Oftentimes during surgery it is necessary or desirable to obtain images to help guide the surgeon. There are several modalities that are commonly used in medicine that can be applied to intraoperative imaging, including Magnetic Resonance Imaging (MRI), Computed Tomography (CT), x-ray, ultrasound, microscopy, and other modalities such as optical imaging. There are unique challenges in applying standard imaging modalities to the operating room. This website presents the current state of these intraoperative imaging modalities, discusses the special challenges for implementing these systems, and presents a glimpse of the future of these and other imaging modalities in the operating room. Click on the links above or to the left to find out more about the individual modalities.
Intraoperative x-ray, ultrasound, and microscopy is already quite common, if inconvenient. Intraoperative CT and MRI both exist, but are less common due mostly to cost. One common use for these modalities is in lesion detection, either to identify a lesion during surgery or to verify its complete removal.
The future of all these imaging modalities will have to include several common features for them to be practical. Among these are convenience, size, and cost. MRI is a great imaging modality, but its cost outside the operating room is sufficiently high that any increase in cost for an intraoperative MR system may be prohibitive. One of the key limitations in an operating room is space. These devices must get smaller and more convenient. Perhaps detectors built into the operating table or remote computing stations are possible avenues for reducing the size of these devices. Finally, when a surgeon needs to use one of these devices it needs to be as simple and easy to use as possible. Surgery is no time to try to re-learn or remember how to use a complicated device.
Other possible directions for intraoperative imaging is image-guided robotic surgery. This could be some degree of automation, or some level of feedback for the physician.
Another general trend for the operating room is better communication systems. A good network in a hospital OR could allow for many pieces of equipment to be located remotely instead of in the room itself. the advantage would be that anything that doesn't absolutely have to be in the operating room could be moved out of it. Technicians and other staff could be located in a different room. This would greatly reduce the congestion and some of the confusion of the OR. If a problem occurs with a machine, it can be dealt with easier in another room than in the operating room itself. MRI, CT, ultrasound, x-ray, and other imaging techniques are require bulky imaging and processing hardware. For MR systems most of the hardware is already located in another room, but operating consoles and processing consoles could also be moved out of the operating room. Rather than having half a dozen carts of equipment and bulky computer systems on wheels in the OR, instead a single console with plugs for necessary equipment could be located near the surgeon.
One of the current limitations of intraoperative imaging is poor quality. This will be one of the areas of advancement in future intraoperative imaging. The extra design constraints make this difficult, but higher quality images are always desirable and useful.
Website created by: David Thayer, last edited: May 29, 2006