Visualase

OBJECTIVE: Magnetic resonance-guided laser interstitial thermal therapy is a minimally invasive procedure that uses intraoperative magnetic resonance thermometry (MRT) to generate a thermal damage estimate (TDE) of the ablative area. This study aimed to compare areas produced by the MRT heat map with the system-generated TDE produced by Visualase software. METHODS: All ablations were performed using the Visualase laser ablation system. MRT heat map and TDE were quantified using MATLAB version R2014a...

BACKGROUND: Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a minimally invasive procedure that utilizes intraoperative magnetic resonance thermal imaging (MRTI) to generate a thermal damage estimate (TDE) of the ablative area. In select cases, the MRTI contains a signal artifact or defect that distorts the ablative region. No study has considered the impact of this artifact on TDE accuracy. OBJECTIVE: To determine the effect of intraoperative MRTI signal artifact on postoperative magnetic resonance imaging (MRI)-predicted ablative area...

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OBJECTIVE: Intraoperative dynamics of magnetic resonance-guided laser-induced thermal therapy (MRgLITT) have been previously characterized for ablations of naive tissue. However, most treatment sessions require the delivery of multiple doses, and little is known about the ablation dynamics when additional doses are applied to heat-damaged tissue. This study investigated the differences in ablation dynamics between naive versus damaged tissue. METHODS: The authors examined 168 ablations from 60 patients across various surgical indications...

INTRODUCTION: MR-guided laser interstitial thermal therapy (MRgLITT) has emerged as a safe and effective treatment option for the ablation of epileptic foci. Its minimally invasive nature makes it attractive due to decreased morbidity and hospital stay. OBJECTIVE: To report the efficacy and safety of MRgLITT as a minimally invasive procedure for the ablation of epileptic foci in the pediatric population of medically refractory lesional epilepsy. METHODS: A retrospective review of patients who underwent MRgLITT via Visualase laser ablation at a single pediatric center was performed...

BACKGROUND: Magnetic resonance imaging-guided laser interstitial thermal therapy (LITT) has emerged as a promising treatment for mesial temporal lobe epilepsy. Surgeons must understand the relevant anatomy that is traversed by the catheter and affected by ablation. OBJECTIVE: To study the anatomic structures crossed by the LITT catheter until it reaches the amygdala. METHODS: Three human cadaveric heads were implanted with catheters using a frameless stereotactic technique...

BACKGROUND: Magnetic resonance guided laser induced thermal therapy (LITT) is a minimally invasive method to treat a wide range of intracranial pathologies. The Arrhenius model is used to generate a thermal damage estimate (TDE) predicting ablation extent. OBJECTIVE: Evaluation and correlation of the TDE to magnetic resonance imaging (MRI)-estimated ablation extent in human cases. METHODS: The Medtronic Visualase system (Medtronic Inc, Dublin, Ireland) was utilized...

PURPOSE: Magnetic resonance-guided laser-induced thermal therapy (MRgLITT) is a minimally invasive procedure used to treat various intracranial pathologies. This study investigated the effects of variable power on maximal estimated thermal damage during ablation and duration required to reach maximal ablation. MATERIALS/METHODS: All ablations were performed using the Visualase Thermal Therapy System (Medtronic Inc., Minneapolis, Minnesota), which uses a 980 nm diffusing tip diode laser...

Successful treatment of hypothalamic hamartoma (HH) can result in the resolution of its sequelae including epilepsy and rage attacks. Risks and morbidity of open surgical management of this lesion have motivated the development of laser interstitial thermal therapy (LITT) as a less invasive treatment approach to the disease. Although overall morbidity and risk would appear to be lower, complications related to LITT therapy have been reported, and the longer-term follow-up that is now possible after initial experience helps address the question of whether LITT provides equivalent efficacy compared to other treatment options...

BACKGROUND: Magnetic resonance-guided laser-induced thermal therapy (MRgLITT) is a minimally invasive surgical procedure for ablating intracranial lesions. The presence of a fluid body can sequester thermal energy generated by the laser catheter, which compromises the performance of MRgLITT, resulting in suboptimal ablation of cystic lesions. We report our use of stereotactic fluid evacuation followed by MRgLITT in 2 patients with cystic brain tumors. This is the first report on lesion optimization by fluid aspiration before MRgLITT...

