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laser interstitial thermal therapy

Shuhei Okuyama, Tadanobu Nagaya, Kazuhide Sato, Fusa Ogata, Yasuhiro Maruoka, Peter L Choyke, Hisataka Kobayashi
Near-infrared photoimmunotherapy (NIR-PIT), a promising cancer therapy utilizing an antibody-photoabsorber conjugate (APC) and NIR light, which induces rapid necrotic cell death only in APC-bound cells. Effective NIR-PIT in mouse models has been achieved using superficial light illumination (SLI) with light emitting diodes (LEDs) or lasers, but in the clinical setting, fiber optic diffusers have been employed to deliver light to deeper tumors. However, the performance of NIR light in tissue delivered by fiber optic diffusers is poorly understood...
February 16, 2018: Oncotarget
Richard Rammo, Karam Asmaro, Lonni Schultz, Lisa Scarpace, Salim Siddiqui, Tobias Walbert, Steven Kalkanis, Ian Lee
Cerebral radiation necrosis (CRN) is a known complication of radiation therapy. Treatment options are limited and include steroids, bevacizumab, and surgery. This study seeks to determine the safety of laser interstitial thermal therapy (LITT) for CRN and identify the pattern of post-ablation volume change over time. Patients undergoing LITT for tumor treatment at Henry Ford Hospital between November 2013 and January 2016 with biopsy-confirmed CRN were prospectively collected and retrospectively reviewed with attention to ablation volume, survival, demographic data, steroid dose, and complications...
March 13, 2018: Journal of Neuro-oncology
Vejay N Vakharia, Rachel Sparks, Kuo Li, Aidan G O'Keeffe, Anna Miserocchi, Andrew W McEvoy, Michael R Sperling, Ashwini Sharan, Sebastien Ourselin, John S Duncan, Chengyuan Wu
OBJECTIVE: Surgical resection of the mesial temporal structures brings seizure remission in 65% of individuals with drug-resistant mesial temporal lobe epilepsy (MTLE). Laser interstitial thermal therapy (LiTT) is a novel therapy that may provide a minimally invasive means of ablating the mesial temporal structures with similar outcomes, while minimizing damage to the neocortex. Systematic trajectory planning helps ensure safety and optimal seizure freedom through adequate ablation of the amygdalohippocampal complex (AHC)...
March 12, 2018: Epilepsia
Martin Holtkamp, Lars Büntjen, Friedhelm C Schmitt
New treatment approaches in epilepsy - such as novel antiepileptic drugs and neurostimulation - generally at first are assessed in animal models in regard to feasibility, efficacy and safety. The aim of this review was to elucidate and summarize the available literature on in vivo experimental studies on radiofrequency thermoablation and laser interstitial thermal therapy. We have found two in vivo studies on radiofrequency ablation of an acute seizure focus, one assessed the conventional transcranial and the other one a transvenous approach...
March 3, 2018: Epilepsy Research
Dimitri Laurent, Seth F Oliveria, Michael Shang, Frank Bova, Rachel Freedman, Maryam Rahman
BACKGROUND: Magnetic resonance imaging (MRI) guided laser interstitial thermal therapy (LITT) is an emerging neurosurgical treatment modality that is typically performed under general anesthesia. We describe a novel workflow developed at the University of Florida to deliver LITT in conscious patients without the use of general anesthesia. OBJECTIVE: To describe a novel workflow for LITT implementation in the awake patient with equivalent treatment results when compared to procedures performed under general anesthesia...
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
Sanjeet S Grewal, Krzysztof R Gorny, Christopher P Favazza, Robert E Watson, Timothy J Kaufmann, Jamie J Van Gompel
BACKGROUND AND IMPORTANCE: Laser interstitial thermal therapy (LiTT) has increasingly been used as a treatment option for medically refractory epilepsy, tumors, and radiation necrosis. The use of LiTT requires intraoperative magnetic resonance (MR) thermography. This can become an issue in patients with other implanted therapeutic devices such as pacemakers and vagal nerve stimulators due to concerns regarding increases in the specific absorption rate (SAR). This is a technical case report demonstrating a successfully and safely performed LiTT in a 1...
