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January 9

Attendees: Venus, Stu, Gary Z, Kirby, Dan O, Alex G, Clare T, Paul M, John Hegde, Danielle, Kim L, Alex G, Patti Goldberger, Ehud Schmidt, Ferenc, Rachel R.

  • Friday research day: Operations Management (need improvement?).
    • Venus can work with various administrative groups to ensure operations, billing runs smoothly. Danielle needs better set of instructions on who has closure responsibility. Has to be someone who has responsibilities for overall oversight on this as there appears overlap between Danielle, Angela, Patti, venus etc. Venus willing to be point person. There is no central manager in AMIGO. The way we need to solve is perhaps have Venus play larger role in coordinating with experts like stu etc. It is not quite clear what running rules are, says Kirby who is broaching these issues mainly. As needed, techs are available, says Clare
    • Alex points out difference between times when patients are there and when they are not. Totally different standards apply when patients enter AMIGO.
    • Somebody was developing protocol sequences. They are responsible for PCP, then refer them to one. (Patty) PI has to be notified. Scans on volunteers and consent forms. Get consent form with PI's name. On Rybicki's IRB the co-investigators on it are responsible for patient. Refer someone to primary. Policy put in place that no person scanned until series of things done and registered. Patti says this is the policy. We are reviewing volunteers who have been scanned and consents. Marcia and Janice should be looped into this. Research and clinical scanning process is different, says Stu. Need consents if we do not have them for volunteers. Louise to find consents for different cohorts.
    • Updated AMIGO policies are being distributed today.

January 2

Holiday Observed


December 26

Holiday Observed

December 19

Kirby, Ferenc, Clare, Alex, Kim, Rivka, Venus, Rachel, Gary Z, Ehud S, Noby Hata, Stu H, Danielle

  • Stu is point person for MR technology. Discussion of slots in scanner.
  • Spare emergency jumpsuits with Danielle; however, if in AMIGO over 30 minutes you need scrubs and to check in through OR part if vendor is there, they need to be checked in.
  • Discussion of policy/procedures for new research versus ongoing clinical time
  • Policy and procedure manual as a whole is archived and can be updated here:
  • Discussion of Healthstream and onboarding of residents

December 12

Attendees: FErenc, Clare, Stu, Victor, Patti, Kirby, Gary, Angela, Rivka, Danielle, Terry, John, Dan, Louise

  • Research in AMIGO (Kirby and Venus)
  • Syngo Via training Tue/Wed
  • Research Policy
    • document complete, and now on sharepoint
    • An email will be sent out with a link to the document this week so potential researchers know the requirements for doing research in AMIGO
    • meeting(s) will be set up to review the document with interested researchers starting this week.
  • DPH for PET is expected at the end of December. Siemens folks will be here to do apps training Jan 9-13, 2012.
  • New x-ray physicist: Lena to be introduced to AMIGO
  • MR Coil/Cable issue in the OR room - Kirby brought to team's attention. Ferenc will communicate to IMRIS.

December 5

Cancelled for AMIGO Budget Meeting

November 28

Cancelled- RSNA

November 21

Venus, Clare, Ferenc, Paul, Dan K, Patty, Kim, Kirby, Noby, Victor, Ehud, John Hegde, Louise, Danielle,

  • AMIGO policy and procedures (including safety) and schedule to be filed in some central place for use and referencing by Venus and Patty G.
  • First pituitary procedure performed last Wed by Ed Laws. First cryotherapy procedures done with Paul on kidney, hepatic cancer.
  • PET/CT approval by DPH expected end of Dec. Training for patients happening.
  • Use of dyna ct discussed. for sarcoma cases. Discussion of imaging techniques being tried with Kirby, Ehud that have applicability to PET
  • Noby, Clare and Ferenc at RSNA. Ferenc to meet with Siemens' Christine Lorenz.
  • Training of residents and fellows discussed and how it will be managed onto healthstream.
  • Ultrasound, equipment turn off discussed.
  • Black Diamond refinements discussed with president and IMRIS reps.
  • Managing communication discussed with vendors.
  • Stereotactic brain biopsy solutions compared and discussed. A homegrown device to be developed.
  • Optical tracking discussed. Visualaze doing first case with SurgiVision at Emory on brain.

November 14

No meeting held. GE Site Visit.

November 7

  • Radvision update
  • Syngo Via training dates December 6 and 7 or December 7 and 8
  • Schedule for this week:
    • Monday - cervical brachy

October 31

  • Introducing Jenn Cofske
  • AMIGO Schedule this week:
    • Tuesday Angio case (port placement)
    • Thursday prostate biopsy
  • Competency checklist for each device (Patti)
    • MR one is close to done
    • Siemens Ultraosund as a template
  • Prep for AMIGO cases outside AMIGO
    • AMIGO or NCIGT research projects
    • Siemens Ultrasound intra-cardiac probe for Gyn (Ehud Schmidt, Tina Kapur)
    • using integration with biosense webster from EP lab for EM navigation
    • strain imaging
    • BK Ultrasound will be used in Prostate Brachy Suite to prepare for AMIGO (Mehdi Moradi, Tina kapur, Clare Tempany PI)
    • microbubble perfusion for thermal ablation ..(greg clement, ncigt)
    • Ultrasound Owner: John Sophis
  • AMIGO MR Tech Training
    • Walter's training in its second week
  • Cardiac EP
    • Need to have a mtg with larry epstein and clinical staff to get cases going. Sean will set it up.
  • Ed Laws' Cases need to start
  • Visualization Systems in MR
    • Syngo Via mtg at RSNA about oncology package
    • 4 MRI monitors need to be integrated by Black Diamond/Invivo. Should be done by December.
  • Scrubs or attire
    • Elaine Weiswasser can give scrub access to BWH ID holders
    • jump suits only to be used for <30 minutes
  • Flood resolution
  • Breast Intervention
  • Table Weight limit item
    • pelvic table item with IMRIS

October 17

Attendees: Clare, Ferenc, Kirby, Rachel, Kim, Janice, John, Gary, Danielle, Venus, Patti, Paul, Louise, Dan O, Alex K

Surgeons ready, plans submitted. including Ed Laws with resident.Alex in Africa for ten days, leaving 2 wed slots open.

Alex ready for laser and to meet with Paul, Dan O and Dan K as well as Angela, Isaiah to plan.

Cryo ready at QA stage

Update on NeuroArm and IMRIS equipment incl headholder and coils. Optimization of imaging being worked on.

Refining how to manage teams. Eventually will have two rooms occupied concurrently.

Ferenc spoke about quick trial R21s for AMIGO. Kim to coordinate page to track these to leverage info, etc. They would go to different study sections. Imaging could be covered.

October 10

Columbus Day

October 3

Attendees: Clare, Ferenc, Kirby, Tina, Rachel, Angela, Dan, Janice, Ehud, Kim, Janice, Rivka, John, Gary, Danielle, Venus, Patti, Paul, Louise

  • Staffing for Friday (MR movement)
  • Need to have a second MR Tech to be AMIGO trained (to fill for Patrick, who took another position). To be discussed with Stu. In general, what is bacup coverage for all our technologist.
  • MR EP AMIGO IRB Approval
  • Next set of procedures that we are ramping up for:
    • Cryo
    • Prostate Brachy
    • Cardiac EP
    • Breast
  • Cases scheduled Oct 4 and 5
  • MR Cryo installation on October 13
    • Larry and Janice should be in charge of QA
  • AMIGO Tours/AMIGO Tours Committee (Angela)
  • AMIGO Video capture policy
  • NCIGT Workshop Proceedings Draft: (This goes to the printer this evening at 3pm)
  • DK: Syngo Via Training: Two sequential days. Please decide:
    • October 18 and 19 or October 19 and 20
    • October 25 and 26 or October 26 and 27
    • November 15 and 16 November 16 and 17
    • Rivka- canNOT do Nov 17
    • Clare - canNOT do Oct 18
    • Junichi - can do Oct 26 - 27 or Nov 16-17.
    • Neuro Radiology - can NOT do Oct 18-19
    • Andriy - All date work

September 26

Attendees: Clare, Tina, Rachel, Patti, Louise, Angela, Dan, Janice, Venus, Paul, Kim, Gary, Danielle, Stu, John, Junichi, Marsha, Pearl

  • AMIGO Research Policy Currently:
    • There is no off hours use of AMIGO until further notification.
    • On hours are M-Th 7-4:30pm
    • Will be widely shared with the team
  • Task Force (Janice)
    • MR Physics and engineering team to certify MR scanner and device users (Dan, Ehud)
    • Tina will compile a list of researchers certified for AMIGO
  • DK: Syngo Via Training: Two sequential days. Please decide:
    • October 26 and 27
    • November 16 and 17
  • AMIGO MRI scanner gradient coil burned out Sept 16th.
    • Gradient coil was replaced
    • Final shimming occurring today

September 19

  • DK: Syngo Via Training: Two sequential days. Please decide:
    • October 18 and 19 or October 19 and 20
    • October 25 and 26 or October 26 and 27
    • November 15 and 16 November 16 and 17
    • Rivka- canNOT do Nov 17
    • Clare - canNOT do Oct 18
    • Junichi can do Oct 26 - 27 or Nov 16-17.
    • NeuroRadiology can NOT do Oct 18-19
    • Andriy ??

September 12

Attendees: Kirby, Alex, Marcia, Rivka, Dan Orringer, Gary Z, Noby, John H, Louise, Kim, Paul Morrison

  • DK: Need to populate the below list with contacts from Research community. Kim to gather names from Dan and Kirby to check with Patty regarding what needs to be done by these people on an ongoing basis operationally to ensure requirements of research agreements are met.
  • AMIGO Policy and Procedure (Kirby, Venus). Venus and Kirby along with Chris Martel are meeting to ensure this manual gets finished. It will contain distinguishing documents for the AMIGO that differentiate from other ORs as well as perhaps OR boilerplate materials. At least 20 documents collectively. This should not slow anything down.
  • Alex concerned about speed of getting fiducials for tracking US probes as these have not yet arrived from BrainLab. Pratik Patel is our contact and he has been informed of urgent need. They are reflective sphere probe trackers with rotational dimensions.
  • Alex concerned about raw acquisition of MRI is good enough for analysis, tractography although data transfer appears to be going well. The acquisition issue is a physics problem. Ferenc has been informed that Alex wants to proceed in having Sharon Peled as a dedicated resource for MRI physics work for neuro in the AMIGO to deal with these issues and prevent unnecessary hurdles here. Ehud can then focus on cardiac and other applications. Sharon already has budgeted time on Alex's R21 for MRI physics.
  • Siemens Syngo Via functionality is being explored. Noby spoke of its automated transfer capability. Easy to move sequences through hospital once set up. Its HIPAA Compliant and FDA approved. The oncology version can track the change in tumor size over time such as through a case.
  • Cryo system installed by end of September with Paul as technical liaison.
  • Louise has three pending IRBs. Laser renewed.

August 29

Attendees: Kim, John Hegde, Rivka, Ferenc, Paul, Venus, Ehud, Dan, Louise, Marsha, Patty, Danielle, Rachel.

  • First cases in AMIGO this week
  • Databases need to be updated to reflect this. Louise to do this with Sean or Angela.
  • Venus spoke about training. Healthstream. 40 people requested training. 16 people left to do orientation training to show suite. Operation side of manual done. Research part to be finalized. Following up with Chris Martel and Kirby. FMEA: Mapped out potential disk issues and things to focus on for training. Ensuring process in place for codes. The dry runs on that occurred last week.
  • During this case we will perform craniotomy and scan at end. Potentially go back. We want to ensure clinical sterility. Alex in dry run at the moment.
  • Sign off on suite is scheduled for today at 1:15.
  • Last week we met with IMRIS because we had issues with service. IMRIS has PO w Siemens. Venus is making list of which organization contact is to be contacted for what. We have ability says Ferenc to contact about service and consultation. For ex. IMRIS not one to contact about sequences. That is not service and maintenance issue. IMRIS is not going to be able to answer us on these issues.
  • BlackDiamond IT component issue. Not ready and IMRIS isn't in position to force this subcontractor. We don't have direct contact with BD as IMRIS needs to handle. Venus believes issues are being resolved. Monitoring controls integration in OR is going black so this needs to be dealt with. Can be controlled from control area but nursing believes it is less than ideal. There is question of trust. We are getting BlackDiamond to come in and then proceed. We need to discuss whether case to proceed given this situation.
  • Brain tumor laser ablation approved for scheduling.Four programs now approved: 2 brain and 1 prostate and 1 soft tissue biopsy.
  • Monday is holiday for Labor Day but Venus to do debriefing following this week's cases to inform about operational review.
  • Tues and Thurs is when Program Officer Abraham Levy is coming to observe case on Tues and Thurs. Sean Jackson, scheduler in AMIGO, is to be informed of Dr. Levy's coming by Venus. Dan to help in this visit.
  • Case on Tues. Biopsy of tissue. Post primary resection. Begins at 7:30 approximately and end around noon. Patient to be awake. Monitoring is key.
  • NCRR Reporter going to write about AMIGO before ends as agency ending. We have materials on hand for this from our previous article in that publication.
  • Rachel distributed workflow process.
  • BK Ultrasound to arrive tomorrow. Delayed trip due to weather. Updates from Dan later today.

August 22


August 15

Attendees: Kim, Dan, John hedge, ALex, Ferenc, Paul, Kirby, Rachel, Tina, Venus, Ehud, Venus, Stu, Noby, Angela, Dan, Janice, Louise, Marsha, Pearl

  • neurosurgery dry run this afternoon. last dry run was very smooth.
    • tina to ensure that latest brainlab and bk software are available
    • latest brainlab software should be dry-run with dan, isaiah, and pratik
    • do a dry run with bk ultrasound
  • look into Shellock's company to do needle safety test ( (Tina)
  • stu, rachel to work on admitting privileges for kemal and clare
  • october novartis lecture by Ferenc (he will invite nathalie)

August 8

Dan out, Kirby out, Clare out, Ferenc right on time


  • Amigo video integration system training today. Angela to dictate start time this afternoon. (The first session can start at 1:30 and we have the vendor for as long as we need him). Black Diamond video training. They will be on site. Honeywell is not completed and coming in today and tomorrow to adjust pressure in suite. Working mainly outside of room with ladders. Requested work following dry run tomrrow. A little electrical needs to be done too.

Major Agenda item:

Timeline for Opening:

  • 95% of IMRIS Work done but OR not totally stable in terms of image projection. Waiting for ports, AV issues to be resolved. List with Dan. MR room better off.
  • Desire to talk to IMRIS (Rachel, Ferenc etc.) to see time line on resolving. That said, dry runs continue
  • Aug 30 first clinical case in AMIGO (Brain tumor resection), prostate biopsy is second case.
  • Rachel to announce going live with Brigham community to ready all involved/affected. No marketing however. Website up and ready by end of month though. We want to wait until success stories to do marketing well.
  • Four physicians need admitting privileges to book into room. They are in process. We are only allowing Golby case as she is not one of four.
  • IMRIS/Siemens legal issues. Can we use Siemens protocols in IMRIS environment. Ferenc contacted IMRIS to resolve and it is in process of resolution.
  • IMRIS site in China. not doing physics things. They do not have the same set up as us. Nobody has our set up or breadth of procedures so there is no precedent for some of our "set up" and ongoing issues.
  • Noby question about inventory control.

August 1

Attendees Danielle, Venus, Rivka, Ehud, Stu, Kim, Angela, Janice, Patti, Louis, Paul, Ferenc, Rachel, Noby, Dan, Tina, Clare, Akila Absent Kirby

  • AMIGO Program and timeline update
    • August 25th, 29th potential dates for first case
    • Dry runs to occur between Aug 8th and cases
    • First tier - Brain, laser, prostate BX, cryo (after installation)
    • Need pulse sequence licenses (Ravi, Ehud identified list)
    • Need research licenses for WIPS (Ravi, Ehud identified list)
    • Second tier -Breast, cervical cancer HDR brachy, prostate brachy
    • Verbal DPH approval received last Thursday. Need written approval to proceed to patients
    • HVAC returning Wednesday
    • Video integration to be finished by this Friday in OR and MR
    • Terminal cleaning and stocking necessary
    • Should PET/CT video integration be done at time of table transfer delivery?
      • No. Finish ASAP with everything but table.
  • FMEA group wants to do dry runs with prostate biopsy and brain tumor resection to identify gaps
  • Need consistent methods for needle/instrument artifact and heat testing (Janice)
    • ASTM testing for implantable electronic device available for purchase
    • Larry Panych to assist
    • IMRIS has test method (Dan to request)
    • Need appropriate phantom
  • Concern about sourcing of biopsy guns and needles
    • Cook, EZ-EM (test up to 1.5T, two choices), In-Vivo (tested up to 1.5T)
    • Marsha began review six months ago
    • Instrument company visiting at end of month - can they make needles? Holly Serba
    • Simal (Belgium company) back in business
  • Development Office meeting (Ferenc)
    • Referrals for Friends of AMIGO
    • They will solicit funding
    • Funds to be used for non-operations costs - training, education, travel, etc.
  • 10th iMRI Symposium to be hosted by BWH in Boston, 2012
    • Need volunteers, venue
    • To be combined with NCIGT meeting??
    • CME's
    • Streaming from AMIGO to Shapiro Board Room
  • Three month observership for physicians from foreign and domestic hospital
    • Build international referrals

July 25


  • Draft Reseach Policy
    • We will circulate a new version to AMIGO Leadership
    • Comments must be received by Thursday AM
    • Q: Will this be a stand-alone or incorporated in the overall AMIGO policy? A: The Research Policy will be a section of the AMIGO Policy (As per Rachel R)
    • Incidental findings
    • Moving MRI scanner to OR - need resolution on how to do it safely
  • DON approval for PET/CT received
    • DPH application can go out
  • Discuss commissioning activities and dry runs
    • Trying to establish drop dead date for end of installation
  • Dry Runs
    • Cervical cancer
      • Table top that has been used at Bay 2 modified to be washable. Cutout in place so speculum can drop
  • Cross discipline communication
    • AMIGO Q/A workshop with PIs?
    • Monthly technical meeting
  • Slicer update
    • High end HP computers on-line
    • VM latency 3x that of the native OS
    • Need dual boot - Linux and Windows
    • Network cable run from scanner's switch and HP computers
  • MR Imaging Protocols
    • MR Physics meetings occurring this week
  • Proceduralist meeting (5pm today)
    • Program Introduction process
    • Review block schedule and scheduling process, billing

July 18

  • AMIGO Draft Research Policy
  • File:AMIGO procedures 7-14-11 v12 (dist).doc
  • AMIGO this week
    • Tuesday morning a radiology postdoc visitor (Tina will bring)
    • Monday: Srini Mukundan/Alex Golby laser mtg today at 2pm
    • Wed July 20th AM - IMRIS team coming to test OR to PET table transfer prototype
    • Wed July 20th PM - IMRIS team coming to test prototype coils
    • Thursday Akila Viswanathan Thursday 10am
  • Siemens Syngo via
    • for each procedure have it evaluated by a three person team radiology, tech, IT person
    • need to figure out which modalities are available in US, Europe, vs in roadmap
    • have it for PET (yes), Angio (MMWP - Leonardo, no syngo via yet), MR (exists, we need it), CT (same as MR)
  • Brainlab Research agreement in progress for DTI+Crainial2.1+vvlink software

July 11

Attendees: Paul, Ehud, Danielle, Marsha, Isaiah, Venus, Louise, Kirby, Noby, Tina, Rivka, Daniel Orringer (new neurosurgery fellow with Alex), Clare,Ferenc, Andrew O'connell (intern), Gary, Stu, Angela, Pearl, Rachel, Janice

  • Discuss AMIGO Research Application DRAFT
  • Research Policy and Procedures (Kirby, Ferenc)
    • A new draft policy is being assembled by Kirby, Ferenc, Patti. This should be ready for general circulation and comment later this week.
    • Ferenc emphasizes that safety and success will come from resarchers taking responsiblity for their actions, and leaving the AMIGO suite in perfect running order after each experiment.
    • It was noted that each project must be brought to a conclusion (incluing complete clean-up and system restoration) before the next one starts.
    • We will attempt to schedule human subject cases on Fridays, 8:00-4:30 to optimize the avaiaility of supporting staff.
    • Researchers may have access to the Suite as soon as the clinical work is done for the day. We will need a process to ensure that works efficiently.
    • We do not anticipate that preventative maintenance will intefere withthe Friday schedule, except possibly in PET/CT.
  • File:AMIGO Research Application draft 3.pdf
  • File:AMIGO Sign in.xls
  • Ferenc is conveneing a series ow working sesson with each clinical team using the MRI to define the protocols and pulse sequences.
  • Admitting privileges are needed before Radiologists can book cases in AMIGO (Rachel)
  • Documentation will be done using eScription. (Rachel)
  • Billing Grids are in good shape. (Rachel)
  • Failure Mode Effects Analysis is being done (Rachel)
  • (Alex) An extensive discussion was held regarding the training of Fellows and Residents to support clinicians. A process is being worked out.

