Even superheroes don’t always win the first round in a fight.
But, 7-year-old Gavin Pierson came out ahead this week. Gavin, who has a brain tumor that he nicknamed Joe Bully, underwent Visualase MRI-guided laser surgery on Oct. 29. He is the first person in the country with a mature teratoma to have the surgery.
Nothing has come easy for Gavin, who has endured five craniotomies, chemotherapy and countless drugs since his diagnosis a year and a half ago. That included the MRI-guided laser surgery, in which it took two attempts before his tumor could be ablated. But, Gavin had an army on his side. Led by Dr. Joseph Petronio, a team of neurosurgeons, radiologists, nurses and our partners set out to fight Joe Bully.
Here’s a synopsis of how Joe Bully went down:
At approximately 8:09 a.m., Gavin was transported to the OR for sedation.
Bone-in fiducials were placed at approximately 8:46 a.m. A fiducial is an object placed in the field of view of an imaging system and appears in the image produced to provide a point of reference.
Gavin was taken to CT for scans at about 9:05 a.m. and returned to the OR around 9:30 a.m.
With the help of Dr. Richard Patterson, Dr. Petronio began mapping out a plan for placing small flexible laser probes to the intended target area – the tumor.
Around 10:26 a.m., Dr. Petronio created two burr holes before placing the probes.
About 30 minutes later, Dr. Petronio removed Gavin’s shunt, which was unrelated to the Visualase procedure.
Gavin was taken around 11:18 a.m. to MRI for additional scans. The MRI allows the physician to precisely monitor treatment using special Visualase software.
However, Gavin’s tumor deflected the probes. Ablation was halted.
The probes were removed, and skin fiducials were placed to for additional scans.
Gavin’s determined team took him back to the OR, where Dr. Petronio mapped out a new plan and entry point for another probe.
At approximately 3:39 p.m., Gavin was wheeled back to MRI.
About 45 minutes later, the team started ablation, in which laser light heated and destroyed the target area. Temperature maps showed the team the extent of the tissue being destroyed.
Pow! A significant portion of the tumor – an area that Dr. Petronio was unable to reach during craniotomies – was incinerated! Equally significant was the way the lesion responded to Visualase. Because of the type of tumor and its biology (relatively low blood perfusion), the laser distributed the heat extensively and the thermal distribution corresponded nicely to the shape of the tumor and the tumor/normal brain interface, Dr. Petronio said.
“To me, this represents perhaps the most significant development in Gavin’s case, in that we found, perhaps for the first time, that ‘Joe Bully’ has a weak spot, or an Achilles’ heel,” Petronio said. “I’m really encouraged about what we will be able to do with future ablations.”
By 3 p.m. on Oct. 30, Gavin was on his way home – less than 24 hours after surgery.
If you haven’t been following Gavin’s story, catch up here.