Thermal therapy of canine cerebral tumors using a 980 nm diode laser with MR temperature‐sensitive imaging feedback

Kangasniemi, Marko; McNichols, Roger J.; Bankson, James A.; Gowda, Ashok; Price, Roger E.; Hazle, John D.

doi:10.1002/lsm.20069

Cited by 93 publications

(56 citation statements)

References 27 publications

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“…7,19 A skull bolt was placed and secured into the entry point. A cannula was passed through the bold incision and advanced to the predetermined depth.…”

Section: Treatmentmentioning

confidence: 99%

“…18 Potential therapies include medicine (e.g., high doses of cortical steroids or monoclonal antibodies 16 ) and resection; for patients who are not strong candidates for surgery and who have medically refractory radiation necrosis, LITT is potentially an alternative. 7,13 For instance, Torres-Reveron et al used LITT to successfully treat two cases of cerebellar lesions in which one patient tested positive for tumor recurrence and the other for radiation necrosis. 19 Our report provides further evidence that LITT is a viable treatment option when more conventional therapies are contraindicated.…”

Section: Fig 1 A: Preoperative Axial Mr Image Showing Infratentoriamentioning

confidence: 99%

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Stereotactic robot-assisted MRI-guided laser thermal ablation of radiation necrosis in the posterior cranial fossa: technical note

Chan

Tran

Gill

et al. 2016

FOC

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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. A 60-year-old man presented with facial weakness and brainstem symptoms consistent with radiation necrosis. He had a history of anaplastic astrocytoma that was treated with CyberKnife radiosurgery 1 year prior to presentation, and he did well for 11 months until his symptoms recurred. The location and form of the lesion precluded excision but made the patient a suitable candidate for LITT. The location and configuration of the lesion required a trajectory for LITT that was too low for arc-based stereotactic navigation, and thus the ROSA robot (Medtech) was used. Using preoperative MRI acquisitions, the lesion in the posterior fossa was targeted. Bone fiducials were used to improve accuracy in registration, and the authors obtained an intraoperative CT image that was then fused with the MR image by the ROSA robot. They placed the laser applicator and then ablated the lesion under real-time MR thermometry. There were no complications, and the patient tolerated the procedure well. Postoperative 2-month MRI showed complete resolution of the lesion, and the patient had some improvement in symptoms.

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“…7,19 A skull bolt was placed and secured into the entry point. A cannula was passed through the bold incision and advanced to the predetermined depth.…”

Section: Treatmentmentioning

confidence: 99%

Section: Fig 1 A: Preoperative Axial Mr Image Showing Infratentoriamentioning

confidence: 99%

Stereotactic robot-assisted MRI-guided laser thermal ablation of radiation necrosis in the posterior cranial fossa: technical note

Chan

Tran

Gill

et al. 2016

FOC

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“…9,16,17 Sapareto and Dewey 16 developed the CEM 43 model as a simplification of the Arrhenius model via approximation and normalization to hyperthermia results and used it to predict the isoeffects that would be produced if the tissue had been exposed to a cumulative equivalent number of minutes at 43°C ͑CEM 43 ͒. The CEM 43 model was then later extended to high-temperature ablations by Damianou et al 18 Lastly, the simplest thermal dose model to apply is a simple temperature threshold, which assumes that tissue is damaged nearly instantaneously once it reaches a certain temperature.…”

Section: Introductionmentioning

confidence: 99%

“…8͒ has been used for comparison to post-treatment contrast-enhanced T1-weighted imaging 20 min after therapy. Likewise, in studies using the Arrhenius model, different parameters and thresholds have been used to predict cell death: Thermal damage threshold, ⍀ =1, 9,16 and ⍀ = 6.9. 10 Temperature thresholds have been reported in the range of 48 to 53°C.…”

