Nathalie Y. R. Agar
Daniel E. Ponton Distinguished Chair in Neurosurgery, Brigham and Women's Hospital
Associate Professor of Radiology, Harvard Medical School
The overarching goal of my research laboratory in the Departments of Neurosurgery and Radiology at BWH/HMS, and Cancer Biology at Dana-Farber Cancer Institute is to improve the care of patients affected by cancer. My research team develops and implements mass spectrometry and optical imaging approaches for surgical pathology and oncology. We also develop, validate, and apply imaging approaches for drug development research and molecular classification of disease, and work toward translating methodologies for the practice of individualized medicine. More specifically, part of our research takes place in the Advanced Multimodality Image Guided Operating (AMIGO) suite, standard operating rooms, and a state of the art laboratory equipped for tissue culture and optical and mass spectrometry imaging. Since receiving the NIH Director’s New Innovator Award in 2010 for my work on “Real-Time Stereotactic Mass Spectrometry Tissue Analysis for Intraoperative Neurosurgical Guidance”, we have implemented mass spectrometry protocols in the operating room for brain and breast cancer surgery. Our work on the real-time analysis of an onco-metabolite (2-HG) to support surgical decision making now constitutes the basis for the very first IRB-approved study to use mass spectrometry derived diagnostic information to support surgical decision making. Our efforts to improve the management of brain tumors also includes extensive imaging of targeted therapies that transit through the blood-brain barrier in pre-clinical animal models and clinical trial patients with correlation to non-invasive radiologic imaging and detailed pharmacodynamics. Using MALDI FTICR mass spectrometry imaging we can specifically image most drugs and spatially resolve their distribution as it relates to the vasculature by simultaneously imaging heme as a natural biomarker of the vasculature. Using the same approach on stereotactic MRI-registered surgical samples from clinical trials for primary brain tumors and brain metastases, we further assess drug distribution in the 3D anatomy of the tumor and brain to account for the effect of brain anatomy and tumor heterogeneity on the permeability of blood-brain and blood-tumor barriers.
In NCIGT, I lead a project on the real-time analysis of the implementation of mass spectrometry to support neurosurgical decision making.
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