preoperative imaging, or intraoperative XR/CT scanning), OSI is superior in terms of speed and patient safety. It generates accurate maps 100 times faster and eliminates the need for harmful radiation. The main goal of 3D navigation systems is to increase surgical precision. This is necessary, as surgical errors can cause both acute (e.g. hitting underlying blood vessels and nerves) and chronic (e.g. uneven biomechanical stress that cause eventual failure of hardware constructs) problems. As the 3D map is based on landmarks, changes in body position after calibration create inaccuracy. Hence, another aspect of my work is to quantify how and when inaccuracies in registration and navigation may occur, and educate surgeons on recognizing when the system can be inaccurate and how to fix these issues. What are the goals of analyzing the clinical and engineering accuracy of 3D navigation systems? Dr. Guha: The goal of my project, and overall mandate of Dr. Yangâ€™s laboratory, is to demonstrate that the novel navigation systems allow surgery to be done faster without sacrificing quality, accuracy, and patient recovery. As both Dr. Yang and I are neurosurgeons, we aspire to demonstrate the utility of these systems in brain and spinal surgeries, and increase the uptake in these fields. This can subsequently create opportunities for using these technologies in other fields, such as otolaryngology, orthopaedic, and extremity surgeries. What are some challenges that you have faced in your career as a researcher? Dr. Yang: As my laboratory specializes in the area between basic and clinical sciences, major obstacles include knowledge translation and implementation of novel technology into the system. Many factors must be overcome prior to success. These include convincing fellow surgeons to adapt your technology and overcome the associated learning curve. In addition, the end goal is to make my technology widely available to general public. However, this will involve an expensive commercialization process with medical device companies. It is very challenging to alleviate or lower the costs
of the commercialization process, such that the end product can still be afforded by patients from all socioeconomic backgrounds. Last but not least, it is essential to maintain a balance between having a strong belief in your work and being flexible and receptive to ideas from others on where your technology can be used. What are some of the future directions that your laboratory will be embarking on?
Daipayan Guha, MD
Dr. Yang: My laboratory combines the strengths of both engineers and clinician-scientists. While engineers can construct fantastic apparatuses, they may not be patient friendly. The opposite is true as well. As the principal investigator, I envision a grand plan where all navigation systems and modalities converge and work synergistically as one suite capable of tracking, navigating, and delivering therapy. As all navigation systems inherently carry flaws, we hope the systems can compensate for each other and ultimately increase ability to deliver and monitor therapy to ensure better patient outcomes.
PGY-4 Neurosurgery Resident, University of Toronto MSc Candidate, Institute of Medical Science, University of Toronto
What advice do you have to give to potential graduate students interested in your field of research, or research in general? Dr. Yang: For incoming graduate students interested in my field of research (or in joining my lab), it is essential to learn cooperation and collaboration skills. This is readily needed, as developing surgical navigation systems require experts from engineering and biological/medical backgrounds. Both groups of individuals need to combine their expertise in order to construct fantastic apparatuses that are patient friendly.
Victor Yang, MD, PhD Senior Scientist, Physical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute Neurosurgeon, Sunnybrook Health Sciences Centre Associate Professor, Institute of Medical Sciences, University of Toronto
Furthermore, prior to joining a laboratory, incoming graduate students should evaluate how the projects are coordinated. Often, the projects are either run individually by members or led by the entire team, which works in an organic manner. The former style is important for a graduate student to be successful and innovative, as a collaborative environment will allow a graduate student to not be bound by previous education. Instead, students will have freedom to explore new grounds and make greater impact.
Associate Professor of Surgery, Faculty of Medicine, University of Toronto Associate Professor, Electrical and Computer Engineering, University of Toronto Associate Professor, Electrical and Computer Engineering, Ryerson University Adjunct Professor, Medical Physics, Ryerson University Canada Research Chair in Biophotonics and Bioengineering, Tier 2
IMS MAGAZINE FALL 2016 ENGINEERING AND MEDICINE | 15
Photo by Drs. Yang and Guha
The fall issue of the IMS Magazine for 2016, with a feature on Engineering and Medicine.