Week 4: Surgeries and Project Progress
A lot more has happened in this past week now that holidays and out-of-town clinician meetings have passed. I have spent significantly more time in the OR seeing many different pieces of equipment and methods for surgeries. The week began with removing a decently sized tumor originating from the dura and located just behind the patient's left eye. I was shadowing a different clinician that morning from Dr. Schwartz or Dr. Gauthier and it seemed that he was instructing a fellow on how to go about doing the surgery to remove the tumor and to ensure almost no chance of missed cells after removal.
The more interesting procedures were done the following day. The first patient had a history of epilepsy and so the surgery consisted of implanting electrodes, both strip electrodes and depth electrodes, in order to determine the location of the seizure focus and next week, using the data collected, remove the focus in an attempt to reduce or eliminate seizure risk for the patient.
The next surgery was actually the most relevant procedure to the research I do in Chris Schaffer's lab back at Cornell. The surgery first consisted of a biopsy of a tumor believed to have originated from the patient's metastatic lung cancer. The second phase of the surgery following the biopsy involved the use of the MRI and an ablation laser provided by Monteris. A robotic arm with a laser diode at the end is inserted into the brain of the patient and, using the MRI and phase shifts to track temperature changes, the laser can ablate the tumor in a controlled manner. The physician can control the depth of the arm and with an attachment, control the direction of the laser. In this case, the attachment was not used and so the laser created an oval field of damage to the tumor, unlike what is shown in the example image below. The technician from Monteris explained how the robot and laser worked, as well as his preferences of MRI machine based on either image quality or program compatibility. Overall, the machine and method left a big impression on me. I have included a link to an example video showing how the laser works.
Neuroblate Laser Ablation Rendered Example
As for my project, I am working on a kinetic model for PET scans and attempting to separate the effects of ligand binding to microglia in multiple sclerosis from disruption of the blood-brain barrier due to lesion activity. I began with two initial sets of data to try to fit the model based on an input function found by measuring ligand concentration in the blood. Shown below is an example from the patient data and the model fit under constant kinetic coefficients for one region of the brain. Developing the model using those two sets of data was the simple part because the next set of data using rats will require using kinetic coefficients that will be changing during data collection from injection of mannitol.
Hopefully the next couple weeks go by smoothly.
Figure 1: Patient MRI scan of brain. Tumor is located behind left eye (shown on right side) as large white mass
The more interesting procedures were done the following day. The first patient had a history of epilepsy and so the surgery consisted of implanting electrodes, both strip electrodes and depth electrodes, in order to determine the location of the seizure focus and next week, using the data collected, remove the focus in an attempt to reduce or eliminate seizure risk for the patient.
The next surgery was actually the most relevant procedure to the research I do in Chris Schaffer's lab back at Cornell. The surgery first consisted of a biopsy of a tumor believed to have originated from the patient's metastatic lung cancer. The second phase of the surgery following the biopsy involved the use of the MRI and an ablation laser provided by Monteris. A robotic arm with a laser diode at the end is inserted into the brain of the patient and, using the MRI and phase shifts to track temperature changes, the laser can ablate the tumor in a controlled manner. The physician can control the depth of the arm and with an attachment, control the direction of the laser. In this case, the attachment was not used and so the laser created an oval field of damage to the tumor, unlike what is shown in the example image below. The technician from Monteris explained how the robot and laser worked, as well as his preferences of MRI machine based on either image quality or program compatibility. Overall, the machine and method left a big impression on me. I have included a link to an example video showing how the laser works.
Figure 2: Neuroblate System Screen showing the concept behind how the machine works
As for my project, I am working on a kinetic model for PET scans and attempting to separate the effects of ligand binding to microglia in multiple sclerosis from disruption of the blood-brain barrier due to lesion activity. I began with two initial sets of data to try to fit the model based on an input function found by measuring ligand concentration in the blood. Shown below is an example from the patient data and the model fit under constant kinetic coefficients for one region of the brain. Developing the model using those two sets of data was the simple part because the next set of data using rats will require using kinetic coefficients that will be changing during data collection from injection of mannitol.
Figure 3: Example plot from subject 1. Points indicate measured concentrations on the PET scan, the line indicates the model fit
Hopefully the next couple weeks go by smoothly.
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