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
Eric C Leuthardt, Jeff Voigt, Albert H Kim, Pete Sylvester
BACKGROUND: Brain laser interstitial thermal therapy (LITT) under magnetic resonance imaging (MRI) guidance has recently gained US clinical approval for the ablation of soft, neurological tissue. LITT is a minimally invasive alternative to craniotomy. OBJECTIVE: While safety and efficacy are the focus of most current LITT studies, it is unclear how acute care costs (inpatient care ± aftercare) of LITT compare to craniotomy in an academic medical center. Therefore, the purpose of this analysis is to examine these costs of using brain LITT under MRI guidance compared to craniotomy in complex anatomies...
March 2017: PharmacoEconomics Open
Thomas L Beaumont, Alireza M Mohammadi, Albert H Kim, Gene H Barnett, Eric C Leuthardt
BACKGROUND: Glioblastoma of the corpus callosum is particularly difficult to treat, as the morbidity of surgical resection generally outweighs the potential survival benefit. Laser interstitial thermal therapy (LITT) is a safe and effective treatment option for difficult to access malignant gliomas of the thalamus and insula. OBJECTIVE: To assess the safety and efficacy of LITT for the treatment of glioblastoma of the corpus callosum. METHODS: We performed a multicenter retrospective analysis of prospectively collected data...
February 8, 2018: Neurosurgery
Dario J Englot
Epilepsy surgery has seen numerous technological advances in both diagnostic and therapeutic procedures in recent years. This has increased the number of patients who may be candidates for intervention and potential improvement in quality of life. However, the expansion of the field also necessitates a broader understanding of how to incorporate both traditional and emerging technologies into the care provided at comprehensive epilepsy centers. This review summarizes both old and new surgical procedures in epilepsy using an example algorithm...
February 1, 2018: Epilepsy & Behavior: E&B
Sanjeet S Grewal, Vivek Gupta, Prasanna Vibhute, Jerry J Shih, William O Tatum, Robert E Wharen
OBJECTIVE: The mammillary bodies have long been known as the primary relay center for the hippocampus. The fornix is the primary efferent pathway of the hippocampus, with its postcommissural fibers terminating in the mammillary bodies. In this study, we describe change in mammillary body volume after laser interstitial thermal therapy (LiTT) for mesial temporal lobe epilepsy and correlate it with seizure outcome. METHODS: Pre- and post-LiTT ablation magnetic resonance imaging was reviewed in axial and coronal planes to determine mammillary body volume as calculated by the ellipsoid method...
January 31, 2018: Epilepsy Research
Vivek Tandon, Poodipedi Sarat Chandra, Ramesh Sharanappa Doddamani, Heri Subianto, Jitin Bajaj, Ajay Garg, Manjari Tripathi
INTRODUCTION: Treatment options for hypothalamic hamartoma (HH) include microvascular surgery, stereotactic radiofrequency thermocoagulation (SRT), laser interstitial thermal therapy (LITT) or Gamma knife surgery (GKS). During SRT, thermographic monitoring cannot be performed and therefore highly accurate placement of electrode and confirmation of its position are required. We have utilized robotic guidance (ROSA) and co-registered it with O-Arm, for performing ablation of hamartoma. METHODS: Five patients of HH with gelastic seizures (GS) underwent SRT...
February 3, 2018: World Neurosurgery
Brett E Youngerman, Justin Y Oh, Deepti Anbarasan, Santoshi Billakota, Camilla H Casadei, Emily K Corrigan, Garret P Banks, Alison M Pack, Hyunmi Choi, Carl W Bazil, Shraddha Srinivasan, Lisa M Bateman, Catherine A Schevon, Neil A Feldstein, Sameer A Sheth, Guy M McKhann
OBJECTIVE: Selective laser amygdalohippocampotomy (SLAH) using magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is emerging as a treatment option for drug-resistant mesial temporal lobe epilepsy (MTLE). SLAH is less invasive than open resection, but there are limited series reporting its safety and efficacy, particularly in patients without clear evidence of mesial temporal sclerosis (MTS). METHODS: We report seizure outcomes and complications in our first 30 patients who underwent SLAH for drug-resistant MTLE between January 2013 and December 2016...
February 2, 2018: Epilepsia
David S Xu, Tsinsue Chen, Randall J Hlubek, Ruth E Bristol, Kris A Smith, Francisco A Ponce, John F Kerrigan, Peter Nakaji
BACKGROUND: Hypothalamic hamartomas (HH) are rare lesions associated with treatment-resistant epilepsy. Open surgery results in modest seizure control (about 50%) but has a significant associated morbidity. Radiosurgery is limited to a subset of patients due to latent therapeutic effects. Magnetic resonance imaging-guided laser interstitial thermal therapy (LITT) offers a novel minimally invasive option. OBJECTIVE: To evaluate a single center's outcomes for the LITT treatment of HH...
