- 标题
- 摘要
- 关键词
- 实验方案
- 产品
-
Stereotactic laser interstitial thermal therapy for brainstem cavernous malformations: two preliminary cases
摘要： Brainstem cavernous malformations (CMs) often have high hemorrhage rates and significant posthemorrhage morbidity. The authors present two cases in which magnetic resonance thermography-guided laser interstitial therapy was used for treatment of pontine CMs after recurrent hemorrhage. Both patients showed significant symptomatic improvement and were hemorrhage-free at 12- and 6-month follow-up, respectively. Each had radiographic evidence of lesion involution on serial follow-up imaging. These early results demonstrate this treatment modality may be technically safe; however, larger case numbers and longer follow-up are needed to demonstrate efficacy.
关键词： Cavernous malformation,Cavernoma,Magnetic resonance imaging,Thermometry,Brainstem,Laser interstitial thermal therapy,Minimally invasive,Stereotactic laser ablation
更新于2025-09-23 15:21:01
-
Prediction of recurrent glioblastoma after laser interstitial thermal therapy: The role of diffusion imaging
摘要： Background. Evaluate the utility of diffusion-weighted imaging (DWI) for the assessment of local recurrence of glioblastoma (GBM) on imaging performed 24?h following MRI-guided laser interstitial thermal therapy (LITT). We hypothesize that microscopic peritumoral infiltration correlates with early subtle variations on DWI images and apparent diffusion coefficient (ADC) maps. Methods. Of 64 patients with GBM treated with LITT, 39 had MRI scans within 24?h after undergoing LITT. Patterns on DWI images and ADC maps 24?h following LITT were correlated with areas of future GBM recurrence identified through coregistration of subsequent MRI examinations. In the areas of suspected recurrence within the periphery of post-LITT lesions, signal intensity values on ADC maps were recorded and compared with the remaining peritumoral ring. Results. Thirty-nine patients with GBM met the inclusion criteria. For predicting recurrent GBM, areas of decreased DWI signal and increased signal on ADC maps within the expected peritumoral ring of restricted diffusion identified 24? h following LITT showed 86.1% sensitivity, 75.2% specificity, and high correlation (r? =? 0.53) with future areas of GBM recurrence (P < .01). Areas of future recurrence demonstrated a 37% increase in the ADC value (P < .001), compared with findings in the surrounding treated peritumoral region. A?significantly greater area under the receiver operating characteristics curve was determined for ADC values (P < .01). Conclusions. DWI obtained 24?h following LITT can help predict the location of GBM recurrence months before the development of abnormal enhancement. This may alter future treatment planning, perhaps suggesting areas that may be targeted for additional therapy.
关键词： apparent diffusion coefficient,MRI-guided laser interstitial thermal therapy,laser interstitial thermal therapy,diffusion-weighted image,glioblastoma
更新于2025-09-23 15:19:57
-
Staged Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Analysis of Ablation Volumes and Morphological Considerations
摘要： BACKGROUND: Hypothalamic hamartomas (HH) are a challenging pathology that cause gelastic seizures. Magnetic Resonance Imaging-guided Laser Interstitial Thermal Therapy (MRgLITT) offers a safe and effective treatment for HHs via a minimally invasive technique. OBJECTIVE: To determine how clinical outcome correlates to residual tumor volume and surgical strategy by analyzing radiographic data and reconstructing volumetric imaging. METHODS: Clinical and radiographic information of 58 pediatric patients who underwent MRgLITT for HH with at least 6 mo of follow-up were retrospectively reviewed. MR imaging was volumetrically reconstructed to analyze the impact of hamartoma and ablation volumes on outcome. Primary outcome measure was freedom from gelastic seizures. RESULTS: Eighty-one percent of patients were completely free of gelastic seizures at last follow-up; of 22 patients with secondary nongelastic epilepsy, 15 were free of additional seizures. Postoperative complication rate was low. There was no significant difference in gelastic seizure outcome related to pre- or postoperative hamartoma size. Residual hamartoma percentage in those free of gelastic seizures was 43% compared to 71% in those with continued seizures (P = .021). Larger hamartomas required multiple ablations to achieve seizure freedom. CONCLUSION: This large series of patients confirms the safety and efficacy of MRgLITT for pediatric HH and describes morphological considerations that predict success. Our data suggest that complete ablation of the lesion is not necessary, and that the focus should be on appropriate disconnection of the epileptogenic network. We have found that a staged approach to hamartoma ablation allows adequate disconnection of the hamartoma while mitigating risk to surrounding structures.
