A seizure in 2009 was the first sign that Cody Krulac had brain cancer. He had two surgeries to remove his tumor, but it came back for a third time. Krulac got the bad news two days before Christmas 2015.

“I’m 27 and I’m a man,” Krulac told the Peoria Journal Star. “Did I cry? Yes, I did. You can cry about anything you want, but it doesn’t change the outcome. I’m not happy I have to do it at all, but I’m glad it’s me and not my brother or my dad.”

His luck, however, changed — his doctor was at an institution that was about to become just the second Illinois site to utilize intraoperative magnetic resonance imaging (iMRI). Now the brave young man is back home on his family farm, with the lesion removed and a new lease on life.
Krulac was the first patient to benefit from the newly installed technology at OSF Saint Francis Medical Center in Peoria, Ill. It let his surgeons scan during his delicate brain surgery — a frontotemporal supratentorial craniotomy for tumor resection.

INI Brain Tumor Center Director Dr. Andrew Tsung, who spearheaded the 20-member operating team, expressed delight with the results of the inaugural 7-hour operation. “It vindicates our ability to come together as a team and complete an enormously complex task from conception to implementation - and furthermore on the first patient, without a single technical complication,” he noted in a statement.

Krulac was able to go home just three days after the surgery.

The use of imaging during procedures is a growing market in the U.S., according to a recent North American intraoperative imaging market report. This study estimated the market will reach $1092 million by 2019, at a CAGR of 1.8 percent between 2014 and 2019.

Tsung says the technology paid off during Krulac's procedure. “The iMRI allowed us to see a small cubic centimeter residual tumor against the brainstem. We were then able to remove this residual cancer prior to closure, allowing a more complete resection adjacent to dangerous areas while preserving normal brain function.”

This type of precision cuts the need for repeat surgeries and reduces the potential for collateral damage to healthy brain tissue. “Normally patients would have their surgery done with maybe a scan beforehand, you take a guess of how much you’ve removed of the cancer or tumor, and then you close the patient up. After a period of time they get another scan,” said Tsung.

“Now it’s a streamlined process. We don’t even have to undrape the patient. The patient remains sterile, the brain remains open as we run them through the scanner and we roll them back out. So we’re pretty much able to make it as efficient as possible,” he explained.

After its successful maiden outing the INI iMRI will be phased into the surgical rotation so that patients with cases that need its real-time capabilities can have them — and will offer improved care at the institution and throughout the region. “I think it’s unique anywhere. Not just for OSF, not just for Illinois, but it’s very unique everywhere to have this type of setup. To have the support from the physician side, from the hospital’s side, where we can provide the service.”

For OSF HealthCare's new CEO of Neuroscience Service Line, Dr. Tony Avellino, iMRI at this institution "is truly a game changer." It was one of the top reasons he came to Peoria in 2014 from the University of Washington Medical Center, he told the Journal Star, and it puts the INI in line to develop into one of the top neuroscience centers in the U.S.

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