Magnetic resonance imaging of interstitial laser photocoagulation in brain

Tracz, Robert A.; Wyman, D. R.; Little, P B; Towner, Rheal A.; Stewart, Wendy A.; Schatz, Stanley W.; Pennock, P W; Wilson, Brian C.

doi:10.1002/lsm.1900120209

Cited by 80 publications

(38 citation statements)

References 19 publications

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“…The gadolinium enhancement pattern in T1-weighted MR images has also been reported to enable visualization of the induced tissue damage immediately after thermal coagulation of brain tissue. In an experimental acute model, the outer border of enhanced rim apparent in these images corresponded to the border of an area of thermally induced necrosis in brain tissue (27,28). Because of the varied numbers of follow-up days for three dogs in our study, and the dynamic nature of edema and reactive effects, the histologic findings in these three dogs were inconsistent with the MRTI dosimetry results.…”

Section: Discussionmentioning

confidence: 56%

Multiplanar MR temperature‐sensitive imaging of cerebral thermal treatment using interstitial ultrasound applicators in a canine model

Kangasniemi

Diederich

Price

et al. 2002

Magnetic Resonance Imaging

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Purpose:To study the feasibility of an interleaved gradientecho, echo-planar imaging (iGE-EPI) sequence for multiplanar magnetic resonance temperature imaging (MRTI) to monitor intracerebral thermal treatment three-dimensionally using multielement ultrasound applicators. Materials and Methods:Transmissible venereal tumor (TVT) fragments were injected into the right cerebral hemisphere of five dogs. Guided by MRI, an interstitial ultrasound applicator was inserted into the tumor or normal brain tissue. The iGE-EPI sequence was used to estimate temperature changes by computing the complex phase-difference induced by temperature-dependent shifts in the proton resonance frequency of water. The thermal dose maps were updated every 6 -8 seconds for five to seven image planes during treatment. The results of MRTI were compared with those of post-treatment MRI and histologic analysis. Results:The multiplanar MRTI monitored temperature and thermal dose distributions in tumor and normal brain tissue over the entire user-defined treatment volume. The ultrasound applicators produced contiguous areas of coagulative necrosis, resulting in 1.5-4.0 cm 3 volumes of tissue necrosis. MRTI-based assessments of thermal-dose distributions were consistent with the results of post-treatment MRI and histologic analysis. Conclusion MAGNETIC RESONANCE IMAGING (MRI) guidance for thermal treatment of brain neoplasms has been examined in several clinical studies (1-8).MRI is used to localize tumors for treatment planning, to guide placement of the treatment applicator within the tumor, and to provide visualization of the effects post-therapy. One study (5) used MR temperature-sensitive imaging (MRTI) to estimate temperature changes in the target volume of tissue during thermal treatment. MRTI allows real-time measurement of delivered thermal doses, but traditionally has been limited to a single imaging plane (5,9 -11). A multiplanar MRTI technique would allow three-dimensional temperature monitoring to delineate therapeutic temperatures and thermal doses over the entire treatment volume, providing better user control over treatment delivery, which might help to minimize damage to adjacent normal brain tissue.Previous clinical studies used either laser (1,3-8) or radiofrequency (RF) (2) devices to deliver thermal energy to intracerebral tumors. Recent laboratory and in vivo studies showed that interstitial ultrasound applicators with multielement construction can provide a spatial control of thermal coagulation (12)(13)(14)(15)(16)(17), and that these applicators appeared to be compatible with the use of MRI (18).The purpose of this study was to evaluate the feasibility of performing multiplanar MRTI using an interleaved gradient-echo, echo-planar imaging (iGE-EPI) sequence for three-dimensional measurement of temperatures and thermal doses during thermal treatment of brain and intracerebral tumor tissue in a canine model. The feasibility of interstitial ultrasound applica-

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Section: Discussionmentioning

confidence: 56%

Multiplanar MR temperature‐sensitive imaging of cerebral thermal treatment using interstitial ultrasound applicators in a canine model

