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History of Brain Mapping and Neurophotonics
Published in Yu Chen, Babak Kateb, Neurophotonics and Brain Mapping, 2017
Babak Kateb, Frank Boehm, Alexandra Jalali, Vassiliy Tsytsarev, Vicky Yamamoto, Bahram Jalali, Derek Backer, Brian Pikul, Parham Yashar, Yu Chen
More recently, the research of Ferenc Jolesz (1946–2014) with image-guided therapy enabled the enhancement of targeting and the resolution of monitoring toward the improved management of surgical procedures employing the data acquired from diagnostic imaging. Along with Peter Black (professor of neurosurgery at Harvard Medical School), he established the area of intraoperative MRI (iMRI)-guided interventions and developed various novel medical procedures, including for the treatment of brain tumors, derived from unique synergies between imaging and the delivery of therapies.
MRI-guided endovascular intervention: current methods and future potential
Published in Expert Review of Medical Devices, 2022
Bridget F. Kilbride, Kazim H. Narsinh, Caroline D. Jordan, Kerstin Mueller, Teri Moore, Alastair J. Martin, Mark W. Wilson, Steven W. Hetts
Relatively little attention has been paid to this critical issue. Hall et al. explored the costs and benefits of MRI-guided brain tumor resections [174], concluding the potential costs of interventional MRI could be offset by improved health outcomes. Their work demonstrated that adults who had a brain tumor resection in an intraoperative MRI had a 54.9% shorter hospital length of stay compared to those who had resection performed in a conventional OR, showing a higher turnover rate and financial advantage to using MRI. Currently, the cost of a diagnostic MRI exam is typically 2–3 times more than that of a CT or ultrasound, and the increased cost is an area of significant scrutiny. Nonetheless, there have been efforts in recent years for a ‘Limited MRI’ Current Procedural Terminology (CPT) code. This is an MRI scan with only a few essential, focused sequences, for a clinical indication that should have the best visualization on MRI. The reduced overall time in the MRI scan room (~15 minutes including set-up), in combination with the ability to avoid imaging modalities that are less specific, allow the overall cost to be lowered, such that the cost is on par with that of an ultrasound or CT scan [175]. This same concept could be applied to reduce the cost of interventional procedures; however, MRI-guided therapy must first thoroughly prove its cost-effectiveness and value as a minimally invasive surgery over open surgery [176]. In body interventional radiology, biopsy and ablation CPT codes used for CT procedures have been applied to MRI-guided procedures [177]. Authors emphasized the importance of patients consulting with billing offices and their health insurance provider to predetermine out-of-pocket expenses or prior authorization requirements. Ultimately, demonstrating improved clinical outcomes, such as shorter length of hospital and rehabilitation stay and reduced disability in acute ischemic stroke, will drive reimbursement strategy and insurance coverage determination. Access to an interventional MRI unit may help other interventional procedures maximize use and demonstrate clinical value as a return on investment.