关键词： Epilepsy,Laser ablation,Hypothalamic hamartoma,Gelastic seizures,Laser interstitial thermal therapy
更新于2025-09-19 17:13:59
-
Neurosurgical applications of MRI guided laser interstitial thermal therapy (LITT)
摘要： MRI-guided laser interstitial thermal therapy (LITT) is the selective ablation of a lesion or a tissue using heat emitted from a laser device. LITT is considered a less invasive technique compared to open surgery that provides a non-surgical solution for patients who cannot tolerate surgery. Although laser ablation has been used to treat brain lesions for decades, recent advances in MRI have improved lesion targeting and enabled real-time accurate monitoring of the thermal ablation process. These advances have led to a plethora of research involving the technique, safety, and potential applications of LITT. LITT is a minimally invasive treatment modality that shows promising results and is associated with decreased morbidity. It has various applications, such as treatment of glioma, brain metastases, radiation necrosis, and epilepsy. It can provide a safer alternative treatment option for patients in whom the lesion is not accessible by surgery, who are not surgical candidates, or in whom other standard treatment options have failed. Our aim is to review the current literature on LITT and provide a descriptive review of the technique, imaging findings, and clinical applications for neurosurgery.
关键词： Laser interstitial thermal therapy,Laser ablation
更新于2025-09-19 17:13:59
-
Laser interstitial thermal therapy for pediatric atypical teratoid/rhabdoid tumor: case report
摘要： Herein, the authors describe the successful use of laser interstitial thermal therapy (LITT) for management of metastatic craniospinal disease for biopsy-proven atypical teratoid/rhabdoid tumor in a 16-month-old boy presenting to their care. Specifically, LITT was administered to lesions of the right insula and left caudate. The patient tolerated 2 stages of LITT to the aforementioned lesions without complication and with evidence of radiographic improvement of lesions at the 2- and 6-month follow-up appointments. To the authors’ knowledge, this represents the first such published report of LITT for management of atypical teratoid/rhabdoid tumor.
关键词： laser interstitial thermal therapy,ATRT,atypical teratoid/rhabdoid tumor,pediatric brain tumor,LITT
更新于2025-09-19 17:13:59
-
Laser Interstitial Thermal Therapy for Metastatic Melanoma After Failed Radiation Therapy: A Case Series
摘要： Laser interstitial thermal therapy (LITT) is a growing technology to treat a variety of brain lesions. It offers an alternative to treatment options, such as open craniotomy and stereotactic radiosurgery. OBJECTIVE: To analyze our experience using LITT for metastatic melanoma. METHODS: This is a retrospective chart review of the patients from our institution. Our case series involves 5 patients who had previously failed radiation treatment. RESULTS: Our patients have low complication rates and short hospital stays. Both are considerably lower when compared to the literature for metastatic melanoma. CONCLUSION: LITT is a safe therapy, with few complications and short hospital stays.
关键词： Melanoma,LITT,Laser interstitial thermal therapy
更新于2025-09-19 17:13:59
-
Laser interstitial thermal therapy (LITT) of the brain – Experiences and new indications
摘要： The glioma is the most common type of primary brain tumor; more than 40% of gliomas are malignant. For decades, open microsurgical resection and postoperative radiochemotherapy have been the international standard methods of treatment. During the last few years, the importance of the (sub-)total tumor resection has been recognized, especially in respect of the patient’s progression-free survival time. Different modalities of neuronavigation, intraoperative imaging (“open MR” system) and intraoperative fluoroscopy with 5-ALA have proved to be important technical achievements to support this aim. However, the overall survival time of patients with anaplastic gliomas is poor. Successful curative treatments are statistically insignificant. As a result, it was and still is important to find new adjuvant methods to treat (recurrent) brain tumors. One of the most promising minimally invasive procedures is the laser interstitial thermal therapy (LITT), performed under stereotactic or “open” magnetic resonance imaging (MRI) guidance.
