Stereotactic Guided Laser-Induced Interstitial Thermotherapy (SLITT) in Gliomas with Intraoperative Morphologic Monitoring in an Open MR: Clinical Expierence

Leonardi, M.C.; Lumenta, C. B.

doi:10.1055/s-2002-36203

Cited by 56 publications

(34 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Leonardi and Lumenta report that the mean progressionfree survival for recurrent Grade III and IV HGGs was 10 and 4 months, respectively. 38 The mean overall survival for recurrent Grade III and IV HGGs was 30 and 9 months, respectively. 38 Schwarzmaier et al reported that the overall survival of 16 patients with recurrent HGG after LITT was 11.2 months.…”

Section: Stereotactic Laser Ablation As a Salvage Therapy For Recurrementioning

confidence: 97%

“…38 The mean overall survival for recurrent Grade III and IV HGGs was 30 and 9 months, respectively. 38 Schwarzmaier et al reported that the overall survival of 16 patients with recurrent HGG after LITT was 11.2 months. 65 Carpentier et al reported that overall survival among 4 patients with HGGs was 10 months after LITT.…”

Section: Stereotactic Laser Ablation As a Salvage Therapy For Recurrementioning

confidence: 97%

“…38, 41 Leonardi and Lumenta found that overall survival for WHO Grade III tumors was 20 months post-LITT. 38 Several authors reported WHO Grade IV-specific outcome data. 13,38,41,64,65,67 Progressionfree survival for WHO Grade IV HGGs ranged from 1 to 5 months post-LITT.…”

Section: Stereotactic Laser Ablation For Who Grade III Versus Grade Imentioning

confidence: 99%

See 2 more Smart Citations

Stereotactic laser ablation of high-grade gliomas

Hawasli¹,

Kim

Dunn

et al. 2014

FOC

111

View full text Add to dashboard Cite

Evolving research has demonstrated that surgical cytoreduction of a high-grade glial neoplasm is an important factor in improving the prognosis of these difficult tumors. Recent advances in intraoperative imaging have spurred the use of stereotactic laser ablation (laser interstitial thermal therapy [LITT]) for intracranial lesions. Among other targets, laser ablation has been used in the focal treatment of high-grade gliomas (HGGs). The revived application of laser ablation for gliomas parallels major advancements in intraoperative adjuvants and groundbreaking molecular advances in neuro-oncology. The authors review the research on stereotactic LITT for the treatment of HGGs and provide a potential management algorithm for HGGs that incorporates LITT in clinical practice.

show abstract

Section: Stereotactic Laser Ablation As a Salvage Therapy For Recurrementioning

confidence: 97%

Section: Stereotactic Laser Ablation As a Salvage Therapy For Recurrementioning

confidence: 97%

See 1 more Smart Citation

Stereotactic laser ablation of high-grade gliomas

Hawasli¹,

Kim

Dunn

et al. 2014

FOC

111

View full text Add to dashboard Cite

show abstract

“…11,13,21,22 The minimally invasive nature of LITT coupled with advances in MR thermography techniques has led to the exploration of this technique's use for various neurosurgical indications such as deep-seated glioma, 8,9,20,22 brain metastasis, 2,5,21 radiation necrosis, 4,16,21 and epilepsy. 7,23 LITT has shown promising results in the management of patients with difficult-toaccess brain tumors 12 and has emerged as a potential tool in the armamentarium of neurosurgeons.…”

Section: Neurosurg Focus 41 (4):e6 2016mentioning

confidence: 99%

Thermal injury to corticospinal tracts and postoperative motor deficits after laser interstitial thermal therapy

Sharma

Habboub

Behbahani

et al. 2016

FOC

View full text Add to dashboard Cite

OBJECTIVE Laser interstitial thermal therapy (LITT) has been increasingly used to treat deep-seated tumors. Despite its being minimally invasive, there is a risk of LITT damaging adjacent critical structures, including corticospinal tracts (CSTs). In this study, the authors investigated the predictive value of overlap between the hyperthermic field and CSTs in determining postoperative motor deficit (PMDs). METHODS More than 140 patients underwent an LITT procedure in our institution between April 2011 and June 2015. Because of the tumor's proximity to critical structures, 80 of them underwent preoperative diffusion tensor imaging and were included in this study. Extent of the hyperthermic field was delineated by the software as thermal-damage-threshold (TDT) lines (yellow [43°C for 2 minutes], blue [43°C for 10 minutes], and white [43°C for 60 minutes]). The maximum volume and the surface area of overlaps between motor fibers and the TDT lines were calculated and compared with the PMDs. RESULTS High-grade glioma (n = 46) was the most common indication for LITT. Postoperative motor deficits (partial or complete) were seen in 14 patients (11 with permanent and 3 with temporary PMDs). The median overlap volumes between CSTs with yellow, blue, and white TDT lines in patients with any PMD (temporary or permanent) were 1.15, 0.68, and 0.41 cm3, respectively. The overlap volumes and surface areas revealed significant differences in those with PMDs and those with no deficits (p = 0.0019 and 0.003, 0.012 and 0.0012, and 0.001 and 0.005 for the yellow, blue, and white TDT lines, respectively). The receiver operating characteristic was used to select the optimal cutoff point of the overlapped volumes and areas. Cutoff points for overlap volumes and areas based on optimal sensitivity (92%–100%) and specificity (80%–90%) were 0.103, 0.068, and 0.046 cm3 and 0.15, 0.07, and 0.11 mm2 for the yellow, blue, and white TDT lines, respectively. CONCLUSIONS Even a minimal overlap between the TDT lines and CSTs can cause a PMD after LITT. Precise planning and avoidance of critical structures and important white matter fibers should be considered when treating deep-seated tumors.

