Laser Interstitial Thermal Therapy in Neurosurgery (2024)

Related Papers

Journal of neurosurgery

Complication avoidance in laser interstitial thermal therapy: lessons learned

2016 •

Michael SCHULDER

OBJECTIVE Complications of laser interstitial thermal therapy (LITT) are underreported. The authors discuss how they have modified their technique in the context of technical and treatment-related adverse events. METHODS The Medtronic Visualase system was used in 49 procedures in 46 patients. Between 1 and 3 cooling catheters/laser fiber assemblies were placed, for a total of 62 implanted devices. Devices were placed using frameless stereotaxy (n = 3), frameless stereotaxy with intraoperative MRI (iMRI) (n = 9), iMRI under direct vision (n = 2), MRI alone (n = 1), or frame-based (n = 47) techniques. LITT was performed while monitoring MRI thermometry. Indications included brain tumors (n = 12), radiation necrosis (n = 2), filum terminale ependymoma (n = 1), mesial temporal lobe epilepsy (n = 21), corpus callosotomy for bifrontal epilepsy (n = 3), cavernoma (n = 1), and hypothalamic hamartomas (n = 6). RESULTS Some form of adverse event occurred in 11 (22.4%) of 49 procedures. These ...

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Neurosurgery

Journal club: Magnetic resonance imaging-guided focused laser interstitial thermal therapy for intracranial lesions: single-institution series

2014 •

Namath Hussain

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Cancer Imaging

Neurosurgical applications of MRI guided laser interstitial thermal therapy (LITT)

Dhiego Bastos

MRI-guided laser interstitial thermal therapy (LITT) is the selective ablation of a lesion or a tissue using heat emitted from a laser device. LITT is considered a less invasive technique compared to open surgery that provides a nonsurgical solution for patients who cannot tolerate surgery. Although laser ablation has been used to treat brain lesions for decades, recent advances in MRI have improved lesion targeting and enabled real-time accurate monitoring of the thermal ablation process. These advances have led to a plethora of research involving the technique, safety, and potential applications of LITT. LITT is a minimally invasive treatment modality that shows promising results and is associated with decreased morbidity. It has various applications, such as treatment of glioma, brain metastases, radiation necrosis, and epilepsy. It can provide a safer alternative treatment option for patients in whom the lesion is not accessible by surgery, who are not surgical candidates, or in...

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Neurosurgical Focus

Intracerebral laser interstitial thermal therapy followed by tumor resection to minimize cerebral edema

2016 •

Paul Camarata

OBJECTIVE Laser interstitial thermal therapy (LITT) is used in numerous neurosurgical applications including lesions that are difficult to resect. Its rising popularity can be attributed to its minimally invasive approach, improved accuracy with real-time MRI guidance and thermography, and enhanced control of the laser. One of its drawbacks is the possible development of significant edema, which contributes to extended hospital stays and often necessitates hyperosmolar or steroid therapy. Here, the authors discuss the use of minimally invasive craniotomy to resect tissue ablated with LITT in attempt to minimize cerebral edema. METHODS Five patients with glioblastoma multiforme prospectively underwent LITT followed by resection. The LITT was performed with the aid of an MR-compatible skull-mounted frame in the MRI suite. Ablated tumor was then resected via small craniotomy by using the NICO Myriad system or cavitron ultrasonic surgical aspirator. Postoperative management involved dex...

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Interventional Urology

Laser Interstitial Thermal Therapy

2016 •

Michael Ivan

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International Journal of Hyperthermia

The use of laser interstitial thermal therapy in the treatment of brain metastases: a literature review

Dhiego Bastos

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Operative Neurosurgery

Laser Interstitial Thermal Therapy in the Treatment of Thalamic Brain Tumors: A Case Series

alireza mohammadi

BACKGROUND Surgical options for patients with thalamic brain tumors are limited. Traditional surgical resection is associated with a high degree of morbidity and mortality. Laser interstitial thermal therapy (LITT) utilizes a stereotactically placed laser probe to induce thermal damage to tumor tissue. LITT provides a surgical cytoreduction option for this challenging patient population. We present our experience treating thalamic brain tumors with LITT. OBJECTIVE To describe our experience and outcomes using LITT on patients with thalamic tumors. METHODS We analyzed 13 consecutive patients treated with LITT for thalamic tumors from 2012 to 2017. Radiographic, clinical characteristics, and outcome data were collected via review of electronic medical records RESULTS Thirteen patients with thalamic tumors were treated with LITT. Most had high-grade gliomas, including glioblastoma (n = 9) and anaplastic astrocytoma (n = 2). The average tumor volume was 12.0 cc and shrank by 42.9% at 3 ...

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Journal of Neuro-Oncology

Laser interstitial thermotherapy (LITT) for the treatment of tumors of the brain and spine: a brief review

2021 •

Theresa Elder

Introduction Laser Interstitial Thermotherapy (LITT; also known as Stereotactic Laser Ablation or SLA), is a minimally invasive treatment modality that has recently gained prominence in the treatment of malignant primary and metastatic brain tumors and radiation necrosis and studies for treatment of spinal metastasis has recently been reported. Methods Here we provide a brief literature review of the various contemporary uses for LITT and their reported outcomes. Results Historically, the primary indication for LITT has been for the treatment of recurrent glioblastoma (GBM). However, indications have continued to expand and now include gliomas of different grades, brain metastasis (BM), radiation necrosis (RN), other types of brain tumors as well as spine metastasis. LITT is emerging as a safe, reliable, minimally invasive clinical approach, particularly for deep seated, focal malignant brain tumors and radiation necrosis. The role of LITT for treatment of other types of tumors of t...