January 13, 2018: Neurosurgery
Drew Mitchell, Samuel Fahrenholtz, Christopher MacLellan, Dhiego Bastos, Ganesh Rao, Sujit Prabhu, Jeffrey Weinberg, John Hazle, Jason Stafford, David Fuentes
We evaluated a physics-based model for planning for magnetic resonance-guided laser interstitial thermal therapy for focal brain lesions. Linear superposition of analytical point source solutions to the steady-state Pennes bioheat transfer equation simulates laser-induced heating in brain tissue. The line integral of the photon attenuation from the laser source enables computation of the laser interaction with heterogeneous tissue. Magnetic resonance thermometry data sets (n = 31) were used to calibrate and retrospectively validate the model's thermal ablation prediction accuracy, which was quantified by the Dice similarity coefficient (DSC) between model-predicted and measured ablation regions (T > 57°C)...
January 17, 2018: International Journal of Hyperthermia
Montserrat Lara-Velazquez, Rawan Al-Kharboosh, Stephanie Jeanneret, Carla Vazquez-Ramos, Deependra Mahato, Daryoush Tavanaiepour, Gazanfar Rahmathulla, Alfredo Quinones-Hinojosa
Glioblastoma (GBM) is the most common primary intracranial neoplasia, and is characterized by its extremely poor prognosis. Despite maximum surgery, chemotherapy, and radiation, the histological heterogeneity of GBM makes total eradication impossible, due to residual cancer cells invading the parenchyma, which is not otherwise seen in radiographic images. Even with gross total resection, the heterogeneity and the dormant nature of brain tumor initiating cells allow for therapeutic evasion, contributing to its recurrence and malignant progression, and severely impacting survival...
December 20, 2017: Brain Sciences
Vivek B Beechar, Sujit S Prabhu, Dhiego Bastos, Jeffrey S Weinberg, R Jason Stafford, David Fuentes, Kenneth R Hess, Ganesh Rao
We analyzed volumetric response of metastatic brain tumors that progressed despite treatment with stereotactic radiosurgery (SRS) after treatment with laser interstitial thermal therapy (LITT). We retrospectively reviewed consecutive patients treated from 1/2012 to 10/2015 with LITT for metastatic brain tumors demonstrating progression after SRS. Volumes were quantified using MRI with contrast-enhanced T1-weighted (T1W) and fluid-attenuated inversion recovery (FLAIR). Fifty lesions from 36 patients were studied...
March 2018: Journal of Neuro-oncology
James X Tao, Shasha Wu, Maureen Lacy, Sandra Rose, Naoum P Issa, Carina W Yang, Katherine E Dorociak, Maria Bruzzone, Jisoon Kim, Ahmad Daif, Jason Choi, Vernon L Towle, Peter C Warnke
OBJECTIVE: To 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). METHODS: We 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)...
November 28, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
Daniel G Eichberg, Ryan VanDenBerg, Ricardo J Komotar, Michael E Ivan
BACKGROUND: Treating recurrent posterior fossa metastases after previous radiation therapy and surgical resection remains challenging. Magnetic resonance laser-induced thermal therapy (MR-LITT) is a promising treatment for recurrent lesions, but data on safety, efficacy, and postablation volume change in the posterior fossa are lacking. METHODS: All patients with recurrent posterior fossa metastatic lesions treated with MR-LITT by the senior neurosurgeon were included in the study...
February 2018: World Neurosurgery
Vanessa M Holanda, Abuzer Gungor, Serhat Baydin, Erik H Middlebrooks, Shabbar F Danish
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...
November 11, 2017: Operative Neurosurgery (Hagerstown, Md.)
Yarema B Bezchlibnyk, Jon T Willie, Robert E Gross
Stereotactic laser ablation of mesial temporal structures is a promising new surgical intervention for patients with mesial temporal lobe epilepsy (MTLE). Since this procedure was first used to treat MTLE in 2010, the literature contains reports of 37 patients that underwent MR-guided stereotactic laser amygdalohippocampotomy (SLAH) using Laser Interstitial Thermal Therapy (LITT) with at least 1year of follow-up. This early body of data suggests that SLAH is a safe and effective treatment for MTLE in properly selected patients...
October 27, 2017: Epilepsy Research
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