Advanced Multimodality Image Guided Operating (AMIGO) Suite
Image-guided Therapy
Imaging has become essential not only for the detection and monitoring of disease but also for improving the outcome of therapy. The overall goal of Image Guided Therapy (IGT) is to help the physician improve the efficacy and reduce the morbidity of minimally invasive procedures by providing intra-operative image based anatomic and physiologic information in real-time. Traditional surgery is based on hand-eye coordination; IGT advances this concept by enhancing what the eye can see with multimodal imaging, and what the hand can do with robotic and therapy devices. IGT integrates therapy with intra-operative imaging and transforms invasive procedures into reduced-risk minimally invasive or non-invasive ones. In IGT, pre-operative and real-time intra-operative image information is displayed, and the technologies for imaging, guidance, and therapy are all integrated within complex therapy delivery systems. In addition, multimodal imaging guides therapies using comprehensive information derived from the different physical and biological characteristics of the tissues in ways that a single imaging modality cannot. Through this fusion of data from various imaging sources, compensations are made for any weakness of an individual modality.
The History of Image-guided Therapy at Brigham and Women’s Hospital
The BWH began its IGT program in 1991. Since then, it has become an internationally recognized pioneer in real-time intra-operative MRI-guided therapy. Using the well-known “double-doughnut” system, BWH teams performed over 3,000 surgical and interventional procedures. By 1994 the BWH IGT Program introduced non-invasive MRI-guided focused ultrasound surgery. Constructed in 2009, AMIGO continues these pioneering efforts with multimodal image guidance.
| MRT 1991 | Focused Ultrasound Surgery 1994 | AMIGO 2010 |
AMIGO
The Advanced Multimodality Image Guided Operating (AMIGO) Suite is an innovative surgical and interventional environment that is the clinical translational test bed of the National Center for Image-Guided Therapy (NCIGT) at the Brigham and Women’s Hospital (BWH) and Harvard Medical School. The AMIGO is an integrated, 5,700 square foot area divided into three sterile procedure rooms in which a multidisciplinary team will treat patients with the benefit of intra-operative imaging using multiple modalities. In AMIGO, real-time anatomical imaging modalities like x-ray and ultrasound are combined with cross sectional digital imaging systems like CT, MRI, and PET. Molecular image-guided therapy will be pioneered with the use of multiple molecular probes, such as PET, optical imaging, and targeted mass spectrometry, to increase the sensitivity and specificity of cancer detection. Application of these technologies is expected to improve the ability to define tumor margins to more completely excise or thermally ablate tumors. In addition to multi-modality imaging, the AMIGO has various navigational devices, robotic devices, and therapy delivery systems that help physicians to localize and treat tumors and other targeted abnormalities. The AMIGO represents and encourages multidisciplinary cooperation and collaboration among teams of surgeons, interventional radiologists, imaging physicists, computer scientists, biomedical engineers, nurses and technologists to reach the common goal of delivering the safest and the most effective state-of-the-art therapy to patients in a technologically advanced but patient-friendly environment.
