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This is Alan Conlin with the Becker's Healthcare Podcast,
and I'm thrilled to be joined today by Dr. Mason Kire,
medical director of the neurosurgery program at Children's Minnesota. Uh, Mason,
before we dive into our discussion today,
I'd love to turn the floor over to you here a little bit about your role and of
course, your background.
Sure, of course. Thanks for having me. Uh, my name is Mason Kire,
like you mentioned. Uh, I've, uh,
been a pediatric neurosurgeon for a little over 10 years now. Uh,
before that obviously seven year residency year fellowship, and then, uh,
the 10 years in practice at Children's Minnesota. Uh,
and I've been the medical director here for about a year and a half.
We have one of the largest, uh, programs, uh, neurosurgery,
pediatric neurosurgery programs in the, uh, in the state. And I'm, uh,
I'm very proud of, uh, the services we, we have to offer our, our patients.
Fantastic. So yeah, let's dive right into that. Exactly. Uh,
children's Minnesota, like you'd mentioned, open, uh,
an MRI neurosurgery suite this year.
Can you give us a little bit of insight into about that suite and how it's
improving patient care?
Absolutely. This is a piece of technology that we're really excited about,
not just in our department, but really as an institution, uh,
for our community and,
and our patients in the state and in the region as well too. So we have a, uh,
one of its kind intraoperative MRI suite, uh, and, uh, the,
the idea of an intraoperative MRI suite, even though it's novel,
it's been around for, um, you know, a few years. But, uh, what makes our mri,
uh, suite special and, uh, the, the only one of its kind is that we,
we have three rooms attached to it. So the mri, uh,
stays in a room where we can do diagnostic imaging.
So patients come in from outside,
they can get imaging of their brain in spinal cord. Uh,
and then in the meanwhile, it's attached to two operating suites altogether,
about 3000 square foot, uh, rooms. And so, uh, we,
we can do surgeries in these rooms and, uh, and get an,
and when we're done with the surgery, we can get an MRI before we close.
And really, uh,
I look at the MRI and we can have our radiologist look at it as well too.
And at the point of, uh, treatment,
we can look and make sure we've removed all the tumor. For example,
if it's a spinal cord tumor,
we've removed all the tumor that we wanted to see for removed and that there's
no complication, like a postop blood clot or a hematoma that we need to address,
uh, before we close up. And really, it, uh, it, it's,
it's very exciting to be able to offer, offer this to our, to our patients.
Yeah, I mean, sounds like a huge, a huge, hugely exciting piece of technology.
Can you break it down, I guess, uh, you, you've touched on kind of the,
some of the benefits and advantages there,
but how has this really affected your workflow patient care?
What are the biggest advantages, I guess, you're seeing, uh, for the,
from the surgeons aspect,
in terms of how you're operating in this new MRI and sleep compared to how you
were operating before?
Well, I would say, you know,
in 2023 to get the best outcomes for patients in any field,
especially ours, is that you have to have the right people,
but also the right technology, you know,
and I really truly believe that we have the right people that are able to offer
our patients the best care, but also we've got the best latest technology.
So this intraoperative MRI suite really allows us to,
to make sure that we give our patients the best chance of the best outcome that
we can give 'em. So in the case of a spinal cord tumor, the,
the number one prognostic factor for survival is the
extent of resection to how much tumor we remove. And a lot of times,
spinal cord tumors on their microscope,
they look very similar to normal spinal cord tissue.
And a spinal cord is very small and very thin. And so the, you know, the,
you really aren't, there's not really a lot of margin for error. And the,
with intraoperative, uh, mri, once we, we, we are done under the microscope,
looks like we've removed all the tumor, we can get an mri.
And really that's another advantage.
And it'll be help us more to see if we've left any residual or any remaining
tumor that we can just go back in and get,
since there's already the exposure is done, we're already right there,
and we can utilize that to make sure that our patients have the best chance of
survival.
We can utilize the same technology for epilepsy surgery to make sure our
patients have the best chance of becoming seizure free.
And same form for brain tumors as well. So it makes our, uh,
intraoperative MRI suite,
the only one of its kind in North America is the fact that it h while it houses,
um, in a, in a setting where we can get intraoperative, get, um, uh,
outpatient MRI scans, it also is attached to two operating room suites.
And what makes it unique is that we can have three rooms going at the same time,
and one of the suites that has rails on the, on the ceiling,
and so the patient can roll into the MRI when it's time to get an intraoperative
mri and the other operating room, the MRI comes to the patient.
And so this is really a unique way to be able to utilize the footprint that we
have to have three rooms and two operating rooms going at the same time while
we're able to get diagnostic MRI scans and utilizing one MRI to, uh,
knock out three birds and one stone, if you will.
Nice. Thanks to so much for breaking that down, Dr. Kiri. Um,
so fa fascinating to hear about this new kind of cutting edge technology.
Wh when you think about the next big step for this neurosurgery program,
the next, in the next coming months, the next year,
are there any new technologies, anything else you're looking to implement to,
to improve patient care as well?
