans a subject from head to toe as the subject steps through the portal. With built in redundancies and a sensitivity that can be set to detect very small ferrous objects, the Ferroguard represents the best available way for protecting patients and staff from inadvertent introduction of ferrous objects into the magnetic environment.

History of the BWMRC

The Brigham and Women’s MRI Research Center, located in the Eugene Braunwald Research Center at 221 Longwood Avenue, has long been a site for advanced MRI research. Scientists from BWH, Harvard Medical School and other academic institutions in the greater Boston area have used the scanners at 221 Longwood for a wide variety of research projects. A previous renovation occurred in 1991 under the direction of Ferenc A. Jolesz, MD, and the facility served the research community well for many years. However, interference from environmental factors due to the building’s location in a dense urban setting restricted the development and implementation of advanced imaging techniques, leading to additional renovations.

In 2009, President Obama announced the American Recovery and Reinvestment Act (ARRA), commonly referred to as the Stimulus or Recovery Act. Among the release of funds that was authorized by the ARRA, $10.4 billion was earmarked to the National Institutes of Health. A BWH team, led by Emily Stern, MD, applied for and successfully obtained $6.1 million for the BWMRC renovation. After the NIH grant was awarded, Brigham and Women’s Hospital contributed funding for the purchase of new devices and outfitting of the new space. Construction began in early Spring 2012, and the Center took delivery of the new Siemens 3.0T MRI scanner in July, 2012.

Under terms of the ARRA, the BWMRC renovation project created and helped to maintain a significant number of jobs. Multiple vendors were hired for various aspects of the project and numerous construction jobs were created.

Image Guided Therapy Program (IGTP)

The Image Guided Therapy Program (IGTP) is combining advances in imaging and therapeutic technology to develop minimally invasive surgical and interventional techniques. The program represents a multidisciplinary clinical and research effort and has developed several novel therapies.
The IGTP is supported by the Center for Innovative Minimally Invasive Therapy (CIMIT) which is funded by the Department of Defense (DOD).
The IGTP includes a number of research initiatives with various funding sources.

• National Center for Image Guided Therapy Program (NCIGT)
• Focused Ultrasound Surgery (FUS)
• Surgical Navigation and Robotics Laboratory (SNR)
• Surgical Planning Lab (SPL)

What is Image-Guided Therapy?
The use of medical imaging for guidance of therapy is not a new concept. Since the discovery of x-rays, various imaging methods have been used to localize normal anatomical structures and pathologic lesions, as well as to locate instruments. These images are fundamental in finding optimal access to the target of interventions and in defining trajectories for therapeutic instruments. All available imaging modalities have been exploited for localization, targeting, and monitoring of interventions.

Initially, x-ray systems were used in operating rooms, but now ultrasound (US) machines have become predominant. More recently, computed tomography (CT) and magnetic resonance imaging (MRI) systems have been brought into the operating room environment for intraoperative image-guidance. At the same time, with the advance of computerized image processing and visualization tools, image-guidance systems have been introduced for various surgical and radiation oncology applications. These systems make use of preoperatively acquired images to create anatomical models, which provide localization, targeting, and visualization of the three-dimensional (3D) anatomy. Using the models, one can calculate radiation doses and optimize trajectories for beams.

This radiation therapy planning is very similar to surgical planning. In both cases, the preoperative image-based 3D models are used for defining various access strategies and to simulate a planned treatment. The so-called navigational systems are one step closer to intraoperative guidance, because the preoperatively created 3D models are registered to the patient. This provides a link between the image-based coordinates and the actual surgical position, defined by an instrument's location in the surgical field.

The increasing acceptance and dissemination of minimally invasive procedures has resulted in the recognition of the feasibility of image-guided approaches. Although interventional radiology has combined imaging with various novel therapeutic methods, the full utilization of advanced imaging technology has not yet been accomplished. Progress in computer technology has accelerated the development of image-processing algorithms, interactive visualization, and display methods, and has revitalized the field of image-guided therapy. The current tendency is the evolution of integrated therapy delivery systems in which advanced imaging modalities are closely linked with high-tech therapy devices and/or surgical systems.

Surgery today relies conceptually on the same principles as it did three thousand years ago: the surgeons use their hands directly to control instruments, and they use their eyes to provide them with feedback about the effect of their manipulations. Accordingly, a surgeon needs both visual and mechanical access to the site of an operation. The modern trend in surgery, however, is toward minimally invasive approaches, where the damage set for accessing the surgical site is reduced by using rigid or flexible long-necked instruments introduced through natural openings or small incisions into the target areas. These instruments typically carry some form of visualization equipment and some way to introduce instruments for procedures. Advanced imaging technology could expand the successful application of such endoscopic surgery, and at the same time improve planning and outcomes for traditional, open surgery.