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August 2009 Issue

Stacy Buzzard underwent a complicated surgery to remove a malignant brain tumor the size of a fist. A day after surgery, she was walking the hallways at University Hospital and even took a shower unassisted.
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Stacy's Story: Advanced Imaging Technology Saves a Life

By Cindy Starr
Published August 2009

In the eyes of John Tew, MD, Stacy Buzzard’s journey is a story of hope and something more.

“Her story marks the culmination of one of the most important developments in brain tumor surgery in the last 100 years,” says Tew, a neurosurgeon with the Mayfield Clinic, clinical director of the UC Neuroscience Institute and professor of neurosurgery at UC.  

That is no small statement, coming from a man who has operated on an estimated 12,000 patients over a period of 45 years.

In February 2009, after specialists at two other brain tumor centers said they could not safely operate on Buzzard, Tew successfully removed a fist-sized tumor from her brain at University Hospital.

The operation, which involved eight members of the Brain Tumor Center at the UC Neuroscience Institute, was performed with the help of a new imaging technology that fused four separate imaging techniques. The data was then installed into a surgical guidance computer whose function is similar to a global positioning system.

By revealing the tumor’s relationship to all of the functional centers, electrical pathways and arteries and veins in Buzzard’s brain, the technology enabled Tew and his team to map out a safe pathway to Buzzard’s tumor.

Tew and his team had previously used the fusion of magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and diffusion tensor imaging (DTI) as a guide to stereotactic surgery.

“And now, with Stacy’s case, we’ve added a map of the blood vessels through computed tomography angiography (CTA),” Tew says. “The ability to completely map the brain and to understand—before we operate—where the tumor lies in relation to important structures is a milestone in our use of digital computer technology to heighten patient safety during complex brain tumor surgery.”

Image processing and fusion of the MRI, fMRI, DTI and CTA images was performed by  James Leach, MD, associate professor of neuroradiology at UC, Cincinnati Children’s Hospital Medical Center and UC Neuroscience Institute, using the BrainLab iPlan system.

Assisted by the three-dimensional brain-mapping, Tew was able to navigate a trajectory through Buzzard’s brain and remove 90 percent of the malignant tumor, an anaplastic astrocytoma, without harming the healthy brain tissue—including the deep nerve-fiber tracts—that surrounded it. Buzzard was talking normally right after surgery, and she was walking the halls and able to take a shower without assistance one day after surgery.  

“I feel better now than I’ve felt in years,” Buzzard says. “When we were sitting in Dr. Tew’s office that first day and he was talking to us about the surgery, he said there were two main risks: I could be paralyzed on my left side and I could die. And, I thought at the time, I’m pretty much not living a life right now, so I might as well take that risk. But I don’t think anyone expected me to recover the way I have. And I certainly didn’t expect it either.”

Concurrently, Buzzard is undergoing treatment with a chemotherapy agent. If the radiotherapy and chemotherapy are not effective, she could face another operation.

Buzzard was working as an administrative assistant and raising two children in Ft. Wayne, Ind., when she first became ill.

“One morning in the summer of 2006 I didn’t feel good,” Buzzard says. “I was dizzy and nauseated. I went back to my room to lie down. My 17-year-old son woke up for school and found me having a grand mal seizure. He called 911. No one knew why I was having the seizure.”

An MRI revealed a tumor 2.5 centimeters in diameter.

“They thought it was a slow-growing tumor that had been there a long time,” Buzzard recalls. “They did a biopsy and gave me the impression that I didn’t have to worry. They thought if they removed it I would be paralyzed on my left side. They prescribed anti-seizure medications and told me to get an MRI once a year. They said it was benign, but they said we should keep an eye on it.”

A follow-up MRI in February 2007 showed no change.

Buzzard says that, in retrospect, she and her husband, Jeff, relaxed too soon. “We got a false sense of complacency and had no additional MRIs. We were not expecting any more problems.”

But on Mother’s Day 2008 Buzzard had another seizure, and five months later she had another MRI that revealed the tumor had mushroomed from 2.5 centimeters to 7. Because of the tumor’s size, two prominent clinics declined to accept her as a patient.

In the days following her surgery with Tew and with 52 staples in her head and no hair, Buzzard had many tearful moments.

But she amazed everyone associated with her care with her almost instant recovery. She was not merely alive: she was breathing, thinking, conversing and moving. During her second day in intensive care, Jeff asked Tew what he thought of her recovery.

Tew put his arms around Jeff’s shoulders and said, “nothing short of a miracle.” 

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