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Alvin Y Chan, Diem Kieu T Tran, Amandip S Gill, Frank P K Hsu, Sumeet Vadera
Laser interstitial thermal therapy (LITT) is a minimally invasive procedure used to treat a variety of intracranial lesions. Utilization of robotic assistance with stereotactic procedures has gained attention due to potential for advantages over conventional techniques. The authors report the first case in which robot-assisted MRI-guided LITT was used to treat radiation necrosis in the posterior fossa, specifically within the cerebellar peduncle. The use of a stereotactic robot allowed the surgeon to perform LITT using a trajectory that would be extremely difficult with conventional arc-based techniques...
October 2016: Neurosurgical Focus
Sindhura Pisipati, Kyle A Smith, Kushal Shah, Koji Ebersole, Roukoz B Chamoun, Paul J Camarata
OBJECTIVE Laser interstitial thermal therapy (LITT) is used in numerous neurosurgical applications including lesions that are difficult to resect. Its rising popularity can be attributed to its minimally invasive approach, improved accuracy with real-time MRI guidance and thermography, and enhanced control of the laser. One of its drawbacks is the possible development of significant edema, which contributes to extended hospital stays and often necessitates hyperosmolar or steroid therapy. Here, the authors discuss the use of minimally invasive craniotomy to resect tissue ablated with LITT in attempt to minimize cerebral edema...
October 2016: Neurosurgical Focus
James Wright, Jessey Chugh, Christina Huang Wright, Fernando Alonso, Alia Hdeib, Haley Gittleman, Jill Barnholtz-Sloan, Andrew E Sloan
OBJECTIVE Laser interstitial thermal therapy (LITT), sometimes referred to as "stereotactic laser ablation," has demonstrated utility in a subset of high-risk surgical patients with difficult to access (DTA) intracranial neoplasms. However, the treatment of tumors larger than 10 cm(3) is associated with suboptimal outcomes and morbidity. This may limit the utility of LITT in dealing with precisely those large or deep tumors that are most difficult to treat with conventional approaches. Recently, several groups have reported on minimally invasive transsulcal approaches utilizing tubular retracting systems...
October 2016: Neurosurgical Focus
Jonathan G Thomas, Ganesh Rao, Yvonne Kew, Sujit S Prabhu
OBJECTIVE Glioblastoma (GBM) is the most common and deadly malignant primary brain tumor. Better surgical therapies are needed for newly diagnosed GBMs that are difficult to resect and for GBMs that recur despite standard therapies. The authors reviewed their institutional experience of using laser interstitial thermal therapy (LITT) for the treatment of newly diagnosed or recurrent GBMs. METHODS This study reports on the pre-LITT characteristics and post-LITT outcomes of 8 patients with newly diagnosed GBMs and 13 patients with recurrent GBM who underwent LITT...
October 2016: Neurosurgical Focus
Mayur Sharma, Ghaith Habboub, Mandana Behbahani, Danilo Silva, Gene H Barnett, Alireza M Mohammadi
OBJECTIVE Laser interstitial thermal therapy (LITT) has been increasingly used to treat deep-seated tumors. Despite its being minimally invasive, there is a risk of LITT damaging adjacent critical structures, including corticospinal tracts (CSTs). In this study, the authors investigated the predictive value of overlap between the hyperthermic field and CSTs in determining postoperative motor deficit (PMDs). METHODS More than 140 patients underwent an LITT procedure in our institution between April 2011 and June 2015...
October 2016: Neurosurgical Focus
David Y A Dadey, Ashwin A Kamath, Matthew D Smyth, Michael R Chicoine, Eric C Leuthardt, Albert H Kim
OBJECTIVE The precision of laser probe insertion for interstitial thermal therapy of deep-seated lesions is limited by the method of stereotactic guidance. The objective of this study was to evaluate the feasibility of customized STarFix 3D-printed stereotactic platforms to guide laser probe insertion into mesiotemporal and posterior fossa targets. METHODS The authors conducted a retrospective review of 5 patients (12-55 years of age) treated with laser interstitial thermal therapy (LITT) in which STarFix platforms were used for probe insertion...
October 2016: Neurosurgical Focus
Anthony M Burrows, W Richard Marsh, Gregory Worrell, David A Woodrum, Bruce E Pollock, Krzysztof R Gorny, Joel P Felmlee, Robert E Watson, Timothy J Kaufmann, Steven Goerss, Jamie J Van Gompel
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...
