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

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.

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

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.

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

Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S155-S155
Author(s):  
Roger Murayi ◽  
Hamid Borghei-Razavi ◽  
Gene H Barnett ◽  
Alireza M Mohammadi
Keyword(s):  
Brain Tumors ◽  
Case Series ◽  
Thermal Therapy ◽  
Laser Interstitial Thermal Therapy

scholarly journals Current applications and safety profile of laser interstitial thermal therapy in the pediatric population: a systematic review of the literature

2021 ◽  
pp. 1-8
Author(s):  
Sabrina Zeller ◽  
Joel Kaye ◽  
Fareed Jumah ◽  
Shilpa S. Mantri ◽  
Jamshaid Mir ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Tumors ◽  
Case Reports ◽  
Pediatric Population ◽  
Case Series ◽  
Thermal Therapy ◽  
Neurological Deficits ◽  
Attractive Alternative ◽  
Brain Surgery ◽  
Laser Interstitial Thermal Therapy

OBJECTIVE Laser interstitial thermal therapy (LITT) provides a minimally invasive alternative to open brain surgery, making it a powerful neurosurgical tool especially in pediatric patients. This systematic review aimed to highlight the indications and complications of LITT in the pediatric population. METHODS In line with the PRISMA guidelines, the authors conducted a systematic review to summarize the current applications and safety profiles of LITT in pediatrics. PubMed and Embase were searched for studies that reported the outcomes of LITT in patients < 21 years of age. Retrospective studies, case series, and case reports were included. Two authors independently screened the articles by title and abstract followed by full text. Relevant variables were extracted from studies that met final eligibility, and results were pooled using descriptive statistics. RESULTS The selection process captured 303 pediatric LITT procedures across 35 studies. Males comprised approximately 60% of the aggregate sample, with a mean age of 10.5 years (range 0.5–21 years). The LITT technologies used included Visualase (89%), NeuroBlate (9%), and Multilase 2100 (2%). The most common indication was treatment of seizures (86%), followed by brain tumors (16%). The mean follow-up duration was 15.6 months (range 1.3–48 months). The overall complication rate was 15.8%, which comprised transient neurological deficits, cognitive and electrolyte disturbances, hemorrhage, edema, and hydrocephalus. No deaths were reported. CONCLUSIONS As of now, LITT’s most common applications in pediatrics are focused on treating medically refractory epilepsy and brain tumors that can be difficult to resect. The safety of LITT can provide an attractive alternative to open brain surgery in the pediatric population.

Lessons Learned in Using Laser Interstitial Thermal Therapy for Treatment of Brain Tumors: A Case Series of 238 Patients from a Single Institution

2020 ◽  
Vol 139 ◽  
pp. e345-e354 ◽  
Author(s):  
Jianning Shao ◽  
Nathan R. Radakovich ◽  
Matthew Grabowski ◽  
Hamid Borghei-Razavi ◽  
Konrad Knusel ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Case Series ◽  
Lessons Learned ◽  
Thermal Therapy ◽  
Single Institution ◽  
Laser Interstitial Thermal Therapy

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

2020 ◽  
Vol 20 (1) ◽  
pp. 18-23
Author(s):  
Kyle P O’Connor ◽  
Ali H Palejwala ◽  
Camille K Milton ◽  
Victor M Lu ◽  
Chad A Glenn ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Tumor Volume ◽  
Treatment Plan ◽  
Case Series ◽  
Lesion Size ◽  
Recurrent Glioblastoma ◽  
Thermal Therapy ◽  
Recurrent Glioblastoma Multiforme ◽  
Laser Interstitial Thermal Therapy ◽  
Recurrent Gbm

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.

scholarly journals Corpus callosotomy via laser interstitial thermal therapy: a case series

2019 ◽  
Vol 23 (3) ◽  
pp. 303-307 ◽  
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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