# AccuGyd: Accelerated Guidance for Accurate MRI-Guided Neurosurgery

> **NIH NIH R44** · IMGGYD LLC · 2024 · $886,703

## Abstract

Abstract: Advanced neurosurgery techniques are increasingly delivering life-changing therapies, and even
cures, for a range of serious and life-threatening conditions. Neurosurgeons using minimally invasive surgery
(MIS) techniques with MRI and CT guidance can ablate epileptic foci and place FDA-approved devices such as
deep brain stimulators (DBS), all with sub-mm accuracy. Intraoperative imaging is guiding intraparenchymal
administration of gene therapies in NIH trials of brain cancer and PD treatments. Cures for rare pediatric genetic
diseases are on the cusp of using guided gene therapies. However, effective placement of these tiny devices
and leads, as well as effective drug delivery, are held back by significant technical challenges.
Neurosurgeons typically use MRI for pre-surgical planning and post-surgery validation. They clearly see it as
enabling minimally invasive ablations for epilepsy or recurring tumors. But despite MRI’s transformative
intraoperative abilities, it is seen as too complex and time-consuming by many neurosurgeons with already
pressing surgical schedules. Leading neurosurgeons cite the lengthy workflow for catheter guidance within the
scanner bore as a barrier to MRI-guided neurointerventions. The leading MRI trajectory guide requires multiple
complex steps. Aligning the trajectory to hit a brain target requires multiple iterations of MRI acquisitions and
device manipulations, requiring 6-14 highly trained personnel per procedure. The time to achieve alignment is
quite variable, so the workflow is unpredictable.
Our Phase I project demonstrated the innovation of a quantized, indexed device guide, which we term AccuGyd.
The main innovation of AccuGyd is that by using a discrete indexing system, a brain location can be targeted
with greater accuracy than is needed. This opens the door to design a much smaller and less complex device.
AccuGyd requires only one MRI acquisition to determine its 3D orientation. Software uses that orientation and
the desired brain target point to determine which of AccuGyd’s ~20,000 supported indexed trajectories is closest
to the brain target point. Without further imaging, the software calculates which of several different cassettes,
each with a guide shaft at a different angle, should be inserted into the AccuGyd base. The software outputs a
second parameter, an indexed rotation, that aligns the guide with excellent accuracy for device positioning (<0.5
mm at 12 cm depth). Our Phase I innovation proved a brain guide could be rapidly aligned with only one image
acquisition. Phase II innovation centers on opportunities discovered in formal customer interviews: 1) radically
simplify fixation of the guide relative to the skull; 2) automate computation of AccuGyd’s 3D orientation; and 3)
create CT compatibility. The Phase II will culminate in an efficient surgical workflow and regulatory planning for
FDA 510(k) application. AccuGyd can significantly lower the barrier for image guided procedures...

## Key facts

- **NIH application ID:** 11007367
- **Project number:** 2R44NS122713-02
- **Recipient organization:** IMGGYD LLC
- **Principal Investigator:** TERRENCE R OAKES
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $886,703
- **Award type:** 2
- **Project period:** 2024-08-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11007367

## Citation

> US National Institutes of Health, RePORTER application 11007367, AccuGyd: Accelerated Guidance for Accurate MRI-Guided Neurosurgery (2R44NS122713-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11007367. Licensed CC0.

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