Neurosurgical Focus October 2016

Laser interstitial thermotherapy (LITT), sometimes referred to as stereotactic laser ablation or SLA, is a minimally invasive surgery approach that uses thermal energy delivered by a laser to ablate tissue.

Advances in technology and near real-time thermography have generated renewed interest in this technology for the treatment of diseases of the brain and spine.

Several authors report technical adjuncts for improving the precision and speed of LITT using customized 3D printed frame as well as robot-assisted guidance for LITT.

Other groups have focused on assessing the safety of LITT procedures performed in a conventional operating room compared to the intraoperative MRI suite, and utilizing diffusion tensor imaging of the corticospinal tract to predict postoperative motor deficits.

Clinically oriented series include reports of LITT for rare lesions such as hypothalamic harmartomas, subependymal giant cell astrocytomas, and hypothalamic and intraventricular lesions often associated with epilepsy.

A multicenter review of LITT for brain metastases that recur after stereotactic radiosurgery and a comparison of LITT for newly diagnosed and recurrent glioblastomas (GBMs) are also presented.

Two groups describe the outcomes after efforts to minimize complications associated with post-LITT cerebral edema of large GBMs by combining LITT with minimally invasive craniotomies 1).

Barnett GH, Chen CC, Gross RE, Sloan AE. Introduction: Laser ablation techniques. Neurosurg Focus. 2016 Oct;41(4):E1. PubMed PMID: 27690650.



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