Anesthetic management and outcomes for MRI‐guided laser interstitial thermal therapy (LITT) for seizure focus in pediatrics: A single‐centre experience with 10 consecutive patients

2020 ◽  
Author(s):  
David Neville Levin ◽  
Craig D. McClain ◽  
Scellig S. D. Stone ◽  
Joseph R. Madsen ◽  
Sulpicio Soriano
Keyword(s):  
Anesthetic Management ◽  
Thermal Therapy ◽  
Single Centre ◽  
Seizure Focus ◽  
Laser Interstitial Thermal Therapy ◽  
Single Centre Experience ◽  
Mri Guided

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

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Usama Salem ◽  
Vinodh A. Kumar ◽  
John E. Madewell ◽  
Donald F. Schomer ◽  
Dhiego Chaves de Almeida Bastos ◽  
...  
Keyword(s):  
Treatment Options ◽  
Thermal Therapy ◽  
Invasive Technique ◽  
Laser Device ◽  
Invasive Treatment ◽  
Laser Interstitial Thermal Therapy ◽  
Alternative Treatment Option ◽  
Selective Ablation ◽  
Potential Applications ◽  
Mri Guided

Abstract 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 whom other standard treatment options have failed. Our aim is to review the current literature on LITT and provide a descriptive review of the technique, imaging findings, and clinical applications for neurosurgery.

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

Oncology ◽  
2014 ◽  
Vol 87 (2) ◽  
pp. 67-82 ◽  
Author(s):  
Gazanfar Rahmathulla ◽  
Pablo F. Recinos ◽  
Kambiz Kamian ◽  
Alireza M. Mohammadi ◽  
Manmeet S. Ahluwalia ◽  
...  
Keyword(s):  
Clinical Applications ◽  
Thermal Therapy ◽  
Laser Interstitial Thermal Therapy ◽  
Mri Guided

Phase I study of PD-L1 inhibition with avelumab and laser interstitial thermal therapy in patients with recurrent glioblastoma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. TPS2074-TPS2074 ◽  
Author(s):  
Adilia Hormigo ◽  
John Mandeli ◽  
Constantinos Hadjipanayis ◽  
Sacha Gnjatic ◽  
Seunghee Kim-Schulze ◽  
...  
Keyword(s):  
Treatment Options ◽  
Recurrent Glioblastoma ◽  
Thermal Therapy ◽  
Successful Implementation ◽  
Open Label ◽  
Stage Design ◽  
Laser Interstitial Thermal Therapy ◽  
Dismal Prognosis ◽  
Mri Guided ◽  
Clinical Trial Information

TPS2074 Background: Glioblastoma (GBM) the most frequent malignant brain tumor in the adult has a dismal prognosis and limited treatment options. Current advances have highlighted how tumors and specifically GBM evade the immune system by exploiting the mechanisms of tolerance and inducing local and systemic immunosuppression. Another hurdle in the treatment of GBM is the blood-brain barrier (BBB). Recent work suggests that MRI-guided laser interstitial thermal therapy (LITT) can increase the permeability of the BBB and may have an abscopal effect. Therefore, utilizing MRI-guided LITT, a potential immunogenic cell death-inducing procedure that disrupts the BBB and makes Avelumab a PD-L1 monoclonal antibody being more accessible to GBM tumors, seem a valid approach for immunomodulation and successful implementation of a combined regimen to treat brain cancer. Methods: This is a prospective non-randomized open label to characterize the tolerability and safety profile of Avelumab in combination with LITT in patients with recurrent glioblastoma who were treated with radiation therapy with concurrent Temozolomide chemotherapy at diagnosis, and whose tumor at recurrence measures less then 3 cm3. Avelumab is administered within a week after real-time MRI-guided LITT therapy and every 2 weeks thereafter. On part A patients are treated with intravenous Avelumab alone and on part B patients receive Avelumab in combination with MRI-guided LITT. Part A completed enrollment without DLT. Enrollment on part B began in October 2018. A Simon minimax two-stage design is being used for efficacy. Toxicity will be scored using the NCI-CTCAE 4.03 criteria. Blood samples and tumor tissue will be collected for correlative studies. Quantification of the changes in inflammatory and immunosuppressive profiles across time points for patients receiving treatment with Avelumab will be obtained. This information will instruct future immunotherapy approaches to treat GBM and the rational for those combinations. Clinical trial information: NCT03341806.