Kangasniemi

Diederich

Price

et al. 2002

Magnetic Resonance Imaging

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“…Several experimental animal models were developed and further demonstrated the brain tissue changes in response to hyperthermia. 11,12,17,53,54 However, the lack of accurate control and the inability to monitor the laser-induced thermal effects limited the widespread application of this therapy. The development of magnetic resonance (MR) thermography, 14 based on the temperature dependence of the proton resonance frequency, allowed realtime image guidance of laser thermal energy delivery and rendered the treatment of deep, otherwise inaccessible lesions feasible.…”

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confidence: 99%

Renaissance of laser interstitial thermal ablation

Missios

Bekelis

Barnett

2015

FOC

162

124

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Laser interstitial thermal therapy (LITT) is a minimally invasive technique for treating intracranial tumors, originally introduced in 1983. Its use in neurosurgical procedures was historically limited by early technical difficulties related to the monitoring and control of the extent of thermal damage. The development of magnetic resonance thermography and its application to LITT have allowed for real-time thermal imaging and feedback control during laser energy delivery, allowing for precise and accurate provision of tissue hyperthermia. Improvements in laser probe design, surgical stereotactic targeting hardware, and computer monitoring software have accelerated acceptance and clinical utilization of LITT as a neurosurgical treatment alternative. Current commercially available LITT systems have been used for the treatment of neurosurgical soft-tissue lesions, including difficult to access brain tumors, malignant gliomas, and radiosurgery-resistant metastases, as well as for the ablation of such lesions as epileptogenic foci and radiation necrosis. In this review, the authors aim to critically analyze the literature to describe the advent of LITT as a neurosurgical, laser excision tool, including its development, use, indications, and efficacy as it relates to neurosurgical applications.

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“…Any interval increase in lesion size, heterogeneity, peripheral nodular enhancement, restricted diffusion, CBF/CBV, and surrounding edema in a lesion treated Ͼ40 -60 days prior should raise suspicion for recurrence (Fig 5). 36,37 Recurrence usually occurs within the peripheral rim of enhancement and presents as new or enlarging peripheral enhancing nodularity (Figs 5) or simply as thickening of the rim of enhancement (Fig 6). Comparison with prior images is vital in monitoring tumor recurrence because normally evolving lesions can demonstrate asymmetric enhancement similar to that of recurring lesions.…”

Section: Recurrencementioning

confidence: 99%

Current Applications of MRI-Guided Laser Interstitial Thermal Therapy in the Treatment of Brain Neoplasms and Epilepsy: A Radiologic and Neurosurgical Overview

Medvid¹,

Ruiz²,

Komotar

et al. 2015

AJNR Am J Neuroradiol

176

125

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SUMMARY:Minimally invasive stereotactic tumor ablation is a viable option for the treatment of benign and malignant intracranial lesions. Although surgical excision constitutes first-line therapy for various brain pathologies, it can cause irreversible neurologic deficits. Additionally, many patients who may benefit from surgery do not qualify as surgical candidates due to multiple comorbidities. Recent advancements in laser interstitial thermal therapy, namely the ability to monitor ablation in real-time under MR imaging, have improved the safety and efficacy of the procedure. MRI-guided laser interstitial thermal therapy is currently used as a minimally invasive treatment for brain metastases, radiation necrosis, glioma, and epilepsy. This article will discuss the principles, suggested indications, complications, and imaging characteristics of MRI-guided laser interstitial thermal therapy as they pertain to the treatment of brain pathology. ABBREVIATIONS:GBM ϭ glioblastoma multiforme; LITT ϭ laser interstitial thermal therapy; MRgLITT ϭ MRI-guided laser interstitial thermal therapy; MRTI ϭ MRI thermal imaging; RN ϭ delayed radiation necrosis; SRS ϭ stereotactic radiosurgery

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Magnetic resonance imaging of interstitial laser photocoagulation in brain

Cited by 80 publications

References 19 publications

Multiplanar MR temperature‐sensitive imaging of cerebral thermal treatment using interstitial ultrasound applicators in a canine model

Multiplanar MR temperature‐sensitive imaging of cerebral thermal treatment using interstitial ultrasound applicators in a canine model

Renaissance of laser interstitial thermal ablation

Current Applications of MRI-Guided Laser Interstitial Thermal Therapy in the Treatment of Brain Neoplasms and Epilepsy: A Radiologic and Neurosurgical Overview

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