July 5

Scheduled from 3:30-4:00 PM in Hollenberg Conference Room

  • Brief discussion of Research Policy (Kirby, Patti)
    • Draft policy to be circulated
    • Janice provided list of in suite orientation items
    • Danielle to handle research scheduling
    • Off-hours research
      • No human subject PET, CT, laser, angio
  • Can portable equipment be used outside of suite?
    • Yes - if efforts are towards AMIGO
    • No - if routine use
    • E.g.,Paul Shyn's efforts at L1 CT/US with Siemens US/Sentinelle is permissible.
    • Amigo Outlook calendar externally available
    • Scrub access to be given to people with badge access to AMIGO (via Elain Weisenbach).
      • Where do clothes go? We have four lockers in main suite for patient belongings.
    • Cleaning 6:30AM before case
    • Schedule coordinated such research use of equipment shall not occur night before case
    • Notification of issues

  • Brief Discussion of Room Access Procedure for

Researchers (and also for clinicians?) (Kirby)

June 27

Attendees: Tina, Dan, Angela, Danielle, Kirby,Noby, Paul, Patti

Alex- at IMRIS Users Meeting, Jolesz & Tempany- out of office, Rachel & Venus- unable to attend

  • DPH Update -- will be a desk audit. This means that we have hope of approval without significant delays.
  • Construction Update needed from Brendan Whalen
  • Other readiness issues:
    • Need dates on when Stirrups will be ready (Noby is the owner and will confirm that the date is July 11)
    • Black Diamond -- needs to be able to route Partners PC. Swapped out parts will be delivered mid week. Need to install their adapters on cryo and laser equipment so that they can be viewed on in room monitors.
    • Cryo installation needs to be completed.
    • Angela needs to confirm process of terminal suite cleaning. It may take 3 days. After this, everyone will need to wear to wear scrubs and hats.
  • [Hata] Clarification is requested what procedure/approval is necessary to gain swipe card access to AMIGO after a BWH employee take AMIGO safety course. Which level of BWH employee needs chief's support email to get access, and which level is not. Are researchers treated fairly? I (Hata) was not requested to provide my supervisor's name. Laurent Chauvin, NCIGT core member, needed to provide his supervisor's name.
    • Tina, Noby, Kirby will make decisions on which researchers get badge access. Ferenc and Clare will be asked to clarify when needed.
  • [Hata] What is the status of implementing policy in research use of the MRI scanner. It is Ok to have policy unique to AMIGO, but prolonging the execution of the policy is not acceptable. Who is in charge?
  • What should the logbook in AMIGO have (Danielle will prepare this):
    • Project Name
    • Person Name
    • Cell Phone of Person (Essential)
    • Time In
    • Time Out
    • Did you use your own badge to enter?
    • If you did not use your badge to enter, when were you AMIGO trained? (If not trained, please leave the suite and contact Angela for the next training date.)
    • PI
    • Location or Rooms being used
    • Equipment being used
    • Has the room been restored to clinical use after research use?
  • Tina to meet with Angela and Pearl Cunningham about scrub card for researchers
  • Tours
    • Thurs July 28 - Siemens visit 50 people 8:30-9:15, 15min tours, N groups of 6 people, subset of 50 people. Leave BWH at 3pm. - Coordinate with Rachel
    • Date TBD- Johns Hopkins University iMRI Tour - Coordinate with Rachel
  • Holiday next week. Move AMIGO Leadership to Tue July 5 3:30pm, Abrhams Conference Room, to precede AMIGO Ops meeting
  • Cervical Cancer - Noby has budget to modify board for prostate but not for cervical cancer. Noby and Clare to meet.
  • Siemens confirmed Dyna CT angio is NOT installed. To be scheduled for 1/2 day.
  • Siemens (Ravi) installed cardiac MR sequence licenses last Friday, including gating software

June 20

Attendees: Kim, Angela, Janice, Sean Jackson, Louise, Clare, Rachel, Alex, Rivka, Noby, Danielle, Ehud, Marsh, Venus, Delan Fellow(?)

  • Phase I DPH approval update on - Brendan
  • Last week obtained copy of state's approval of radiaton shielding plan
  • Need copy of documentation substantiating staff coverage.
  • Next volley of DPH paper work will go out today.
  • If we get desk audit, approval could come in days. July 11th is possible.
  • Otherwise site survey approval could be two months to schedule survey
  • Brendan to update as soon as more info is in
  • Phase II: Clinical DON for PET expected six months after DON
  • What is our policy re: non-AMIGO procedures in AMIGO (beyond the planned "starter" cases)? - Rachel
    • Non-imaging procedures to learn the suite
    • One AMIGO procedure. Can same PI follow with non-AMIGO procedure in his/her block time? Given PI has given up OR block time
    • Non-imaging procedure to prevent the room from being empty
    • Competition for room time is Development Time for technical staff
    • If PI who owns block time does not have AMIGO case, will second PI be allowed to book AMIGO case?
    • Clare - can org chart review process decide this?
    • To be taken up with Medical Directors
  • What case will be the first human patient case in AMIGO? -Rachel
    • Public Relations and Marketing focuses on particular patients.
    • Clare - do not need to focus on first patient
    • All Phase I procures that are ready to go are candidates. Prostate and Neurosurgery are best candidates.
  • Visitors during first cases
    • Write who needs to be there.
    • Limit visitors
    • Angela to address with PIs during dry runs
  • Scheduling
    • Radiology procedures - will go through Rich Baum.
      • Carla and Diane and Robby and Vattaya will need to be trained on use of OR scheduling software
  • Should Janice Fairhurst be given consenting privileges (e.g., Rybicki IRB) so that we can image volunteers at AMIGO. Otherwise a Radiologist is needed many times per week.
    • Louise to inquire with Frank Rybicki about adding Janice (as per Clare Tempany)
    • Alex Golby question - does everyone observing need to be added to IRB?
  • Policy for organizing tours of AMIGO- Angela
    • When can they be scheduled?
    • Who gives them? Tour Leader
    • Who needs to be notified?
    • What is criteria for saying yes to group?
    • Close suite on Fridays to tours
    • Tour leader responsible for screening forms
    • To be reviewed at Operations Committee
  • Allowing use of AMIGO equipment outside of AMIGO (OR, CT)- Angela
    • E.g., Sentinelle Medical US tracking system in Rad Onc or L1 MRI
    • AMIGO personnel to go with the device - clinical techs or research leads
    • Send requests to Medical Leadership Committee
    • If AMIGO research is tied to US service then there may be an issue

PRM away at CARS meeting June 20-23.

June 13

Attendees Stu, Robert Cormack, Gary, Danielle, Patti, Clare, Kim, Rivka, Angela, Venus, Louise, Paul, Kirby, Tina, Janice, Dan

  • Oversite committee to review Leadership Committee's review of Phase I {RACHEL}
    • Kirby putting together workplans
      • Abdominal ablation still outstanding
    • What is research, what is standard of care - e.g., intra-operative MRI in Golshan plan
    • Results from dry runs
    • IRB review status
  • Medicare Coverage Analysis
    • Need clarification on request for budget, what level or detail? one year? five year?
    • Kirby, Clare, Patti to meet with Jennifer Kim (Kirby) and Integrity (Patti)
    • Venus to bring to Rachel's attention that there is confusion on this issue

As we move through the Dry Run phase, it seems to be a good time to discuss some of the decsions and processes. Many of these are still being refined, but topics include

  • Work Plan and IRB Submission
  • Room use procedures, training/certifications, AMIGO practices
  • Scheduling of research time and researcher responsiblities (report of ad hoc committte)
    • Project must be relevent to AMIGO
    • Non-Friday devleopment time will be opened when no clinical procedures
  • Other relevant topics
  • Issues before first cases
    • Cryo system not installed (still negotiating)
    • RF noise in MR images in OR
    • Foot pedal is ferromagnetic.
    • Pelvic procedure positioning system is pre-product. Need to release Sentinelle of liability
    • Need ruling on privacy glass for use with laser
  • Out of suite training
  • In suite training - check list tour and competancy. Content not signed off yet
  • Request from NeuroRadiology to organize their own training. Official answer is they must go through standard AMIGO training. Kirby to send e-mail to Hiroto and Geoff Young

  • Tracked requests to IMRIS {DAN}
    • Installation punchlist, Requests for information, Feature requests
    • Capturing issues coming out of dry runs
    • Capture requests attached to workstatements (Kemal, Ehud)
  • Generate list of the names of the researchers who NEED to have card access to AMIGO because they have a pre-approved project/reason that requires them to be there. {ANGELA}
    • Criteria - is researcher competant to be left in MR room by him/herself?
    • Policy must be developed and communicated
    • Working group to generate list: Kirby, Tina, Noby, Dan

  • Technical owner for major equipment
    • BrainLab iPlan Net - Isaiah
    • BrainLab Vector Vision navigation system - Isaiah
    • Sentinelle Medical Navigation system - Tina Kapur, Jan Eggar
    • Sentinelle Medical pelvic BX system - Tina Kapur, Jan Eggar
    • Zeiss microscope (IRB for 400nm, 5-ALA agent) - N/A at this time
    • Hand held beta probe - Mei-Ai Park
    • BK Medical US - Kirby Vosburgh
    • Siemens S200 US - Kirby Vosburgh
    • Ultrasonic aspirator - Nathalie Agar
    • Siemens Syngo Via image processing software
    • EP
      • St. Jude Medical navigation system - Ehud, Zion
      • GE CardioLab ECG - Ehud, Zion
      • Fischer/ Pruka pacing - Ehud, Zion
      • RF Ablation generator - Ehud, Zion
    • Black Diamond Video integration - Dan Kacher
    • PIMS integration - Dan Kacher
    • Dyna CT - Tina Kapur
    • Galil Cryotherapy system - Paul Morrison
    • Visualase laser - Paul Morrison

June 6

Meeting to be held in AMIGO

  • Non-clinical time procedures
  • Exploring procedures for specimens (Kirby, et al.)
  • Potential Demand from Rad Onc
  • Multi-Room Use
  • Experiences from Dry Runs
  • BrainLab training
    • File:Brainlab users rev03 20110606.xls Add to this?
    • Tues June 7 10-12 Ed Law, 12:30-2:30 Alex Golby
    • Attend if you are affiliated with the clinical procedure
    • Date TBD: Training for researchers unrelated to those two clinical cases

May 30

No Meeting- Memorial Day

May 23

Attendees Kim, Angela, Noby, Rivka, Rachel, Louise, Clare, Paul, Kirby, Patti, Dan, Tina, Venus, Danielle, Gary, Stu, Hiroto

  • Ops Update (Rachel)
    • Dashboard
    • IRB update
      • 5/12 Proste brachy should have gone in (Paul from RadOnc)
      • Prostate BX in place
      • Laser brain tumor ablation in place
    • Billing grid in next few weeks. IRBs needed / workplans
  • Acceptance testing
    • Larry Panych has stated scanner in MR room passed, scanner in OR with phantom at A/P isocenter passes. May be off isocenter may be of issue.
    • Rachel to pusue signoff for MR scanner with IMRIS
  • Billing - need list of procedures that do not use imaging. Want to start with easy procedures to learn room
  • Dry-runs to be scheduled for procedures. Who needs to attend each one? (Angela)
  • Personnel flow
    • Lockers in hallway to storage room for wallets, keys, etc.
    • Cardiology controls card access to shared cooridor
    • Ferromagnetic metal detection in hallway to storage room
    • Two people assigned to safety - one inside procedure room, one outside procedure room
    • During cases, scrubs
    • Off hours, bunny suits
  • Brainlab in AMIGO June 7-8 (Angela)
    • June 7 10am-12n Ed Law Team
    • June 7 12:30-2:30pm Alex Golby Team
    • June 8 10am-12n Registration team + Nuc Med
    • June 8 12:30-2:30pm <other>
  • Abdominal navigation - coordinate efforts through Noby - Nicu grant
    • BrainLab
    • Sentinelle
  • Sterile markers for Neurosurgery (Tina)
  • Getting organized (Kirby)
    • Complete set of First Phase plans
    • First phse IRBs
    • Non clinical scheduling
      • Pulse sequence development must be AMIGO related. Process to vet activity and set priorities for scheduling conflict (9am Wed morning meeting)
    • Tracking work plans for industrial relationships
      • EP - nature of agreement (clinican vs technical) [Patty]
      • Siemens US to cover ongoing service contracts [Kirby]
      • Sentinelle Medical - cervical cancer [Clare/Kirby/Tina/Dan]
  • Surgical Planning Lab access at AMIGO
    • Want to review laser brain data with Paul Morrison and Isiah from Golby Lab
      • Can have SPL IP address at AMIGO
    • Purchased two workstations that will run Slicer
    • Rolling carts - Kirby, Gary, Noby
  • Which Dyna CT hardware/software coming?

May 16

Attendees Noby, Kim, Patti, Rachel, Janice, Angela, Louise, Alex G, Ferenc, Paul, Tina, Marsha, Rivka, Dan, Ehud

  • July 11th - target date for first patient (date named in DPH documentation)
    • Alex Brain Tumor resection - use as conventional OR to learn room
    • Kemal Abdominal tumor ablation
    • Clare Prostate BX
    • Meetings for each procedure: Angela, Janice, Dan, Kirby, Venus -technical support person assigned to procedure, PI, radiologist
    • Next set of dry runs
  • AMIGO Policies
    • Where will it live? -
      • Rad Commons
      • PikeNotes
      • Sharepoint
      • Wiki
    • Venus/Janice spearheading effort.
  • Black Diamond Video integration training for researcher 5/17 (Tue at AMIGO) 11am-1pm
  • Research and Clinical point person for each device
    • Relationship with vendor
    • Own application
    • Model after Paul Morrison / Kemal with Galil Medial cryo
    • Who will operate clinically - tech, clinical fellow, residents, nursing, research fellow.
    • e.g., BrainLab. In OR, fellow loads data before case. Need to identify AMIGO personnel to handle updated imaging.
      • Erlangen, Germany - MR tech transfers and loads data

  • Training of researchers
    • Accreditation process
    • Scheduling, Tracking activity, Centralized location
    • Modules
      • Video integration
      • Network
      • Syngo Via
      • BrainLab
      • Door interlocks
      • MRI - operate with IMRIS coils, move, rotate
      • Angio
      • PET
      • CT
    • Gary Z's list
    • Noby's list
      • Noby
      • Junichi
      • Andriy
    • Other
      • Lei
      • Zion
      • Paul Morrison
      • Rivka
      • Balasz
      • Tina
      • Jan Egger
  • Syngo Via visit from Siemens May 31
  • iMRI Symposium 2012
  • Streaming video - main interest in camera over surgical field / microscope /endoscope / BrainLab.
  • AMIGO: The Movie (Rivka). Use BlackDiamond. High def photos. After PET/CT ready. Panarama photos.

May 9

Attendees Marsha, Hiroto, Stu, Gary, Kim, Patti, Louis, Paul, Kirby, Dan

  • Areas of emphasis for the next few weeks:
    • IRB
      • DFCC - no presubmission and feedback process.
      • Amanda Hammond, Sarah Harmsish- cancer diagnosis / research / prevention. >50% of patients have cancer
      • Alex G told Medicaire Cost Analysis will not happen for old protocols. Allison Moriority working to remedy this topic. Submit as is to use as test case?
    • Complete Work Plans, including technical requirements.
    • Closure on Work Statements for AMIGO vendors
  • How is suite time scheduled for research and development?
    • Starting date for MR
    • Starting date for Angio
    • Starting date for CT
    • Starting date for US
    • Scheduling of technologists
      • Friday is research day. No tech coverage
    • Competancy/certification for researchers to run modalities and to move/rotate MRI scanner
  • Marketing
    • Can Alex G and Ed Law send letters to referring physicians (Kirby to find info)

  • Workstatements and Show Site Agreements
    • Should EP work be technical or clinical
    • What are expectations of EP group if we include procedures on N patients? (Andrew Menard)
    • Visualase
    • Analogic
    • Galil
    • Etc
  • EP Procedures
    • EP equipment purchased by Cardiology
    • It must be mobile such that it can go to Hybrid OR for open ablations
    • If open ablations (Greg Cooper) can be done at AMIGO, equipment can be stationary
    • Greg Cooper does about 4 procedures per year.
    • Most patients have cardioverters (contra-indication for MRI)
    • Might be interested in CT

DPH Letter

1. If the NIH is using these as part of a media relations strategy, please have them first contact either me or Kevin Myron, Manager of Media Relations, in the Public Affairs office. Our media relations strategy centers on publicizing the stories of the first patients treated in AMIGO and we want to make sure that effort is coordinated with the NIH and other third parties connected to AMIGO. 2. If any of the photos are used in print material, they are to be credited as follows:

Photo: J.D. Levine Photography

  • Amigo ribbon cutting 20110504 (7).JPG
  • Amigo ribbon cutting 20110504 (6).JPG
  • Amigo ribbon cutting 20110504 (5).JPG
  • Amigo ribbon cutting 20110504 (4).JPG
  • Amigo ribbon cutting 20110504 (3).JPG
  • Amigo ribbon cutting 20110504 (2).jpg
  • Amigo ribbon cutting 20110504 (1).jpg

May 2

No meeting held

April 25

Attendees: Kirby, Ferenc, Tina, Ehud, Gary, Rachel, Kim, Gary, Danielle, Louis, Venus, Paul, Patti, Alex, Angela, Clare, Marsha

  • IMRIS Trainers are here all week
  • Topics for future meetings: what will be the mechanism for archiving research images + non-image data?

April 18

Attendees: Danielle, Stu, Rivka, Venus, Ferenc, Clare, Kirby, Kim, Patty, Rachel, Marcia, Alex G.

  • AMIGO Operations Group update (Rachel) She handed out Dashboard of Outstanding Implementation Iterms. This week Siemens MR Training occurs, next week IMRIS training next week will occur and we are concerned about cancellling due to lack of full integration by IMRIS on operations.
  • Don't know when we will get DPH approval. Hoping for June. DON for magnet is separate and we already have that.
  • PET items. Saying it will be done soon. Room ready for May 4 Opening Ceremony. Did submit DON app for PET. We answered DPH questions. Still waiting.
  • Procedure planning bucket. Rachel handed out flow chart that illustrates a 6-12 mo process for check, permission of new procedure roll out. Goes through AMIGO oversight committee. Stuck on does it fit in AMIGO for certain procedures at leadership level according to Kirby. Ferenc: only one that is really outside AMIGO scope at present due to lack of champion and that is spine. Dont have to do dry run for cardiac ablation down on the dashboard. Ferenc and Clare to speak to clinicians about status of procedures and dry run roll out such as Ali T and Larry Epstein. Handholding needed as questions linger. Epstein team needs IRB. Desire expressed to hold off on dry run for procedures that do not have workflow worked out such as Ruan's parathyroid resection. Research/clinical divide? Ed Laws expressed desire to work in AMIGO and not under IRB. Should radiologist under Laws get IRB for neuroradiology imaging connected to his procedures? Yes. Speak to Mukundan. Radiologist will be PI. Cannot publish on AMIGO procedures unless you have an IRB. Do we need an IRB for all AMIGO procedures. Ferenc says yes and no as one rule shouldn't apply to all. Can we charge to grants for any of the dashboard procedures? None of our grants have patient care monies embedded in them. Today in terms of billing, we will bill normally for procedures. Looking forward we want to build in "billing and costs" into industry agreements, grants, etc whenever possible. There are two issues with one being access based on high end instrumentation 75% research project requirements and the clinical billing procedures. Rachel crafting email update w questions posed to PIs that will come from Clare and Ferenc. Separately doing recruitment, meeting with Sanjay set up. Right now for procedure in OR regardless of clinician its normal dictating routine. Hybrid OR is a billing model to take page from. Meeting w Alison Moriarty and Kirby V to discuss billing further. Stu Hooten says we need official Siemens/IMRIS sign off before our staff signs off on competency of systems. Schedule meeting with IMRIS CEO/people for opening day. Know service people etc. If we are to be a show site, we need to be perfect, says Ferenc

April 11

No meeting held

April 4

Meeting held in the AMIGO Suite

March 28

Attendees - Kim Louis, Rivka, Tina, Paul, Kirby, Dan, Ehud, Gary, Noby, Alex

  • (Tina) De-identification of AMIGO images -- what is the best way to handle this? Is it possible to have a process that works across procedures? A potential solution: de-identify using Simens/GE workstation in AMIGO, and then transfer only the de-identified series to research machines. The respective IRB protocol manager maintains the key. Does it make sense to use the research PACS/Imaging Core in this process?
  • Dan response: 3D Slicer machines will have Partners log ins. Patient info is not de-identified when being pushed to, for example, BrainLab nav. Will we need to de-identify?
  • Training
    • Speadsheet
  • Technology glitches
    • What are critical technologies?
      • e.g., IMRIS magnet mover
    • What are contingency plans to work around technology failures?
      • Loss of power
      • Computer crash?
    • Direct connections to display (go around Black Diamond system)
    • Network connection failure - use memory stick / DVD?
    • Application owner
    • Technology owner
    • Loser Brainlab frame of reference (patient moves, Brainlab reference moves), patient draped
  • Laser cases in Bay 2 with FDA cleared system
    • Alex and Kirby to talk with Ferenc and Hiroto and Stu Hooton
  • Template research agreement (Patti)
    • Under review by IMRIS legal team
  • Bay 1 L1 upgrade
    • M, W, F Bay 3 available for research
    • T, Th Bay 2 available for research
    • end of April, Beginning of May

March 21

Attendees Patti, Stu, Marsha, Ehud, Gary, Louis, Angela, Rivka, Janice, Dan, Tina, Kirby, Paul, Ferenc

  • Request from IMRIS re: PET/CT guided procedures requiring table transfer (Kacher)
    • Issues
      • Head holder above plane of table
      • Longer table requires thicker material - greater attenuation
      • Head in PET/CT scanning
    • PET-MR isotope research (Gerbaudo)
    • Neurosurgery (Golby)
    • Female pelvic intervention (Viswanathan)
    • Abdominal ablation (Tuncali, Shyn)
    • Registererd Endoscopic intervention(Chris Thompson/Kirby Vosburgh)
    • Registererd Endoscopic intervention(Ali T)
    • Registererd Endoscopic intervention(Raphael Bueno)
    • Spine surgery (champion? John Chi?)
    • Orthopaedic surgery (champion? Mitch Harris?)
    • Spine intervention (Tom Lee, Srini M)
  • I would like to have a T-con as soon as possible, say Monday morning, to understand what type of procedures are planed for the hybrid PET/CT system with the trolley. Can you please gather all the interested parties from your end and please let me know when you can be available to set up the T-con. Best regards, Labros S. Petropoulos, Ph.D.

