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How Technology Helps Us Treat Your Tumor

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When you have a brain tumor, having an advanced level of care that an academic-based medical center provides can safer, more minimally invasive, and improved outcomes. Sylvester’s Brain Tumor Initiative offers the most sophisticated diagnostic and treatment methods available in South Florida, thereby optimizing patient’s quality of life and survival.

Our techniques and technologies allow us to treat tumors other facilities often consider inoperable.

After a thoughtful and thorough review of your condition, our Brain Tumor Board recommends a treatment option. We then develop your personalized treatment plan to address your needs before, during and after surgery.

To ensure the safest, most effective treatment options, we invest in a variety of advanced technologies. The following provides a general overview of our capabilities. Your surgeon will review your specific procedure with you and answer any further questions you may have.

Innovative Surgical Planning

Brain Mapping (fMRI/DTI): Considered the gold standard of neuro-oncologic care, functional MRI and diffusion tensor imaging give our surgeons valuable information about a tumor’s characteristics. These neuronavigation tools help our surgeons perform pre-surgical planning known as “brain mapping”. Armed with this knowledge, they remove as much of the tumor as possible while preserving vital areas of the brain.

The Most Up-to-Date Clinical Trials

Clinical Trials: We made medical history by using a patient’s tumor to create a vaccine to prevent recurrence. To make the vaccine, the surgeon harvests and purifies proteins from the tumor. The proteins are concentrated, then injected back into the patient as a vaccine. This stimulates the immune system to fight the tumor and prevent its return. Our program is one of a few in the U.S. which have conducted immunotherapy clinical trials.

Minimally Invasive Surgery

Endoscopic Surgery: Using an endoscope, a thin, flexible tube with an attached light and camera, a neurosurgeon can reach difficult to access tumors within the brain and within its fluid-filled cavities (ventricles). Guided by this advanced micro-camera, our surgeons safely remove tumors while protecting the brain and surrounding nerve tissue. For pituitary tumors and anterior skull base tumors in particular, our surgeons perform incision-less endoscopic surgery to remove the tumors completely through the nose.

Robotic Assisted Biopsies (ROSA robot): Our surgeons use robotic assistance to access, biopsy and treat tumors deep within the brain with submillimeter accuracy. ROSA enhances minimally invasive techniques such as laser ablation, by ensuring a highly precise placement of the laser catheter that is used to destroy tumors. Patients experience less pain, a faster recovery and typically spend just one night in the hospital.

Laser Interstitial Thermal Therapy (LITT): Patients often seek a second opinion when told their primary or metastatic brain tumor is inoperable. LITT is a viable response to many of these requests. To perform LITT, we insert a small laser catheter into the tumor through a tiny 3 mm incision. The catheter tip is heated to a temperature that destroys the tumor from the inside out. Using real-time MRI feedback, the surgeon uses direct visualization to regulate the laser temperature while focusing directly on difficult-to-reach tumors. LITT also improves blood brain barrier penetration, which may improve the efficacy of adjuvant treatments such as chemotherapy. Most patients go home the next day and resume normal activities quickly.

Tubular Minimally Invasive Neurosurgery: Using a small minimally invasive tubular retractor system, our neurosurgeons remove large, deep brain tumors without significantly displacing or manipulating brain tissue. Using this system we keep the surgical opening to less than 3cm. By minimizing surgical trauma, we reduce complications, hasten healing and improve long-term outcomes.

Radiation Therapy

Gamma Knife Radiosurgery: One of the most precise and effective treatments for benign or malignant brain tumors, gamma knife radiosurgery aims multiple weak radiation beams at the tumor. This focuses a stronger level of radiation directly on the tumor, while protecting surrounding healthy tissue. Because it requires no incisions, this method is used when traditional open surgery is too risky.

Advanced Brain Surgery

Awake Craniotomy Surgery: Using a sophisticated intraoperative monitoring and neuro-stimulation system, we safely remove gliomas and metastatic tumors while the patient is sedated but awake. In this way, our surgeons remove complex tumors while protecting crucial speech and motor functions. Throughout the procedure, the surgical team instructs the patient to speak or move parts of their body. This alerts the surgeon to avoid affecting areas of the brain responsible for these functions. By providing real-time feedback, the surgeons can provide a more extensive surgery that is safer which provides patients a better quality of life after surgery. We are one of the few hospitals in the state performing this procedure.

Fluorescence-guided Surgery: The new FDA-approved medication 5-ALA actually “lights up” tumors to aid in identification and removal. During surgery, it can be difficult to tell a tumor apart from healthy brain tissue. When patients take the 5-ALA compound before surgery, the drug turns the tumor neon pink but does not affect healthy tissue. This helps the surgeon accurately identify and remove unhealthy masses. Clinical trials show that surgeries performed with 5-ALA maximize the ability to completely and cleanly remove malignant tumors. We were one of the first facilities in Florida using this technique.

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