Brains leave little room for error. Encephalitis, cancer, and other causes of dangerous brain tissue swelling can quickly derail the nervous system while diagnostic difficulties can send treatment in the wrong direction. Now veterinarians at the Cornell University Hospital for Animals plan to change these prospects for dogs suspected to be suffering from encephalitis using a new computer-guided brain biopsy device with unprecedented potential for safe and precise diagnosis.
Young toy and small-breed dogs are especially vulnerable to encephalitis, brain inflammation that causes symptoms from circling, stumbling, personality changes, and blindness to seizures, coma, and death. Many things can cause it, including a slew of non-infectious disorders. These are clumped together under one imprecise presumptive diagnosis because there is no reliable way to definitively diagnose them safely in living dogs. Current diagnostic methods, mostly imaging and cerebrospinal fluid taps, aren’t definitive and can lead to inaccurate presumptive diagnoses of disorders such as infections, autoimmune problems, and cancer. Misdiagnosis often leads to suboptimal treatment and shortened survival.
“We can do better,” said Dr. Sofia Cerda-Gonzalez, assistant professor of neurosurgery at Cornell’s College of Veterinary Medicine. “Encephalitis is one of the things we see most commonly in neurology, especially in small dogs. When a dog comes in with seizures you might see a lesion on an MRI but you still can’t prove anything. Brain biopsies obtained through a craniotomy give better diagnoses, but they’re invasive. Our new device merges both methods. We’re now using it in a clinical study we think will show that veterinarians can use this technology to definitively diagnose encephalitis’s causes more safely and reliably than ever before.”
The device, a frameless magnetic resonance imaging (MRI)-guided brain biopsy system called Brainsight®, is one of only five in the country. Such machines are the standard of care for diagnosing brain lesions without surgery in humans, but Brainsight is the only one designed specifically for veterinary use. Unlike any other machine, it allows pre-surgical planning through 3-D visualization of a biopsy needle’s intended trajectory through the brain. Its frameless setup gives unlimited choice of trajectory angles, and surgeons can watch the biopsy’s path through the brain real-time, while performing a biopsy. It is also the first machine that lets surgeons change trajectories during a biopsy if needed, to minimize potential neural damage.
“We attach the halo-like hardware to a dog’s head and the computer learns where the dog is in space, shows any brain lesions, and tells us where to go,” said Cerda-Gonzalez. “Its safety and biopsy precision in dogs has already been well established; we’ve used it in several cases and we’re conducting a clinical study to determine its ability to aid diagnoses. We’re glad to have this technology in our hospital and think it will transform the future of diagnosing canine encephalitis, giving a better outlook for the dogs it affects.”
Dr. Cerda-Gonzalez is recruiting dogs with encephalitis for a clinical trial to determine diagnostic accuracy. If interested, contact firstname.lastname@example.org