VP, Research & Development. IMRIS Inc.

  • Syngo Via visit recap (Ferenc)
    • MMWP/Leonardo being phased out in favor of Syngo Via
    • BWH to be beta site for new roll outs of apps on Via
    • Cardiology software has reporting for tracking procedure (time of first imaging, time of contrast injection). Can we extend reporting to other procedures?
    • Test site for running whole department on Syngo Via
  • Applications training (Dan to put together list)
    • Identify technical person/engineering and clinician for each application.
    • Angio April 4
    • MR third week April
    • Siemens US
    • Analogic US
    • IMRIS / Black Diamond
  • Lecture delivered by Ferenc to Dana Farber leadership
    • Source of patients
  • Friends of AMIGO account open
    • Post Rivka video
      • Pike Notes
      • NCIGT web sites
      • Facebook commercial to collect donations
      • Youtube (Pubic relations?)
    • Professional photography once PET/CT is installed

March 14

Attendees: Kim, Angela, Gary, Danielle, Louise, Paul, Kirby, Tina, Venus, Stu, Marsha, Noby, Hiroto, Ehud, Rachel, Ferenc

  • Dan away this week.
  • Training Dates in the future:
    • March 16 Wednesday MRI and General Orientation 630-730AM Shapiro Breakout room
    • March 18 Friday 12:30-4pm Full Session (MRI is 3-4)Duncan Reid
    • March 22 Tuesday 7am-10:30am Full Session (MRI at beginning) Carrie Hall
  • Dan's notes from meeting with Christine Lorenz and Andy Hall. Ammendments? media:Agenda siemens brigham 20110309 action items.pdf
  • Operations Meeting Review
    • Ready for dry runs: Golby/Laws, Tempany: Brachy, Biopsy, Tuncali, Golshan Lumpectomy, cervical, cardiac, endoscopy
  • File:AMIGO Project Plan Template.doc

March 7

Attendees: Ehud, Hiroto, Kim, Rivka, Rachel, Kirby, Dan, Louise, Tina, Danielle, Clare,Ferenc, Angela, Janice, Victor,Venus, Patti, Paul

  • Tumor Ablation Observership Observer, Dr. Athreya, 20 min AMIGO tour Tuesday (Paul M)
  • Tue - Customer visit from IMRIS re: EP
  • Wed - Visit from Christine Lorentz (Siemens Corporate)and Andy Hall(Siemens x-ray)
    • 10:00 TOUR OF AMIGO
    • 11:30 LUNCH and Syngo plans discussion
    • Andy needs to leave at 3pm (wrap-up earlier with him)
    • Christine needs to leave at 4pm
  • Visitor policy
    • Coordinate visits through Angela and Janice.
    • Screen
    • Log
    • Must be accompanied
    • Video?
    • Permission from proceduralist
  • Information for Finance Committee / IRB (Kirby, Rachel)
    • Existing clinical standard of care procedure with extra imaging step presents no significance issue for finance committee (to be confirmed)
    • OR use : bill time and team, document through OR dictation. Radiologists must be trained.
    • MRI or PET/CT room : Radiology billing documentation
  • IRBs
    • Existing for Brain tumor laser ablation (Golby)
    • Existing for Prostate BX (Tempany), Prostate brachy (Tempany)
    • Cervical cancer IRB submission in progress
  • Operations Committee Update
    • Recruitments done except for two positions
    • 207 personnel trained. 40 remaining. Scheduling evening session
    • Green lanyards, orange sticker for badge to indicate AMIGO training was completed
    • In suite training
      • Orientation
      • Vendor in services
      • Dry run - workflow
    • Delay: 3-4 month DPH approval -> June/July
    • Image optimization
  • Schedule Brendan update to this group every other week

Feb 28

Attendees: Ferenc, Louise, Paul, Tina, Kirby, Dan, Kathy, Patti, Ehud, Gary, Rivka, Stu Kim sick, Noby&Alex at AMIGO training

  • Training update (Venus) - at training
  • AMIGO has an email address;
    • Currently goes to Danielle
  • Post Eur J Radiol paper on Nuc Med safety
  • AMIGO Website - NCIGT site: add list of procedures (Tina)
  • AMIGO card access
    • Turned on due to MRI scanner ramping (Fri)
    • Must take training to receive card access
  • AMIGO Newsletter being finalized by Dr. Seltzer
    • Photo of AMIGO - IMRIS people working
  • IMRIS visit (Dan, Ehud)
    • Localized shim is WIP - must come through Siemens (Christine Lorenson)
    • IDEA license to come through Siemens - not IMRIS as previously thought. Meir Dehan from IMRIS to help (Christine Lorenson)
    • Laser workstatement - IMRIS interested in laser ablation with Visualase. Wants introduction to company
    • Robot workstation - IMRIS wants BWH to pay 50% cost of robot if we are to proceed. Table for now.
    • Cryo workstatement - revised based on IMRIS request, now being revised by Kemal T.
    • EP workstatement
    • Cardiac gating - how is it done at BWH? Do we use In Vivo?
  • Christine Lorenson agenda
    • Moving organ MR
    • IDEA license
    • WIPS
    • Coils - cardiac coil used on heart, breast, and spine

Feb 21

No meeting - Holiday

Feb 14

Attendance: Ferenc, Louise, Gary, Marsha, Ehud, Rachel, Rivka, Patti, Kim, Kathy, Kirby, Paul, Stu, Hiroto (Dan at Amigo Training lectures. Tina at NCIGT biostats mtg)

  • Update Operations Committee - Rachel
    • important to have plans completed and submitted
    • Amigo training - sign up
  • Partners IRB link -
  • IRB for Clinical testing of new MR Pulse Sequences; Frank Rybicki [1]
  • Consent forms
    • Volunteer Scan [2]
    • Participate in Clinical Activity [3]


Attendees Venus, Noby, Kathy, Angela, Janice, Kim, Gary, Priyanka (observer, Brandeis Health Policy Student), Dan, Paul, Tina, Stu, Patti, Alex, Ferenc, Rivka

  • Training update - Venus
    • Session will be recorded on Feb 28th
    • Sessions offered Feb 14, 16, 18, 25, 28 Mar 01.
    • Locations: Bornstein, and Jimmy Fund
    • Exams collected day of training and graded.
    • Every personnel with have all training modules, without exception
    • Incoming fellows and residents - take on-line course and test during three day orientation. Attending present during AMIGO in-service.
    • Completion of training does not imply card access. Based on need.
  • MRI Scanner Operation training
    • Sign off from physicist
    • Q/A
    • Site specific orientation - coil plugs, move magnet
  • Breast surgery
    • Send Janice to Lee Bell for more training
    • Ravi - help us install coil file for cardiac (breast) coil on Lee Bell scanner (DK)
  • When can technical staff start development activity? [Noby]
  • Brendan Whalen - updates (will be here at 10:30am)


Attendees: Stu, Gary, Ehud, Louis, Angela, Rivka, Patty, Kim, Ferenc, Rachel, Kirby, James, Tina, Kathy, Marsha, Clare, Dan

  • AMIGO Policies - Ferenc
    • Rad commons are where the Radiology AMIGO policies can be found.
    • contact Louise for IRBs
    • Computer infrastructure meeting today at 2:30.
  • AMIGO Opening Ceremonies are scheduled for Weds May 4th (kathy)
    • Please submit any names of people you would like to invite
    • PI's send list of people to Kathy
    • All chiefs will be invited
    • Rachel to supply list to Kathy, Sanjay etc...
  • Update Project spreadsheet - Kirby
    • starting to receive program plans back from PI's. Will send back if incomplete.
  • AMIGO Logo under construction
  • Updated Block Schedule - Kirby [4]
  • Summary of first Planning Committee meeting - Kirby
    • Members consist of Ferenc, Clare, Raphel Bueno, Ali T, Kirby, Alex, Kemal.
  • "When can I walk in the room and start examining the IT and engineering setup?" [Noby]
    • Jan 20th received Certificate of Occupancy - Not received on Jan 20th. We need to check back with Brendan. We will ask Brendan to come to Feb 7th meeting for update.


Attendees: Rachel, Kathy, Rivka, Angela Bader, Jason Silver, Marsha, Clare, Alex G, Paul, Kirby, Patti, Ehud, Kim, Tina, Ferenc, Gary, Janice

  • Planning Committee Meeting review Jan 21, 2011
    • Setup website for distributing templates and disseminating information (not WIKI, not Sharepoint). Candidates: Pike Notes, Radiology Research Website
    • Finalize template - use Alex G/Clare/Kirby procedures to take first pass. Review with Billing and Ops Committee (Medicaire Coverage Analysis needs IRB. Before IRB, gain Oversite Committe approval)
    • Submit proposals to Kathy as point of contact
  • Guest - Dr. Angela Bader and Jason Silver of the Weiner Center for Pre-Operative Evaluation (Rachel)
    • Met with Ramon Martin, Rachel R, Stu H.
    • Want to build in screening process to triage patients to AMIGO.
      • Co-morbidity, contra-indication implants
      • Continuation of MRT policy
    • Need AMIGO admin to work with Jason Silver on procedures requiring an Anesthesiologist (general, MACs, blocks). Not nursing IV conscious sedation.
    • Need standardized MR screening process that will capture both Weiner Center patients and IV conscious sedation patients
    • MR phone screening done by AMIGO flow coordinator within 24?48? hours of booking case (backed up by MR tech)
    • Scan form into LMR
      • Many patients will have already had diagnostic MR
      • All patients (even CT patients) screened for MR in case there is a request for MR scan while patient is on table.
  • Ops Committee Update (Rachel)
  • Feb. Recruitment - approval for hiring
  • Mid Fed. Out of suite classroom training (4.5 hrs long, offered six times)
  • Mid March. On-site training starts in after IMRIS hands over rooms.
  • Healthstream will not be used in near term to track/offer training modules. Checklist and filing of post-testing will be kept on file (paper).
    • Will identify list for points of contact along patient scheduling process
  • Badges encoded for door access. Sticker adhered to badge to indicate personnel who have had training. Visual cue for Tech/coordinator watching the door.
  • Proceduralist documentation. Billing based on time/team. Radiologists need to dictate into BICS (will need training). Professional billing dictated as Op Note. Rad Onc Op Note for radio surgery may be predicate. Get weigh in from MIIT for Powerscribe.
  • Imaging and surgery charge. Currently OR (time/team). Radiology (PCT billing code).
  • MRT was time and team for surgery.
  • MRT for major or minor case cart for intervention was also time/team. No CPT based billing.
  • Need to form committee to come to consensus.
  • Summary of equipment meeting - Dan or Rachel
    • $375k approved but outstanding PO's. $900k on wishlist.
    • No additional budget. Must make decision of what not to fund.
    • Computation/visualization/storage solution - can it be supported by MIIT? Ferenc to talk to Ramin


No meetings - Holiday


  • Schedule blocks will be presented (venus)
    • 165 people signed up. 100 identified as ASAP
    • Lecture series - MRI, laser, radiation, xx, xx
      • 4.5 hours
      • Offered Feb 14, 21, 28, morning and evening slots
    • On-site orientation (practical)
    • Lectures will be video'd. Looking into Healthstream for future training.

  • ACTION ITEM: Post official list to WIKI
  • Purpose of list
    • Medicare coverage analysis
    • Workflows
    • Scheduling
    • Equipment budget
    • Case carts
    • IRB
  • Questions
    • Separately list brain BX and soft tissue BX?
    • Spine is not on list. Oversight or decision?
    • Should we make purchases for Bueno/Wee and Ali T cases?
  • Schedule
    • Jan 17 Certificate of Occupancy
    • Feb 7 IMRIS installation finished
    • Late Feb/early March FTE start dates
    • March 4 IMRIS Start up
    • March 7-18th IMRIS training
    • April 15 PET/CT delivery
    • May 4 Opening Ceremony
    • May ?? DPH approval
  • DPH question - can we scan volunteers before DPH approval?


  • Attendees:

Venus, Ehud, Gary, Noby, Rachel, Angela, Louise, Rivka, Clare, Paul, Kirby, Kathy, Tina, Patti

Items for this and future meetings:

  • AMIGO Project plan Status (Kirby)[5]
  • AMIGO opening ceremonies: Wed May 4, 2011
  • Slicer architecture
    • reseach agreement with IMRIS needed on hardware extensions
    • IMRIS will be in town for early Jan for an AF mtg -- this may be a good opportunity to meet with them
  • AMIGO Operations Committee updates: who and what will be presented to this group at future meetings
    • 1/10 - Venus, safety training schedule
    • 1/17 - Stu, contracts
    • MRI safety training offered Jan 27. Must be the last one before AMIGO opening to engineering teams, unless special session is held for AMIGO personnel new to MRI rooms). The following is the email circulated in Radiology department.
The next MRI Safety lecture has been scheduled for:
Thursday, January 27, 2011
11- 12:00 pm
Abrams Conference room
Please let me know if you will be attending and provide the following-
Employee # (9 digits on the back of your badge)
Card reader # (located below your employee #)
MRI areas requiring access
Supervisor's name
Donna Oka R.T. (R) (MR) "Oka, Donna" <DOKA@PARTNERS.ORG>



  • No meeting


  • Update on block scheduling (Rachel)
  • Update on steps for AMIGO accreditation (Janice)
  • Clinical Slicer roadmap and timeline (Ron and Noby?)
  • Friends of AMIGO Newsletter (Kathy)


Attendees Clare, Noby, Kirby, Patti, Dan Kim, Kathy, Rivka, Louis, Venus, Janice, David, Gary, Ehud, Stu

  • SharePoint Site used by Operations Committee
    • Issue finding the most recent/relevant documents. Sort by date option
    • Stu is key-giver
    • Kathy to put documents from Leadership group relevant to Operations on site
  • Kirby to provide update on project descriptions (Kathy is requesting)
    • Kathy to distribute questionnaire for each project (# of patients, grant funding, associated radiologist, what are IT needs?)
  • David to give update from billing meeting
    • Research compliance to separate protocol into billable and non-billable pieces. MCA (Medi Care analysis).
    • PI responsible for identifying standard of care vs research activity (e.g., extra scan)
    • Attach f numbers to reseach portion
    • ??Should PI or their admin provide billing code?? AMIGO charge master will use same CPT code, but its own cost center. Under discussion with Operation Committee
  • Discuss the principle of IT and computer set up for clinical studies involving custom research computer and IT setup (Noby)
    • Issue: in MR/T, the investigators used the shared research computer w/o policies on sharing, leading to a) lack of quality maintenance of the computer b) loss of data/software, c) malfunctions of the computer, and d) unexpected cancellation of the study.
    • Issue: This meeting has delegated the discussion for improvement to sub-comittee without discussing the improved policy.
    • Discussion item: Better policy on responsibility of purchasing, maintaining, storing, and sharing, removing clinical research computer.
    • Proposition: PIs of each IRB protocol purchase, store, bring in, and maintain their computers. AMIGO provides intra-AMIGO IP address, network port, and KVM extension from the console area to OR, and auxiliary display in OR. Example: Computerized PET/CT-guided biopsy (PI: Hata, Archip, Silverman). Use a linux computer purchased using Noby's fund. Noby's team maintain, store, backup the computer on a cart. No Partners computer is involved.
    • Schedule Ron/Noby presentation of Slicer timetable and plan.
  • PRM out, due to conflicting meeting (Tumor Ablation Observership presentation).
  • Training
    • 200 people planned in first round of training
    • 50 Radiology residents - list being pruned
    • 14 neurosurgery residents - Alex G requests all be trained
    • Ed Laws fellow
    • Rad Onc
  • IMRIS Site Visit review
    • Drawing of concept for OR to PET transfer
      • 8-12 month timeline
      • No regulatory clearance
    • 32 channel coil connection (now 16) planned for rear of MR scanner
    • Clinical Liaison (MD) assigned to BWH


  • Attendees: Hiroto, Gary, Marsha, Clare, Paul, Kirby, Tina, Dan, Kim, Patti, Rivka, Ben Seisler, Andrew Werner, Venus, Rachel, Louise, Ehud, Stu H, Susan
  • AMIGO vendor agreements - Ben Seisler and Andrew Werner from Research Ventures and Licensing
    • MTA, NDA, Sponsored research agreement, institutional services agreements (consulting, codevelopment, beta testing, in kind equipment use)
    • See regarding info needed to initiate agreement: Scope of work, use of resources, conflicts, information back to company, standard of care vs research, vendor personnel on site.
  • Here is the current list of suppliers with whom we need agreements; the SOW point of contact is noted(please correct):
    • BrainLab navigation (Golby/Hata)
    • BK Medical US- or Analogic (Kapur)
    • Visualase laser (Golby/Morrison)
    • Siemens US (Vosburgh)
    • Sentinelle Medical nav (Shyn/Kacher)
    • Sentinelle Medical prostate BX (Tempany/Kacher)
    • Galil Medical (Tuncali/Morrison/Silverman)
    • IMRIS
      • adbominal (Tuncali, Ali T?)
      • neuro (Golby)
      • robot (Golby, Hata)
      • cardiac (Schmidt, Epstein)
      • PET/CT table transfer (Jolesz)
  • Would like Year 2+ service contracts funded by workstatements for duration of research
  • Issues:
    • Ownership of IP. Publication/research use of information
    • Hypothesis testing vs how does product work
  • ISA model - give away IP rights more freely because chance of new IP is low.
  • SRA model - we keep IP
  • Template creation in progress
  • Materials management issue - large discounts, NIH funded.
  • Deliverables: IP or data back to company

11-29-- No Meeting (RSNA)


  • Attendees: Marsha, Louise, Angela, Noby,Stu,Kim, Gary, Ehud, Patti, Paul, Kirby, Rachel, Dan, Ferenc, Kathy, Rivka
  • Updates
    • Meeeting with first surgical users (FJ)
    • IRB Strategy (CT)
      • Prospective or retrospective IRB necessary.
      • Jeff Clark at Dana Farber and Libbi Holmann at BWH engnaged by Clare Tempany
      • Umbrella IRB will not work
      • We will have boiler plates for safety and contrast
      • Three months lead time (six month for primary cancer)
  • Newsletter
    • Send to Dr. Nabel's list
  • Opening ceremony - must happen before first procedure. Would like to have PET/CT room ready (April 15 PET/CT delivery, 4 weeks installation).
  • Coils and Tracking Systems review - Ehud, Dan, Noby
  • IMRIS Coils
    • Split Array Head Coil - 2 Piece
    • 16 Channel Cardiac Coil
    • Work in progress that is not in our quote - flexible head coil
  • Siemens coils
    • 32 Channel Head Coil
    • Head Matrix Coil
    • Neck matrix Coil
    • Spine Matrix Coil
    • CP Flex Coil, Large
    • CP Flex Coil, Small
    • Flex Coil Interface
    • NOTE: An extension cable and validation of safety is necessary to use Siemens coils while the patient is on the table in the middle room. These coils CAN be plugged directly into the scanner's table, just as we do now in Bay2.
  • Tracking systems
    • Robin Medical Endoscout
      • Sensors be inside the scanner.
      • Tracks based on scanner's gradients
      • A low acoustic noise pulse sequence exists
      • Vendor is working on supine breast BX, liver cryo, and prostate BX applications
      • System travels with the MRI scanner - can be used in MR room or middle room
    • St Jude Navix for EP (cardiac ablation)
      • EHUD?
    • BrainLab
      • Optical tracking
      • Neurosurgery -centric
      • Ceiling mounted in middle room
      • NOBY- research?
    • Sentinelle Medical
      • Attaches to any vendor's US transducers
      • Can navigate with previously acquired MR/CT/PET
      • Optical tracking is in our quote. They will work with us on hybrid EM/optical
    • NOBY - research systems?



  • Attendees: Marsha, Louise, Angela, Rivka, Noby, Kim, Gary, Ehud, Patti, Paul, Kirby, Rachel, Dan, Ferenc, Kathy, Tina, Alex
  • AMIGO Procedures [6]
    • see AMIGO Workplan on Sharepoint (Stu - invite to Kirby)
    • see Breast workflow
    • draft detailed workflow for all procedures
  • AMIGO website. Discuss, considering 3 needs:
    • External presence (use NC-IGT or link therein?)
    • Internal (BWH) working space
    • Pikenotes Policies
    • agendas, lists of work in process, action items...
    • Admin space on SharePoint
    • Marketing to outside physicians - templates + another link
    • AMIGO Sharepoint
    • See Dana Farber (internal, external) as predicate (Rivka)
  • Updates around the table and action items
  • Training [Janice]
  • Technology review topics
    • physiological monitoring [Ehud]
    • coils [Dan and Ehud]
    • tracking and display
    • interface with Rad Onc
  • Syngo Via demo Nov 17
  • Platform for AMIGO/Slicer Workstations - Win7, WinXP, Linux
  • RVL - working on vendor agreements. Invite Andrew Warner to present on process. Focus on IMRIS.
  • CSI Body Tumor Ablation[Paul Morrison]
    • Twelve Fridays 12n-3pm timeblock request
  • Clinician training
    • General Safety Lecture
    • Orientation to AMIGO Suite
    • IMRIS Training
    • Nuc Med as needed (lecture + practical)
  • Shared Instrument grant for 2nd AMIGO Brainlab system. Study section comments back. Resubmit?