Besides other innovative stereotactic procedures (radiofrequency thermocoagulation, focused ultrasound, gamma knife) laser interstitial thermotherapy (LiTT) provides minimally invasive destruction of pathological soft tissues which could be especially relevant for epilepsy surgeries involving adult and pediatric patients. Unlike standard resections, no craniotomy is required; just a tiny borehole trepanation is sufficient. Damage to cortical areas when accessing deep lesions can be minimized or completely avoided, and treating epileptogenic foci near eloquent or even vital brain areas becomes possible...

In common with other stereotactic procedures, stereotactic laser thermocoagulation (SLT) promises gentle destruction of pathological tissue, which might become especially relevant for epilepsy surgery in the future. Compared to standard resection, no large craniotomy is necessary, cortical damage during access to deep-seated lesions can be avoided and interventions close to eloquent brain areas become possible. We describe the history and rationale of laser neurosurgery as well as the two available SLT systems (Visualase® and NeuroBlate®; CE marks pending)...

Laser-induced thermal therapy has become a powerful tool in the neurosurgical armamentarium. The physics of laser therapy are complex, but a sound understanding of this topic is clinically relevant, as many centers have incorporated it into their treatment algorithm, and educated patients are demanding consideration of its use for their disease. Laser ablation has been used for a wide array of intracranial lesions. Laser catheter placement is guided by stereotactic planning; however, as the procedure has popularized, the number of ways in which the catheter can be inserted has also increased...

OBJECTIVE Hypothalamic hamartomas (HHs) are associated with gelastic seizures and the development of medically refractory epilepsy. Magnetic resonance imaging-guided laser interstitial thermal therapy (MRg-LITT) is a minimally invasive ablative treatment that may have applicability for these deep-seated lesions. Here, the authors describe 3 patients with refractory HHs who they treated with MRg-LITT. METHODS An institutional review board-approved prospective database of patients undergoing Visualase MRg-LITT was retrospectively reviewed...

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...

OBJECTIVE Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a novel, minimally invasive treatment that has multiple advantages in pediatric use and broad applicability for different types of lesions. Here, the authors report the preliminary results of the first series of pediatric brain tumors treated with MRgLITT at Golisano Children's Hospital in Syracuse, New York. METHODS Pediatric brain tumors treated with MRgLITT between February 2012 and August 2014 at Golisano Children's Hospital were evaluated retrospectively...

OBJECTIVE MR-guided laser-induced thermal therapy (MRgLITT) can be used to treat intracranial tumors, epilepsy, and chronic pain syndromes. Here, the authors report their single-center experience with 102 patients, the largest series to date in which the Visualase thermal therapy system was used. METHODS A retrospective analysis of all patients who underwent MRgLITT between 2010 and 2014 was performed. Pathologies included glioma, recurrent metastasis, radiation necrosis, chronic pain, and epilepsy. Laser catheters were placed stereotactically, and ablation was performed in the MRI suite...

OBJECTIVE: To report the feasibility, safety, and clinical outcomes of an exploratory study of MR-guided Laser Interstitial Thermal Therapy (MRgLITT) as a minimally invasive surgical procedure for the ablation of epileptogenic foci in children with drug-resistant, lesional epilepsy. METHODS: Retrospective chart review of all MRgLITT procedures at a single tertiary care center. All procedures were performed using a U.S. Food and Drug Administration (FDA)-cleared surgical laser ablation system (Visualase Thermal Therapy System)...

BACKGROUND: Magnetic resonance-guided, laser-induced thermal therapy is a real-time magnetic resonance thermometry-guided, minimally invasive procedure used in the treatment of intracranial tumors, epilepsy, and pain. Little is known about its dynamics and the effects of various pathologies on overall ablation. OBJECTIVE: To determine the relationship between thermal energy delivery and the time to maximal estimated thermal damage and whether differences exist between various intracranial pathologies...

UNLABELLED: From April 2013 to July 2014, 25 consecutive men participated in a longitudinal outcomes study following in-bore magnetic resonance imaging (MRI)-guided focal laser ablation (FLA) of prostate cancer (PCa). Eligibility criteria were clinical stage T1c and T2a disease; prostate-specific antigen (PSA) <10 ng/ml; Gleason score <8; and cancer-suspicious regions (CSRs) on multiparametric MRI harboring PCa. CSRs harboring PCa were ablated using a Visualase cooled laser applicator system...