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Molecular and Intraoperative Imaging Working Group

  1. Department of Neurosurgery
  2. Science and Research
  3. Scientific Working Groups
  4. Molecular and Intraoperative Imaging Working Group

Intraoperative visualization of fine brain structures

In order to provide the best possible neurosurgical treatment, neurosurgeons must have all the information about the disease at their disposal. Medical imaging, such as magnetic resonance imaging, makes an indispensable contribution to this by allowing morphological, functional and metabolic information about pathologies to be determined non-invasively. The intensive cooperation with the Department of Biomedical Imaging and Image-guided Therapy ensures that new methods of contrast imaging are also integrated.

In order to improve imaging not only before but also during surgery, we have an MR device with intraoperative usability, the first in Austria with a field strength of 3 Tesla. This ensures high image quality. Together with modern neuronavigation systems, all available clinical images of the brain can be made available in the operating theater.

Molecular imaging: Ultra-strong magnetic fields for research into brain tumor biology

For many years, the Department of Neurosurgery and the Department of Biomedical Imaging and Image-guided Therapy have been cooperating both in the context of treatment planning for patients and in research projects. One milestone is the joint research into pathologies on the High Field MR Centre’s 7 Tesla scanner.

A new method of 7T spectroscopic imaging developed here in Vienna allows the differentiation of metabolites such as glycine and glutamine with high resolutions, which is not possible at low field strengths.
Compared to neuroradiological tumour segmentation, we see strong correlation and different metabolic profiles between necrosis, contrast enhancement and oedema.

A detailed description of our research status can be found in the following brochure: "Meilensteine und Anwendungen der 7 Tesla Magnetresonanz-tomographischen spektroskopischen Bildgebung in Wien" (TEXT AVAILABLE ONLY IN GERMAN!)

Since 2014, latest metabolic imaging based on high-resolution MRSI (magnetic resonance spectroscopy imaging) has been tested in gliomas in collaboration with Prof. Georg Widhalm.

In the past, this research facility was scientifically and practically substantiated as part of an FWF-funded project, "3D 2HG mapping as biomarker for IDH-mutation in glioma".

Since then, gliomas, lymphomas and meningiomas have been measured isotropically using a world-leading 3D MRSI sequence with a resolution of 3.4 mm. First results in high-grade gliomas were successfully published in "NeuroImage: Clinical" in September 2020: „High-resolution metabolic imaging of high-grade gliomas using 7T-CRT-FID-MRSI“.

Since then, we have been working on improved methods and clinically relevant derivations of this technology, for example as part of the FWF project "Quantitative metabolic 7T imaging of tumor microenvironments", which started in 2023. The goals of the project are a better quantitative representation of metabolites, sampling during surgery based on these data and confirmation of metabolic imaging by analytical chemistry and molecular pathology. Furthermore, we will evaluate the potential advantages for therapy planning and monitoring and investigate the correspondence to the current state of the art, such as 5ALA fluorescence.

In 2020, we started studies on epilepsy.
A relevant percentage of people with focal epilepsy cannot be successfully treated with medication and therefore require surgical intervention. The origin of seizures in the brain is not always clear, which is why we want to investigate whether additional information from spectroscopic 7T imaging can lead to better treatment. The preliminary results appear to be promising in terms of elucidating metabolic changes in epilepsy-associated diseases better than ever before.

Prof. Karl Rössler and Gilbert Hangel presenting these studies: “7T MRSI for Epilepsy: Developing a new neurochemical imaging paradigm”

Although intraoperative MR systems are widely used clinically, only structural MRI methods are used as standard in surgery. Based on the expert knowledge of our clinics, we want to develop further advanced methods for visualizing function and metabolism.
We want to use MR spectroscopy to investigate how tissue behaves after minimally invasive laser-based heating.
Functional imaging can also be performed intraoperatively to image the motor cortex and resting networks in the brain directly before and after a surgical procedure.