Systematic review of corpus callosotomy utilizing MRI guided laser interstitial thermal therapy

2020 ◽  
Vol 76 ◽  
pp. 67-73 ◽  
Author(s):  
Clint A. Badger ◽  
Alejandro J. Lopez ◽  
Gregory Heuer ◽  
Benjamin C. Kennedy
Keyword(s):  
Systematic Review ◽  
Thermal Therapy ◽  
Corpus Callosotomy ◽  
Laser Interstitial Thermal Therapy ◽  
Mri Guided

MRI-Guided Laser Interstitial Thermal Therapy for Radiation Necrosis in Previously Irradiated Brain Arteriovenous Malformations

2020 ◽  
Vol 10 (4) ◽  
pp. e298-e303 ◽  
Author(s):  
Christopher S. Hong ◽  
Branden J. Cord ◽  
Adam J. Kundishora ◽  
Aladine A. Elsamadicy ◽  
Jason M. Beckta ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Radiation Necrosis ◽  
Thermal Therapy ◽  
Laser Interstitial Thermal Therapy ◽  
Brain Arteriovenous Malformations ◽  
Mri Guided

MRI-Guided Laser Interstitial Thermal Therapy for Epilepsy

2017 ◽  
Vol 28 (4) ◽  
pp. 545-557 ◽  
Author(s):  
Robert Y. North ◽  
Jeffrey S. Raskin ◽  
Daniel J. Curry
Keyword(s):  
Thermal Therapy ◽  
Laser Interstitial Thermal Therapy ◽  
Mri Guided

Stereotactic EEG-guided laser interstitial thermal therapy for mesial temporal lobe epilepsy

2017 ◽  
Vol 89 (5) ◽  
pp. 542-548 ◽  
Author(s):  
James X Tao ◽  
Shasha Wu ◽  
Maureen Lacy ◽  
Sandra Rose ◽  
Naoum P Issa ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Thermal Therapy ◽  
Temporal Lobectomy ◽  
Laser Interstitial Thermal Therapy ◽  
Selective Amygdalohippocampectomy ◽  
Significant Difference ◽  
Mesial Temporal Lobe ◽  
Mri Guided

ObjectiveTo determine the outcomes of combined stereo-electroencephalography-guided and MRI-guided stereotactic laser interstitial thermal therapy (LITT) in the treatment of patients with drug-resistant mesial temporal lobe epilepsy (mTLE).MethodsWe prospectively assessed the surgical and neuropsychological outcomes in 21 patients with medically refractory mTLE who underwent LITT at the University of Chicago Medical Center. We further compared the surgical outcomes in patients with and without mesial temporal sclerosis (MTS).ResultsOf the 21 patients, 19 (90%) underwent Invasive EEG study and 11 (52%) achieved freedom from disabling seizures with a mean duration of postoperative follow-up of 24±11 months after LITT. Eight (73%) of 11 patients with MTS achieved freedom from disabling seizures, whereas 3 (30 %) of 10 patients without MTS achieved freedom from disabling seizures. Patients with MTS were significantly more likely to become seizure-free, as compared with those without MTS (P=0.002). There was no significant difference in total ablation volume and the percentage of the ablated amygdalohippocampal complex between seizure-free and non-seizure-free patients. Presurgical and postsurgical neuropsychological assessments were obtained in 10 of 21 patients. While there was no group decline in any neuropsychological assessment, a significant postoperative decline in verbal memory and confrontational naming was observed in individual patients.ConclusionsMRI-guided LITT is a safe and effective alternative to selective amygdalohippocampectomy and anterior temporal lobectomy for mTLE with MTS. Nevertheless, its efficacy in those without MTS seems modest. Large multicentre and prospective studies are warranted to further determine the efficacy and safety of LITT.

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