Attendees: Ferenc, Clare, Marsha, Louise, Rachel, Angela, Stu, Kim, Kathy, Dan, Patti, Paul, David, Ehud, Gary


Attendees: Ferenc, Angela, Kim, Rivka, Paul, Kirby, Tina, Dan, Ehud, Stu, Louise, Gary, Patti, Marsha, Kathy, Clare, Hiroto

  • Training - Amigo Facility - custom to each procedure [FAJ]
  • Log book will be used to track research hours to document 75%/25% Clinical/Research
  • How do we document for clinical AMIGO use?
    • Sharepoint (must be inside Partners firewall or use VPN)
  • IRBs
    • Angela to put incident report forms on WIKI
  • Siemens Software Demo. Syngo Via and Multi Modality Workplace (MMWP) [Kacher]
    • Proposed dates Nov 17 (all day) Nov 18 (afternoon)
    • Syngo Via is in PET/CT AMIGO quote
    • MMWP is in Angio quote
    • MMWP will be obsoleted. We may want to take delivery of loaner
    • Only a few applications FDA approved for Syngo Via
    • Syngo Via may serve as research PACS - network archival storage
    • Sarah Khan to map software applications to our first phase procedures so we invite the right clinicians
  • Workstatements
    • BrainLab navigation
    • BK Medical US
    • Visualase laser
    • Siemens US
    • Sentinelle Medical nav
    • Sentinelle Medical prostate BX
    • IMRIS (adbominal, neuro, robot, cardiac, PET/CT table)
    • Galil Medical


Attendees: Kim, Kathy, Rivka, David, Rachel, Marsha, Paul, Kirby, Tina, Dan, Gary, Ehud, Stu, Patti, Victor

  • Kirby running AMIGO meetings.
  • View Rivka's P41 promo video
  • Friends of AMIGO newsletter meeting to be scheduled. Send letter before end of year. Electronic distribution only. Informational and fund raising vehicle.
  • All procedures involving radiation will need RDRC approval in addition to IRB- radiation dose review committee (Victor). Chris Martel is the point person for these.
  • Rachel will give Kirby the "real list" for AMIGO.


Attendees: Louise, Noby, Kim, Kathy, Dan, Janice, Kirby, Paul, Ferenc, Gary, David, Ehud, Victor, Rivka, Stu, Patti, Alex, Steve M

  • Welcome to Kirby
    • Liason for AMIGO scheduling/programs
    • Site miner for CIMIT
  • Welcome David, new Delan Fellow working with Rachel
  • Update from Leipzig iMRI conference (Ferenc, Clare, Noby, Janice, Angela, Ehud)
    • Next meeting in Boston Oct 2012
      • Program committee, Organization committee
    • Grand opening 2011
  • Update from visit to a IMRIS site in Beijing (Noby, Ron)
    • photos
    • Complaints from PLA301 Mike Chan: head clamp is flimsy, not enough space for bottom coil element.
  • PET/CT funding sufficient to fund table transfer
  • Ali T AMIGO abdominal procedure meeting Wed 8:30am, (driven by Kirby)
  • IMRIS training
    • Issue 1: How do we do awake cranis with IMRIS's suggested draping method? Solution? Hybrid OR may have a useful drape
    • Issue 2: OR table is powered down when MR enters room. Two minutes to reboot. When cardiac table is fully extended, we cannot do chest compressions. Solution? Design leg to put under table.
    • Ramon Martin requests trip to Yale IMRIS site
  • AMIGO construction. MRI scanner to be moved mid Oct. Construction completion timeline slipped by to weeks to mid Dec.
  • IMRIS users meeting
    • Yale organizing first
    • BWH will take over
  • IMRIS robot
    • Unimanual in-bore procedure
    • BWH input prior to shipping?
  • NIH update
    • IRB must be associated each NIH funded equipment
    • Blanket IRB?
    • Natalie Agar sits on committee. She suggests meeting with Libby Holman from IRB
    • April, 2011 procedure start time. Must start writing IRB now
    • Neuro AMIGO IRB containing all equipment?
    • Separate IRB for PET, beta probe - radiotracer
      • IND must be filed with FDA for each tracer that is not FDA-cleared. Second level of approval is 2 pages, 30 day wait (Victor).
  • Next round of U41 equipment money reserved until AMIGO opens
  • MRI compatible endoscope
    • Jim Ellsmere giving access to one (Kirby)
    • Presentation in Leipzig on different effort (Ferenc)


Attendees: (Kirby at Orientation!) Hiroto, Rivka, Paul,Louise, Dan, Marsha, Tina, Patty, Rachel, Stu, Kim, Ehud, Noby, Gary, Clare, Alex Agenda:

  • FYI: IMRIS training September 28th. Target trainees: Janice, Angela, Dan, Paul, Maureen Kelly, Pearl Cunningham, Carol Upson, Victor Gerbaudo
    • Janice is working on agenda with IMRIS
    • A second training session will be scheduled for Dec/Jan.

  • Equipment list_Brandon's list AMIGO_Equipment_List_MASTER_201000901
    • Grant spending vs capitol spending review with Stu H, Dan, and Brendan last week
    • Meeting this Thursday to recommence
      • Remaining purchases
      • Service contracts -> workstatements
      • Service ownership issues (Biomed vs service contracts)
  • BK Ultrasound/Analogic Meeting Request (September 27-October 1)
    • Monday morning: Prostate (about two hours). Meet with Kirby of his guidance work. (~2 hours)
    • Monday afternoon instruction on operation of UltraView for engineers (I will arrange to have the UltraView setup by service in the morning)
    • Wednesday: Slicer Integration. If we could give some guidance to Robert before hand so that he can prepare before coming.
    • Thursday Morning: Pituitary Probe
      • Zack Litvak - Ed Law's fellow
    • Thursday Afternoon: Noon onward, we will be in other meeting.
    • Friday morning: Pituitary Probe recap. We hope to layout a draft requirements document during meeting to see if we captured all of the requirements. (Robert will need to leave around noon on Friday.)
  • Laser - if it is loaner, how do we charge? bill?
  • Recap of PET/CT t-conn this moring at 9am.


Attendees: (People out: Tina, Dan, Ferenc) Noby, Kathy,Kirby, Kim,Louise, Clare Ehud,Patty, Marsha, Rivka, AlexG, Angela, Stu Hooten, Rachel


  • Equipment list reconciling
  • Tables for surgery in endoscopy. Validation of procedure or position using CT or MRI. Current neuro table does not image abdomen. Have to think about CT. Need fast images for 25-30 min procedures. Patient positioned in strange ways. Noby to take Kirby on tour w Verio to discuss table/workflow
  • Workflows: Eight in the works: breast, cervix, prostate (two)), upper GI (Two) (Ali and Thompson), Neurosurgery, Cardiac, Spine. Timeline: Complete in next two weeks along with equipment list.
  • Louise and Janice looking at safety procedures regarding IRBs. Incorporate dept. guidelines into those specific to AMIGO. Consider laser safety as this is a special hospital designation. Talk to Paul Morrison. Alex inquiring as to nurses being certified. Angela says they are trained in lasers.
  • (Continued Agenga Item) Need a plan for how to manage different levels of safety knowledge in AMIGO as procedures begin and end during the day. How will it be known should a laser be introduced if the people in the AMIGO at a given time have laser safety training? How is this "Flow" managed or compliance managed? This plan needs to be discussed.


Attendees: (People out: Dan, Tina, Alex, Kirby, Noby)


  • PET/CT decision is moving along. Money an issue as is settling integration challenges with IMRIS.


  • Equipment inventory and tagging to AMIGO: Media:AMIGO_NCIGT_Equipment.xls
    • Who will join the Friday walkthrough and which locations will be covered
      • SPL, Verio 3T, FUS Lab, AMIGO, Rad Onc (ultrasound brachy) -- these locations were discussed in last Thursdays Friends of AMIGO meeting
      • A 360 video of AMIGO should be made on Wednesday as mentioned in the mtg


Attendees Kim, Nathalie, Rachel, Patti, Angela, Marsha, Ehud, Ferenc, Paul, Kirby, Dan, Tina, Kathy Rivka

  • Update on BK Medical collaboration
  • AMIGO:Procedure_List -- Discuss Clinical procedures and leads for Phase I
  • NCIGT Video (This is also relevant for the future AMIGO video)
  • (Update from Janice) Trainer at IMRIS (Dawn Schenkeveld) has offered to do mock training at BWH on September 28. Any reason to not schedule this?
  • ? Deploy Sentinelle Medical US Navigation system into cross-sectional intervention? Paul Shyn would be clinician champion. Deploy Siemens S2000 with it?
  • Deploy BK Medical US. Kirby looking into space in Chris Thompson's lab to begin research
  • Note: Sentinelle Medical's software to become platform for companies held by Hologics. Rob Cormack dosimetry planning may be of interest
  • FTEs. Ehud should be supported 1/3 time. Liason with other physicists (e.g., PET). Technical director position. Remove US tech.
  • KV: Will there be a point person for software integration? FAJ: Ramin K's group will support PACS. Noby is point person for software.


  • Need to initiate workstatements using this form
    • BK Medical (US)
    • BrainLab (Nav)
    • Integra (US asprirator)
    • Sentinelle Medical
    • Visualase
  • and seek grant opportunity with
    • Sentinelle Medical
      • Meeting with Akila followed by t-conn with Sentinelle. Dates?
  • AMIGO Training update


Attendees Ehud, Kim, Rachael, Rivka, Kemal, Louis, Marsha, Clare, Ferenc, Paul, Angela, Noby, Patti, Dan, Tina, Kathy

  • Educate hospital leadership about AMIGO
    • Newsletter - no solicitation
  • Rachael update on process to introduce procedures/patients to AMIGO
    • Intake document, similar to cyclotron program, for consideration of inclusion in AMIGO
    • New Program -> Scientific Advisory Group -> Ops Planning Committee -> Oversite Committee
    • .............................................................................-> Finance / Billing Committe -> Oversite Committee
    • Analyze volume? staff/equipment needs? IRB? Billability vs research budget? Workflow? Training?
    • Mechanism to feed information back into departments -
  • Core Directors and Associate Directors Meeting today
  • PET/CT
    • Risk assessment to be performed. Brendan to determine how much it will cost in construction if we accept grant
    • Siemens is willing to shorten table. They are studying our room drawings.
  • U41 equipment budget spent
    • Which items need to be delivered to BWH now?
    • Before AMIGO space is available, where should they live?
  • Items purchased under U41 Supplement
  1. IMRIS Change order
  2. Integra Ultrasonic Aspirator
  3. Brainlab VVSKY Navigation System
  4. Brainlab Microscope interface
  5. Optoacouostics IMROC Optical Communication System
  6. Robin Medical MRI In Bore Navigational System
  7. Invivo Patient Vital Signs Monitor - MRI x2
  8. Sentinelle Aegis Navigation Workstation !!
  9. Datex-Ohmeda MRI Anesthesia machines x2
  10. Visualase Medical Laser !!
  11. B-K Medical Systems Surgical Ultrasound !!
  12. Siemens Radiologic Ultrasound !!
  13. SPEAG EM Modeling software
  14. Zeiss Microscope
  15. Integra Luxtec 300 Light Source
  16. Covidien Electrosurgical unit
  17. Codman Malis Monopolar Electrosurgical Unit
  18. IntraMedical Imaging Node Seeker !! Mi-Ae, Noby
  19. Medrad MR Contrast Power Injector
  20. Medrad X-ray Contrast Power Injector
  21. Medrad CT Contrast Power Injector
  • !! To be delivered before AMIGO construction done
  • Get documentation from Vendor stating the year 1 service contract does not start until clinical use/acceptance - Year 2 budget for maintenance contract begins Oct 2011
  • Items purchased under U41 carry over
  1. NDI Vicra System !!
  2. NDI Aurora !!
  3. Ascension 3D Guidance medSAFE !!
  4. Sentinelle 3D Workstation - ProstateBX !!


Attendees: (Tina out) Ferenc, Clare, Kim, Janice, Patti, Dan, Louise, Gary, Paul, Stu, Marsha, Ehud, Kathy, Kemal, Angela


  • AMIGO IRB Update:AMIGO:IRB#Upcoming_IRB_Dates (Louise)
    • Targeting November committee meeting
    • Laser Brain IRB - Joan O'Hara in neurosurgery modifying MRT IRB for AMIGO/(OR+Bay 2). Note: PI defines department submitting IRB - Alex Golby will take over from Peter Black as PI.
    • Cryo - MRT IRB closed. planned w/o IRB at Bay 2. Will have IRB for AMIGO
    • Prostate cancer, Cervical cancer
  • AMIGO Safety Training Update: (Janice)
    • Janice will present AMIGO MR Safety Training Mock presentation in the August 9th AMIGO mtg (and on July 29th at AMIGO Safety Mtg)
    • Working on gathering materials from IMRIS. So far, it doesn't look like any of it is specific to IMRIS -- just basic training that we have already.
    • Working on gathering materials from Dundee for interventional MR training. TCON scheduled for August 3rd.
  • PET/CT Supplement Update (Ferenc)
    • Must decide on vendor within two weeks
  • Question to MR room users- is boom reach adequate?
    • Note boom mounts are outside of vents for air curtain
    • Alex - BrainLab camera will not reach midline. Will not site down bore. Should we put camera on floor stand?
    • media:AMIGO_MR_boom_reach.pdf


Attendees: Kim, Louise, Paul, Rachel, (summer intern), Ferenc, Noby, Kirby, Angela, Tina, Kathy, Patti, Stu, Gary, Clare, Hiroto

  • NCIGT/AMIGO Supplement Update
  • AMIGO IRB Task Force (in process)
  • Friends of AMIGO mailing list?
  • AMIGO Safety Update
  • Org chart to be put on wiki this week
  • Noby met Mr. Yamaoka, the country manager of IMRIS in Japan. He is also the former local president of BrainLab. Two sites of mini AMIGO in discussion. FDA approved. BWH/IMRIS collaboration featured in their web page.
  • VVlink sales surging due to BWH's work.


  • AMIGO PET funding
    • Form committee to select vendor/product
  • Safety Committee report (Janice)
    • Make AMIGO training part of training for all services - mandatory credentialing? - Alex Golby
  • Cryotherapy dry run on Bay2 (Paul M)
  • AMIGO IS Committee update (Rachel)
    • Scheduling/billing support
    • Cases start with ESP reservation software. Must educate non-surgeons.
    • OR scheduling triggers events in other software (e.g., Nuc Med knows isotope is ordered)
  • AMIGO Operations Committee update (Rachel)
    • New hires slated for Jan - mixture of dedicated staff and cycled personnel from main OR. 13 positions.
      • 3.25 nursing. Nurse in charge. Nurse. Scrub tech
      • 3.25 techs.
      • 1 Inventory controller
      • 0.25 Physicist
      • 1 Clinical Engineer
      • 1 Flow coordinater
    • Dry runs Jan,Feb,March. First case in April
    • Time and team across the board
    • Reduce charges per case rather than charge every nth case
    • Physicians charge consistent with main OR unless doing P41 project (% salary covered)
    • Goal is to cover operating costs + permanent staff
    • Record keeping system needed for off hours research (e.g., development for BrainLab)
    • Clinical rediness - QA before handing system from research to clinical
    • QC program for each modality. Software updates. Protocol development. Physicist and physician.
    • Split DON for PET/CT to make existing PET/CT half clinical/half research
  • Oversight Committee Kickoff to be scheduled
    • E.g., purchases to enable thoracic surgery?
  • Louis Greenberg Introduction - AMIGO IRB
    • Meet with head of IRB to discuss blanket IRBs vs procedure specific IRBs vs No IRB vs Medical Records review
    • AMIGO IRB task force to be set up, and start meeting this month


  • Tina to update success and events of Project week.
  • AMIGO Training Courses ideas
    • MR intervention safety course (Andreas Melzer)
    • AMIGO for engineers
    • AMIGO for clinicians
    • Siemens/IMRIS course -- Dan Kacher is aware of this.
    • Current MR/Previous MRT course content
      • Donna Oka's Safety in MR materials
    • Finally it should be a healthstream course (Eileen Boz.)
    • Radiation training course (Rob Schleipman -- Department Radiation Safety officer)
    • Tina to make an AMIGO Training page here to stage here
  • All orders for first round of u41 equipment have been placed (Dan Kacher)
  • Construction Update
    • first cases targeted for April
  • Idea: Animal "AMIGO" in 221 Longwood (Ehud and Tina will brainstorm)


Meeting canceled


Attendees Clare, Janice, Rivka, Marsha,Stu, Kathy, Dan, Ehud, Paul, Gary, Ferenc, Tina

  • June 20th is the date to finalize AMIGO/U41 purchases: ultrasound (siemens s2000), microscope, brainlab microscope link.
  • Ultrasound -- any action items? No.
  • laser - visualase order has been placed
  • Galil cryotherapy installation completed on Bay 2 Siemens Verio
  • Microscope purchase-- discussion next week. ALex to discuss Leica experience at Yale.


Attendees Clare, Janice, Rivka, Patti, Rachel, Stu, Kathy, Dan Kirby, Paul, Gary, Kim

  • US purchase - decision is Siemens
    • Competitive matrix posted on WIKI
    • Which probes?
    • Competitive quotes - no
  • IMRIS site visit
    • Action items - coils and positioning and table, under table attachment for EM tracking, continuous table positioning between head and liver.
    • Two sponsored research projects
      • Neuro - Internal phone call tomorrow - Alex, Srini, Patti, Dan
      • Abdominal - Kemal
    • Dec meeting slides - send if research agrees
  • IMRIS Siemens scanner
  • Rev 15 to Rev 17 is no cost upgrade
  • Redact quote, send to Ravi to understand coil compatibility
    • What research sequences / coils are enabled?
  • 32 channel head coil - working with Bay 2. Not Lee Bell.
  • Rev 15 to Rev 17 is no cost upgrade
  • What IMRIS sites are doing fMRI? Yale?
  • Vibration analysis results
  • SurgiVision
    • Visit Thurs anfternoon
    • Stan Anderson -
  • Laser
    • Visualase
    • Place fiber in conventional OR with navigation
    • Similiar to ICP monitor - wire / bolt coming out of head
    • Transfer from OR to Bay 2
    • Paul to contact Monteros re: keeping the door open for future collaboration
  • Safety meetings
    • Review issues at AMIGO Leadership
    • Contact Yale re: policy
    • Contact Royal Prince Alfred re: policy
  • L1 Dx MRI safety extending to iMRI
    • Donna - Training
    • Lisa B - MRI Safety
    • Mumata Crane (reports to Hiroto) - MRI Safety from physicians perspective
    • Include Ramon Martin from anesthesia
    • Include Larry Panych (Stu to confirm)



  • IMRIS site visit
  • Agenda: Along with our industry partner, IMRIS, we would like to schedule separate 1 hour meetings with each team slated to perform a procedure in Phase I of Amigo. The purpose of these meetings is to educate IMRIS regarding our clinical and technical goal, and to identify gaps in resources/features that we will ask IMRIS to address under our research agreement.


