Systems, Software, and Instruments

The PoleStar Surgical MRI Neurosurgery Suite

PoleStar N30 Surgical MRI

A suite that includes intra-operative MRI from Medtronic includes:

• PoleStar N30 Surgical MRI system
• StealthStation^® S7™ Surgical Navigation System, with surgeon monitor cart and staff monitor

StarShield Portable RF Shield

 

PoleStar System and StarShield

The PoleStar^® surgical imaging system doesn’t require radio frequency (RF) shielding of the entire OR due to the portable StarShield^® RF Shield solution. StarShield is a local, moveable RF shield that can be used to protect the PoleStar surgical imaging device from external RF noise.

StarShield Benefits

• Reduces overall project costs and complexity by eliminating need for full room RF shielding
• Significantly reduces OR downtime needed for construction
• During scanning in surgery, it allows electronic devices to remain turned on in the OR and personnel can come and go at will

StarShield – Extended

StarShield – Folded

OR Positioning

The StarShield is confined to the area around the OR table. It is folded at the patient's feet throughout the surgery, and extended for scanning.

Accessories

The PoleStar System accessories greatly improve the ergonomics, simplify current interfaces, and enhance the overall PoleStar surgical imaging system experience.

Table Adapter

StealthStation Navigation System Integration

iOR Suite with PoleStar

The PoleStar^® Surgical MRI System integrates seamlessly with StealthStation^® surgical navigation systems.

The PoleStar computer-assisted navigation tools allow:

• Advanced surgical navigation on pre-operative and intra-operative MRI images
• Surgical navigation on PoleStar system images merged with pre-operative diagnostic images
• Surgical navigation without registration of PoleStar system images
• Concurrent navigation of up to four co-registered image sets (utilizing Compare feature)
• Integration of microscopes, biopsy solutions, and other procedure specific technology
• Passive instrument tracking
• Surgical navigation even when iMRI is not needed

Imaging Capabilities

PoleStar Surgical Imaging Capabilities and Highlights

• Image fusion of pre-operative diagnostic scans (CT, MR, PET and fMRI) with intraoperative images
• Available scanning sequences  – T1, T2, FLAIR, and e-steady (combination of T1 and T2)
• Intraoperative scanning times from 8 seconds to 13 minutes

Detail

 

Low-grade Glioma

Glioblastoma

PoleStar N30 Recent Imaging Upgrades and Improvements

• Significantly faster and stronger MRI gradient system
• Higher SNR and shorter imaging times for T2/FLAIR
• Thinner T2/FLAIR slices for more precise navigation
• Enhanced imaging of low-grade gliomas – further confirmation of the value of resection control in all types of tumors

Comparison of FLAIR image between the PoleStar N30 and the PoleStar N20 illustrating a reduction in noise
(No Pathology)

OR Configurations

The PoleStar Surgical Imaging System Retrofits Into Existing ORs

Due to its modular, compact size, the PoleStar^® surgical imaging system does not require a specially constructed surgery suite. It can inexpensively retrofit existing ORs, located on any floor of the building.

PoleStar N20 Surgical MRI in the OR.

PoleStar N20 Surgical MRI stowed under the operating table.

Sample OR Configuration

RF Shield Positioning

StarShield – Extended for Scanning

StarShield – Folded During Surgery

The PoleStar surgical imaging system doesn't require RF shielding of the entire OR. The portable StarShield^® RF Shield – a local, moveable RF shield – can be used to shield the PoleStar surgical imaging system from external RF noise.

PoleStar Surgical Imaging System Storage

The entire unit can be wheeled to the patient table and resides underneath the table when not in use and is then elevated back to its scanning position with the push of a button.

When the OR is using the PoleStar surgical imaging system for navigation alone, the PoleStar scanner is stored in the Magnet Storage Cabinet, which contains the PoleStar's magnetic field to eliminate it from the OR.

PoleStar system magnetic storage cabinet

PoleStar system stowed in magnetic storage cabinet

Note: The PoleStar magnetic field is confined to the volume between the magnet poles and its immediate area. Surgical tools and systems outside the magnetic field will not be affected by the PoleStar's presence. Life support equipment as well as instruments that remain in the surgical field during scans must be MRI-compatible. All other instruments should be of a non-ferromagnetic material.

Site Preparation Guide

A Site Preparation Guide is provided to aid you and your organization in preparing for the installation of the PoleStar MRI system. A company-certified Site Preparation Specialist will be involved in all stages of your OR preparation, including consulting with the personnel at your facility during the design stage and monitoring the entire construction process.

Best Practices

The design of the PoleStar^® system is optimized for performing intracranial operations. The gap between the magnet poles accommodates all clinically required head positions while allowing the surgeon to conveniently access the surgical site whether the magnets are in scan position or lowered under the OR table. The system's dedicated Head Holder System provides both traditional three-pin and pinless fixation.

Step-by-Step Procedure

	While the patient is anesthetized, PoleStar remains in its storage cabinet enabling the medical personnel unrestricted access to the patient.
	The patient is positioned in the system Head Holder.
	The magnet is positioned and preoperative images are acquired.
	Gadolinium-enhanced images show the location of the tumor.
	The images are used for planning the craniotomy.
	The magnet is lowered and the tumor resection is performed.
	An intraoperative image acquisition is performed, revealing residual tumor.
	Navigation based on the intraoperatively acquired images allows the surgeons to precisely locate the residual tumor.
	The surgery continues using the guidance of intraoperative StealthStation® navigation.
	Online comparison of images acquired at different stages of the surgery facilitates complete removal of the tumor.