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This is Alan Conlin with the
Becker's Healthcare Podcast,

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and I'm thrilled to be joined
today by Dr. Mason Kire,

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medical director of the
neurosurgery program at
Children's Minnesota. Uh, Mason,

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before we dive into our discussion today,

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I'd love to turn the floor over to you
here a little bit about your role and of

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course, your background.

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Sure, of course. Thanks for having
me. Uh, my name is Mason Kire,

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like you mentioned. Uh, I've, uh,

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been a pediatric neurosurgeon for
a little over 10 years now. Uh,

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before that obviously seven year
residency year fellowship, and then, uh,

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the 10 years in practice at
Children's Minnesota. Uh,

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and I've been the medical director
here for about a year and a half.

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We have one of the largest,
uh, programs, uh, neurosurgery,

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pediatric neurosurgery programs in
the, uh, in the state. And I'm, uh,

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I'm very proud of, uh, the services
we, we have to offer our, our patients.

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Fantastic. So yeah, let's dive
right into that. Exactly. Uh,

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children's Minnesota, like
you'd mentioned, open, uh,

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an MRI neurosurgery suite this year.

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Can you give us a little bit of insight
into about that suite and how it's

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improving patient care?

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Absolutely. This is a piece of technology
that we're really excited about,

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not just in our department, but
really as an institution, uh,

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for our community and,

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and our patients in the state and in the
region as well too. So we have a, uh,

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one of its kind intraoperative
MRI suite, uh, and, uh, the,

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the idea of an intraoperative MRI
suite, even though it's novel,

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it's been around for, um, you know, a
few years. But, uh, what makes our mri,

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uh, suite special and, uh, the, the
only one of its kind is that we,

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we have three rooms attached
to it. So the mri, uh,

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stays in a room where we
can do diagnostic imaging.

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So patients come in from outside,

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they can get imaging of their
brain in spinal cord. Uh,

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and then in the meanwhile, it's attached
to two operating suites altogether,

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about 3000 square foot,
uh, rooms. And so, uh, we,

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we can do surgeries in these
rooms and, uh, and get an,

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and when we're done with the surgery,
we can get an MRI before we close.

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And really, uh,

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I look at the MRI and we can have our
radiologist look at it as well too.

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And at the point of, uh, treatment,

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we can look and make sure we've
removed all the tumor. For example,

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if it's a spinal cord tumor,

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we've removed all the tumor that we
wanted to see for removed and that there's

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no complication, like a postop blood clot
or a hematoma that we need to address,

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uh, before we close up. And
really, it, uh, it, it's,

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it's very exciting to be able to offer,
offer this to our, to our patients.

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Yeah, I mean, sounds like a huge, a huge,
hugely exciting piece of technology.

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Can you break it down, I guess, uh,
you, you've touched on kind of the,

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some of the benefits and advantages there,

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but how has this really affected
your workflow patient care?

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What are the biggest advantages, I
guess, you're seeing, uh, for the,

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from the surgeons aspect,

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in terms of how you're operating in this
new MRI and sleep compared to how you

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were operating before?

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Well, I would say, you know,

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in 2023 to get the best outcomes
for patients in any field,

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especially ours, is that you
have to have the right people,

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but also the right technology, you know,

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and I really truly believe that we have
the right people that are able to offer

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our patients the best care, but also
we've got the best latest technology.

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So this intraoperative MRI
suite really allows us to,

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to make sure that we give our patients
the best chance of the best outcome that

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we can give 'em. So in the case
of a spinal cord tumor, the,

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the number one prognostic
factor for survival is the

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extent of resection to how much
tumor we remove. And a lot of times,

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spinal cord tumors on their microscope,

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they look very similar to
normal spinal cord tissue.

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And a spinal cord is very small and
very thin. And so the, you know, the,

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you really aren't, there's not really
a lot of margin for error. And the,

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with intraoperative, uh, mri, once we,
we, we are done under the microscope,

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looks like we've removed all
the tumor, we can get an mri.

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And really that's another advantage.

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And it'll be help us more to see if
we've left any residual or any remaining

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tumor that we can just go back in and get,

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since there's already the exposure
is done, we're already right there,

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and we can utilize that to make sure
that our patients have the best chance of

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survival.

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We can utilize the same technology
for epilepsy surgery to make sure our

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patients have the best chance
of becoming seizure free.

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And same form for brain tumors
as well. So it makes our, uh,

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intraoperative MRI suite,

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the only one of its kind in North America
is the fact that it h while it houses,

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um, in a, in a setting where we can
get intraoperative, get, um, uh,

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outpatient MRI scans, it also is
attached to two operating room suites.

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And what makes it unique is that we can
have three rooms going at the same time,

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and one of the suites that has
rails on the, on the ceiling,

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and so the patient can roll into the MRI
when it's time to get an intraoperative

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mri and the other operating room,
the MRI comes to the patient.

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And so this is really a unique way to
be able to utilize the footprint that we

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have to have three rooms and two operating
rooms going at the same time while

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we're able to get diagnostic MRI
scans and utilizing one MRI to, uh,

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knock out three birds and
one stone, if you will.

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Nice. Thanks to so much for
breaking that down, Dr. Kiri. Um,

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so fa fascinating to hear about this
new kind of cutting edge technology.

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Wh when you think about the next big
step for this neurosurgery program,

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the next, in the next coming
months, the next year,

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are there any new technologies, anything
else you're looking to implement to,

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to improve patient care as well?

