MRI-Guided Thermal Therapy for Brain Tumors

Abstract OBJECTIVE In neuro-oncology, it is believed that one major obstacle to effective chemotherapy is the high vascularity and heterogenous permeability of brain tumors. Focused ultrasound (FUS) exposure with the microbubbles has been shown to transiently open the blood-brain barrier (BBB) without depositing thermal energy, and thus may enhance the delivery of various therapeutic drugs into brain tumors. The aim of this study was to evaluate the BBB opening using 220-kHz transcranial MRI-guided FUS (TcMRgFUS) device and microbubbles in mouse and rat. METHODS The experiments were performed with the 220-kHz ExAblate Neuro TcMRgFUS system (InSightec) and novel lipid bubbles (LB, Teikyo Univ.). Normal mouse and rat brains were irradiated with TcMRgFUS (output power, 5W; duration of irradiation, 30 s; duty cycle 100%) following intravenous injection of 6x107 LB per mouse and rat, respectively. On irradiation, target temperature rise & cavitation signal were monitored by MR thermometry and cavitation receiver, respectively. Immediately after irradiation, BBB opening and complications were detected based on T1, T2, T2*, and Gadolinium (Gd) enhanced T1-weighted images. RESULTS The maximum temperature of brain tissue was under 42 C. There were no risky-cavitation signals causing hemorrhage. The FUS-LB exposure induced successful BBB opening effect in both mouse and rat, confirmed by Gd enhancement in the target region, lateral ventricles, and sulcus. In addition, there were no complications such as edema, coagulation, and hemorrhage. CONCLUSIONS Although there remain many conditions to be optimized, BBB opening using a 220-kHz TcMRgFUS device and LB can offer a non-invasive and feasible drug delivery for brain malignancies.

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Early economic evaluation of MRI-guided laser interstitial thermal therapy (MRgLITT) and epilepsy surgery for mesial temporal lobe epilepsy

PLoS ONE ◽

10.1371/journal.pone.0224571 ◽

2019 ◽

Vol 14 (11) ◽

pp. e0224571 ◽

Cited By ~ 3

Author(s):

Elysa Widjaja ◽

Tina Papastavros ◽

Beate Sander ◽

Carter Snead ◽

Petros Pechlivanoglou

Keyword(s):

Economic Evaluation ◽

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Epilepsy Surgery ◽

Mesial Temporal Lobe Epilepsy ◽

Thermal Therapy ◽

Laser Interstitial Thermal Therapy ◽

Mesial Temporal Lobe ◽

Mri Guided

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Sci-AM1 Sat - 01: A system for MRI-guided thermal therapy of prostate disease with transurethral ultrasound heating applicators

Medical Physics ◽

10.1118/1.2031042 ◽

2005 ◽

Vol 32 (7Part3) ◽

pp. 2422-2422

Author(s):

R Chopra ◽

V Choy ◽

S Baker ◽

K Tang ◽

A Boyes ◽

...

Keyword(s):

Thermal Therapy ◽

Prostate Disease ◽

Mri Guided ◽

Transurethral Ultrasound

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

Cancer Imaging ◽

10.1186/s40644-019-0250-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 22

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.

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