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The Warsaw Voice » The Polish Science Voice » November 28, 2013
Neuroscience
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Mapping out the Brain
November 28, 2013   
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Prof. Wiesław L. Nowiński, a Singapore-based Polish researcher who has developed a range of three-dimensional atlases of the human brain that help doctors better diagnose brain diseases and plan neurosurgical procedures, talks to Danuta K. Gruszczyńska.
Your three-dimensional, highly accurate computerized atlases of the human brain can help doctors in making a diagnosis and in planning treatment. Can you tell us in more detail how they come in useful?

At the moment we have two generations of atlases. The newest generation, based on scans of my own brain, comprises The Human Brain in 1492 Pieces and The Human Brain in 1969 Pieces. We have just finished the second version of the latter, expanded to include the structures of the head. For me, these two dates [1492 and 1969, the discovery of America and man’s first flight to the Moon respectively] are symbolic “journeys into the human brain.” It’s like discovering a new world in neuroanatomy and crossing a new frontier in neuroscience.

We have created a total of 31 atlases, including one for the World Stroke Organization and two for the world Society for Brain Mapping and Therapeutics. We have also produced an atlas for the general public and an atlas of neurological disorders, for which in 2012 we won first prize from the American Society of Neuroradiology.

And we started out with just a vascular atlas that was produced using equipment for magnetic resonance imaging with a field intensity of 1.5 T (Tesla). In 2003 we got an award for it. This was when I started to look for more accurate and more powerful 3 T and 7 T scanners. Now I’m looking for a 9 T scanner. The higher the T number, the greater the resolution and the easier it is to see various brain structures.

A vascular atlas, an atlas of neurological disorders, now a stroke atlas—all these are all highly specialized products for neurologists, neurosurgeons and psychiatrists. Why the idea of an atlas for the general public?

I believe that every patient should have the opportunity to learn about their brain, so that in the event of illness they could make decisions about their future. If I were diagnosed with brain cancer, I’d like to know what the doctors want to cut out from my brain and what consequences this would have. I would like to be able to make the choice myself of whether if I prefer to live like a vegetable or live a shorter life to the fullest.

In 1994, when we started to create our digital atlases, I went to the John Hopkins Hospital in the hope that the experts there would tell me everything that I needed. Unfortunately, no one had time for me for six weeks. So I went back thinking that if I wanted to produce a digital atlas of the brain, I had to do it all by myself. I learned anatomy, physiology, neurology, neuroradiology and neurosurgery. I built a bridge between medicine, science and information technology. By creating the atlases, I transform the image of the entire brain into a three-dimensional model. I can look inside the brain, make cuts and open it in any place. I can show the vessels, nerves, connections, add or remove individual structures.

Your newest project is a stroke atlas...

Society is getting older, and stroke affecting the brain is one of the leading causes of death and the main cause of permanent disability. Quick diagnosis is very important, identifying the area and scope of stroke risk. Everyone knows that time is the most critical factor in the treatment of stroke. Within one minute 1.9 million brain cells die. We use several different atlases, including a probabilistic atlas for making predictions. The atlas makes it possible to quickly locate the site affected by stroke. And treatment can be undertaken within 3-4.5 hours. In the case of an ordinary CT scan, the ischemic site may not be visible for a long time. The effect becomes visible 24 hours after a stroke when it’s too late for treatment—a huge stroke, but it’s too late. Our system will confirm what’s happened very early on, and the patient’s life can be saved. We have already examined 600 cases and identified the characteristics and parameters.

What about hemorrhagic stroke?
The approach these days is this: a hole is drilled in the skull to remove the clot. Our system scans, examines and measures the volume and builds three-dimensional models of the clot. This makes it possible to precisely insert a catheter and deliver a drug to dissolve the clot. Without the trepanation procedure, of course.
But we have an even newer project, a stroke atlas that correlates a vascular disorder such as stenosis, embolism or aneurysm, with the dysfunction resulting from these. This atlas has been expanded to include the pathology of local anatomy and cranial nerves. Called an atlas of neurological disorders, it has been adapted for use on an iPad. It will soon be made available to doctors, nurses and medical students.

Factfile
Prof. Wiesław L. Nowiński has lived and worked in Singapore since 1991, where he is the chief scientist and director of the Biomedical Imaging Laboratory run by the Singaporean Agency for Science, Technology and Research established by that country’s Ministry of Trade and Industry in 1991. He has authored over 500 research publications and filed 51 patent applications, securing 30 patents, including 15 in the United States. He has spun off four hi-tech companies from his lab.
Nowiński has a list of 39 awards to his name, including the Magna cum Laude from the Radiology Society of North America (RSNA)—a major award in the radiology community—and the Pioneer of Medicine Award from the Society for Brain Mapping and Therapeutics (SBMT), granted in 2013.
In 2012, he was named an “Outstanding Pole” in the Teraz Polska (Poland Now) competition held under the auspices of the Polish president.
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