Laser Interstitial Thermal Therapy Case Series: Choosing the Correct Number of Fibers Depending on Lesion Size

Abstract BACKGROUND Laser interstitial thermal therapy (LITT) is being used for the treatment of recurrent glioblastoma multiforme (GBM). Lesions can be treated using 1 or multiple LITT fibers depending on the preference of surgeons. Usually, more fibers are needed for coverage of larger tumors. OBJECTIVE To investigate and analyze how tumor size affected the number of LITT fibers used. METHODS This is a retrospective review of patients undergoing treatment of recurrent GBM. Patients were treated with up to 4 LITT fibers for adequate tumor coverage. Patient demographics, tumor characteristics, length of stay, complications, and biopsy results were recorded. RESULTS A total of 43 cases were treated using LITT, and of these cases, 31 consisted of contiguous lesions. We used more fibers to treat larger tumor volumes. On average, for each 5 cc of tumor volume, a fiber was added for proper coverage (P = .554). Complications and length of stay were similar across the groups (P = .378, P = .941). CONCLUSION LITT can be used for the treatment of recurrent GBM. For each 5 cc of tumor volume, a LITT fiber can be added to the treatment plan.

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Corpus callosotomy via laser interstitial thermal therapy: a case series

Journal of Neurosurgery Pediatrics ◽

10.3171/2018.10.peds18368 ◽

2019 ◽

Vol 23 (3) ◽

pp. 303-307 ◽

Cited By ~ 8

Author(s):

Atilio E. Palma ◽

Robert T. Wicks ◽

Gautam Popli ◽

Daniel E. Couture

Keyword(s):

Surgical Procedure ◽

Case Series ◽

Thermal Therapy ◽

Corpus Callosotomy ◽

Surgical Ablation ◽

Laser Interstitial Thermal Therapy ◽

Generalized Seizures ◽

First Case ◽

Invasive Method ◽

Open Surgical Procedure

Corpus callosotomy has been used as a form of surgical palliation for patients suffering from medically refractory generalized seizures, including drop attacks. Callosotomy has traditionally been described as involving a craniotomy with microdissection. MR-guided laser interstitial thermal therapy (MRg-LITT) has recently been used as a minimally invasive method for performing surgical ablation of epileptogenic foci and corpus callosotomy. The authors present 3 cases in which MRg-LITT was used to perform a corpus callosotomy as part of a staged surgical procedure for a patient with multiple seizure types and in instances when further ablation of residual corpus callosum is necessary after a prior open surgical procedure. To the authors’ knowledge, this is the first case series of corpus callosotomy performed using the MRg-LITT system with a 3.3-year average follow-up. Although MRg-LITT is not expected to replace the traditional corpus callosotomy in all cases, it is a safe, effective, and durable alternative to the traditional open corpus callosotomy, particularly in the setting of a prior craniotomy.

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Magnetic resonance–guided laser interstitial thermal therapy for pediatric periventricular nodular heterotopia-related epilepsy

Journal of Neurosurgery Pediatrics ◽

10.3171/2021.5.peds21171 ◽

2021 ◽

pp. 1-6

Author(s):

Vijay M. Ravindra ◽

Sungho Lee ◽

David Gonda ◽

Ilana Patino ◽

Lucia Ruggieri ◽

...

Keyword(s):

Phase Ii ◽

Focal Epilepsy ◽

Surgical Techniques ◽

Case Series ◽

Median Number ◽

Thermal Therapy ◽

Invasive Approach ◽

Periventricular Nodular Heterotopia ◽

Laser Interstitial Thermal Therapy ◽

Nodular Heterotopia

OBJECTIVE Periventricular nodular heterotopia (PVNH) is a result of disrupted neuronal migration from the ventricular system and can be a rare cause of refractory focal epilepsy. The goal of this case series was to describe the treatment of pediatric PVNH-related epilepsy with MR-guided laser interstitial thermal ablation. METHODS Patients treated at a single institution with MR-guided laser interstitial thermal therapy (MRgLITT) for PVNH-related epilepsy were identified. Preoperative and postoperative seizure outcomes and procedural information were evaluated. RESULTS Five children with PVNH treated with MRgLITT were reviewed; 1 child was treated twice. Three patients were female; the median age was 10.9 years. Five of 6 treatments were preceded by stereoelectroencephalography phase II monitoring. Three children experienced unilateral PVNH, and 2 had bilateral seizures. The median number of seizures recorded during phase II monitoring was 2; the median number of ablation targets was 2 (range 1–4). All patients experienced a decrease in seizure frequency; 4 patients (80%) had an Engel class ≤ III at the last follow-up (range I–IV). One child experienced right hemianopia posttreatment. CONCLUSIONS This case series investigation has illustrated a novel, minimally invasive approach for treating pediatric PVNH-related epilepsy. Further study of this technique with comparison with other surgical techniques is warranted.

