Stereotactic laser ablation of high-grade gliomas

Hawasli, Ammar H.; Kim, Albert H.; Dunn, Gavin P.; Tran, David; Leuthardt, Eric C.

doi:10.3171/2014.9.focus14471

Cited by 116 publications

(69 citation statements)

References 79 publications

(143 reference statements)

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“…6,10 Landmark studies have demonstrated the feasibility and safety of this approach for the treatment of challenging neurooncological lesions that cannot be safely treated via conventional surgical approaches. 2,5,10 Although the procedure has fundamentally reshaped the landscape of neurosurgery, the safety of thermal ablation requires real-time MRI monitoring of thermocoagulation by using a technique called MR thermometry.…”

Section: Neurosurg Focus 41 (4):e7 2016mentioning

confidence: 99%

Safety of stereotactic laser ablations performed as treatment for glioblastomas in a conventional magnetic resonance imaging suite

Rennert¹,

Carroll²,

Ali³

et al. 2016

FOC

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OBJECTIVE Stereotactic laser ablation (SLA) is typically performed in the setting of intraoperative MRI or in a staged manner in which probe insertion is performed in the operating room and thermal ablation takes place in an MRI suite. METHODS The authors describe their experience, in which SLA for glioblastoma (GBM) treatment was performed entirely within a conventional MRI suite using the SmartFrame stereotactic device. RESULTS All 10 patients with GBM (2 with isocitrate dehydrogenase 1 mutation [mIDH1] and 8 with wild-type IDH1 [wtIDH1]) were followed for > 6 months. One of these patients underwent 2 independent SLAs approximately 12 months apart. Biopsies were performed prior to SLA for all patients. There were no perioperative morbidities, wound infections, or unplanned 30-day readmissions. The average time for a 3-trajectory SLA (n = 3) was 436 ± 102 minutes; for a 2-trajectory SLA (n = 4) was 321 ± 85 minutes; and for a single-trajectory SLA (n = 4) was 254 ± 28 minutes. No tumor recurrence occurred within the blue isotherm line ablation zone, although 2 patients experienced recurrence immediately adjacent to the blue isotherm ablation line. Overall survival for the patient cohort averaged 356 days, with the 2 patients who had mIDH1 GBMs exhibiting the longest survival (811 and 654 days). CONCLUSIONS Multitrajectory SLA for treatment of GBM can be safely performed using the SmartFrame stereotactic device in a conventional MRI suite.

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Section: Neurosurg Focus 41 (4):e7 2016mentioning

confidence: 99%

Safety of stereotactic laser ablations performed as treatment for glioblastomas in a conventional magnetic resonance imaging suite

Rennert¹,

Carroll²,

Ali³

et al. 2016

FOC

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“…Several lesion types including epileptogenic foci, tumors, and radiation necrosis have been shown to respond to thermal ablation. 5,6,15,17 Furthermore, LITT has benefited greatly from intraoperative MRI, which allows for real-time monitoring of thermal ablation to ensure conformality of treatment zones. 16 AbbreviAtioNs DBS = deep brain stimulation; EEG = electroencephalography; ICU = intensive care unit; LITT = laser interstitial thermal therapy; mT = microTargeting; TDT = thermal damage threshold.…”

mentioning

confidence: 99%

Utilizing personalized stereotactic frames for laser interstitial thermal ablation of posterior fossa and mesiotemporal brain lesions: a single-institution series

Dadey

Kamath

Smyth

et al. 2016

FOC

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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. Bone fiducials were implanted in each patient's skull, and subsequent CT scans were used to guide the design of each platform and incorporate desired treatment trajectories. Once generated, the platforms were mounted on the patients' craniums and used to position the laser probe during surgery. Placement of the laser probe and the LITT procedure were monitored with intraoperative MRI. Perioperative and follow-up MRI were performed to identify and monitor changes in target lesions. RESULTS Accurate placement of the laser probe was observed in all cases. For all patients, thermal ablation was accomplished without intraoperative complications. Of the 4 patients with symptomatic lesions, 2 experienced complete resolution of symptoms, and 1 reported improved symptoms compared with baseline. CONCLUSIONS Customized stereotactic platforms were seamlessly incorporated into the authors' previously established LITT workflow and allowed for accurate treatment delivery.

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“…In neurosurgery for example, laser interstitial thermal therapy (LITT) is a preferred treatment option for patients who are not ideal surgical candidates (22). Since their introduction to neurosurgery, lasers have become increasingly safe to use and have been successfully applied for the treatment of unresectable gliomas as well as hard and hemorrhagic tumors such as meniniomas, tumors of the deep skull base, or tumors deep in the ventricles (10,23). Mucosal ablation techniques using lasers are currently being widely and successfully used for the treatment of superficial gastrointestinal cancers including early gastric cancer, superficial esophageal cancer, colorectal adenoma, and high-grade Barrett's esophagus (24).…”

Section: Oncologymentioning

confidence: 99%

Laser applications in surgery

Azadgoli¹,

Baker²

2016

Ann. Transl. Med.

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In modern medicine, lasers are increasingly utilized for treatment of a variety of pathologies as interest in less invasive treatment modalities intensifies. The physics behind lasers allows the same basic principles to be applied to a multitude of tissue types using slight modifications of the system. Multiple laser systems have been studied within each field of medicine. The term "laser" was combined with "surgery," "ablation," "lithotripsy," "cancer treatment," "tumor ablation," "dermatology," "skin rejuvenation," "lipolysis," "cardiology," "atrial fibrillation (AF)," and "epilepsy" during separate searches in the PubMed database. Original articles that studied the application of laser energy for these conditions were reviewed and included. A review of laser therapy is presented.Laser energy can be safely and effectively used for lithotripsy, for the treatment of various types of cancer, for a multitude of cosmetic and reconstructive procedures, and for the ablation of abnormal conductive pathways. For each of these conditions, management with lasers is comparable to, and potentially superior to, management with more traditional methods.

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Stereotactic laser ablation of high-grade gliomas

Cited by 116 publications

References 79 publications

Safety of stereotactic laser ablations performed as treatment for glioblastomas in a conventional magnetic resonance imaging suite

Safety of stereotactic laser ablations performed as treatment for glioblastomas in a conventional magnetic resonance imaging suite

Utilizing personalized stereotactic frames for laser interstitial thermal ablation of posterior fossa and mesiotemporal brain lesions: a single-institution series

Laser applications in surgery

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