Magnetic resonance imaging (MRI) at ultrahigh field strengths, such as 7 Tesla (7T), offers exceptional resolution and contrast and is particularly effective at elucidating nerves, vasculature, fiber tracts and tumor anatomy. We propose the first ever application of 7T multi-modal MRI to provide ultraprecise image guidance for endoscopic surgical planning and intraoperative decision-making. Our lab has the specific expertise in developing signal transmission tools, such as novel adiabatic radiofrequency (RF) pulses, to upgrade conventional imaging methods to robustly perform at ultrahigh fields. We hypothesize that our optimized 7T imaging techniques will depict tumor anatomy and adjacent structures in unprecedented detail, transforming pre- and intra-operative decision making for endoscopic endonasal surgery (EES), and dramatically increasing the success rate, safety and applicability of the technique.

Lab Members:

Raj Shrivastava, MD
Alan Siefert, PhD
Akbar Alipour, PhD
Gaurav Verma, PhD
John (Jack) Rutland, BS
Bradley Delman, MD, MS

At Mount Sinai, we use the state-of-the-art research-dedicated 7T human MRI scanner to increase imaging conspicuity of epileptogenic abnormalities. It produces improved detection efficiency and reduced use of invasive electrophysiological evaluation. The 7T MRI provides accurate delineation of lesion boundaries, aiding in neurosurgical planning. Our lab designs innovative RF pulses and pulse sequences to overcome limitations and fully utilize the signal-to-noise ratio and novel contrast mechanisms offered by high-field MR magnets for imaging and spectroscopy of epilepsy. These tools will be combined to compose a comprehensive 7T epilepsy imaging protocol. We are collaborating with neurologist doctors Madeline Fields and Lara Marcuse to evaluate this protocol in a pilot study of epilepsy patients who are candidates for surgical intervention.

Lab members:

Mackenzie Langan, BS
Gaurav Verma, PhD
Yael Jacob, PhD
Ameen Al Qadi, BS
Bradley Delman, MD, MS

There is a critical need to provide more targeted and effective treatments for trigeminal neuralgia (TN), which is considered to be one of the most painful afflictions known to medical practice and currently has no cure. We will develop and validate non-invasive, highly sensitive imaging techniques using state-of-the-art 7T MRI to elucidate the delicate structures involved in TN pathology. We have already demonstrated this integration of 7T imaging into TN diagnosis and neurosurgical planning for a preliminary set of patients. We are also providing novel tools to extend and refine 7T MR imaging methods to better detect and visualize the nerves and vessels involved in TN. We hope to transform the diagnosis and treatment of TN through improved detection and characterization of the physiological source of pain for each patient. Our work will also provide valuable imaging markers to enhance our overall understanding of TN etiology.

Lab members:

Judy Alper, MS
Yael Jacob, PhD
Bradley Delman, MD, MS
Raj Shrivastava, MD
John (Jack) Rutland, BS
Alan Siefert, PhD

Although neurological symptoms have been observed in a significant number of COVID-19 patients, a prospective study aimed at scanning recovered COVID-19 patients with advanced multi-modal neuroimaging methods has yet to be performed. There is much to be learned about the persisting effects of the SARS-CoV-2 virus on the central nervous system, and high-resolution magnetic resonance imaging (MRI) is the ideal non-invasive tool to reveal these effects as well as mechanisms of infection. We will leverage the high resolution and enhanced contrasts offered by multi-modal 7 Tesla (7T) imaging to study the structural, vascular, functional, and connectomic changes in the brain related to the pathophysiology of COVID-19. In particular, we will reveal, in unprecedented detail, brain abnormalities resulting from the SARS-CoV-2 infection as well as shine a brighter light on possible links to loss of respiratory drive due to viral infection through the brainstem.

Lab members:

Oleksandr Khegai, PhD
Akbar Alipourm, PhD
Gaurav Verma, PhD
Laurel Morris, PhD
Alan Siefert, PhD
Yael Jacob, PhD
Ameen Al Qadi, BS
Mackenzie Langan, BS
Bradley Delman, MD, MS
Nathalie Jette, MD