  • Zeiss microscope purchase
    • Alex to speak with users at Hitchcock / Dartmouth
    • Noby to describe scope of work together
    • Call to Dirk Bruner in Germany (6 hrs ahead)
      • Ron K
      • Ed Laws (who is his secretary?)
      • Noby
      • Alex
  • IMRIS visit May 26, 27
    • Purpose: to establish specific items for workstatement driven by procedures
    • David Graves coming morning of 26th to meet with Ferenc
    • Graves wants us to move up the 1pm all-hands meeting so he can fly out
    • Alternative: Set up meeting with Graves and Andrew Menard re: work statement??
  • Friends of AMIGO: set up committee for it
    • newsletter to start monthly/quarterly after opening ceremony


  • Updates from Brendan
    • Got preliminary IMRIS schedule. November 1st is teh date Brendan is pushing for - and it is looking possible.
  • IMRIS meeting - want to come to Boston week of May 24 (not on 24th due to Canadian holiday)
    • Intention is to perform gap analysis, determine items for workstatement (timeline, deliverables)
    • IMRIS does not want to enable a procedure in the MR room than can be done on their table.
      • reach-in cases for brain BX - head first off of IMRIS table. Can Alex walk to back of scanner and kneel on Siemens table?
      • IMRIS will not provide head fixation for Siemens table (options are
  • U41 purchases
    • Pending
      • Laser
      • US
    • Change to PO's driven by Biomed/Anesthesia
      • Anesthesia from Draeger to GE
      • In Vivo anesthesia machine mount to mobile



  • NO OPS meeting this week.
  • Kathy Andriole PACS (Dan Kacher) (10-15 minutes)
    • Web based centricity is being proposed by Kathy. Kathy will demonstrate/test that for Clare, Kemal. Paul to rep Kemal for this.
  • Construction Update (Brendan)
    • IMRIS research agreement status (Patti to check)
    • Potential meeting with IMRIS at ISMRM (Clare, Dan, Ehud)
  • Ultrasound
    • AMIGO:Ultrasound_Discussion
    • Once we know the questions we want to ask, the next set of meetings with GE/Philips/Siemens will be scheduled.
    • GE mtg date: April 23rd. Confirmed: Ferenc, Ehud, Greg. Kirby? Noby? Dan? Kemal? Alex?
    • Philips keen to do tcon anytime we want. Siemens - who knows the status?(Please Confirm)


  • April 12: AMIGO Ops update (Rachel Rosenblum). (Going forward once a month, we will use this timeslot for this purpose.). The topic will be discussion of time budgeting for different procedures. Alex, Kemal, Ali should attend. Rachel will send out questions to answer by email ahead of time.
  • Construction update (Brendan)
    • Lingrin starts RF shielding on April 12. THis will take 12 weeks.
  • Tuesday 9am is the current time for the Monteris (laser company) call.
  • Ultrasound Discussion
    • Aloka: has burr-hole probe, and we need to find equivalent probes for other systems
    • what is needed in order to be able to use probes (for cardiac eg) offlabel (for neuro eg.)
  • EAB (candidates)
    • Andreas Melzer
    • Garnette Sutherland
    • Norbert Pelc?
    • Cynthia Menard/David Jaffray
    • Brad Wood
    • Jonathan Lewin
    • Look at list from AMIGO EAB mtg held in 2006


  • REGULAR MEETING HAS BEEN CANCELED. A LIMITED MEETING WILL BE HELD (people who need to be present have been emailed separately) to discuss
    • AMIGO Ultrasound


REGULAR MEETING HAS BEEN CANCELED. A LIMITED MEETING WILL BE HELD (people who need to be present have been emailed separately) to discuss


  • next Monday discussion: ultrasound
  • compile list of coils+pics from Ehud/Dan (Tina)
  • GAP ANALYSIS during tcon scheduled with IMRIS for this wednesday (Ehud)
    • Breast Cancer Lumpectomy
    • XMR guided Cardiac Ablation
    • Prostate Biopsy
    • Percutaneous Ablation:liver, kidney, +


  • IMRIS - a coil connector is needed.F and D will convey this to IMRIS today.
  • Analogic is coordinating with F about a visit to BWH
  • setup mtg re. RT with Akila (gyn), Paul(prostate), Phil Devlin(brachy), Robert Cormack(physics). Discuss Jaffray/Princess Margaret setup also. Tina to put together a summary of what Princess margaret has/planned.


IGT Workshop in Arlington, VA


AMIGO Equipment Specifications

  • Ultrasound for Image-Guided Therapy (Toshiba/Philips/GE/Siemens)and Navigation (Traxtel(Philips/Sentinelle) - Key personnel: Carol Benson, Greg Clement, Kirby Vosburgh, Stu Silverman, Kemal Tuncali,Noby Hata

  • BrainLab Navigaiton System - What research activities can we offer them for favorable pricing? Discuss SIG grant for second system in MR room. Key personnel: Alex Golby, Noby Hata, Srini Mukundan
    • Should we compare vendors? No BrainLab is final decision.
    • Stealth station competitive quote
  • Interventional Laser.
    • Visualase - soft tissue ablation (prostate), diffusion tip,
    • Monteras - soft tissue ablation, neurosurgery, no diffusing tip. rotates and modulates power to sculpt ablation zone
    • Key personnel: Nathan McDannold, Paul Morrison, Stu Silverman, Kemal Tuncali
    • Bueno applying for laser for thoracic
  • Cryotherapy
    • Lease to own vs move Bay 2's unit
    • $150k including installation
    • Pedestal bedside at PET/CT


  • Releasing drawings to IMRIS, electronic engineering and contracting to meet
  • Structural steel for magnet to be hung on Sat., RF enclosure must come after
  • Patty to get invoice in place for IMRIS
  • Ferenc-meeting with surgeons March 2, Ali, Alex, Kamel to attend
  • AMIGO operational committee will have Clare and Ferenc as co-directors, rep from radiology, nursing, administration
  • Siemens confirmed for April 17th


Attendees: Stu, Kim, Rivka, Paul, Ferenc, Clare, Gary, Dan, Kirby, Noby, Tina, Patti, Hiroto, Gary, Ehud,Alex

  • Equipment Budget to hospital by Feb 19 for $1.8MM
  • Zatcha scheduling mtg on PACS/Comp/Vis in AMIGO for this week
  • Hedi Hricak here tomorrow. Please join talk at 12:15 in Bornstein


  • DK: Need buy-in for plans for PACS at AMIGO
Suite Layout
PACS corner
  • DK: Followed up with Geoff Young re: Leonardo. Not delivered yet. He likes idea of client-server relationship. Leonardo is being replaced by Syngo Via. To be discussed Tuesday.
  • Jan 12: Siemens Research Meeting at BWH
Reminder from Ron - our team members should review relevant signed Siemens research agreements to be familiar with terms in general
  • JHACO Readiness: Eileen B. to come Jan 25
  • No meeting Jan 18, MLK Holiday


  • Happy New Year
  • JHACO readiness Eileen B to come for a quick reminder next week
  • Siemens meeting next Tue 1/12: Agenda
    • January 12, Siemens Research Meeting
    • DK: Is Leonardo a vehicle for research PACS?
    • DK: Miyabi table and head holder for MR-only neuro BX, quick egress
    • DK: interventional coils on roadmap
    • DK: pulse sequences on roadmap


December 14

Attendees: Kim, rivka, gary, ehud, chris, janice, paul, patti, brendan, tina, clare. (dan kacher at final exam!)

  • patti drooff, Radiation safety, joined meet. documents are being developed around the new radiation shielding plan.
  • Jan 12: Siemens AMIGO and IGT Research Meeting at BWH
    • christine lorenz and MR+fluoro group from Baltimore
    • u41 projects to be presented as well
  • Some AMIGO outstanding equipment items to think about
    • extension of the angio table by 70 cm to allow for abdominal/cardiac/prostate interventions
    • some prep discussions to be held before this meeting:
      • spine table modifications - some pictures sent by Siemens(ehud)
  • IMRIS agreement to be sent by Brendan to Tina (circulate)

November 23

  • Introduce Rivka Colen (R25 fellow)
  • Who has agenda for Dec 7th meeting? Please put on wiki.
  • Starting reviewing needs for AMIGO Phase I proceures: File:AMIGO Procedure Details.xls
  • AMIGO:
    • consider a big UPS into which devices can be plugged in
  • Siemens Research Collaboration Meeting Committee:
    • Christine Lorenz
    • BWH Committee: Ehud, Noby, Dan, Paul, Tina
    • Get their Research Collaboration projects, and select those that fit with our needs
    • Need advice on what to purchase in future
    • Outline: 1) what are we doing 2) they present their ongoing work/collaborations with other sites 3) outcome: joint projects
    • Timing: 2010 First Quarter

Nov 16

  • Discuss Nov 19th IMRIS meeting agenda
    • Premeeting with Steve Hushek with Dan, Brendan (design), Noby, Ehud (Technical), Clare, Ferenc (Future)
  • Discuss Dec 7th IMRIS meeting agenda
    • Debbie has sent these out already
  • A high level mtg between SIemens, IMRIS and us has to be arranged soon also to discuss future research agreements
  • We will have PET/CT grant decision in January
  • Need to review Philips Ultrasound offerings across cores (Noby, Tina)

Nov 9

  • Ali here. talk in san diego tomorrow.
  • IMRIS meetings:
    • technical meeting this week with Steve Hushek
    • Dec 7th
  • RSNA
    • noby, dan
    • mtgs: ge ultrasound, IMRIS, sentinel (noby, dan)

October 19

September 28

  • Advanced Multi-Modality Image Guided Operating Suite sideview GE IMRIS 20090928.bmp
  • Amigo All hands (stake holders?) meeting proposed by for before RSNA so they can react to comment
    • After Site visit (Nov 2nd) and before RSNA
    • Shapiro breakout room

September 21

  • Brendan unable to attend - at project staff mtg. (ImageStream mtg being scheduled for tomorrow (Tuesday).
  • Thursday - visit to Yale IMRIS construction site
  • This page needs to be updated ASAP and sent to NIH as part of supplemental material on October 1st:
  • [CIMIT Exploratorium Plan] (October 27,28)
  • Hold the date for the next NCIGT workshop in Washington DC: March 8-9, 2010
  • To IMRIS: How can we do surgery out the back of the bore (feet first Miabi transfer)?

September 14

  • IMRIS recap from Ferenc
    • NIH supplemental - which items can be covered by IMRIS, e.g., coils, Brainlabs
    • Facilities budget - shielding, booms, lighting, video itegration
  • Multivendor?
    • GE PET
    • Philips US (Traxtel)
  • HEI PET grant table funds -> IMRIS
  • PET/MR
  • DK: AMIGO single plane fluoro. Should it be floor or ceiling mounted?
    • For Alex G: Tracks on ceiling may be infection control issue. Can we drape patient or does clinician need to interact with open wound in real time (e.g., Art Day clamps vessel during AVM resection)?
  • Can we give up idea of surgery/brain BX/DBS electrode placement in MR room since MRI scanner will be mobile?

Aug 10

Agenda Payette architects attending to discuss potential changes

Aug 3

Attendees: Ferenc, Clare, Ehud, Kim, Brendan, Janice, Noby, Paul, Dan, Patti, Alex, Tina

July 27

  • Prepare Friends for AMIGO when AMIGO opens, one-page newsletter (January)

-Kim, Dan, involved

-Meet with development office, Kim to contact Radiology Development liaison through Dr. Seltzer's office, contacting Brian Murphy who produces Radioactivities

-MR mailing list. every AMIGO patient on list..

  • Billing issues are resolving..

-PET/CT only for research so cannot be reimbursed clinically (corporate-sponsored research)-no CON

-MR can be reimbursed for clinically, planning on 20-30% diagnostic use

-Billing involves state-controlled/managed certificate of need (CON) for devices.. patient volume, geographic distribution

  • Targeting beginning of April to be clinical opening.. training, etc. must happen in concert with this date

July 20

July 13

July 6

  • AMIGO Billing Discussion. Invited: Sonya Huggins (from Sanjay Pathak's office), Elaine Logue, Marsha O'neil.

June 29

  • Introduce Patti Goldberger
  • DK: G20 Grant for 221 Longwood in preparation (Stern) for scanners/architecture of LMRC. Should we try to include CT?
    • Emily Stern is the person to talk to.
  • AMIGO Supplemental NCIGT equipment list
  • Brendan: Infection control update
  • July 31st: BWH NCIGT team to visit Siemens IGT folks at JHU. Allocate time to discuss agenda on this. Paul Morrison/Kemal is taking lead on this for Stu Silverman's group.

June 22

No meeting

June 15

No meeting

June 8

June 1

attendance andrew menard, ehud, janice, kim, gary, kacher, golby, tina, paul, ferenc

  • SGS looking to discuss reimbursement fro AMIGO (PRM)
  • Question of funding for the cryotherapy system for AMIGO (PRM)
  • Operations meeting to be overtaken by construction meetings (Thurs 9:30-11am)
  • Allocation of space outside the MRI room (anesthesia, PACS, special teams - e.g., EP, brachy)
  • Industrial funding discussed. JAMA article from Columbia
  • June 11 12n: Ground Breaking Ceremony - agreement will be finished by then as per A Menard. If agreement isn't signed, no groundbreaking.
  • June 11 10am-12n: Mike Harsh visit. Kacher and Ehud to discuss Amigo with him.
  • Every AMIGO procedures should have an IRB. A generic blanket Data collection IRB should be done.

May 18

  • AMIGO Groundbreaking lunch and photo opportunity
    • June 11
    • At the AMIGO site
    • Brendan will bring a mounted poster of AMIGO + physical model
    • Ask Mike Halle to take photos
    • Martina from Dev Office needs to know program so she can invite potential donors
    • Gottlieb confirmed for 12-12:30, Seltzer will confirm today, Mike Harsh from GE will be here 12-4
    • plan the EAB mtg accordingly i.e. start at 7:30, and be ready to break at 11:30am

May 11


April 27

Construction update from Brendan (who is at bidding mtg):

1. Bids came in below budget so were off to a good start. Based on price alone, it looks like we'll be using Berry.

2. Asbestos was found in the mastic (adhesive used to lay the vinyl tile) inside the AMIGO space on LL2. This is an issue that has come to light since asbestos was found in the patient tower (which LL1 and LL2 are part of) last month. Asbestos was banned from manufacturing in 1975 but companies were allowed to use excess inventories which the Tower, built from 78 to 80, used. This could effect schedule by about as much as a month to go through the regulatory/asbestos removal process prior to removing the mastic.


  • Noby to let Robert Cormack know about LAP laser.
  • Siemens funded 3 IGT projects: 2 Noby, 1 Ablation.
  • BWH IGT team to meet with Siemens IGT team. Kemal taking the lead in arranging this meeting. Noby and Paul to help. Likely at Hopkins.
  • William Stan Anderson new neurosurgeon doing DBS

March 30

  • AMIGO Grants update:
    • NCI P01: CUSA (Alex), Endoscope (Noby), Computer stuff (Gary)
    • NCI BRP:
    • Dan,Tina, Evelyn to review AMIGO Equipment list for items that are not covered by MOU, under 100K, and match with NCI grants
  • AMIGO Workflow for neurosurgery by April 15 (Tina, Angela)
  • Review prices of big ticket items in equipment list (Dan)
    • Imagestream vs. Blackdiamond: IS quote for hidef is much more expensive.
  • Construction grants (G20, C06)
    • straggered deadlines starting July for C06
    • brendan whalen is already supplying blueprints for this
    • G20 deadline is September - this is the bigger one
  • Liver cases update
    • kemal did biopsy in 3T in Siemens Verio
    • tumor was only visible in MR
    • IVCS
    • time: hour from scan to scan
  • Ferenc needs 1 page description, usage, justification (uniqueness) of PET/CT table and a paragraph of AW workstation/server for HEI grant. This week.
  • Ehud could write a BRP style grant for an engineering grant with an industrial partner- upto 750K
  • Contracting went out for competitive bids. April 20th when we get them in. Berry (Shapiro) and Suffolk (MR suite on L1)
  • Radonc meeting to be scheduled: Ferenc, Clare, Philip Devlin, RObert Cormack, Brendan (Tina to ask Debbie)

March 23

No meeting due to travel.

March 16

  • Should we grow PET/CT computer room to enable siting of PET/CT Discovery 690? This comes at cost of shrinking other space.
    • Yes. Brendan will work this into the plan.
  • Alex, Brendan, and Dan have been working on bringing down the costs of the boom quote. We are trying to shave $38k to match our initial budged estimate. One thought is to use Argos "eyeball" lights in the MR room. Here's the breakdown of the revised quotes:
    • Trumpf Proposal MRI - $60,265.00 Budgeted - $22,000.00
    • Trumpf Revised OR - $224,446.00 Budgeted - $225,000
    • Trumpf Revised PET - $50,412.00 Budgeted - $50,119.00
    • Totals - $335,131.00 Budgeted $297,119.00 Variance - $38,012.00
    • Trumpf original proposal - $422k; there is a savings of $86,869.00 so far without effecting operations. Do you want to cut out an equipment and anesthesia boom in the OR, too?

March 9

  • Brendan out today - DPH Prep
  • To add booms in MR will cost 100+ over original budget
  • Close on Radonc in AMIGO
    • list modifications to the PET room - DONE by Radonc
    • confirmation that radonc will purchase equipment - have they been asked?
    • confirmaton of #cases that radonc will do in AMIGO - have they been asked?
    • Current plan: to move the project forward, Brendan instructed the architects to proceed with the PET room without incorporating changes to the plans to include Rad Onc Simulation requirements. Payette will modify documents and issue a change order to the project if it is agreed to proceed with including Rad Onc in the project.
  • Radonc plan: Clare, Ferenc, and Brendan to meet with Devlin to discuss this esp. that construction budget belongs to AMIGO but equipment to radonc.
  • Start sketching out patient flow for Neurosurgery patients on AMIGO slides, including crash scenarios - Tina to discuss with Angela
  • AMIGO Scheduling: Tina to discuss with Elaine
    • first 3 months should be reserved for clinical training
    • involve Hugh Flanagan in schedule planning

March 2


  • Meeting cancelled.

February 23

Attendees: Evelyn, Gary, Janice, Kim, Paul, Ehud, Ferenc, Noby, Clare, Tina, Alex, Brendan

  • Review PET Hot Toilet Options - Brendan will review the plan with DPH today.
  • Radonc CTsim in AMIGO - Ferenc will give decision on this to Brendan this week.
  • Trumpf lights - who gives final approval. Ferenc, CLare, Ali, Alex, and Jim Philip (?), Evelyn
  • March 4th 12-5 Mike Barber
    • 12noon: High level mtg (Clare, Ferenc, Alex, Marcelo, +)
    • 2 hours: AMIGO project and U41 research presentations on wall (posters?)
    • Andrew Menard
    • Marcelo DiCarli
    • PET/CT Team
    • Paul Shin, Stu, Servette
    • Alex (has to do early, flying out that day)
    • Brendan: site and model, site visit if possible
    • 1 hour for discussion

February 16

Presidents' day holiday

February 9

  • Minimally invasive
  • Kacher recommendations for Amigo network
    • Use Multi-protocol label switching MPLS
      • Pros: allows us to use single switch for Parnters and SPL. (note this is the plan for Charles Guttmann's lab. He invites us to try our applications on his setup. Contact Antal Kucsai <>)
      • Savings $55k up front + no need to upgrade SPL switch later
    • Utilize closet in hallway across from Amigo (versus 3T computer room)
      • More direct shot to console area. Do not have to cross over shielded room
      • Frees space for research use in computer room
    • Concerns with this approach
      • Q: Partners networking people have turned off drops in the past without telling us. A: Network switch maintenance is done remotely and the concern is the same no matter the location. Clinical switches are treated differently than switches feeding offices. This should not happed.
    • Con - we must send request to Partners every time we want to switch a jack from Partners to SPL (or SPL to Partners).
  • Zientara recommendations for Amigo network
    • Networking rack for separate SPL switch and Partners switch in computer room
    • Fiber pull to service center for SPL connectivity
    • Parters maintains their switch
    • Harry/Bob maintain SPL switch
    • Pro- 10G connectivity to SPL
    • Pro- can change jacks from Partners to SPL on the fly.
  • Shared Instrumentation Grant for Table and Navs
    • Not enough supporting grants to make application fundable
    • Recruit PI from another institution (outside Boston) to be a user?

February 2

  • Review of DPH meeting
    • Issue 1: Narrative for purpose of workstations at back wall of PET/CT. Give examples (Kacher)
    • Issue 2: How does "research PET/CT" impact clinical care. Non-routine use. IRB procedures. DON is for research. Research scanner for Cyclotron personnel.
    • Issue 3. Hot toilet inside operating room area. DPH encourages us to apply for waiver. Some patients catheterized. Dispose of hot urine in hopper in instrument processing area? Drug discover is mostly outpatient.
  • Brendan to get budget update from Kate Walsh
  • Ehud - GE cannot put non-product in a PO. Need to keep cash reserve for when they become available (e.g., surgical coils for DVMR, change to wide bore). Or put items in definitive agreement.
  • Requirements for using Amigo PET/CT as a Rad Onc simulation room
    • Space for mold making
    • No place to mount lasers on walls
    • End of the patient table to double doors have 3'. Wants 10'.
  • How can simulation equipment help interventional procedure?
  • Differnt method for resp comp that does not require infrastructure changes?
  • Ask Dr. Delvin to write up narrative of what he wants to do in Amigo.
  • No budget allocated to this project
  • Zeiss relationship - consign surgical microscope, we pioneer florescence (5aLa, which is approved for skin photo dynamic therapy). Bring in Nadine and people from Zeiss. Navigation microscope - can already track scope with Brainlabs platform.

January 26

Attendees: Phil Devlin, Akila V., Mike M., Robert Cormack, Brendan, Angela, Dan, Evelyn, Alex, Gary, Paul, Alison Duncan and Millie (Payette), Noby, Ehud, Tina, Ferenc

  • Radonc meeting confirmed. Brendan to present review of AMIGO.
  • [7] Review Amigo Boom meeting and Payette physical model


  • Alison Duncan from Payette brought the AMIGO environment (no equipment - just rooms) physical model (that belongs to Payette until BWH pays for it) for demonstration.
  • HDR and LDR Radiation oncology procedures will not be done in AMIGO. Only "very low dose", like in the MRT can be done.
  • Radiation oncology planning will be done in AMIGO, and then the patients wheeled to the radonc room also on L2.
  • Robert will send a list of radiation therapy software that is needed for the planning to Ferenc/Tina, and this will be worked into the GE definitive agreement
    • Q: will radonc have block times? Ans: limited time for procedures for each type that are on the AMIGO list (this list was reviewed with the group), and additional time over evenings and weekends
    • Q: does GE sell Varian's software?
  • the RTvision system can potentially be used for monitoring breathing related organ motion in liver ablation/FUS temperature mapping in AMIGO.
  • For planning n the CT room: marking systems, lasers, and ceiling mounts for systems such as RTvision are needed.
  • Lighting should in rad onc rooms should be emulated in PET/CT room
    • Action item: Amigo Facilties group should visit Rad Onc room and adapt features to Amigo plan
  • Akila: MR compatible stirrup mechanism needed for brachytherapy.
    • Action item: Discussion needs to be held on targeting approach for cervical cancer in closed bore. Stirrups may not be practical
  • The docking table that was demonstrated by GE in Boston a couple of years ago can be used for patient transport.
    • Action item: Discussion needs to be held on how patient will be transferred to destination table. Can it be made compatible with Maquet transfer board?