We would like to thank the Departments of Biomedical Imaging and Image-guided Therapy, of Neurology - Division of Neuropathology and Neurochemistry, of Medicine I - Division of Oncology and of Pediatric and Adolescent Medicine, as well as the Center for Medical Physics and Biomedical Engineering for the intensive and productive cooperation within our university, which makes our research possible in the first place.

Our national and international cooperation partners include:

Our current projects:

  • „Quantitative metabolic 7T imaging of tumour microenvironments“;
    FWF KLI 1098-B
  • „Exploring HR neurochemical imaging for epilepsy“; FWF KLI 1121-B
  • „BIOMAK“; Christian Doppler Laboratory DFH 50 doc.funds.connect
  • „Platform for brain research using UHF MRI, histology, and AI“; FWF
  • „5-ALA as contrast marker for advanced MRI: An investigation of pre- and intra-operative imaging methods“; MedUni Wien Comprehensive Cancer Center Grant
  • „Development of intraoperative MR spectroscopy for the prediction of MRgLITT outcome and side effects in patients with brain tumours“; Medical-Scientific Fund of the City of Vienna
  • „GLURAG: Unravelling the role of peritumoral glutamate and glutamine in diffuse gliomas using 7T MRSI"; Medical-Scientific Fund of the City of Vienna
  • „Passive intraoperative motor fMRI at 3 Tesla: Developing a new tool for personalised medicine“; Meduni Wien Medical Neuroscience Cluster Grant 2023

  • Development of new biomarkers for neurosurgical planning
  • Research projects in cooperation with the Division of Neuroradiology , in connection with the new intraoperative MRI
  • Localization of important areas for memory, speech and motor skills using functional MRI.
  • Cooperation with the High-Field MR Center for the clinical testing and further development of 7 Tesla spectroscopic imaging for brain tumors and epilepsy
  • Integration of modern pre- and intraoperative MR methods in surgical neuronavigation.
  • Joint evaluation of metabolic and quantitative images in collaboration with the neurosurgical research laboratory, the Division of Neuropathology and Neurochemistry and other partner institutions.

Selected publications:

The following publication, which is the result of a collaboration of international experts under the leadership of Prof. Trattnig and Prof. Rössler, evaluates for the first time the consensus protocol for 7 Tesla in focal epilepsy. The results support the previous research results regarding the advantages of 7T MRI for preoperative examinations:

In the following work, we were able to show that the amino acids glycine and glutamine, which can only be imaged with 7 Tesla spectroscopic imaging, correspond better than previous clinically available methods to the results of clinical positron emission tomography:

Further publications:

The potential of modern MR imaging for neurosurgery can also be seen in the following scientific contributions of our working group:

© Universitätsklinik für Neurochirurgie© Wiener Gesundheitsverbund / Huber© Universitätsklinik für Neurochirurgie

Team of the Molecular and Intraoperative Imaging Working Group

Head:
Priv.-Doz. Dipl.-Ing. Gilbert Hangel, PhD
E-Mail: gilbert.hangel@meduniwien.ac.at

Clinical supervisor:
Univ.-Prof. Dr.med.univ. Karl Rössler
E-Mail: karl.roessler@meduniwien.ac.at

Scientific Staff:
Sagar Acharya - PhD Student
Ahmet  Azgin - PhD Student
Cornelius Cadrien - PhD Student
Stefanie Chambers - Studentische Assistentin
Ralph Flandorfer - Studentischer Assistent
Sara Huskic - PhD Studentin
Philipp Lazen - PhD Student
Lorenz  Pfleger - PostDoc
Nicolas Weilguny- Studentischer Assistent

Clinical Staff:
Dr.in med.univ.et. scient.med. Barbara Kiesel
Dr.med.univ. et scient.med. Mario Mischkulnig
Dr.in med.univ. Julia Shawarba
Dr. med.univ. Matthias Tomschick
Dr. med.univ. Fabian Winter
Dr. med.univ. Jonathan Wais
Dr. med.univ. Vitalij Zeiser