The Brain Tumor Program


The brain is the body's most complex organ, so it's no overstatement that treatment for brain tumors requires the latest technology skillfully used by a highly experienced medical team. The Brain Tumor Program offers a comprehensive, multi-program, neurosurgical center providing the most advanced care for brain tumors available in New Jersey.

The state-of-the-art modalities used at the Brain Tumor Program-such as intraoperative MRI; functional image-guided surgery; frameless stereotactic radiosurgery; frameless stereotactic radiation therapy; and leading-edge neuroendoscopic techniques-provide minimal invasion and maximum precision in the treatment of brain tumors.

Additionally, the Program is:

. affiliated with the New Jersey Medical School, making it the only academically based brain tumor surgery program in the state.

. a partner in training neurosurgeons of the future through its association with New Jersey Medical School's neurosurgical residency program.

A Nationally Recognized Pediatric Neurosurgery Center

The Program's Center for Pediatric Neurosurgery, under the leadership of Dr. Peter Carmel, is widely recognized as one of the nation's premier pediatric neurosurgical programs. It continually pioneers new techniques and technologies for the treatment of brain tumors in children. The Center recently reported the highest number of successfully treated craniopharyngiomas-brain tumors located near the pituitary gland that usually affect infants and children-in North America. Dr. Carmel's team was the first in the state to place programmable shunts in children, which allows for the control of intracranial pressure without an invasive procedure.

The Center's multidisciplinary approach uses the skills and experience of university-level specialists and subspecialists in Pediatrics, Neurology, Otolaryngology, Emergency Medicine, Plastic Surgery, Oncology, and Cranial and Oral Maxillofacial Reconstruction, as well as General and Family Medicine. And University Hospital is also the only facility in the state with its own dedicated pediatric neurosurgical intensive care unit, the Whitney Houston Pediatric Special Care Unit.

Center for Image-Guided Neurosurgery

Under the leadership of Dr. Michael Schulder, the Center for Image-Guided Neurosurgery specializes in advanced, computer-assisted, minimally invasive surgery, radiosurgery, and single- dose and fractionated radiation therapy for the treatment of brain tumors.

At present, the Program is pioneering what is expected to be one of the most significant advances in image-guided neurosurgery: the use of intraoperative MRI scans to confirm the location of lesions, plan and reconfirm the optimal surgical approach, and verify complete lesion removal prior to closure. University Hospital is the second hospitals in the world to utilize a compact OR-based MRI system to obtain the most precise image possible to minimize the risk of harming healthy and/or eloquent areas of the brain. MRI images obtained during surgery provides the surgical team with a navigation route that adjusts for brain shift during the procedure. Furthermore, it provides the surgeon with the opportunity to safely expand the operative area if necessary for maximum lesion removal.

The Center offers the full range of stereotactic techniques. For frameless stereotactic procedures, the Center uses the Stealth® surgical navigation system, which features a series of infrared transmitters that provide interactive, intraoperative guidance.

An experienced, multidisciplinary team consisting of a neurosurgeon, radiation oncologist, physicist, and neuroradiologist cooperatively plans and executes treatment approaches for stereotactic radiosurgery and radiation therapy. The team utilizes CT scans, MRI, and 3-dimensional simulations for treatment planning.

The Center pioneered the use of Functional Image-Guided Surgery (FIGS). A functional MRI maps "eloquent" areas of the brain (such as those controlling movement, speech, etc.). This information, once entered into the guidance software, provides the neurosurgical team with additional reference for precise navigation and excision.

Next-Generation Research & Clinical Trials

The Brain Tumor Program is an active participant in research studies and national clinical trials, and as such, is at the forefront of some of the most exciting developments in the treatment of brain tumors. Currently, the Program is the principal investigator for a multi-center study involving the combined approach use of Gliadel®, (a chemotherapy wafer that is implanted at the tumor site), radiation therapy, and radiosurgery for patients with newly diagnosed malignant gliomas. Previously, the Program participated in a national trial involving Gliadel and its application for recurrent malignant gliomas.

The Program was also part of a national, multi-center study run by Clarus Medical Systems of Minneapolis, an industry leader, exploring next-generation neuroendoscopic techniques. Additionally, the Brain Tumor Program participated in a clinical trial involving programmable shunt technology for hydrocephalus, which makes it possible to adjust shunt valve pressure in the office, without an invasive procedure.

New Jersey's Primary Resource for Brain Disease and Injury

University Hospital and the New Jersey Medical School are New Jersey's primary resource and focus of activity for the most advanced and comprehensive research, diagnosis, and treatment of the full range of brain and spinal cord injuries and disease. University Hospital is the state-designated Level I Trauma Center for New Jersey, making it the primary resource for adult and pediatric brain injury in the state. It is one of 18 federally designated model sites nationwide for the treatment of spinal cord injuries.

Centers of Excellence Environment & Faculty

The Brain Tumor Program operates in a university-level, "centers of excellence" environment, bringing together topflight clinicians and basic science researchers from a variety of subspecialties, including Neurosurgery, Neurology, Orthopedics, Ophthalmology, Pediatrics, Radiology, Oncology and Cranial and Oral Maxillofacial Reconstruction. In addition to the Brain Tumor Program, other brain and spinal cord programs include: the Neuro-Trauma Center; the Skull Base Surgery Center; the Cerebrovascular Surgery Center; the Spine Center; and the Peripheral Nerve Center.