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Well, absolutely. There, there's a
lot of that, uh, exciting technology,

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some of which we've already offer.

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We're already offering our patients and
coupling that with the interrupted MRI

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suite really will, will take us to the
next level and, and give, give us the,

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give our patients, you know, the,
the quite a bit more opportunity for,

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for better outcomes, even though
what we were getting before.

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And one of those is using a
robot, which we've been using, uh,

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to implant stereotactic, uh,

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electrodes deep into the brain to be
able to study where their seizures are

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coming from. Uh,

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and then once we're able to study that
so we can really map out where seizures

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are coming from within a few millimeters.
And once we're able to do that, um,

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and let me go back and just say that
we can do that without making a single

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incision, which makes us really exciting.

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It's minimally invasive for the patient,

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then we monitor 'em afterwards
and when they have seizures,

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we know exactly where
those are coming from.

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And then we can meet as a group and go
over where we think those seizures are

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coming from with really good accuracy.

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And then bring that patient to
the intraoperative MRI suite,

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remove that portion of
the brain, uh, safely, uh,

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that we think is causing
the seizures, get an mri,

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make sure we removed exactly
what we have planned to remove,

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and then that patient will have the best
chance of, uh, of, of seizure freedom.

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Uh, and so that, that's
one. And then also we,

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there's a laser technology laser
inter interstitial thermo therapy,

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which is a mouthful. So we just call it
lit, uh, where we insert a fiber, uh,

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laser fiber again with the robots. This
is a robot into abnormal brain tissue,

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whether it be a tumor or an area
where that causes, um, seizures.

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And we're able to, in real time
in our intraoperative MRI suite,

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heat that tissue up with our laser while
making sure that we're not heating any

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normal tissue and destroy that tissue.

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And then we take that laser out and the
patient's usually go home the next day.

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So those are all really, uh, exciting
piece of technology. And now with our new,

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uh, intraoperative mri, the, the picture
is quite a bit better than what's,

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what's, you know, quote
unquote the center of care too,

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because with intraoperative
MRIs or any kind of mri,

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the size of the magnet really matters, uh,

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as far as what kind of a
quality of the picture.

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And so usually 1.5 T is a
center of care for magnet,

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and ours is three T. So
really the picture we,

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we are getting with our new
interrupter MRI is like, uh, you know,

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looking at watching a football
game on high def versus, uh,

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an analog catheter ray tube. So
it's really, uh, a beautiful thing.

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Yeah, I appreciate the analogy there.

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I break it down in layman's terms
for people like me. Um, really,

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really exciting. Thank you so much. Uh,
I wanted to wrap up one last question.

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I know Dr. Kire,

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you've been medical direct medical
director of the neurosurgery program at

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Children's Minnesota, like you said,
for the last year or so, uh, for,

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for other emerging leaders stepping
into similar medical director roles like

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yourself, whether in an orthopedics,
spine, neurosurgery program,

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what are the keys to really building a,

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a comprehensive multidisciplinary
team within that specialty?

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Is there anything that
you'd recommend that they,

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they kind of to kickstart that journey?

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Well, I, I think, I think you, uh,

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you mentioned that you
hit the nail on the head.

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You really have to treat a patient
in a comprehensive fashion.

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So you really have to
collaborate, uh, with,

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with other teams and other experts in
your area and to make sure you've got the

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right people. I think that's the first
step. And then once you have that,

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then you have to look at what you have
as far as equipment to be able to offer

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your patients the best care, uh,
that you can as an institution.

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And so a lot of, uh, a lot of healthcare
systems, they have fantastic people,

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but they're really siloed. So I think
collaborative care, like in the,

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in the care of patients
with, uh, spinal cord tumors,

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having a neuro oncologist and
neuroradiologists, neuropathologists,

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neurosurgeon, neurologists on board,

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discussing each patient to be able
to custom tailor, uh, you know,

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their care and treatment plan for them
and care. And in terms of epilepsy,

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having a, uh, epilepsy center where
you have epileptologist, neurosurgeon,

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neuroradiologist, neuropsychologist, uh,

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and people that really can
discuss those patients and again,

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be able to custom tailor the,
their treatment plan and,

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and come up with the best outcome.
You, you couple that with, uh,

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cutting technology and you really can
offer patients the best care that you can.

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Another key to success in building a
successful program is that a lot of

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healthcare systems in the United
States are non-for-profits.

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So Children's Minnesota is a
non-for-profit hospital system.

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And really to be able to have access
to this technology and innovation,

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all these costs, quite a bit of money,

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money that a hospital and non-for-profit
hospital doesn't have on its own.

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And so another key to, uh,
building a successful program,

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I would say for emergence,

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emerging leaders would be keeping a good
line of communication open with your

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board and also your community,

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and let your community know
what you're doing and, and,

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and what grade work you're doing so that
they can be engaged in your hospital

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and in taking care of your patients. And,

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and a lot of times communities are very
generous and they're happy to donate if

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they know that's going
to good cause to, to, uh,

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bring better outcomes for patients.

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Nice. I think some excellent, uh,

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advice for emerging leaders there to
wrap up on. Uh, Dr. Kire, thank you so,

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so much for, for taking the
time to join the Becker podcast.

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I have certainly learned a lot, a lot
of exciting things certainly happening,

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uh, within the neurosurgery program
at Children's Minnesota. Uh,

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look forward to connecting
with you again down the line.

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Thanks for the opportunity.
Very nice talking to you.