MCH unveils cutting-edge intraoperative MRI

On any ordinary day, six year old Émilie Gagnon gets up and heads off to her elementary school in la Chaudière- Appalaches. But October 19 was no ordinary day. Instead of taking the bus to school Émilie was wheeled in to the new operating room at The Montreal Children’s Hospital where she underwent brain surgery.

Émilie suffers from epilepsy caused by a tumour located on her occipital lobe, the rear most portion of the brain. Émilie’s tumour was the size of a large egg and the roots of the tumour ran deep into her brain.

Émilie was the first child to undergo brain surgery in The Montreal Children’s Hospital (MCH ) of the McGill University Health Centre’s new Pediatric Interventional Brain Suite, home to the first intraoperative magnetic resonance (MRI ) in a Canadian pediatric hospital.

“We’re incredibly pleased to be the first pediatric hospital in the country to be able to offer our patients the benefit of this remarkable new technology,” says Dr. Harvey Guyda, Associate Executive Director of The Montreal Children’s Hospital. “Equipment like this is helping us transform how we care for our patients—a transformation that will take another major step forward when we build the new Montreal Children’s Hospital at the Glen Campus.”

“The new intraoperative MRI gives us a tremendous advantage as we navigate through the brain to remove tumours,” says Dr. Jean-Pierre Farmer, Chief-of-surgery and a member of the neurosurgery team. “Traditionally, during brain surgery, we are guided by MRI images taken prior to the operation. But during brain surgery, the brain can actually shift as a result of a slight movement of the head, retraction of the brain, or the draining of cerebrospinal fluid. Thus the images are no longer as precise as the surgery proceeds. With the new MRI, we will have access to images of the brain in real time. This will allow us to be much more accurate at determining where the tumour begins and ends.”

During Émilie’s 11-hour surgery, Dr. Farmer removed all visible traces of the tumour. Normally, this is when the operation ends. However, thanks to the new intraoperative MRI, Emilie was wheeled into the adjacent MRI room. The child was still under anesthesia, was still in the same position as on the operating table. The MRI indicated roots of the tumour remained. So, Émilie was rolled back in to the OR and Dr. Farmer continued the surgery. Basically, the new equipment prevented Emilie from having to undergo a second surgery.

“Having to operate a second time on Émilie would have been extremely traumatic for her and her parents,” says Dr. Farmer. “In most cases, with the new MRI, we’ll be able to avoid second surgeries. In the case of Émilie, by removing more of the tumour we stand a much greater chance of stopping her epileptic seizures.”

The new Pediatric Interventional Brain Suite was made possible thanks to generous donors of The Montreal Children’s Hospital Foundation, including donations from Opération Enfant Soleil, The Sarah Cook Fund and Hydro-Québec.