The Técnico alumna Inês Machado (PhD in Biomedical Engineering under the MIT Portugal Program), was the winner of Fraunhofer Portugal Challenge 2020, in the PhD category. The work titled “Sneaking into the brain with a new GPS-like technology” presents a technological solution validated by neurosurgeons, radiologists and engineers at the Massachusetts Institute of Technology (MIT), Harvard Medical School and Brigham and Women’s Hospital, in Boston. This technological solution leads to a more complete removal of brain tumors and helps to prevent important neuronal damage, which reduces patient’s morbidity and mortality, reduces the cost of health and improves the preservation of neurocognitive functions after the patient survival.
“This award recognises my work over the last 4 years”, says the Técnico alumna. “It all started in 2015, after an informal conversation with Dr. Herculano Carvalho, a neurosurgeon at Hospital de Santa Maria, in Lisbon, and professor Jorge Martins from the Center of Intelligent Systems at Instituto Superior Técnico. We discussed the current challenges in neurosurgery, in Portugal, and defined a 4-year project to respond to the most ambitious one – brain shift correction during real-time brain tumor surgery”, recalls Inês Machado. “This technological solution has a great impact on society and it is very rewarding for us that it has been recognised the best research work of practical utility developed in Portugal”, highlights the award winner.
An open-source technology solution that is positively impacting the world of neurosurgery
The brain controls the function of many organs within our body, our thoughts and emotions. For this reason, surgical procedures that involve the brain are very complex and have high associated risks, since brain tumors are usually located around critical brain structures. Damaging these structures can cause the loss of brain functions, which are often irreversible. “The main purpose of neurosurgery is to maximize tumor removal and, at the same time, to minimize damage to the surrounding brain tissue”, stresses Inês Machado.
One of the biggest challenges of this type of surgery is to distinguish brain tumor cells and healthy brain tissue. “To the naked eye, healthy brain tissue and brain tumor can look almost identical”, says the Técnico alumna. “In recent decades, neuronavigation systems have been revolutionizing neurosurgical practice, allowing surgeons to be guided by pre-operatively images of the patient’s brain, such as magnetic resonance imaging (MRI)” stresses Inês Machado. “These systems are a GPS-like technology that identify any part of patient’s brain and its corresponding point on the MRI image” she adds. “In addition, these systems allow for less invasive approaches and avoid errors on brain tumor location that could lead to serious consequences, namely the increase in neurological disorders or the need for re-intervention”.
However, traditional neuronavigation has some important limitations: “the most important one is the dependence on pre-operative images. If these are not complemented with intraoperative imaging, precision may be lost due to the significant deviation of the distance of intracranial structures during the surgery”, highlights Inês Machado. “This phenomenon is known as brain shift and occurs due to multiple factors, such as brain parenchyma retraction, cerebrospinal fluid aspiration during critical surgical stages, namely the craniotomy itself and dura mater incision”.
The consequences of brain shift on neurosurgery are serious and can severely compromise neurosurgeries. “First, it can lead to partial tumor removal, which means a need for reoperation; second, it can damage healthy brain tissue, which means that critical brain functions can be affected and, finally, it can lead to longer surgical procedures, representing increased costs”, highlights the Técnico alumna.
“This technique allows a real-time image acquisition during critical surgical stages, namely after craniotomy and dura mater incision”, explains the alumna. The open-source technological solution developed by Inês Machado uses real-time intraoperative imaging for automatic brain shift correction. “The acquisition of 3D ultrasound images can help in real-time decision making and it is much more cost effective – scanning costs, consumable costs, total time of surgery”, explains the researcher.
The academic path that inspired Inês Machado
The winner of the Fraunhofer Portugal Challenge 2020 won a Bioengineering PhD scholarship under the MIT Portugal Program in 2015, which allowed her to develop work at Técnico during 2 years, and at MIT and Harvard Medical School another 2 years. “It is very important to be surrounded by the best scientists and mentors when we are doing a PhD thesis, and I was lucky to be surrounded by people who have always inspired and motivated me to work in a rigorous and professional way”, says Inês Machado.
Currently, Inês Machado is a research associate and visiting professor of “Computer Programming” and “Computing in Medical Image” at King’s College London. “I continue to work in the field of medical imaging every day, in SmartHeart project, with researchers from Imperial College London, King’s College London, Queen Mary University of London and University of Oxford , which aims at developing next-generation cardiovascular imaging techniques for improved diagnosis”, shares the alumna.
Fraunhofer Portugal Challenge 2020
Organised since 2010, the Fraunhofer Portugal Challenge seeks to encourage cooperation between industry and the scientific community, motivating and rewarding research of practical utility by awarding a prize to students and researchers who best contribute to the philosophy that underpins the Fraunhofer’s vision AICOS: create technological solutions with a positive impact on people’s lives, as well as its mission to create ‘Remarkable Technology / Easy to Use’ (Remarkable Technology / Easy to Use).
The winners of the idea contest were voted by a jury and a panel of invited experts in the field of technologies. The online ceremony took place on 28th October.