January 19

No Meeting. MLK Holiday.

January 12


  • Review the state of AMIGO by Brendan
    • Floor Plan
    • Ceiling Plan
    • Shielding Decision
    • OR Lighting: Trumpf Decision
    • IT: all aspects
    • OR Table/Bed: 1150 + bed on wheels (anesthesia, neurosurgery on board)
  • Jan 26th - Radonc invited to AMIGO meeting (Anthony D'A, Mike M, Akila V, Philip D., Robert C.)

January 5

Attendees: Gary, Evelyn, Dan, Kim, Paul, Janice, Angela, Tina


  • Summarize highlights from pet/ct discussion
  • Follow up with Steve Moore on shielding from radiation
  • Elaine QUery: IS systems needed in the suite
  • Radiation Oncology needs for AMIGO: Set up meeting/discussion w/ Phil Devlin, Akila V, Robert Cormack, Angela
  • Note: add IS, IT, scheduling/reservation, interconenctivity - in summary LOTS MORE
  • Add the latest image stream/brainlab quotes here
  • OR:
    • OR Times
    • PIMS
    • AV System: Video routing
    • Advantage WIndows (AW) system
    • Cardiology System: MUSE system
  • PET/CT: IDX,Centricity
  • MRI: RIS (includes Centricity, Precipio etc. - this is not just MRI)
  • GE NAV - get update from their navigation and headholder (BNI version) in AMIGO plans (Tina)
  • Traxtal - Jan 27th, Veran - third week of Jan. Details to be circulated.
  • Meeting with ALi on Monday, Jan 12th: Tina, Dan, Angela


December 22

Attendees: Noby, Evelyn, Dan, Victor, Kim, Brendan, Angela, Janice, Elaine, Steve, Tina, Gary



  • Patient flow:
    • group1 of patientsprep in CBRR (?) and then taken to nuclear med
    • group2 - surgical patients:
      • FDG - these patients would be prepped same as above. How long is the prep time? which agents will be used in neurosurgery?
      • Methynine - 20 min. Need to be injected in AMIGO. Use of distinguishing low/high grade tumors.
    • FET/FDOPA/FLT (FET better than FDOPA, FLT-labeled evidences cell proliferation for cancer) - 40 min. Need to be injected in AMIGO.
  • Resolve radioactivity shielding needs: Should one inch be required for the sliding door (approx. 6-7 ft.) or is a lesser amount suitable. Every ¼ inch adds hundreds of thousands of dollars? But planning for the PET/CT is defaulting to the worst case scenario in terms of radioactive exposure. ISSUE NOT RESOLVED.
  • Resolve different handling of radiation workers and non radiation workers: What standards should each type of worker be held to? Are there standards to be set that apply to workflow here? ISSUE NOT RESOLVED.
  • Resolve workflow timing issues of how to inject patients and image them before tracer decay. ISSUE NOT RESOLVED. Alex mentioned that using the C11 tracer during neuro would be difficult as the tracer decays in 20 minutes.. not long enough to be practical for most neuro operations. PET would be useful at first for validation of beta probe or to compare post op MRI to post op PET. To use PET tracers with neuro, lots of details about patients flow would need to be worked out including estimating how long it will take to move the patient.

Anticipated workflow

Half of patients injected in AMIGO/half outside of AMIGO in nuclear medicine

Hybrid model will occur whereby OR will have 100% occupancy, with two to one cases per day, mostly neuron at the beginning of AMIGO’s life. PET/CT and MR will have cases separate from the OR. Most of PET/CT procedures will be ablations, biopsies of parts of the body other than the head.

December 15

Attendees: Brendan, Gary, Evelyn, Ehud, Kim, Clare, Alex, Angela, Paul, Janice, Elaine, Tina


  • Electrical infrastructure contract starts on December 22th
  • Add navigation to agenda in January
  • OR layouts being planned for booms w/ Trumpf. Brendan to review layouts with Alex at 8:15am this wednesday.
  • Brendan to invite Victor G and Steve Moore, Christina Feeley (PET/CT coordinator) to next Monday meeting to review radiation (lead lining) safety plan.
  • During the build out of the space, grounding needs to be paid careful attention to. The xray power from the fixed room C (innova) will be huge. (Ehud)
  • Crosstown group research meetings on Monday at noon. Kathy sets that up. Gary to go meet with her sometime.
  • GE Logiq ultrasound information:


  • <Dan K taking a final exam today>
  • Note from meeting with Kacher/Zientara/ PACS group. Centricity EA slated in our MOU does not come with long term storage. HP NAZ server is recommended. Contact within GE is Joe Darr (Chicago Informatics Group).
  • UCSD / Salk Institute MRI Facility - DARTS software collaboration starting
  • Debriefing from RSNA
    • Logic E9 ultrasound approved to be put into MOU by Mike Barber
    • OEC 99xx series roadmap - will have some tube as Innova product line, but run at lower power
    • OEC willing to demo 9900 on patient in neuro IR for side-by-side comparison
    • No need to plan Amigo for Innova-readiness (to be confirmed by FAJ)
    • CT on PET/CT will have 64 slices
  • Brain Lab meeting with DK, GZ, Jared Chandler Senior Area Sales Manager - NorthBrainLAB, Inc. Integrated OR Solutions
    • Amigo integration - Digital Lightbox product as a DICOM router, and registration vehicle.
    • Bay 2 Siemens 3T integration - monitors
  • BWH Finance Committee gave approval to proceed with the Infrastructure portion of the project.
    • Electrical work starts on Dec 22nd
    • Mechanical work starts around Jan 10.

November 24

  • Evenlyn from Biomed to join meetings
  • Brainlab update (Noby)
    • 6K needed to get engr. support from brainlab.
    • noby can provide 3K. Another 3K needed.
  • Update from Thursday meeting (Dan, Angela)
  • GRC visitors here tomorrow (Tuesday) (Ehud)
  • AMIGO brochure update (Tina)
  • AMIGO Physical Model Update (Tina, Dan)
    • Contacted Terry Yoo. Will follow up today. (Tina)
    • Collected CAD models (Dan)
  • Integration of department PACS with AMIGO PACS update (Gary)
  • Dec 16th - plan to discuss Slicer Algorithms to Sandeep. Jim Miller asked for Ron to do this.

November 17

November 10

No meeting. Radiology Research retreat.

November 3

  • 10-10:30 - Kirby will join
    • agenda: Johnson and Johnson
  • CIMIT event debriefing
    • Live Data will work with us at cost.
    • Introduction made by Janice Crosby
      • 3D US with fused MR/CT for neuro navigation
      • Setting up US office in Boston (based in Norway)
      • Contact: Atle Kleven Dir of Research
    • Introduction made by Janice Crosby
      • Eric Bailey - CEO/President
      • Coming soon High res portable SPECT
      • Currently marketing portable CT
    • Introduction made by Isaac Fram (formerly of Mercury)
      • Perfint
      • Contact:, CEO
      • Based in India
      • CT lung BX
      • One time calibration (repeatable docking, knowledge of offset from center of CT)
      • 1 mm accuracy
      • Interested in our needs other robot applications
  • Finalizing modality quotes with Karl Leibich
    • PET/CT quote
  • Prague Course:

October 27

October 20

Attendees: Gary, Angela, Dan, Kim, Ehud, Paul, Noby, Tina, Ferenc, Clare

  • HEI deadline for PET/CT in September, 2009.
  • Shared instrumentation grant - 500K. Need to identify amigo equipment that is not already accounted for, and apply for the grant. March 2009.
    • Need 3 PIs with NIH grants [8]
      • Partners with STTR are not eligable
      • Raphael Bueno
      • Jerosh Harold
      • Raymond Kwong
      • Hatabu (R21) pulmonary (not interventional)
    • robot
      • I think a simple one with regulatory clearance ( at least in Europe) would be the best. One is Innomedic-
      • Hanson for catheter manipulation (research program can include modifications for MRI??)
      • DaVinci for middle room - NO $2M
    • EP equipment
      • Saint Jude Navx system for vascular tracking ( we may get one for free now, but that is not sure). This system is regualtory cleared
      • See Hanson
    • Infrastructure
      • in-room MRI compatible monitors- $72k for six 18" (Conrac) or $24k/monitor for 30" LCD (In Vivo [9])
      • MRI-compatible booms
      • MRI and X-ray compatible surgical table ( that is the highest priority). This is a table where we could perform abdominal and vascualr intervention.
      • Pneumatic tube from cyclotron to PET/CT to enable use of short half-life isotopes
      • Video/data integration (Gary Z)
    • Other
      • Surgical microscope (Zeiss Pentero, Israeli Surgivision)
      • Audio communication system
      • Mass spectrometer (Hungarian)
      • Endoscope, US with access to raw RF, motion tracking system using US - too low cost
      • Frangione optical
      • MR Elastography from Mayo Clinic/GE
    • Grant 1: Gary writes on video/data integration
    • Grant 2: Kacher writes on table/transfer. Clare T - PI
      • Involve Rad Onc
      • Share background
  • Video integration update

  • Amigo Table Day (date TBD)
    • Maquet
    • GE MR
    • GE PET??
    • BWH clinician stake holders - to choose table type
  • CIMIT Oct 28-29

October 13

No meeting. Columbus day.

October 6

Attendees: Gary, Angela, Dan, Kim, Ehud, Paul, Noby, Tina

Action items:

  • create user survey for OR table selection (Dan, Tina)
  • setup engr meeting with Macquet rep (Dan)
  • resolve any OR table selection discrepancies at an AMIGO meeting
  • create strategy to phase cost of video integration or scale back scope of project

  • Imagestream quote at $1M. Have $0.6M budgeted for video integration
    • Need to reduce scope of work
    • Currently every source can be routed to every monitor
    • Costs
      • $1.5 list price
      • $190k base cost for video routing
      • $580k hi def upgrade
      • $180k monitors
      • $50k custom programming - 1 man month (no charge)
      • of the above costs, hd between rooms $200k
MR ++ $422,902 $337,938
MR Control $47,038 $38,832
PET $436,621 $344,999
PET Control $33,680 $27,631
IOR $499,480 $398,430
IOR Control $47,038 $38,832
TOTAL $1,486,937 $1,186,663

  • ++ Does dot include purchase price for Conraq monitors. Must buy them through Siemens.
  • Payette - Physical model and story board renderings
    • Trying to get DVMR drawings, GE Navs drawings
    • Deliver 3 rooms+control area for Oct 28th. Deliver support space later
    • Delivering high quality still frames instead of animation
  • Scheduling of Maquet table day
    • Stake holders ??
      • Maquet VP of Business Development
      • John Ferut
      • PET/CT GE representative
      • Xray GE rep (OEC and/or Innova)
      • Alex Golby
      • Ehud Schmidt
      • Dan Kacher
      • Ali T
      • Clare T
      • Angela Kanan
      • Charles Cho, spine interventionalist
      • Rick Baum, angio
      • Darren Orbach
      • Paul Morrison
    • Agenda
      • Choose table for OR
      • Discuss 750 patient transfer
      • Discuss PET/CT patient transfer

September 29

  • Need to hire a firm to give architects design criteria for cabling ASAP. ImageStream?
  • No emails to be on wiki as per FAJ and CMT
  • For each conference, note the ncigt speakers before the meeting and add slides after the meeting
  • Ensure that all slides are linked from the Slides page.

September 22


  • AMIGO Physical 3D Model is being constructed by Payette.
  • Keyvan Farahani here today - AMIGO tour
  • (Brendan and Dan have conflict and won't be at mtg today)
  • Discuss with Brendan:
    • penetration panel
    • grounding of the rooms
  • Slicer was demoed at TAP meeting. Well received.
    • Veran system might be installed in group
    • validation mechanisms for non-rigid registration need to be developed
    • potential collaboration with Mike Miga at vanderbilt
  • Timeline for Verio System (Siemens 70 cms 3T magnet) to be put on the wiki (Marsha, Paul)
  • St Jude visit Wednesday evening, Thursday. (organized by Ehud)
  • Set up a mtg with additional neurosurgeons - spine, skullbase. include new fellow.

September 15


  • Image Stream design package deadline Oct 1
  • OR Boom - need to define criteria for selection of vendor
  • JHU Meeting Update
  • Siemens Meeting Update
  • IMRIS meeting:
  • AMIGO Monthly Pictures: Tina
  • Siemens team here this week
  • AMIGO Deadlines that need to be planned:
    • Jan-Feb?: start construction
    • September? Opening Ceremony
    • Summer - site visit for u41
  • AMIGO Handout needs to be prepared

September 8


  • Alex Golby review of DV MR from Stanford visit
    • Surgery in front of MRI scanner
    • How tall of a person will feet first accomodate?
    • Should we shrink OR and grow MR room?
    • Surgical support equipment in MR room: monopolar, bipolar, headlight?
    • Cannot use In Vivo monitor on platform
    • Anesthesia must agree to undock patient table (code situation)
    • E-mail from Alex: I met with the GE folks and people at Stanford and had a look at the 750.

Certainly it seems like a great machine from an imaging perspective. However, it is not at all designed with intra-operative imaging in mind (we knew that, of course, but it is important to keep it in mind). From my look at it, operating out the back is impossible due to the motors and I think gradient amps. In any event, I thought the only option would be to operate out the front. Feet first into the magnet works in terms of getting the head into the sweet spot of the magnet. However, there will definitely need to be modifications to the table in order to allow a cantilever. Also, there are the plug ins for the coils that I think would be in the way. Stuart xxx who is the project manager for the 750 said he would ask about this at Engineering. I did not get the feeling that this was a real priority for them. Working with Maquette I think will help us very much to define potential solutions. I don’t think and “pit” will have to be very deep (if indeed we end up needing it at all.)

    • Met with Garnet Sutherland - no NIH grants, therefore not viable U41 collaborator
  • FAJ: swap DVMR with GE 3T large bore when ready. move DVMR to another area of hospital
  • Brendan - difficult to get in/out of building
  • Table: Matsuma (Japan) table solution. IMRIS potentially integrate GE iMRI suites
  • Friends of Amigo - fundraising
  • Equivalent body for vendors (Kacher)

  • Risk Management issue - MRI scanner on emergency backup power?
    • Requires UPS and flywheel ($100k + space)
    • Need to take space away from OR (size of dining room table)
    • One power loss in OR in past 10 years. Due to electrician's mistake.
    • MRT was not on emergency power. No issues.
      • FAJ and CT and AG are comfortable NOT being on emergency backup power with MRI scanner.
  • Need to make decision about vendor for booms. Pending Alex Golby's evaluation.
    • Thoracic OR personnel comfortable with Trumpf
  • CIMIT Innovation Congress: Oct 28-29. Demos:
    • Need title and 2 sentence description ASAP.
    • AMIGO 3D model (All)
    • RFID (Dan) - DK: this was a grant from last year and was present last year
    • Swimming Capsule Robot (Noby)
    • FUS - Plume?
    • AG: Interactive tractography - (Alex+Ron)
  • 3D model of Maquet tables and MR scanner have arrived from GE iMRI marketing. No PET scanner.

August 25

In attendance: Dan K, Kim, Paul, Marsha

  • Risk Management issue - MRI scanner on emergency backup power?
    • Requires UPS and flywheel ($100k + space)
    • Need to take space away from OR (size of dining room table)
  • TAP monthly meeting - Bay 2 Siemens cryo
    • Outstanding issue of in-room display, two way communication (no budget).
    • No charge service contract?
  • Alex Golby visiting DV MR (750) in Stanford
    • Looking into feet first positioning for head scanning (in-out brain BX)

August 18

In attendance: Ehud, Dan K, Ron K, Kim, Noby

  • Ehud requesting the magnet be moved away from the wall to perform procedures from the back of the magnet. May be difference between doing neuro procedures near magnet and not doing them at all.
  • AV options and their practicality etc. were discussed, including pros and cons of LCD screens, screen size and projector capabilities. Discussion also went to what infrastructure should be included for AV and what might need to be edited. Are too many ceiling items in OR, given that screens are on both walls at foot and head of table.? Solutions were raised about putting tracks on ceilings and different configurations of tracking were discussed. Questions brought up space issues etc. of equipment vs. utility, immediate versus long-term needs and wants, given projected improvements in AV quality, ensuring OR was well-suited to all clinicians, what equipment must be MR compatible and can be made so given manufacturer capabilities..

Action point: Seek out other sites (Houston) with AV configurations to get feedback on adv/disadvantages?

Deadline: October 10 is deadline for decisions.

August 11

August 4

  • AMIGO Plan
    • ceiling plans need to be reviewed in a meeting - can railings be put there? These need to be finalized by October.
    • Patient narrative for DPH application (from Kim) is complete and works well.
    • Patient flow will be finalized this Thursday.
  • JnJ Meeting Highlights:
    • Rob Pike from Biosense may join MICCAI meeting, or come to a monday mtg
    • In addition, Ethicon Endo, Cordis, Codman identified as companies to send visitors here to establish collaboration
    • Precedent: OR of the Future with MGH

July 28

July 21

  • No JnJ visit this week. Being rescheduled for September.
  • Any new information needed for August 15th submission?
    • last week's patient flow to be discussed with Rick Foley and Colleen Hernandez this wednesday at 12:30pm
    • Tina to give AMIGO narrative to Brendan today
    • Stu (head of MR administrative services) joined meeting today
  • ImageStream visit last week
    • dan and gary visited shapiro demo last week
    • impressed with technology - only some software changes needed but quite doable
    • AMIGO has more image sources than shapiro, hence some modifications needed
    • ImageStream is also a contender for the wall of knowledge
  • AMIGO contract should have AW workstation in it
  • Need to schedule visit to Rafael Bueno OR in September
  • Feedback on AMIGO plan:
    • hot bathroom should be directly off the hallway (two doors - one to hall and one to PET/CT)

July 14th

  • AMIGO Facilities Planning meetings have recommenced. Minutes are here
    • Action Item For Amigo Leadership: We need to describe the patient and staff flow for the Aug 15th submission:
      • What procedures should we submit (all Phase I cases or keep it simple?)
      • Questions to be answerd
        • Where will the patient be admitted, prepped?
        • How will they be transported to Amigo?
        • Who will do the transportation?
        • Where does the patient go for recovery?
  • RICK FOLEY: options- each with it's own series of issues:
  1. . Direct to room from ICU- direct back post procedure
  2. . OP to CVRR for prep/consent- back to CVRR post or ????? (they do not take GA cases)
  3. . OP to SDC for prep/consent- back to PACU post
  4. . OP to L1 Recovery for prep/consent- back to L1 or ????? (no GA/MAC cases)
  5. . Create our own AMIGO prep/consent area- post procedure to ???????
  • We will need to explore and include the other managers in this discussion as I know right now that it will be a struggle. Example is that the CVRR was initially 49 beds- now down to 29 beds.