October 2016: Neurosurgical Focus
Nicholas J Brandmeir, James McInerney, Brad E Zacharia
Over the last several years, laser interstitial thermotherapy (LITT) has gained wide acceptance for the treatment of a myriad of cranial lesions. A wide variety of techniques for placement of the laser fiber have been reported with a spectrum of perceived benefits and drawbacks. The authors present the first report of a customized 3D printed stereotactic frame for LITT. Approximately 1 week prior to surgery, 3-4 skull fiducials were placed after each of 5 patients received a local anesthetic as an outpatient...
October 2016: Neurosurgical Focus
David Y A Dadey, Ashwin A Kamath, Eric C Leuthardt, Matthew D Smyth
Subependymal giant cell astrocytoma (SEGA) is a rare tumor occurring almost exclusively in patients with tuberous sclerosis complex. Although open resection remains the standard therapy, complication rates remain high. To minimize morbidity, less invasive approaches, such as endoscope-assisted resection, radiosurgery, and chemotherapy with mTOR pathway inhibitors, are also used to treat these lesions. Laser interstitial thermal therapy (LITT) is a relatively new modality that is increasingly used to treat a variety of intracranial lesions...
October 2016: Neurosurgical Focus
Thomas J Vogl, Romina Eckert, Nagy N N Naguib, Martin Beeres, Tatjana Gruber-Rouh, Nour-Eldin A Nour-Eldin
OBJECTIVE: The purpose of this study is to retrospectively evaluate local tumor control, time to tumor progression, and survival rates among patients with lung metastatic colorectal cancer who have undergone ablation therapy performed using laser-induced thermotherapy (LITT), radiofrequency ablation (RFA), or microwave ablation (MWA). MATERIALS AND METHODS: Data for this retrospective study were collected from 231 CT-guided ablation sessions performed for 109 patients (71 men and 38 women; mean [± SD] age, 68...
September 28, 2016: AJR. American Journal of Roentgenology
Georgia Kapatai, Carmen L Sheppard, Ali Al-Shahib, David J Litt, Anthony P Underwood, Timothy G Harrison, Norman K Fry
Streptococcus pneumoniae typically express one of 92 serologically distinct capsule polysaccharide (cps) types (serotypes). Some of these serotypes are closely related to each other; using the commercially available typing antisera, these are assigned to common serogroups containing types that show cross-reactivity. In this serotyping scheme, factor antisera are used to allocate serotypes within a serogroup, based on patterns of reactions. This serotyping method is technically demanding, requires considerable experience and the reading of the results can be subjective...
2016: PeerJ
Rosanne C Schoonbeek, Satoshi Takebayashi, Chikashi Aoki, Toru Shimaoka, Matthew A Harris, Gregory L Fu, Timothy S Kim, Yoav Dori, Jeremy McGarvey, Harold Litt, Wobbe Bouma, Gerald Zsido, Andrew C Glatz, Jonathan J Rome, Robert C Gorman, Joseph H Gorman, Matthew J Gillespie
BACKGROUND: Pulmonary insufficiency is the nexus of late morbidity and mortality after transannular patch repair of tetralogy of Fallot. This study aimed to establish the feasibility of implantation of the novel Medtronic Harmony transcatheter pulmonary valve (hTPV) and to assess its effect on pulmonary insufficiency and ventricular function in an ovine model of chronic postoperative pulmonary insufficiency. METHODS AND RESULTS: Thirteen sheep underwent baseline cardiac magnetic resonance imaging, surgical pulmonary valvectomy, and transannular patch repair...
October 2016: Circulation. Cardiovascular Interventions
Zulma Tovar-Spinoza, Hoon Choi
BACKGROUND: Pediatric low-grade gliomas (LGGs) account for approximately half of all pediatric central nervous system tumors. The low-grade gliomas' first line of treatment is gross total resection. However, when gross total resection is not possible, options for adjuvant therapy are limited. MRI-guided laser ablation (magnetic resonance-guided laser interstitial thermal therapy (MRgLITT)) offers a new option for treatment in selected cases. We present a description of the current MRgLITT technology and an exemplary case-series review of our experience in its use in LGGs...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Mark D Litt, Valerie Duffy, Cheryl Oncken
INTRODUCTION: The present study examined the influence of flavouring on the smoking and vaping behaviour of cigarette smokers asked to adopt e-cigarettes for a period of 6 weeks. METHODS: Participants were 88 current male and female smokers with no intention to stop smoking, but who agreed to substitute e-cigarettes for their current cigarettes. On intake, participants were administered tests of taste and smell for e-cigarettes flavoured with tobacco, menthol, cherry and chocolate, and were given a refillable e-cigarette of their preferred flavour or a control flavour...
