Dr. Alexandra Golby and her team at Brigham and Women's Hospital have developed a new approach for brain imaging prior to neurosurgery.

For neurosurgeons, finding your way around your brain is no easy task, since every brain is slightly different. And in brain surgery, mere millimeters can measure the difference between a successful procedure and mind-altering failure.

That’s why Dr. Alexandra Golby and her team at Brigham and Women’s Hospital in Boston are developing inventive ways of mapping each human brain they encounter. Golby, a neurosurgeon, wanted to generate a road map of her patients’ brains in order to help perform as minimally invasive a surgery as possible, and she wanted this information to be tailored specifically to each new patient.

That’s important because our brains are packed with neural tracts, enmeshed cables of connection that carry our nerve impulses inside our skulls.

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“I call it wading through the bowl of spaghetti,” said Golby. “We wanted to give people a way to, in an assistive fashion, find the tracts of interest.”

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Golby and her team of researchers, including Lauren O’Donnell, Sarah Frisken and Yanmei Tie, work closely to translate the data into useable information, harnessing hefty computing power and magnetic resonance imaging to capture highly detailed, 3-D models of these critical connections in each patient’s brain. The mapping also allows a surgeon see something called brainshift — the deformations that happen in the brain from the impact of surgery — in real time.

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“It’s very analogous to what having GPS on your phone has done. You can get information that helps you know where you are in near real time, or real time, which helps you avoid getting lost or gets you where you want to go most quickly and efficiently.”

Golby is now applying her team’s technique in studies of around 120 patients per year, and the mapping has evolved beyond a research technique to one that is clinically used and widely accepted by intracranial surgeons across the country.