  • Where patients go after depends on form of anesthesia. Action item: update AMIGO procedures list with this information.
  • Neurosurgery - all INP? If yes, they go back to bed. check with Alex.
  • Beth McDonald is the contact to check if all AMIGO patients (1 or 2 per day max) can go to cardiac recovery area
  • Prostate biopsy patients currently go to day surgery, and would be ideal to continue that. All biopsies to start at L1 6 bed, bring to AMIGO, perform biopsy, and depending on anesthesia go to the right recovery: IVCS and local -> L1 recovery, general anesthesia or mac -> check out at day surgery?
  • Ablation: today checkin is same as diagnostic patients, and go to PACU for recovery under all anesthesia. We expect all to stay the same except that procedure will be done in AMIGO.
  • Flow: neurosurgery from towers/street to ... cross barrier, (alex to confirm)

July 7th

  • GE MOU Signed!!
    • work on contract to begin now - and complete by end of August (Tina, Dan, Ehud, Noby)
    • carefully scope out what is needed - sw should not be a problem
  • Review of Siemens/GE presentation at Japanese AMIGO conference (Hata)
  • J&J visit on July 21st (Ferenc/Tina)
    • Ferenc's update after phone call with Yousef
    • Primary interest on our side: endoscopy
    • Yousef will bring with him the person in-charge of integration across businesses
    • FAJ sent him phases of amigo and our summary of JnJ research
  • BrainLab Slicer integration (Hata)
    • Summarize Brainlab integration for Ferenc (Noby)
    • started at MIT during NA-MIC Project week
    • Next visit by Xenios: July 23rd or 30th. Travel funds requested $500 (Tina)

June 30th

  • Prague Amigo installation
  • File:Prague Military UVN 320x200.avi
    • 40 cases / months
    • Anesthesia monitor moves with patient
    • [Requests] (Action items for Kacher)
    • Celling plan
    • Monitors
    • construction plan
    • Where are the drapes?
  • Review of Siemens/GE presentation at Japanese AMIGO conference (Hata)
  • BWH finance committee approved AMIGO
  • J&J visit on July 21st (Ferenc/Tina)
    • Ferenc's update after phone call with Yousef
  • BrainLab Slicer integration (Hata)
    • started at MIT during NA-MIC Project week
    • Next visit by Xenios: July 23rd or 30th. Travel funds requested $500 (Tina)

June 23

PRM at Computer Assisted Radiology & Surgery Meeting (CARS) Meeting (

  • GE Healthcare Visit
  • Monday, June 23, 2008, 10am-4pm
  • Ron Von Jako, M.D., Chief Medical Officer
  • Michael Fritts, Inteventional MR Project Leader
  • Morning Session Hollenberg Conference Room
  • 10:00-11:00 am AMIGO Meeting, Hollenberg Conference Room
  • 11:00-12:00 am U41 Meeting, Hollenberg Conference Room
  • 12:00-1:30 am LUNCH with Ferenc Jolesz MD, Clare Tempany MD,
  • Ehud Schmidt, PhD in Dr. Jolesz’s office
  • Afternoon Session - BWH Presentations - SACK Conference Room
  • 1:30-1:50pm Cryotherapy - Kemal Tuncali MD
  • 1:50-2:10pm Neurosurgery - Alex Golby, MD
  • 2:10-2:30pm Spine Intervention - Charles Cho, MD
  • 2:30-2:50pm Radiation Therapy – Robert Cormack, PhD
  • 2:50-3:10pm PET – Victor Gerbaudo, PhD
  • 3:10-4:00pm Wrap up- Ferenc Jolesz, MD
  • 4:00-5:00pm Tour of PET CT with Dan Kacher, Ehud Schmidt
  • "Attendees" Ferenc Jolesz, Brendan Whalen, Clare Tempany, Brendan Whalen, Kim, Ehud Schmidt, Greg Clement, Alex Golby, Michael Fritz, Ron Van Jako
  • ’’Absent’’ Paul Morrison, Tina Kapur, Gary Zientara


  • FAJ presents history of finance and equipment of AMIGO project
    • HEI funds to Mike Barber
  • Biomarkers for tumor margin identification– Brain, Brest, Prostate w/Navigation
  • Ultrasonic Aspirator for sample taking – map of tumor margins using ~20 samples
    • Optical, Mass spectrometer, Ramen spectrometer, isotope measurement (nuclear, beta or gamma)
    • Validate MR perfusion (angiogenesis), diffusion, PET biomarkers
    • Donald Black, Jean Luc, GE biomarkers involved

‘’11am + Susan Cassidy Zipkin’’

  • Jim: Optimize equipment for Biomarkers (SPECT/CT) colon cancer. Hard to read w/o SPECT/CT
  • Jim: Biomarkers have 10-15 yr development timeline
  • FAJ: IP solution. Need on-site people to co-develop isotopes. More effective communication. Like Chris Hardy (GE CRD) arrangement.
  • Jim: Design features to enable or prove imaging agent – e.g, Coils, pulse sequences for competitive advantage.
  • FAJ: No funds can flow from BWH to GE for development. We are capped at $10M for cap equipment and build-out.
  • ES: Develop applications to point where they are practical. First to market can be better than IP.
  • FAJ: 30% lumpectomy patients have residual tumor. 80% brain resection patients have residual tumor
  • Jim: Prague. HDx 3T Neuosurgery w/ VIWAS. 2nd system coming. 30 resections.
  • FAJ: Brain deformation and brain shift detection. Need end point to determine when it is time to refresh structural images. How do we obtain endpoints without stopped surgery?

  • Real-time MR methods
    • Needs: AMIGO intervention, AMIGO radiation therapy planning, FUS with moving organs, cardiac
    • BWH beta test site for whatever GE does
    • Tom Foo will be liaison for Milwaukee/BWH
    • Jim: Need to get funding for a program to productize (multi-year roadmap)
    • Jim: Real-time and wide-bore are the enabling technology
    • FAJ: Radiation therapy planning
    • FAJ: Jim Balter from Chicago working on 3D gradwarp, etc. for overlays
  • Brendan Whalen
  • DPH- need six more months. Three rounds of approval needed.
  • Dec 15, 2008-Jan1, 2009 construction start
  • Ceiling fed cables preferred to raised floor. Gives more clearance around back of magnet.
  • Agents work off AIA guidelines, but can make their own calls.
  • Approvals group, BWH finance. MOU signature makes life easier.
  • Engineers cannot proceed w/o know what infrastructure to support MR platform is.
  • Jim: Cost to make HDx MR system development compatible with DV = $1M
  • Jim: Next development HDw – wide bore 1.5T
  • Uterine fibroids
  • Good alternative treatments, FDA trial was underTX to shrink. Regrowth probable
  • PCT codes relying on long-term survival data


  • X-Ray platfrom
    • OEC does not track c-arm position, no knowledge of table
    • Innova will have features
    • Pascal Vitz – global manager, ‘’Bud Degraff –segment manager, Jean Michelle Mill, Michelle DuMont
  • Laser brain TX (Canadian company working w/ Siemens) w/ thermal mapping workstation. No motion.
  • Brachytherapy – geometric placement. Cannot see radiation like we can see heat
  • Tissue density (Hounsefield units) to dose planning
  • Cryo good business for low field
  • US in AMIGO
    • Registration
    • US w/ MR. Prostate
    • Realtime tracked US to drive visualization of other already acquired modalities

June 16

Attendees: Paul, Kim, Gary, Dan, Ehud, Tina, Ferenc.


  • CIMIT Innovation Congress: need to have an AMIGO presentation and Slicer IGT. AMIGO mockup being created by Kacher/FAJ/Katie.
  • GE MOU - Voluson Ultrasound added as the specific ULS machine.
  • Monday June 23rd GE meeting: Kacher to invite Jim and Ramon from Anesthesia
  • Tina to talk to Ann Humphrey at CIMIT about companies presenting at CIMIT Innovation.

June 09

  • Charles Cho, MD. to join meeting. Spine interventionalist.
  • Soft bed.bmp


  • FAJ Debriefing group on visit to Jim Davis
  • FAJ ES debriefing from visit to Schenectady
  • Table document for Ferenc's pitch to GE
    • MOU signed?
    • Disposition of table
  • CIMIT Innovation Congress Plans from FAJ
    • Combined display with Maquet
  • 2007 GE Workstatement, Prostate project
    • Radiologic interpretation of images for interventional use (Tempany)
    • 3D planning (Hate/Liu/Haker)
  • 2008 Workstatement

June 02

No meeting. U41 EAB.

May 26

  • Memorial Day

May 19

  • JnJ Update - ball in Yousef's court for giving us dates.
  • June 26th is the finance committee meeting (postponed from May)


  • FAJ going to MKE on Thursday to complete MOU.
  • PET/CT grant has to go in for March 2009. Should describe AMIGO and Molecular Imaging. Gary will participate in writing this, Victor should write DON, someone should write AMIGO part, someone should write Molecular imaging part. Our nuc med department can review
  • FAJ met with Larry Epstein re. AMIGO. Cardiac EP setup should be in AMIGO.
  • Two GE meetings: high level at GE w Ferenc to present. Next level down with Mike Fritz, Pete McCabe, Ron von Jako, anesthesia - longer, full-day mtg.
  • June 1st is abstracts deadline for JHU mtg.
  • Noby went to interventional conference in Japan. Noby to summarize presentations - spine ones on june 9th mtg when neuroradiologist (new), Charles Cho joins our meeting. neuro surgeon, Chi (trained from UCSF) who will start in July/August.
  • Tina to follow up with JnJ and CIMIT/BU fundraising and report back this week.

May 12

  • Attendance Ferenc, Ehud, Paul, Kim, Gary, Angela, Dan
  • ISMRM Debriefing
    • Philips: Active tracking catheter with compressed sensing
    • Stanford: Butts - FUS burns to mark location of lesion for surgeon
  • Amigo MOU
    • Ferenc/Barber meeting in Milwaukee
    • $2M from MR HEI grants
    • $2M from PET/CT HE grant (to be submitted March '09)
      • Weisletter (MGH) David P (Sloan Kettering) to validate agents, Optical (BWH, pending))
    • $750k from BWH
    • We either pay $3M or $4M (depending on second HEI grant) for PET/CT + 3T MR
    • Disposition of Alpha Maquet table designated to us originally? Cost of table
  • Nursing coverage discussion with Peggy Doyle
    • 8am-10pm coverage
    • One full time person (Angela)
    • Other nurses float between Amigo and OR
    • How many FTE's do we need to cover two shifts
    • Radiology invervention cases bring Radiolgy nursing
    • Angela to make recommendation
  • Radiology techs
    • PET/CT must send someone to run PET
    • MR/CT techs can run CT (no PET)
  • Dan to send e-mail to Ferenc (for Barber presentation) regarding
    • PET/CT docking with Maquet table
    • MR comaptible single section table top

May 05

  • Amigo Cap Equipment Budget draft 2008 04 21
  • (Brendan report) Seltzer - Gottlieb meeting.
    • Amigo costs over $10M to be covered by Radiology.
    • $8.5M construction
    • $2.5M capitol
    • May need budget to buy air handling unit.
    • Hospital has commited to $1M 2008 $6M 2009, $3M in 2010
    • Hospital committed to construction in September, 2008
    • Does HEI grant pay GE directly, or does BWH need to cover cost then get reimbursed? Susan Cassidy
    • Brigham Finance Committee May 25, 2008.
      • Brigham Finance and Partners Finance will evaluate if cost risks been addressed.
      • Agreement with Radiology to cover costs over $10M
      • MOU to be signed before they comit to $10M
      • Status of PET/CT - consigned or given in MOU? Quote? If consigned, then need to address eventuality of purchase
  • Letter from Ferenc to Art Day inquiring about budget for Amigo Neurosurgery
    • share Shaprio equipment
    • purchase additional equipment
  • Past end-of-life equipment
    • Anesthesia machines
    • Monopolar
    • Bipolar
    • Ultrasonic Aspirator
      • Need buy-in from Risk Management to continue use

April 28


April 21


April 14

  • FAJ not away these two weeks.
  • Dubowsky prostate BX project (Kacher)
    • Advise him to partner with another group?
    • Advise him to develop for different application?
  • U41 Outreach Activity: Visit from Henan China iMRI group (Kacher)
    • [Note] The participants agreeed to discuss this off-line (-> CT, NH, DK)

Updates on Standing Items:

  • Facilities (BW)
  • Finance Committee Prepration (TK)
  • Equipment List (DK)

April 7

  • EP project (FAJ's update)
    • Present Dr. Epstein our current design and plan and solicit inputs. (AI Brendan)
  • J and J (FAJ'supdate)
    • J&J requests to form team in their side, and our side.
    • Biosense, NOGA, endoscope
    • (AI: finalize Research + Clinical project)

Updates on Standing Items:

  • Facilities (BW)
  • Equipment List (DK)
  • Workflows
    • Neurosurgery (NH)
    • Tumor Ablation (PRM)
    • Prostate Interventions (NH)
  • Reminder: NCIGT EAB is June 2nd FYI

March 31


  • PET/CT Closure (Ehud)
    • PM continue to seek availability of fluoroscope function.
    • ES will ask his contact in GE about it.
    • of 1000 installation, a Poland site does intervention.
    • PM will provide ES the pictures from the past case.
    • All decided to continue discussion in Apr 7 meeting.

Updates on Standing Items:

  • Facilities (BW)
  • Equipment List (DK)
  • Workflows
    • Neurosurgery (NH)
      • active dicussion among RK, NH, AG. Possible pre-AMIGO application of Slicer. No Nav.
    • Tumor Ablation (PRM)
    • Prostate Interventions (NH)
  • Budget Update
    • "GE will provide $2.5-3M in program costs including engineering and specific development. We'll also provide ~$2M in hardware (not sure how much in upgrades but that will be in addition) and we'll provide ~$500K in favorable pricing on hardware. " - John Pantano
    • John will itemize costs
    • "We do not have any list prices for the below at this time. The 9900 Elite Navigation is still in development. If you need numbers for estimates I would use these." -Ron Knox, sales rep.
      • 9900 Elite with NAV. $350k
      • Instatrak for Neurosurgery $250k.

March 24

Per Brian Chiango, the important 'milestones' that need to be met to keep the project moving are as follows:

  1. Design & Development continues on schedule;
  2. Tom Walsh responsible for development of the proforma working with Jolesz, Tempany et al;
  3. Colleen Hernandez responsible to assist Jolesz and Tempany with develoment of presentation material for BWH and PHS Finance Committees (May & June respectively);
  4. Completed and agreed upon MOU by - March 31, 2008;
  5. Finalize the purchase price and paperwork for the 3.0T MRI - April 2008;
  6. Definitive agreement by - June 30, 2008; and
  7. If steps above completed renovation begins - July 1, 2008.

Any delay in a milestone could cause a shift in later steps. So, we need to PUSH as much as possible to meet each of these milestones to keep the project moving forward and not stall again. It's time to pull out all the stops!

Updates on Standing Items:

  • Facilities (BW)
    • Art Mombourquette put the AMIGO design on hold until the project finances (MOU, return on investment analysis and funding issues) are settled.
  • Equipment List (DK)
  • Workflows (PM)
    • Neurosurgery (NH)
    • Tumor Ablation (PRM)
    • Prostate Interventions (NH)

March 17

  • Introducing new AMIGO team member: Ehud Schmidt, Ph.D.
  • Update from DC Workshop (FAJ, PM, NH)
  • Equipment list - identify phase I items
  • Dubowsky Collaboration (DK)
  • Tyco, JnJ Partnership (DK)

Updates on Standing Items:

  • Facilities (BW)
  • Equipment List (DK)
    • [FAJ] Needs to have substantial support from the vendors since we are exhibit site, not ordinary user site.
    • FAJ will review and revise the list.
  • Workflows (PM)

March 3

  • Equipment list (presented by Whalen).
    • The equipment list presented.
    • Total cost of equipment in the list is 4.7m.
    • Image Stream: 600k based on Shapiro
    • Live data
    • 5% contingency
    • The list doesn't include FUS equipments.
    • FUS will be used elsewhere. Not included in the list.
    • Duplicated equipments due to variety of procedures.
      • Three lights now.
      • Six video monitors.
      • Construction cost will be reported on Wednesday (3/6/08).
      • usual cost for OR --- 1m
      • column to describe additional source of funding (over year 8-9-10)
      • Upgrade cost?
  • Sing-off process will be initiated by TK, BW, and other stake holder after checking agreement of this list with MOU. Action Item.
  • Timeline for purchasing needed. Action Item
  • Planning BWH and GE issues
  • Workflows - Paul Morrison

February 25

  • New team member- Ehud Schmidt CV
  • Updates from Brendan- list status
  • Finance committee planning-Colleen
  • Review slide presentation for Colleen on wiki- Clare
  • Shared Instrument grant update-Clare


  • IGT grants list- Susan Z, Clare
  • J&J Partnership vs (kacher)
    • Tyco, Radionics, Valley Lab, Cusa, Integra, Elekta
  1. Ultrasonic Aspirator (>$100k)
  2. MR Power Injector
  3. MR iMed pump ($120k for qty 3)
  4. CT Power Injector
  5. Monopolar/bipolar electrosurgical unit ($80k for qty 3)
  6. RF Ablation unit
  • MoU addendum (kacher)
  1. Confirma CAD system
  2. Power injector for MRI
  3. Power injector for CT
  4. Coils
  5. 1 MRI Compatible Patient Monitoring system for PET/CT room: Consigned by GE
  6. 1 MRI Compatible Patient Monitoring system for Operating room: Consigned by GE
  7. 1 MR compatible Patient Monitoring system that is integrated with the above surgical table: Consigned by GE (Note: This applies when the product becomes available) with satellite monitor

February 18

no meeting due to hospital holiday

  • Amigo cartoon.bmp

February 11

  • 'Attendees'

Collen Hernandez-Burns, Clare, Gary, Kim, Brendan Whalen, Angela, Marsha, Dan K

  • AMIGO-Non GE List
  • Most recent plans
  • Network topology / Computational resources meeting planned
    • Noby Hata
    • Gary Zientara
    • Dan Kacher
    • Harry Khidir
    • Nicu
    • Bob McKie
    • Ron Kininis

  • 2 cabinets FUS
  • 4 cabinets GE
  • 4 cabinets research + 2 in research closet
  • 1 pen panel GE
  • 1 pen panel FUS
  • 2 pen panel research
  • 2 half-height pen panels in control room
  • 1 pen panel from research closet
  • Mark Johnson
    • GEMS platform needs?
    • Can we access patient with DV MRI scanner
    • Conductive glass shielding?
    • Wed 9am meeting
  • Review Shapiro building site visit
    • Infection control demands vents along both sides of table
    • Constrains boom placement
    • Limits microscope ceiling placement
    • Limits Inova ceiling placement
  • Construction time-line
    • Drawings out to bid end of April
    • Six weeks to bid
    • Shapiro opening May
    • CPD vacates Amigo space memorial day weekend

February 4

January 28

  • Outline a schedule for focused procedure-based reviews of AMIGO architectural plans by Workflow Teams
  • 01 14 2008 plans

January 14

10-11am Hollenberg

January 7

10-11am, Hollenburg Facilities meeting continued with Brendan Whalen and Architects. Final plans for AMIGO suite. Attendance: Brian C, Clare T, Paul M, Gary Zientara, Mike R, Ginger D, Allison (Payette), Dan K, Brendan W, Alex G

  • Payette drawings for discussion
  • Discuss figures needed from Payette for Jolesz grant proposal (Kacher)
  • Option 2 ratified by Brian/Clare. Already ratified by Stu Silverman, Kemal Tuncali, Ramon Martin, Jim Philip, and Victor Gerbado.
  • Brian C opposed to research closet in corner of OR/MRI. Alex Golby/Gary Zientara supported the need.
  • Brian C brought up need to bring in Innova with minimal disruption to suite. This should be considered in architectural planning.
  • Space for cytology? Cart based microscope that can be kept in storage and wheeled into OR?
  • By end of month, lock down equipment list.
  • By end of month, sign MOU with GE
  • Finalize budget by end of February
  • Meet again Jan 14 (next Mon Amigo meeting)


December 17

10-11am, Hollenburg Facilities meeting continued with Brendan Whalen and Architects. Final plans for AMIGO suite.

  • Equipment list should be finalized
    • Equipment covered in MOU with GE
    • Equipment to be purchased by PHS (non-GE equipment list)
      • Special attention needed to Innova, FUS equipment
  • Review of most accepted plan media:AMIGO-flr-plan-option-2a.pdf.
    • Anesthesia and Nursing reviewed it and prefered this plan most. The other three plan media:AMIGO-flor-plan-2.pdf media:AMIGO-flor-plan-3.pdf media:AMIGO-flor-plan-4.pdf.
    • Door for diagnostic scan patient was discussed
    • Glass wall separating control area
    • Scrub sink in the middle?
    • Surgical and diagnostic patients' flow discussed. FAJ presented concern on OR visible to PET diagnostic scan patient.
    • Door located on the top can be used for PET diagnostic patient
    • Need to check if DPH accepts a toilet in the PET/CT room

December 10

  • PET Program
    • Timothy R. DeGrado, PhD, Director, Cyclotron and Radiopharmaceutical Chemistry
    • Laura Horky, M.D.,Ph.D.
    • Georges El Fakhri, Ph.D.
    • Victor Gerbaudo, Ph.D, MD
    • Marcelo Di Carli, MD
    • Topic: cyclotron plans and ideas for functional Neuro-imaging
  • JHU visit debriefing
    • More detailed notes
    • Facilities: Two XMR suites under IR control (not for surgery)
      • Philips Achieve 3T + portable c-arm
      • Siemens Espree 1.5T + Axiom Artis floor mounted single plane fluoro
      • Mixed animals and patient load
    • Novel procedures ($8M grant funding, 4 IRBs approved or pending)
      • Crones disease – infuse agent into vein, image to target section of bowel
      • Carbon nanotubes into fracture site of bone
      • Gastric artery embo = appetite control
    • Siemens iMRI platform installed at 11 illuminary sites
    • Celon (Olympus) developing bipolar RFA probe/generator for MRI
  • CIMIT Exploratorium Debriefing?

December 3

Continuation of AMIGO architects presentation. (Ali T will also join)

  • Confirm we can support programs with new limited space
  • Phase II:
    • Liver thermal ablation
    • Kidney thermal ablation
    • Cervical cancer brachytherapy
    • Bone metastatsis thermal ablation
    • Bone tumor FUS (research)
    • Vertebroplasty
    • Prostate biopsy
    • Prostate brachytherapy
    • Prostate FUS (research)
  • Phase III:
    • Spine surgery (research)
    • Skull base surgery (research)
    • ENT sinus surgery (research)
    • Craniofacial surgery (research)
    • Liver endsocopic surgery (research)
    • Kidney FUS (research)
    • Lung thermal ablation
    • Lung bronchoscopy (research)
    • Joint endoscopic surgery (research)
    • Trauma fracture correction (research)
    • Joint replacement (research)
    • Cardiac EP ablation (research)
    • AVM embolization (research)
    • AVM FUS (research)

November 26

No meeting on account of RSNA.

November 19

  • AMIGO Architects presentation. Slide Presentation.
  • FYI: for Nov 26th or later: invited Laura Horky MD PhD and Tim DeGrado PhD (BWH Radiology) to join us at one of our upcoming AMIGO Monday meetings. (PET program- cyclotron plans/ideas for functional Neuro-imaging/It would give us a start on planning possible uses in AMIGO)

November 12

No Mtg. U41 all-day retreat.