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Oncology

MRI-Guided Laser Interstitial Thermal Therapy in Neuro-Oncology: A Review of Its Current Clinical Applications

2014 •

Sara Hartnett

Magnetic resonance imaging-guided laser interstitial thermal therapy (LITT) is a minimally invasive treatment modality with recent increasing use to ablate brain tumors. When originally introduced in the late 1980s, the inability to precisely monitor and control the thermal ablation limited the adoption of LITT in neuro-oncology. Popularized as a means of destroying malignant hepatic and renal metastatic lesions percutaneously, its selective thermal tumor destruction and preservation of adjacent normal tissues have since been optimized for use in neuro-oncology. The progress made in real-time thermal imaging with MRI, laser probe design, and computer algorithms predictive of tissue kill has led to the resurgence of interest in LITT as a means to ablate brain tumors. Current LITT systems offer a surgical option for some inoperable brain tumors. We discuss the origins, principles, current indications, and future directions of MRI-guided LITT in neuro-oncology.

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Cureus

A Single-Institution Retrospective Study of Patients Treated With Laser-Interstitial Thermal Therapy for Radiation Necrosis of the Brain

2021 •

Stephen Tatter

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Laser Interstitial Thermal Therapy in Neurosurgery (2024)

FAQs

What is the success rate of laser interstitial thermal therapy? ›

For some patients, LiTT may be an effective alternative to surgery in removing the dead tissue. Using LiTT for radiation necrosis was first reported by U.S. doctors in 2012. Since then, data show that about 75% of people treated with LiTT have had relief from radiation necrosis symptoms.

Is LiTT FDA approved? ›

Laser Interstitial Thermal Therapy (LITT) is FDA approved for soft tissue ablation and is increasingly utilized to treat epilepsy, especially when seizures arise from deeper structures such as the hippocampus, amygdala, or discrete dysplastic tissue, such as hypothalamic hamartomas.

How much does LiTT surgery cost? ›

Mean hospital costs of admission for single-trajectory LITT ($104,929.88) were significantly less than for ATL ($134,980.04) (P = 0.001). In addition, length of stay, anesthesia costs, operative room costs, and postoperative hospitalization costs were all significantly lower in LITT.

What are the side effects of brain laser ablation? ›

Reported complications are rare. They may include narrowing of a person's vision, bleeding in the brain, or nerve damage. All of these are also rarely seen with open surgery.

What are 2 drawbacks of laser therapy? ›

Laser therapy can result in misdirected or excessively intense burns, bleeding from the choriocapillaris, damage to macular and other ocular structures, and breaks in Bruch's membrane.

How quickly does laser therapy work? ›

One of the benefits of laser treatment for arthritis is there are no side effects or downtime. However, it can take a few treatments before you see results. Expect to see results after about four weeks, including decreased pain and morning stiffness.

Can a brain tumor be cured by laser treatment? ›

Laser ablation may be a good choice, and even a cure, for children with brain tumors or abnormal tissue that causes seizures. If the damaged area is deep in the brain, these children may have no other treatment options.

What is the difference between RF ablation and Litt? ›

Generally, LITT offers superior precision and a more predictable ablation volume than traditional radiofrequency ablation and a smaller incision and reduced postoperative discomfort and length of stay by comparison to open surgery.

What are the complications of Litt? ›

Complications of LITT include hemorrhage, brain edema, thermal injury of adjacent structures, and treatment failure.

How long does laser brain surgery take? ›

The procedure takes approximately four hours and patients are usually discharged from the hospital the next day.

Is brain ablation still used today? ›

Currently, the four main ablative techniques that are used for ablative brain surgery are radiofrequency thermoablation, stereotactic radiosurgery, laser interstitial thermal therapy and magnetic resonance-guided focused ultrasound thermal ablation.

What are the indications for the Litt procedure? ›

The current indications are brain tumors, epileptic lesions, and spinal tumors. The primary considerations for the LITT procedure are the heterogeneity of brain tumors, regional blood flow to brain tissue, and MRT, which may not be consistent with heat transfer, causing the potential for normal brain tissue injury.

How much does a laser brain ablation cost? ›

Laser ablation can cost upwards of $40,000 per procedure.

Is laser therapy safe for brain? ›

The treatment is non-invasive and adverse side effects are rare, making cold laser therapy a favorable alternative to other types of treatments. Different frequency and wavelength parameters are used for different treatments.

Is laser ablation expensive? ›

Endovenous laser ablation can be expensive, about $2-3k per leg/treatment session. Insurance companies may cover endovenous laser ablation total costs if they are deemed medically necessary or covered procedures under your specific individual policy.

What is the success rate of laser DCR? ›

The success rates of these procedures as reported in the literature vary from 80–95%, 63.3–90.1%, and 57–100%, respectively. [1-3] Although transcutaneous external dacryocystorhinostomy (ExDCR) is still regarded as the gold standard among all, a few studies have shown superior results with the endonasal approach.

What is the success rate of LPI surgery? ›

Iridotomy closure and necessity for repeat LPI

Closure of the iridotomy has been reported to occur at a rate between 1% at 2 weeks to 20% within the first 6 months after the procedure, but the vast majority of iridotomies may remain patent years after the procedure.

Is laser therapy really effective? ›

While you may think that it is far fetched, you can achieve pain relief with light energy from a laser. Laser light energy can stimulate nerve regeneration, relax muscles, accelerate healing in damaged tissues, and reduce inflammation and pain.

What are the disadvantages of laser therapy in periodontics? ›

Potential for Thermal Damage: If not used correctly, the laser can cause thermal damage to surrounding tissues, leading to complications. Decreased Results: In our experience, laser periodontal therapy doesn't have near the same results as flapping the tissue back and doing it manually.

References

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