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SURG-05. LASER INTERSTITIAL THERMAL THERAPY FOR MELANOMA BRAIN METASTASIS: A CASE SERIES

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz014.140 ◽

2019 ◽

Vol 1 (Supplement_1) ◽

pp. i31-i31

Author(s):

Ali Palejwala ◽

Kyle O’Connor ◽

Chad Glenn ◽

Michael Sughrue

Keyword(s):

Malignant Melanoma ◽

Adjuvant Therapy ◽

Perioperative Complications ◽

Case Series ◽

Thermal Therapy ◽

Treatment Modalities ◽

Intracranial Metastasis ◽

Laser Interstitial Thermal Therapy ◽

Surgical Data ◽

Tumor Regrowth

Abstract Stereotactic radiosurgery (SRS) and whole brain radiation therapy (WBRT) have been established as non-invasive treatment modalities for intracranial metastasis from malignant melanoma, with SRS emerging as a safe and effective stand along therapy. However, either due to tumor regrowth or radiation necrosis, these radiation modalities can fail. MR-guided laser interstitial thermal therapy (LITT) has emerged as an option for these tumors. Clinical data for five patients at our institution was retrospectively reviewed. These were all the patients that had undergone LITT for intracranial metastatic melanoma after prior treatment failure that included a radiation modality. Demographics, prior treatments, surgical data, perioperative complications, adjuvant treatments, and follow imaging data were gathered. Of the five patients, one patient had received WBRT, three patients had received prior SRS to the area that underwent LITT, and one patient had a prior craniotomy with adjuvant SRS. Two of the tumors were located in the premotor area (frontal lobe), two tumors were located in the motor strip, and one tumor was located in the cerebellum. The average tumor volume was 4.32 cc (range 1.86 - 7.84 cc). Median time of hospital stay was 2 days (with a 2.6 day average). No perioperative complications were encountered. Three of the patients had received adjuvant therapy at our institution; these patients were not delayed in receiving adjuvant therapy. Of these three patients, only one patient had a BRAF mutation detected. Four patients received follow up imaging at our institution, with no patients demonstrating tumor regrowth in the site of LITT. Regrowth of intracranial metastasis of malignant melanoma is a known possibility of traditional radiation therapies. LITT should be considered as a safe, effective option for those that fail these traditional therapies, especially those located in areas difficult to access. The low complication rate allows patients to restart adjuvant therapies.

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

Operative Neurosurgery ◽

10.1093/ons/opaa206 ◽

2020 ◽

Author(s):

Roger Murayi ◽

Hamid Borghei-Razavi ◽

Gene H Barnett ◽

Alireza M Mohammadi

Keyword(s):

Brain Tumors ◽

Thermal Damage ◽

Case Series ◽

Outcome Data ◽

Thermal Therapy ◽

Treatment Modalities ◽

Intracerebral Hematoma ◽

Average Hospital ◽

Laser Interstitial Thermal Therapy ◽

Thalamic Tumors

Abstract 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 mo. The average hospital stay was 3.0 d. Median ablation coverage as calculated by thermal damage threshold (TDT) lines was 98% and 95% for yellow (>43°C for >2 min) or blue (>10 min), respectively. Median disease-specific progression-free survival calculated for 8 patients in our cohort was 6.1 mo (range: 1.1-15.1 mo). There were 6 patients with perioperative morbidity and 2 perioperative deaths because of intracerebral hematoma. CONCLUSION LITT is a feasible treatment for patients with thalamic tumors. LITT offers a cytoreduction option in this challenging population. Patient selection is key. Close attention should be paid to lesion size to minimize morbidity. More studies comparing treatment modalities of thalamic tumors need to be performed.

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Laser interstitial thermal therapy with intraoperative O-Arm® neuronavigation in malignant brain tumours – case series

Brain and Spine ◽

10.1016/j.bas.2021.100543 ◽

2021 ◽

Vol 1 ◽

pp. 100543

Author(s):

F. Vaz da Silva ◽

V. Sá Pinto ◽

S. Sousa ◽

C. Silva ◽

J. Reis ◽

...

Keyword(s):

Brain Tumours ◽

Case Series ◽

Thermal Therapy ◽

Laser Interstitial Thermal Therapy ◽

Malignant Brain Tumours

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MRI-guided laser interstitial thermal therapy for the treatment of low-grade gliomas in children: a case-series review, description of the current technologies and perspectives

Child s Nervous System ◽

10.1007/s00381-016-3193-0 ◽

2016 ◽

Vol 32 (10) ◽

pp. 1947-1956 ◽

Cited By ~ 21

Author(s):

Zulma Tovar-Spinoza ◽

Hoon Choi

Keyword(s):

Case Series ◽

Thermal Therapy ◽

Low Grade ◽

Low Grade Gliomas ◽

Laser Interstitial Thermal Therapy ◽

Mri Guided

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Laser Interstitial Thermal Therapy for Metastatic Melanoma After Failed Radiation Therapy: A Case Series

Operative Neurosurgery ◽

10.1093/ons/opaa012 ◽

2020 ◽

Vol 19 (2) ◽

pp. 126-133

Author(s):

Ali H Palejwala ◽

Kyle P O’Connor ◽

Camille K Milton ◽

Panayiotis E Pelargos ◽

Chad A Glenn ◽

...

Keyword(s):

Metastatic Melanoma ◽

Chart Review ◽

Radiation Treatment ◽

Treatment Options ◽

Case Series ◽

Retrospective Chart Review ◽

Thermal Therapy ◽

Complication Rates ◽

Laser Interstitial Thermal Therapy ◽

Hospital Stays

Abstract BACKGROUND Laser interstitial thermal therapy (LITT) is a growing technology to treat a variety of brain lesions. It offers an alternative to treatment options, such as open craniotomy and stereotactic radiosurgery. OBJECTIVE To analyze our experience using LITT for metastatic melanoma. METHODS This is a retrospective chart review of the patients from our institution. Our case series involves 5 patients who had previously failed radiation treatment. RESULTS Our patients have low complication rates and short hospital stays. Both are considerably lower when compared to the literature for metastatic melanoma. CONCLUSION LITT is a safe therapy, with few complications and short hospital stays.

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