VISE Fall Seminar – Walter Jermakowicz, MD, PhD
VISE Fall seminar
to be led by
Walter Jermakowicz, MD, PhD
Department of Neurological Surgery,
Vanderbilt University Medical Center
Date: Thursday, September 5, 2019
Time: 12:25pm start, 12:15pm Lunch
Location: Stevenson Center 5326
Predictive Modeling of Brain Tumor Laser Thermal Ablations
Laser interstitial thermal therapy (LITT) is in the midst of revolutionizing the practice of neurosurgery. Via the stereotactic insertion of a thin laser fiber into the brain, LITT is capable of generating well-defined thermal lesions. As a result, LITT has begun to replace traditional open craniotomies in the management of several pathologies, including brain tumors, epilepsy, and chronic pain. However, significant apprehension to using LITT still exists, which largely stems from our inability to predict a priorihow brain tissues will respond to thermal energy. The consequences of this are severe – underablation may fail to treat the underlying pathology, while overablation is associated with neurological deficits. Our group has been the first to demonstrate that pixel intensities integrated over a target from the preoperative MRI are predictive of how tissues respond to LITT, both during the intraoperative course of ablation and in the weeks that follow. However, given the many anatomic and histologic heterogeneities of brain tissue, it is imperative that these data be extended to the microanatomic scale. During the course of this lecture I will highlight our experiences with the investigation of LITT, which began with trying to understand why a young male undergoing LITT for chronic epilepsy suffered an unintended visual deficit, progressed to the development of LITT efficacy maps for seizure control in mesiotemporal epilepsy, and, more recently, has evolved to the predictive modeling of LITT effects. Our current work is aimed at using non-rigid image registration to predict LITT effects in brain tumors on a voxel by voxel basis.
Dr. Jermakowicz is a Fellow in Stereotactic and Functional Neurosurgery in the Vanderbilt University Department of Neurosurgery. He obtained his M.D./Ph.D. at Vanderbilt, where for his thesis work he studied population coding in the primate visual system under the guidance of Vivian Casagrande and A.B. Bonds. He recently completed his neurological surgery residency at the University of Miami. Dr. Jermakowicz’s research interests include the predictive modeling of laser thermal ablative therapies of the brain and the modulation of neuroinflammation via low-frequency electrical stimulation of brainstem raphe nuclei.