Well, absolutely. There, there's a lot of that, uh, exciting technology,
some of which we've already offer.
We're already offering our patients and coupling that with the interrupted MRI
suite really will, will take us to the next level and, and give, give us the,
give our patients, you know, the, the quite a bit more opportunity for,
for better outcomes, even though what we were getting before.
And one of those is using a robot, which we've been using, uh,
to implant stereotactic, uh,
electrodes deep into the brain to be able to study where their seizures are
coming from. Uh,
and then once we're able to study that so we can really map out where seizures
are coming from within a few millimeters. And once we're able to do that, um,
and let me go back and just say that we can do that without making a single
incision, which makes us really exciting.
It's minimally invasive for the patient,
then we monitor 'em afterwards and when they have seizures,
we know exactly where those are coming from.
And then we can meet as a group and go over where we think those seizures are
coming from with really good accuracy.
And then bring that patient to the intraoperative MRI suite,
remove that portion of the brain, uh, safely, uh,
that we think is causing the seizures, get an mri,
make sure we removed exactly what we have planned to remove,
and then that patient will have the best chance of, uh, of, of seizure freedom.
Uh, and so that, that's one. And then also we,
there's a laser technology laser inter interstitial thermo therapy,
which is a mouthful. So we just call it lit, uh, where we insert a fiber, uh,
laser fiber again with the robots. This is a robot into abnormal brain tissue,
whether it be a tumor or an area where that causes, um, seizures.
And we're able to, in real time in our intraoperative MRI suite,
heat that tissue up with our laser while making sure that we're not heating any
normal tissue and destroy that tissue.
And then we take that laser out and the patient's usually go home the next day.
So those are all really, uh, exciting piece of technology. And now with our new,
uh, intraoperative mri, the, the picture is quite a bit better than what's,
what's, you know, quote unquote the center of care too,
because with intraoperative MRIs or any kind of mri,
the size of the magnet really matters, uh,
as far as what kind of a quality of the picture.
And so usually 1.5 T is a center of care for magnet,
and ours is three T. So really the picture we,
we are getting with our new interrupter MRI is like, uh, you know,
looking at watching a football game on high def versus, uh,
an analog catheter ray tube. So it's really, uh, a beautiful thing.
Yeah, I appreciate the analogy there.
I break it down in layman's terms for people like me. Um, really,
really exciting. Thank you so much. Uh, I wanted to wrap up one last question.
I know Dr. Kire,
you've been medical direct medical director of the neurosurgery program at
Children's Minnesota, like you said, for the last year or so, uh, for,
for other emerging leaders stepping into similar medical director roles like
yourself, whether in an orthopedics, spine, neurosurgery program,
what are the keys to really building a,
a comprehensive multidisciplinary team within that specialty?
Is there anything that you'd recommend that they,
they kind of to kickstart that journey?
Well, I, I think, I think you, uh,
you mentioned that you hit the nail on the head.
You really have to treat a patient in a comprehensive fashion.
So you really have to collaborate, uh, with,
with other teams and other experts in your area and to make sure you've got the
right people. I think that's the first step. And then once you have that,
then you have to look at what you have as far as equipment to be able to offer
your patients the best care, uh, that you can as an institution.
And so a lot of, uh, a lot of healthcare systems, they have fantastic people,
but they're really siloed. So I think collaborative care, like in the,
in the care of patients with, uh, spinal cord tumors,
having a neuro oncologist and neuroradiologists, neuropathologists,
neurosurgeon, neurologists on board,
discussing each patient to be able to custom tailor, uh, you know,
their care and treatment plan for them and care. And in terms of epilepsy,
having a, uh, epilepsy center where you have epileptologist, neurosurgeon,
neuroradiologist, neuropsychologist, uh,
and people that really can discuss those patients and again,
be able to custom tailor the, their treatment plan and,
and come up with the best outcome. You, you couple that with, uh,
cutting technology and you really can offer patients the best care that you can.
Another key to success in building a successful program is that a lot of
healthcare systems in the United States are non-for-profits.
So Children's Minnesota is a non-for-profit hospital system.
And really to be able to have access to this technology and innovation,
all these costs, quite a bit of money,
money that a hospital and non-for-profit hospital doesn't have on its own.
And so another key to, uh, building a successful program,
I would say for emergence,
emerging leaders would be keeping a good line of communication open with your
board and also your community,
and let your community know what you're doing and, and,
and what grade work you're doing so that they can be engaged in your hospital
and in taking care of your patients. And,
and a lot of times communities are very generous and they're happy to donate if
they know that's going to good cause to, to, uh,
bring better outcomes for patients.
Nice. I think some excellent, uh,
advice for emerging leaders there to wrap up on. Uh, Dr. Kire, thank you so,
so much for, for taking the time to join the Becker podcast.
I have certainly learned a lot, a lot of exciting things certainly happening,
uh, within the neurosurgery program at Children's Minnesota. Uh,
look forward to connecting with you again down the line.
Thanks for the opportunity. Very nice talking to you.