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In This Issue:
From left, Steven Seltzer, MD, FACR, Clare M. Tempany, MD, Michael J. Zinner, MD, Angela Kanan, RN, BSN, CNOR, CRN, Gary Gottlieb, MD, MBA, Mairead Hickey, RN, PhD, Betsy Nabel, MD, Ferenc A. Jolesz, MD, Brian Chiango, RT, MBA, Sanjay Pathak and Barbara Bierer, MD, at the ribbon-cutting ceremony.
On May 4, BWH unveiled the Advanced Multimodality Image Guided Operating (AMIGO) Suite, which gives interventional radiologists and surgeons immediate access to a full array of advanced imaging modalities for use during multiple procedures. The integrated, 5,700-square-foot area is divided into three sterile procedure rooms—joined internally by sliding doors—that house real-time imaging modalities like X-ray fluoroscopy and ultrasound, as well as cross sectional digital imaging systems like CT, high field strength MRI and high resolution PET.
“This is the first suite in the world to bring all of these imaging modalities into one integrated operating room,” said Ferenc A. Jolesz, MD, who serves as co-director of AMIGO, along with Clare M. Tempany, MD. “The three-room complex that you see today will be used by a multidisciplinary team of radiologists, surgeons, engineers, computer scientists and physicists. While the construction is over, the innovation is just beginning.”
Image-guided surgeries are not a new phenomenon. In fact, BWH has a long history of innovation in the field: In the early 1990s, the hospital was the first to use magnetic resonance imaging (MRI) to guide neurosurgical, surgical and interventional procedures. Today, this pioneering work has been adopted by more than 100 centers throughout the world. However, the AMIGO Suite is the first to offer this full combination of imaging methods for localizing diseases, guiding, monitoring and controlling numerous therapeutic procedures.
“The availability of advanced imaging modalities in AMIGO’s highly integrated environment represents an unprecedented opportunity and a one-of-a-kind setting,” said BWH President Betsy Nabel, MD. “The investment in AMIGO further reflects BWH’s commitment to providing the highest quality health care to patients and their families and to expanding the boundaries of medicine through research.”
Neurosurgeon Alexandra Golby, MD, one of AMIGO’s three associate medical directors, notes that the multidisciplinary nature of the project was critical in the planning stages, and will continue to be key to the success of the AMIGO suite.
“From the beginning, this has been a multidisciplinary project, relying on expertise from clinicians, engineers, medical physicists, project managers, architects, contractors and facility supervisors,” Golby said. “And, as we move forward, our expertise here at the Brigham will continue to drive us in this area. Everyone from nurses and technicians, to people within the research community, brings a huge amount of expertise that is critical to AMIGO’s success.”
The first procedures that will be performed in AMIGO include open brain surgery, minimally invasive brain tumor laser ablation, radiation treatment of prostate cancer and gynecological tumors, breast conserving breast cancer surgery, removal of suspicious lesions in the pancreas, MRI-guided tumor cryoablation (freezing treatment) and treatment of atrial and ventricular fibrillation.
“In a traditional surgery, you look with your eyes and operate with your hands,” said Golby. “The idea behind AMIGO is to disrupt that simple paradigm and give the surgeon a number of enhanced ways of seeing and operating.
The AMIGO Suite is innovative by today’s standards, and its design also incorporates opportunities for future growth and development.
“We tried to build the site to be ‘future-proof,’” said Dan Kacher, the lead engineer on the AMIGO project. “With insights from our previous intra-operative MRI installations at BWH, we were able to anticipate future needs and accommodate growth and change.”
Partial funding for AMIGO came from grants from the NIH's National Center for Research Resources and the National Institute of Biomedical Imaging and Bioengineering.