November 5

Attendees: Gary, Dan, Kim, Ferenc, Clare, Alex, Tina

  • PRM may be unavailable for this meeting
  • Request from Andrew Maynard: Outside counsel, Steve Snyder has asked for a list of the grants that relate to AMIGO, stating what conditions were imposed by NIH (that relate to AMIGO).This is to help establish that GE's contributions are part of a major, bona fide research program (and not a disguised reward for commercial activities).
  • Update from Ferenc on GE/JnJ meetings last week.

Highlights/Action items:

  • TK to followup with SZ re. updating list of grants.
  • TK to followup w/ Mike V dinner plans, and agenda for Monday.
  • Optical imaging grant app by Frangioni. FAJ asked him to contact Dan, Kim, Noby for AMIGO followup.
  • mass spectrometry P41 at BWH. TK to add that to list of P41s.
  • (Tina)
  • GE workstatements related projects:
    • Breast coil w/ greater than 4 channels. Need to start working on that. (Dan)
    • need to start working on imaging protocols. Dan to talk to Alex. Also potentially to Ehud.
  • Alex to followup with Nicu regarding his work on the P01.
  • Nov 19th U41 meeting will be used for P01.

October 29

  • Ferenc and Clare at Distinguished Chair related meetings
  • Followup with D. Orranbach and Larry Panych about the status of the physics support needed for the perfusion image protocol that DO needs (Tina)
  • BWH research pages pointed out by Gary: Kim will look into whether these are the ones that BRI recommends as the home pages for faculty.

October 22

  • Plan for Oct 29 meeting with GE and JJ
    • IT Integration document draft review (Gary)
    • Review all J&J companies (Noby)


  • Oct 29th
    • luch w/ ge (mb, jp, mv) & jj &kf
    • ask djo to set up the mtgs with above people
    • after lunch mtg: 1) vision: molecular imaging testing, cyclotron, endoscopy, IT 2) execution: more active involvement 3) working on additional fundraising through NIH 4) GE MR funding 300K 5) 3T $2MM
    • AMIGO site planning data - get latest from Dan (TK)

October 15

  • CIMIT Exploratorium Update (Tina)
  • Website Pages for Labs: Labs (Tina)
  • IT Integration Update (Gary)
  • J&J Task force Update (Noby)
  • Plan for AMIGO meetings agendas
    • Prepare for MIke Barber discussion - JJ and IT are only two of the components.
    • Participate in design meetings
    • invite brendan whalen, mike roughan to AMIGO meeting so they can tell us mechanism to participate. dan to invite brendan and mike to next Monday. tina to invite Ali
    • have two assoc directors: Alex, Ali
    • invite carolyn mountford to present in the future: nmr spectrometer.
    • laser based temperature mapping company in canada. FAJ in contact with CEO. works with siemens only currently. nathan to work with them. IRB - Paul to continue IRB.

October 8

Columbus Day Holiday.

October 1


  • Select projects for review in each of the next few meetings
  • Update on Task forces: AMIGO IT, J&J
  • November 13-14, 2007 CIMIT Innovation Congress
Hi, Dan: I’m hoping AMIGO can be represented in the Exploratorium at this year’s CIMIT Innovation Congress on November 13th and 14th. Like last year, we will be replicating clinical care settings – an ED, ICU, Patient Care area, Physicians Office, Home… and “advanced procedure room” or OR, but unlike last year, we’ll have a lot more room (!) to cluster demos and showcase emerging technologies. Let me know what you think would be good to present this year – a demo of your instrument tracker?  Keep in mind that we try to focus on hands-on demos for the Exploratorium (though videos are okay, too). Thanks so much. Ann

Attendees: Gary, Alex, Clare, Kim, Ferenc, Paul, Noby, Tina


  1. J&J potential projects: endoscopes, molecular imaging. JJ task force to present next mtg.
  2. Going forward, ultrasound based deformation with potential validation in IMRIS. Rami and Steve H are at IMRIs. FAJ to discuss with Childrens - Scott.
  3. Alex's CIMIT Project - EEG in MRT. Given no MRT, what should be the plan? FAJ to discuss with Kirby.
  4. Find out who are the CIMIT supervisors for each of our projects. FAJ to do this.
  5. CIMIT Showcase: Noby (Robot/Slicer), Dan (RFID), Dan/John (Cardiac), Steve/Alex (fmri tutorial), FUS (greg). Posters: Noby (3), NCIGT reuse (5?). Deadline is today.

September 24

Gary, Clare, Dan, Kim, Ferenc, Paul, Noby, Tina, Alex

  • AMIGO MOU updated and sent to GE
  • TCON with Mark Morita - data integration across modalities
    • setting up centralized AMIGO data server
    • this should be ready for the first day of installation - so high priority
    • Task force on our side: Gary (MR), Noby, Tina (navigation), Steve Moore (PET/CT),
    • Historical documents from Ron, Noby, Sun should be used
    • Can the server hosting Centricity be used for this?
    • Gary/Noby to talk to Rami Liebenthal about what the IT system should be
  • John Chaminski, GE Diagnostics, Molecular Immunology idea.
  • Molecular Imaging Guided Therapy - new core/entity idea for u41 comp renewal. This would include optical w/ frangioni.
  • Japanese group doing optical tumor margin marking (Noby familiar) using optical.
  • Oct 29 - J&J and GE here.
  • J&J task force: Noby, Kirby, Tina
  • AMIGO two big things: endoscopy and molecular guidance. Science where flexible endosopic view can be merged with pre op patient information - a visualization platform for this.
  • joint grant with Frangioni planned

September 17

Attendees: Gary, Noby, Kim, Ferenc, Marianna, Paul, Alex, Tina

Agenda: catchup on activities.


  • AMIGO will be in IGAP
  • A major benefit of this location is that OR staff (orderlies, nurses, ...) will be shared with AMIGO/MRT.
  • Second: it is ground level which benefits vibration and weight (due to shielding requirements of magnet) issues.
  • Putting MRT in AMIGO allows sharing of additional resource areas like holding/waiting rooms.
  • Putting AMIGO/MRT in IGAP eliminates the dominos that were stalling previous plans.
  • AMIGO MOU - highest priority for TK to get signed by Andrew Maynard ASAP. Note in there that all products should be the latest one that is available at the time of the delivery. Note esp for the PET/CT that it should be the best CT that can be integrated with PET. Ask for one person from GE onsite. Oct 29, GE is visiting, and good opportunity to sign this.

September 10

  • Location: Hollenberg, Thorn 3


September 3

  • Labor Day. No Meeting.

August 27

No meeting

August 20

  • Location: Hollenberg, Thorn 3
  • Clare on vacation
  • Paul on vacation
  • Table tconn recap
    • Requested Transmobile, Modified Signa Table, Head Holder
    • Rami is checking with John Ferut on availibility
  • Update on Amigo schedule??
  • Update on A Golby OR 5
    • Meeting to be scheduled with Lynn Dockser and
      • Sanjay Pathak
      • Vice President, Surgical Services and Imaging
      • Brigham and Women's Hospital
      • (617) 732-8314 begin_of_the_skype_highlighting              (617) 732-8314      end_of_the_skype_highlighting begin_of_the_skype_highlighting              (617) 732-8314      end_of_the_skype_highlighting begin_of_the_skype_highlighting              (617) 732-8314      end_of_the_skype_highlighting (o)
      • (617) 306-4792 (m)

August 13

  • Location: Hollenberg, Thorn 3
  • [JHU X-MR suite] (reported by Noby)
  • Tina on vacation
  • Review of Kacher travels to Royal Prince Alfred Hospital (Syndney), Langfang Hospital (Beijing), and meeting with Professor Cho (Korean PET-MRI suite)
  • Internal RFP for GE Workstatement 2008 (Kacher)
    • Defer one month (as per Ron)
  • Brain Labs trial (Alex G)
    • Wed morning - OR5
    • Display our data (fMRI, DTI) acquired last Friday.
  • Slicer skull base surgery collaborative grant with JHU (Noby).
    • Add Alex Golby and Art Day as consultants to grant?
    • Apply vessel segmentation - CF's group's technology
    • Noby to get list of clinical personnel on JHU side
    • Sumu Mori - DTI scientist in group. F Talos work uses their data.
    • Alex Golby to talk to Menzial (fMRI scientist) re: teaming up on post-processing
  • Workflow Analysis
    • Kirby Vosburgh can help with open abdominal surgery
  • Clinical translation for Neuroendoscopy project (Noby)
    • AG: New hire in neurosurgery?
    • AG: Set up collaboration with leaders in field of neuroendoscopy (e.g., Pittsburgh - Dr. Jho)
    • RK: Meet with Art Day about direction w/ AG, NH, RK.

August 6

  • Location: Hollenberg, Thorn 3
  • Start at 10:30am
  • Note: PRM away today.
  • Discuss IT needs of AMIGO (Noby, Gary)
  • Show ImageStream slides (Dan)

Attendees: Gary, Ron, Alex, Dan, Clare, Kim, Noby, Tina


  • discussion of AMIGO layout (Dan brought printout to meeting)
  • Gary presented IT slides (available on AMIGO page)
  • Noby to schedule IT TCON with Mark Morita

July 30

  • Location: Hollenberg, Thorn 3

July 23

  • Meeting location: Clare's office
  • review workflows for prostate and ablation
  • Note: Tina, Dan, Noby will not be at today's meeting.
  • review coils list

July 16


  • Review Chris Unger's notes from the meeting
    • Finalize list of 6-7 procedures whose workflows will be completed in next 3-4 weeks.
    • Kacher away- revisions after visit uploaded
    • Noby away. Available by cell if needed.

Discussion of Next Steps from Chris' List:

  1. Update Ablation workflow (Tweaks, clarify GE vs. BWH) - Paul to complete by July 23rd
  2. Update MR Prostate (add details to sec. 10, clarify GE vs. BWH) – Noby to complete by July 23rd
  3. Close on coil list (Dan, Karl)- Tina to follow up with Karl and John P. this week
  4. John Pantano to establish discussion of periop roadmap vs. 3rd party. Probably we will leverage Cardinal offering
  5. Establish conversation with Mike Washburne (US) on roadmap for navigated US (John Pantano to OK with TerriB) - Tina to follow up with John P. on this week
  6. Close on MR features (bore size?). Either phone, or JohnP to coordinate a face to face as planned- Tina to follow up with John P. on this week
  7. Establish conversation with Mark Morita on Display/Video Dist/Consultation - Gary to check with Noby/Mark about this
  8. Close on PET/CT ’08 feature offering (Alex Ganin) - Paul to check with Alex on this
  9. Clarify Maquet docking mechanism request (Philips JR Tokai mechanism: what is it, is it a standard Maquet offering)? - Is this Chris' action item?
  10. Clarify that patient transport to Angio an official request - Tina/Clare to verify with FAJ/Andrew Menard about this
  11. Clarify short term delivery request for MR table - Is this Chris' action item?
  12. Develop added workflows…(Oncological Surgery and Intravascular Interventional). Tina to close on final list of ‘driving workflows’ in July 16th AMIGO meeting. - three additional procedures were proposed (neurovascular - using radiolucent headholder, c-arm, stroke/perfusion imaging, liver or breast open surgery, and intravascular interventional). Clare to finalize.

July 9

Regular meeting cancelled. Meeting with Chris Unger from GE re. workflows.

July 2


  • plan for Chris Unger visit on July 9th: 2007_Summer_AMIGO_Programs_Meeting_with_GE#Agenda_Draft
  • Ownership of clinical workflows:
    • Ablation (Paul)
    • Prostate(Noby, Clare)
    • Neurosurgery(Tina, Dan, Alex)
  • All workflows should be submitted to Clare/Tina for final review by Tuesday evening. Feedback will be given by Thursday.
  • there will be no regular meeting on Monday July 9th because of AMIGO visit.

June 25, 2007


"Workflow" Documents (P. Morrison)


1) Review original motivation/timeframe for these Workflows

2) Look at current list of Workflows on Wiki under AMIGO page

3) Agree current priority Workflows are: Neurosurgery, Prostate, Tumor Ablation

  • Confirm current Neurosurgery Workflow: "MRI-PET/CT Guided Neurosurgery"
  • Confirm current Prostate Workflow: "MRI Guided Prostate Brachytherapy"
  • Confirm current Tumor Ablation Workflow: "PET/CT-Guided Tumor Ablation"

4) Review current draft of PET/CT-Guided Cryotherapy Workflow (.doc)

5) Goals of Workflow? Message? Audience?

  • Procedure Description
  • Needs
  • Justifications

6) Format: workflow.doc versus workflow.ppt


7) Name a) P.I. and b) author/go-to for each current priority Workflow

June 18, 2007

  • JHU IGT Away Team (Kacher)
    • Scheduling for Sep/Oct
    • Audience is interventional Radiologists
    • Kemal/Jance/Angela/Dan named by Ferenc to go
    • Carrino request Clare T
  • CIMIT Workflow Grant (Kacher)
    • OLD: Need to take delivery of modified Signa table and Transmobile table and modified In Vivo monitor.
      • OLD: What channel should we use? Kacher to Ferut?
    • OLD: Need to have lines of communication open to Datex Omeda (GE's anesthesia company).
      • OLD: What channel shoud we use?
    • NEW: Barnabas T's work with Kirby finished. Needs funding to continue to travel to Boston.
    • NEW: Baranbas is working towards tracking people/things in room and rendering in software, in collaboration with Sony Pictures.
      • If we cannot get GE parts, should we modify efforts to focus more on Barna's part?
  • 2008 GE Workstatement (Kacher)
    • Propose competative project review (like BRREF)
    • Short list of IGT researchers invited to apply
    • Understanding with IP issues can be built into RFP
    • Only projects without ties to outside institutions eligable
    • Should come with a materials budget to offset limitations of the funds
    • Would cause each researcher to own part of workstatement and progress report
  • Wiring Golby OR (Kacher)
    • OLD: 40" NEC monitor installed under Ramin's budget
    • OLD: Only PACS displayed at this time
    • OLD: Switch hi def video (microscope, GE Navs, PACS, endocsopy, camera views) to monitor
    • BWH OR5 schematic070618.jpg
    • key requirements:
      • a temporary solution, portable to new ORs
      • to avoid having cables running across the floor which could adversely effect circulation within the room and room turnover, and
      • to provide a cost-effective solution based on research funding of $25k.
    • The figure illustrates the proposal.
      • wireless connection from the microscope to the 40” LCD display and to the nStream server.
      • wireless connection between a room camera(PZT) to the nStream server.
      • The nStream server allows the images to be distributed over the hospital network to a few neurosurgeons and/or administrators offices as you deem appropriate.
      • The components are movable and upgradeable as part of a larger solution for either the AMIGO project or the new OR construction.
    • If parameters are acceptable, we can get quote and have work done before the National Heart Lung Institute of Arizona and Houston jobs.

  • What does this mean for low field IGT? (Kacher)
  • Care Core National's minimum requirement for reimbursment
    • Devices with Field strengths of 0.30T through 0.6T and devices with field strength of 1T manufactured prior to 31 December 2001 will be limited to performing examinations of the brain, spine, knees and extremities. However, if the devices described above have gradient strengths of at least 20mT/meter and slew rates of at least 45T/meter/sec, they may apply to perform additional studies by submitting images demonstrating their current capacity to perform them at acceptable quality levels.

June 11, 2007

No Meeting. Time used for U41 EAB Rehearsal at 1249 Boylston.

June 04, 2007

10am-noon: U41 EAB Prepration in Hollenberg. All presenters (core PIs and project leads should be present).

May 28, 2007

No meeting. ISMRM.

May 21, 2007

No meeting. ISMRM.

May 14, 2007

  • 2008 GE Workstatement (Kacher)
    • Propose competative project review (like BRREF)
    • Short list of IGT researchers invited to apply
    • Understanding with IP issues can be built into RFP
    • Only projects without ties to outside institutions eligable
    • Should come with a materials budget to offset limitations of the funds
    • Would cause each researcher to own part of workstatement and progress report

May 7, 2007

April 30 2007


April 23 2007


  • GE collaborative research showcase at ISMRM - slides needed, and should be linked here: 2007 ISMRM
  • P01 Changes Review
  • review agenda/attendees for Yale May 8th visit
  • Ablation/Imaging discussion between Paul and Bruno?
  • do we need to review agenda for GE visit on April 26th?
  • review following document for AMIGO:
  1. Equipment list


  • Invite John Frangioni - lymph node visualization. Invite him to present.

April 16 2007

No meeting. Patriots' Day Holiday.

April 9 2007


April 2 2007


  • Date for GE (Mike Barber) Visit
  • Proposal for GE effort on navigation integration
  • If GZ in meeting - status of P01 JIT info.
  • P01 Contact Information

March 26 2007

No meeting.

March 19 2007


  • P01 - all project leads have been invited to this meeting. Agenda is to ensure that NIH Just in time information is provided to Jack Murphy/Jean Valk, and to discuss the projects/roles.

March 12 2007

List of Clinical Research Activities outside the MRT: IGTP

March 5 2007

Note: DK out of town.

Agenda: Refocusing of Clinical Research Programs without the MRT.

February 26 2007

Note: PRM unable to attend.


February 19 2007

Holiday on account of Presidents' Day.

February 12 2007


  • Introducing Dr. Ali Tavakkolizadeh to the group(Ferenc)
  • Update on MRT (Dan)
  • Ensuring that the list of IGT funding sources is complete (Tina, Clare)
  • Review of AMIGO neurosurgery workflow (Noby)

February 5 2007

Agenda: Review of AMIGO Neurosurgery Workflow (Noby Hata). This was postponed in order to have a discussion about the MRT.

January 29 2007

Attendees: Clare, Tina, Noby, Simon, Paul, Dan, Kim


  • MRT diagnosis will be completed this week, and update available after that.
  • AMIGO Workflow for PET/CT based ablation (Paul). Discussed PET/CT workflow with NH and Chris Unger (GE) and continuing to work on providing clinical justification.
    • Potential scientific points to dig more into are:
      • short half life tracers - which ones are neded
      • highlight which sections of workflow are research vs. in clinical use today
    • Navigation for Abdominal intervention: CU recommendation is to provide proof of concept in Slicer, and then ask GE NAV if they are interested in moving it to their product, rather than ask them to develop it.
    • Point to Note: CT/fluoro is not available in PET/CT scanner. Ultrasound based registration (Kirby Vosburgh) might be an alternative to fluoro registration.
    • Victor Gerbaudo mentioned a registration software package that might be useful to install
    • Phil Lang has performed 5 PET/CT biopsies. It would make sense to invite a fellow from his group to present to AMIGO.
  • AMIGO workflow for Breast Lumpectomy (Dan)
    • PET/CT is needed
    • reg software is needed for MR to physical space
    • group currently uses CADStream package for registration
  • AMIGO Workflow for Cardiac/EP:
    • wean off fluoro
    • Eigil's draft is being worked on by ??
  • Intermediate versions of workflows should be put on Xythos. Simon to look into that.
  • Mike Barber visit - Noby is working on that. Rough time frame is first half of March. Ball is in GE's court on dates right now.
  • John Kroon from ImageGuide is interesting in visiting Ablation Team
  • In future meetings will start reviewing AMIGO workflows in detail, starting with the neurosurgery workflow that Noby has prepared.


December 4 2006


  • RSNA update
    • meeting with Mike Barber and new home for AMIGO
    • meeting with Joe Hogan and the video
    • what are the urgent projects
      • US follow up of brain deformation
      • stroke protocol for neurovascular procedures
      • transgastric laparoscopy with CT and or MRI
      • brain surgery through ventriculoscopy
      • breast biopsy device for 3T
      • PET for ablations

November 27, 2006

Meeting cancelled due to RSNA.

November 20, 2006

Attendees: Ferenc Jolesz, Clare Tempany, Tina Kapur, Simon Dimaio, Dan Kacher, Paul Morrison, Kim Lawson, Noby Hata


  • FAJ in town until Jan 1st. Editing two books: FUS, neuroimage.
  • Joe Hogan DVD- Kacher and Ferenc to meet to finalize before RSNA. Kacher to get Kirby Vosburgh's contribution
  • Two main AMIGO priorities that FAJ would like the group to focus on: ultrasound brain shift detection, and to integrate Kirby's work into AMIGO or U41.
  • Noby will be responsible for the completion of the ultrasound transskull brain shift detection project. Will coordinate with Greg Clement and Jason White
  • Ali Tavakkolizahad (endoscopic surgeon under Zinner) to be invited to future Amigo leadership meeting for orientation to project
  • Surgery planning/tracking - meeting with Barnabas Takas upcoming
  • P01 resubmission to shift science from MRI (sole modality) to multi-modality
  • IGAP potential projects reviewed. FAJ plans to ally with Cardiologists for experimental MRI work (e.g., FUS cardiac ablation, EP)
    • BUMC currenctly doing open surgery FUS ablation
    • closed FUS EP proposal necessary
    • XMR single room to be siting with minimal space
  • IT update from Noby: AMIGO will be under the SL network
  • Noby has been working with GE NAV
  • AV integration update will be provided by Kacher soon.
  • No meeting next week due to RSNA

November 13, 2006

Several attendees travelling. Meeting cancelled.

November 06, 2006

October 30, 2006

October 23, 2006

October 16, 2006

October 09, 2006

October 02, 2006

September 25, 2006

September 18, 2006

September 11, 2006

September 04, 2006

August 28, 2006

August 21, 2006

August 14, 2006

August 07, 2006

July 31, 2006

July 24, 2006

July 17, 2006

July 10, 2006

July 03, 2006

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