show abstract

“…Four studies that evaluated LITT as salvage therapy for recurrent HGG reported an overall survival of 9-15 months posttreatment. 1,5,7,8 Although these promising data are similar to survival achieved with salvage surgery for HGG, it is impossible to control for the contribution of adjuvant chemotherapies to this outcome. Nevertheless, recurrence may represent a favorable context for LITT application, because patients in this cohort are often poor surgical candidates with focal disease.…”

mentioning

confidence: 94%

Editorial: Laser interstitial thermal therapy: an effective treatment for focally recurrent high grade glioma

Malone

Bruce²

2014

FOC

View full text Add to dashboard Cite

Laser interstitial thermal therapy (LITT) is an emerging treatment modality in glioma therapy. The technology is most effectively applied in the treatment of deep-seated lesions that are difficult to access surgically without injury to eloquent neurological structures. The LITT treatment produces focal thermal ablation leading to tumor cytoreduction through tissue coagulation, necrosis, and cellular apoptosis. Historically, laser ablation techniques have been limited by an inability to assess ablation progress and parenchymal temperature during the course of treatment. Advances in MRI capabilities have overcome these limitations, leading to the reapplication of this technology for select intracranial pathological entities, with promising preliminary results.In this issue of Neurosurgical Focus, Hawasli and colleagues review the current literature on LITT for the treatment of high-grade gliomas (HGGs).3 This report underscores the variability in published outcomes following LITT for HGG. Radiographically, the reported reduction in tumor size on follow-up imaging after LITT varies between 15% and 87% of total lesion volume.2,4 The average progression-free survival post-LITT ranges from 1 to 17 months, while overall survival post-LITT varies from 7 to 30 months.3 This variability may in part be attributed to mixed patient cohorts, including both newly diagnosed and recurrent tumors.Treatment results appear more consistent when limited to patients with disease recurrence, although this subgroup analysis is not available in all trials. Four studies that evaluated LITT as salvage therapy for recurrent HGG reported an overall survival of 9-15 months posttreatment. 1,5,7,8 Although these promising data are similar to survival achieved with salvage surgery for HGG, it is impossible to control for the contribution of adjuvant chemotherapies to this outcome. Nevertheless, recurrence may represent a favorable context for LITT application, because patients in this cohort are often poor surgical candidates with focal disease. Data from subgroup analysis of patients treated for newly diagnosed HGG are scarce. The varying indications that led to LITT as de novo treatment in these instances further limit conclusions that can be drawn from these data.Consistent with the surgical literature on extent of resection in HGG, "extent of ablation" appears to be an important factor influencing both overall and progressionfree survival.6 Additionally, increasing the thermal dose appears to be associated with improved radiographic response and perhaps clinical outcome.2,8 Intuitively, dose escalation with more aggressive laser ablation will increase the risk profile associated with LITT, particularly with the propensity for blood vessels and ventricles to act as heat sinks. Hawasli and colleagues report an overall complication rate of 49% after pooling data in their review of 174 HGG cases. Although some of these complications are minor and transient, there were 4 reports of cerebral edema, 30 of neurological deficits, and 6 reports of inf...

show abstract

Stereotactic Guided Laser-Induced Interstitial Thermotherapy (SLITT) in Gliomas with Intraoperative Morphologic Monitoring in an Open MR: Clinical Expierence

Cited by 56 publications

References 31 publications

Stereotactic laser ablation of high-grade gliomas

Stereotactic laser ablation of high-grade gliomas

Thermal injury to corticospinal tracts and postoperative motor deficits after laser interstitial thermal therapy

Editorial: Laser interstitial thermal therapy: an effective treatment for focally recurrent high grade glioma

Contact Info

Product

Resources

About