1. ©2005 Surgical Planning Laboratory, ARR Slide 1 AMIGO: Advanced Multimodality Image-Guided Operating room Randy Ellis, Ph.D.

2. ©2005 Surgical Planning Laboratory, ARR Slide 2 AMIGO: Project Overview Within the Image-Guided Therapy (IGT) program Goal: to translate basic science into clinical practice – Registration for improved treatments – Visualization for improved understanding – Image fusion to lever each modality’s strengths

3. ©2005 Surgical Planning Laboratory, ARR Slide 3 AMIGO: Proposed Facility O.R. with ultrasound, X-ray fluoroscopy, microscopy, endoscopy Table transports “left” to 3T MRI Table transports “right” to PET/CT Integrating images for novel procedures

4. ©2005 Surgical Planning Laboratory, ARR Slide 4 AMIGO: MRI + O.R + PET/CT

5. ©2005 Surgical Planning Laboratory, ARR Slide 5 AMIGO: Main O.R.

6. ©2005 Surgical Planning Laboratory, ARR Slide 6 AMIGO: View to MRI

7. ©2005 Surgical Planning Laboratory, ARR Slide 7 AMIGO: View to PET/CT

8. ©2005 Surgical Planning Laboratory, ARR Slide 8 AMIGO Integrates Modalities Open surgery Endoscopic surgery Percutaneous procedures – Catheter based (vascular) – Ablation probes (RF, cryo, laser) Non-invasive surgery (focused ultrasound)

9. ©2005 Surgical Planning Laboratory, ARR Slide 9 AMIGO: Metabolic Imaging Noninvasive, real-time assessment of the safety of tumor resection margins Assessment of metabolically active tumor volume Metabolically guided tumor biopsy Synergism between OR of the future and molecular imaging

10. ©2005 Surgical Planning Laboratory, ARR Slide 10 AMIGO: Anatomy+Metabolism

11. ©2005 Surgical Planning Laboratory, ARR Slide 11 AMIGO: Radiation Oncology Simulation of treatment – CT/PET alone – CT/PET with MR Guided brachytherapy – Head and Neck – Gynecological – Prostate

12. ©2005 Surgical Planning Laboratory, ARR Slide 12 AMIGO: Modulated Radiotherapy

13. ©2005 Surgical Planning Laboratory, ARR Slide 13 AMIGO: Translational Research Application of basic science to clinical needs Laboratory for novel treatments Studies of treatment efficacy Treatment optimizations – Subcomponents for specific treatments – Add modalities as required