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Dr. John Huston

The benefits of intraoperative MR Q&A with Dr. John Huston

by Lauren Dubinsky , Senior Reporter
From the April 2019 issue of DOTmed HealthCare Business News magazine

Mayo Clinic first started performing intraoperative MR procedures over 15 years ago, but the technology and the applications it’s used for have drastically changed during that time.

Dr. John Huston, a neuroradiologist at Mayo Clinic in Rochester, Minnesota, spoke with HealthCare Business News about the benefits that intraoperative MR brought to his health system and their patients, as well as the direction this technology is headed in.

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HCB News: Can you tell us a little bit about when Mayo first got involved in intraoperative MR and what factors went into that decision?
Dr. John Huston: The first endeavor in combining operative procedures with MR was called the “double donut.” It was the result of a collaboration between Brigham and Women’s Hospital and GE. It fired the imagination of people to use MR as guidance to perform surgery. That particular project didn’t go very far, but it was the start of the idea.

In about 2002, we started planning, because we felt that the concept of using MR-guided neurosurgery would be beneficial. At the time, there were vendors that were excited about this prospect and came forward with a single-room solution. That involved swinging the table or suspending the MR on a ceiling rail.

We assumed that one of those approaches would become our solution. Due to our collaborative nature, we had the surgeons and anesthesiologists in the room with our planning people, and applying their feedback, we actually took a completely different course.

In a single room where you have a powerful magnet, you have to be very careful about metal projectiles that could be attracted into the magnet. If the patient is there, that can be catastrophic. For safety reasons, we went a different direction and decided to separate the OR and MR, and have a sliding door between the two.

When we began, we found that by having the rooms separate we are able to image our hospital patients at the same time that surgery is going on. It was financially beneficial and improved workflow.

We can use the OR and MR separately when they are not used together for a combined case. It was not the driver at the beginning of the endeavor but it has turned out to be extremely helpful. As our hospital volumes increase, we really need that MR capability.

HCB News: For what patients and procedures has intraoperative MR proved most beneficial at Mayo?
JH: I think, without question – glioma resection. Published reports demonstrate that the more complete the glioma resection, the greater the chance of survival. According to our neurosurgeons, the ability to carefully guide the degree of resection during the procedure has made a big difference.
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