关键词： brain tumors,minimally invasive,Laser interstitial thermal therapy,gliomas,LITT
更新于2025-09-16 10:30:52
-
New Techniques for Management of 'Inoperable' Gliomas || Laser interstitial thermal therapy for “inoperable” gliomas
摘要： The standard of care initial treatment for newly diagnosed World Health Organization (WHO) grade III or grade IV gliomas (high-grade gliomas, HGG) is maximal safe surgical resection followed by adjuvant radiation therapy and temozolomide chemotherapy.1,2 Despite this established standard of care, mean length of survival is extremely poor (12–14 months), or up to 21.7 months if the lesion is positive for methylguanine methyltransferase promoter methylation and the patient is treated with radiation therapy and temozolomide.3 Although HGG is a diffuse, nonfocal disease,4 tumor excision with as high of a residual as 12% has been demonstrated to increase overall survival compared with radiation and chemotherapy alone.5 However, despite the survival benefit surgical resection confers, some patients are not candidates for surgery due to multiple medical comorbidities, low functional status, risk factors for poor wound healing such as prior surgery or radiation, inability to tolerate positioning or general anesthesia, deep-seated lesion, or location adjacent to critical neurovascular structures or within eloquent brain areas. In such patients, a less invasive and less morbid alternative than open craniotomy is desired. Thus, laser interstitial thermal therapy (LITT), a technique in which heat created by light absorption ablates tissue, is contemplated for such nonoperative candidates.6 Due to its favorable ability to administer thermal energy to a narrowly defined anatomic area in a tightly controlled fashion with minimal injury to surrounding brain, LITT has demonstrated potential over other minimally invasive therapies.1,7–9
关键词： inoperable,cytoreduction,gliomas,Laser interstitial thermal therapy,minimally invasive
更新于2025-09-16 10:30:52
-
Cognitive outcomes following laser interstitial therapy for mesiotemporal epilepsies
摘要： Objective To provide a review of cognitive outcomes across a full neuropsychological profile in patients who underwent laser interstitial thermal therapy (LiTT) for mesiotemporal epilepsy (mTLE). Methods We examined cognitive outcomes following LiTT for mTLE by reviewing a consecutive series of 26 patients who underwent dominant or nondominant hemisphere procedures. Each patient’s pre- and postsurgical performance was examined for clinically significant change (>1SD improvement or decline on standardized scores), with a neuropsychologic battery that included measures of language, memory, executive functioning, and processing speed. Results Presurgical performance was largely consistent with previous research, where patients suffering from dominant hemisphere epilepsies demonstrated deficits in verbal learning and memory, whereas patients with nondominant hemisphere scored lower on visually mediated tests. Case-by-case review comparing presurgical to postsurgical scores revealed clinically significant improvement in both dominant and nondominant patients in learning and memory and other aspects of cognition such as processing speed and executive functioning. Of the few patients who did experience clinically significant decline following LiTT, a greater proportion had undergone dominant hemisphere procedures. Conclusions Compared with the outcome literature of dominant open anterior temporal lobectomies (ATLs), where postsurgical decline has been documented in up to 40%–60% of cases, our LiTT case series exhibited a much lower incidence of postoperative language or verbal memory decline. Moreover, promising rates of postoperative improvements were also observed across multiple cognitive domains. Future studies exploring cognitive outcomes following LiTT should include comprehensive neuropsychological findings, rather than only select domains, as clinically significant change can occur in areas other than those typically associated with mesiotemporal structures.
关键词： cognitive outcomes,mesiotemporal epilepsy,laser interstitial thermal therapy,neuropsychological profile
更新于2025-09-16 10:30:52
-
Laser interstitial thermal therapy in gliomas
摘要： Laser interstitial thermal therapy (LITT) has been used for brain metastasis, epilepsy, and necrosis, as well as gliomas as a minimally invasive treatment for many years. With the improvement of the thermal monitoring and ablation precision, especially the application of magnetic resonance (MR) thermography in the procedure and the available of two commercial laser systems nowadays, LITT is gradually accepted by more neurosurgical centers. Recently, some new concepts, for example the adjuvant chemotherapy or radiation following LITT, the combination of immunotherapy and LITT regarding the glioma treatment are proposed and currently being investigated. The aim of this study is to summarize the evolution of LITT especially for brain gliomas and a possible outlook of the future.
关键词： gliomas,immunotherapy,blood brain barrier,Laser interstitial thermal therapy
更新于2025-09-16 10:30:52