Section: Introductionmentioning

confidence: 99%

Quantitative comparison of thermal dose models in normal canine brain

et al. 2010

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Purpose: Minimally invasive thermal ablative therapies as alternatives to conventional surgical management of solid tumors and other pathologies is increasing owing to the potential benefits of performing these procedures in an outpatient setting with reduced complications and comorbidity. Magnetic resonance temperature imaging ͑MRTI͒ measurement allows existing thermal dose models to use the spatiotemporal temperature history to estimate the thermal damage to tissue. However, the various thermal dose models presented in the literature employ different parameters and thresholds, affecting the reliability of thermal dosimetry. In this study, the authors quantitatively compared three thermal dose models ͑Arrhenius rate process, CEM 43 , and threshold temperature͒ using the dice similarity coefficient ͑DSC͒. Methods: The DSC was used to compare the spatial overlap between the region of thermal damage as predicted by the models for in vivo normal canine brain during thermal therapy to the region of thermal damage as revealed by contrast-enhanced T1-weighted images acquired immediately after therapy ͑Ͻ20 min͒. The outer edge of the hyperintense rim of the ablation region was used as the surrogate marker for the limits of thermal coagulation. The DSC was also used to investigate the impact of varying the thresholds on each models' ability to predict the zone of thermal necrosis. Results: At previously reported thresholds, the authors found that all three models showed good agreement ͑defined as DSCϾ 0.7͒ with post-treatment imaging. All three models examined across the range of commonly applied thresholds consistently showed highly accurate spatial overlap, low variability, and little dependence on temperature uncertainty. DSC values corresponding to cited thresholds were not significantly different from peak DSC values. Conclusions: Thus, the authors conclude that the all three thermal dose models can be used as a reliable surrogate for postcontrast tissue damage verification imaging in rapid ablation procedures and can also be used to enhance the capability of MRTI to control thermal therapy in real time.

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“…Significantly, this patient also harbored the smallest tumor in terms of tumor volume, measuring 6.6 cm 3 compared with 18 and 94 cm 3 in the nonresponding tumors. Achieving an acceptable cytoreductive effect in lesions of these sizes is made more difficult due to inherent limitations in the volume of thermal effect obtainable from a single catheter, 12 with the preponderance of data in treatment of recurrent gliomas and metastases from tumors with volumes smaller than 10 cm 3 .…”

Section: Discussionmentioning

confidence: 99%

Stereotactic laser ablation for hypothalamic and deep intraventricular lesions

Buckley

Wang

Miller

et al. 2016

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OBJECTIVE Laser ablation is a novel, minimally invasive procedure that utilizes MRI-guided thermal energy to treat epileptogenic and other brain lesions. In addition to treatment of mesial temporal lobe epilepsy, laser ablation is increasingly being used to target deep or inoperable lesions, including hypothalamic hamartoma (HH), subependymal giant cell astrocytoma (SEGA), and exophytic intrinsic hypothalamic/third ventricular tumors. The authors reviewed their early institutional experience with these patients to characterize clinical outcomes in patients undergoing this procedure. METHODS A retrospective cohort (n = 12) of patients undergoing laser ablation at a single institution was identified, and clinical and radiographic records were reviewed. RESULTS Laser ablation was successfully performed in all patients. No permanent neurological or endocrine complications occurred; 2 (17%) patients developed acute obstructive hydrocephalus or shunt malfunction following treatment. Laser ablation of HH resulted in seizure freedom (Engel Class I) in 67%, with the remaining patients having a clinically significant reduction in seizure frequency of greater than 90% compared with preoperative baseline (Engel Class IIB). Treatment of SEGAs resulted in durable clinical and radiographic tumor control in 2 of 3 cases, with one patient receiving adjuvant everolimus and the other receiving no additional therapy. Palliative ablation of hypothalamic/third ventricular tumors resulted in partial tumor control in 1 of 3 patients. CONCLUSIONS Early experience suggests that laser ablation is a generally safe, durable, and effective treatment for patients harboring HHs. It also appears effective for local control of SEGAs, especially in combination therapy with everolimus. Its use as a palliative treatment for intrinsic hypothalamic/deep intraventricular tumors was less successful and associated with a higher risk of serious complications. Additional experience and long-term follow-up will be beneficial in further characterizing the effectiveness and risk profile of laser ablation in treating these lesions in comparison with conventional resective surgery or stereotactic radiosurgery.

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Thermal therapy of canine cerebral tumors using a 980 nm diode laser with MR temperature‐sensitive imaging feedback

Abstract: Targeted thermal coagulation of small intracerebral tumors is feasible using MRTI-based feedback and diffused 980 nm diode laser light.

Cited by 93 publications

References 27 publications

Stereotactic robot-assisted MRI-guided laser thermal ablation of radiation necrosis in the posterior cranial fossa: technical note

Stereotactic robot-assisted MRI-guided laser thermal ablation of radiation necrosis in the posterior cranial fossa: technical note

Quantitative comparison of thermal dose models in normal canine brain

Stereotactic laser ablation for hypothalamic and deep intraventricular lesions

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