We are pleased to announce Professor Alex Golby, Professor of Neurosurgery and Professor of Radiology at Harvard Medical School, is one of the featured speakers of the Hamlyn Symposium on Medical Robotics 2021 (#HSMR21).
Professor Golby gave a talk on ‘Creating road maps for minimally invasive interventions in the brain’ followed by a Q&A session.
Performing safe and effective intracranial neurosurgery is predicated on understanding individual functional anatomy in order to avoid damage to critical brain areas and attendant neurological deficits. Historically, decisions about eloquent brain structure were made on the basis of general neuroanatomic understanding or invasive mapping such as the Wada test and electrical stimulation mapping either intraoperatively or with surgically implanted electrodes.
Such mapping has been very useful in demonstrating the variability of individual functional anatomy both inherent among individuals and also due to lesion induced reorganization. Over the last several decades, numerous non-invasive brain mapping methods have been developed including functional MRI of the cortex and white matter mapping with diffusion MRI tractography. Other approaches include magnetoencephalopathy and transcranial magnetic stimulation.
These methods maybe used to obviate the need for invasive mapping or may help limit the scope of invasive mapping for patients undergoing traditional neurosurgical approaches. However, with the advent of increasing minimally-invasive or non-invasive interventions, the importance of non-invasive individual subject mapping will continue to increase.
For patients undergoing interventions such as laser interstitial therapy thermal therapy, Focused ultrasound, robotically-guided or other emerging interventions, the ability to obtain a non-invasive individual map of functional anatomy will be critical for the optimal deployment of these technologies. Individual functional maps can be obtained in advance of the procedure and integrated with procedural planning and guidance systems to create a virtual roadmap allowing the surgeon to plan the most effective and safest approach to accomplish the therapeutic goals.