September 15, 2016: Tobacco Control
Katie M Litts, Xiaolin Wang, Mark E Clark, Cynthia Owsley, K Bailey Freund, Christine A Curcio, Yuhua Zhang
PURPOSE: To investigate the microscopic structure of outer retinal tubulation (ORT) and optical properties of cone photoreceptors in vivo, we studied ORT appearance by multimodal imaging, including spectral domain optical coherence tomography (SD-OCT) and adaptive optics scanning laser ophthalmoscopy. METHODS: Four eyes of four subjects with advanced age-related macular degeneration underwent color fundus photography, infrared reflectance imaging, SD-OCT, and adaptive optics scanning laser ophthalmoscopy with a high-resolution research instrument...
August 31, 2016: Retina
Francisco Contijoch, Srikant Kamesh Iyer, James J Pilla, Paul Yushkevich, Joseph H Gorman, Robert C Gorman, Harold Litt, Yuchi Han, Walter R T Witschey
PURPOSE: Develop self-gated MRI for distinct heartbeat morphologies in subjects with arrhythmias. METHODS: Golden angle radial data was obtained in seven sinus and eight arrhythmias subjects. An image-based cardiac navigator was derived from single-shot images, distinct beat types were identified, and images were reconstructed for repeated morphologies. Image sharpness, contrast, and volume variation were quantified and compared with self-gated MRI. Images were scored for image quality and artifacts...
August 31, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Daniele Munari, Anna Pedrinolla, Nicola Smania, Alessandro Picelli, Marialuisa Gandolfi, Leopold Saltuari, Federico Schena
BACKGROUND: Stroke is a major cause of death and long-term disability across the globe. Previous studies have demonstrated the trainability of stroke survivors and documented beneficial effects of aerobic exercises on cardiovascular fitness and gait ability. AIM: The main aim of this study was to compare the effects of a high-intensity treadmill training (HITT) against low-intensity treadmill training (LITT) on gait ability, quality of life, cardiorespiratory fitness and cost of walking in chronic stroke subjects...
August 30, 2016: European Journal of Physical and Rehabilitation Medicine
Benjamin Yong-Qiang Tan, Wan-Yee Kong, Jinghao Nicholas Ngiam, Hock-Luen Teoh, Vijay K Sharma, Leonard Leong-Litt Yeo
BACKGROUND: The Alberta Stroke Program Early CT (ASPECTS) leptomeningeal collaterals score on CT-angiography helps in prognosticating functional outcome in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis. We evaluated whether a simplified topological ASPECTS collaterals scoring could serve as a rapid biomarker for early prediction in thrombolyzed AIS patients. METHODS: Consecutive patients from 2010 to 2014 with anterior circulation AIS treated with intravenous thrombolysis were included...
August 30, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Ankit N Khambhati, Kathryn A Davis, Timothy H Lucas, Brian Litt, Danielle S Bassett
In ∼20 million people with drug-resistant epilepsy, focal seizures originating in dysfunctional brain networks will often evolve and spread to surrounding tissue, disrupting function in otherwise normal brain regions. To identify network control mechanisms that regulate seizure spread, we developed a novel tool for pinpointing brain regions that facilitate synchronization in the epileptic network. Our method measures the impact of virtually resecting putative control regions on synchronization in a validated model of the human epileptic network...
September 7, 2016: Neuron
P T S Borman, C Bos, T de Boorder, B W Raaymakers, C T W Moonen, S P M Crijns
MR-guided thermal therapies, such as high-intensity focused ultrasound (MRgHIFU) and laser-induced thermal therapy (MRgLITT) are increasingly being applied in oncology and neurology. MRI is used for guidance since it can measure temperature noninvasively based on the proton resonance frequency shift (PRFS). For therapy guidance using PRFS thermometry, high temporal resolution and large spatial coverage are desirable. We propose to use the parallel imaging technique simultaneous multislice (SMS) in combination with controlled aliasing (CAIPIRINHA) to accelerate the acquisition...
September 7, 2016: Physics in Medicine and Biology
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