Stereotactic Radiofrequency Thermocoagulation of Hypothalamic Hamartoma Using Robotic Guidance (ROSA) Coregistered with O-arm Guidance—Preliminary Technical Note

Tandon, Vivek; Chandra, P. Sarat; Doddamani, Ramesh; Subianto, Heri; Bajaj, Jitin; Garg, Ajay; Tripathi, Manjari

doi:10.1016/j.wneu.2018.01.193

Cited by 24 publications

(10 citation statements)

References 28 publications

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“…Moreover, the good results obtained by surgery and radiosurgery [48], the better volume control of LiTT, and the difficulty to perform a meaningful functional mapping in this area makes it harder to justify SEEG-guided RF-TC in this condition. When economic constraints limit the access to the reference techniques, standard monopolar RF-TC remain an option [49].…”

Section: Indicationsmentioning

confidence: 99%

Surgical techniques: Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC)

Bourdillon

Rheims

Catenoix

et al. 2020

Seizure

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Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC) consists of coupling SEEG investigation with RF-TC stereotactic lesioning directly through the recording electrodes. In this systematic review the surgical technique, indications, and outcomes are described. Maximum accuracy is reached when a frame-based procedure with a robotic assistance and a per-operative vascular X-ray imaging are performed. Monitoring of the lesioning procedure based on the impedance, a sharp modification of which indicates that the thermocoagulation has reached its maximum volume, allows the optimization of the lesion size. The first indication concerns patients in whom a SEEG is required to determine whether surgery is feasible and in whom resection is indeed possible. Even if surgery is performed owing to insufficient efficacy of SEEG-guided RF-TC, the procedure remains interesting owing to its high positive predictive value for good outcome after surgery. The second indication concerns patients in whom phase I non-invasive investigations have concluded to surgical contraindication and who may still undergo SEEG in a purely therapeutic perspective (small deep zones inaccessible to surgery and network nodes of large epileptic networks). Lastly, SEEG-guided RF-TC can be considered as a first-line treatment for periventricular nodular heterotopia (PNH). Independently of indication, the overall seizure-free rate is 23% and the responder rate is 58%. The best results are obtained for PNH (38% seizure-free and 81% responders), while the worst results have been reported for temporal lobe-epilepsy in a dedicated study. The overall complication rate is 2.5%. More evidence is needed to help determine the exact place of SEEG-guided RF-TC in the surgical management algorithm.

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Section: Indicationsmentioning

confidence: 99%

Surgical techniques: Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC)

Bourdillon

Rheims

Catenoix

et al. 2020

Seizure

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“…They reviewed 100 patients with a median follow-up time of 36 months and reported that complete freedom from seizures was achieved in 71.0% of patients. In the present study, we performed SRT with the guidance of a ROSA or Sinovation robot in accordance with the technical note of Tandon et al 27 and made lesions based on findings from intracranial EEG recordings. Intracranial EEG could provide accurate localization of the epileptogenic focus and guidance for reoperation.…”

Section: Efficacy Of Srt and Rsmentioning

confidence: 99%

Stereotactic radiofrequency thermocoagulation and resective surgery for patients with hypothalamic hamartoma

Wang¹,

Zhao²,

et al. 2021

Journal of Neurosurgery

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OBJECTIVEIn this study, the authors compared the efficacy and safety of stereotactic radiofrequency thermocoagulation (SRT) and resective surgery (RS) for patients with hypothalamic hamartoma (HH).METHODSThe authors included all patients with HHs who were treated by SRT or hamartoma resection. Seizure outcomes were assessed by blinded observers according to the International League Against Epilepsy (ILAE) classification. Favorable seizure outcomes were defined as ILAE classes 1 and 2, and unfavorable seizure outcomes were defined as ILAE classes 3–6.RESULTSTwenty-nine patients who underwent SRT or RS met the inclusion criteria; 3 were excluded because they had completed less than 12 months of follow-up. Most of the patients (20 of 26; 76.9%) had small HHs (i.e., maximum HH diameter less than 20 mm). The patients’ follow-up time ranged from 12 to 66 months (median 60 months). At the last follow-up, favorable outcomes were observed in 9 patients (69.2%) who had undergone SRT and 10 patients (76.9%) who had undergone HH resection. No significant difference was found in seizure outcomes between SRT and RS recipients. Patients with giant HHs were more likely than patients with smaller tumors to undergo multiple resections (p = 0.043, univariate logistic regression; significant). However, no significant difference was found between SRT and RS recipients in terms of the number of procedures per patient. SRT recipients had fewer and less-severe adverse events than RS recipients.CONCLUSIONSFor patients with small HHs, SRT provides similar seizure outcomes to RS with a less invasive procedure. Patients who underwent SRT experienced fewer and lighter adverse effects than patients who had RS. Patients with giant HHs were more likely to undergo multiple HH resections.

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“…Since the description of the first experience with SEEG-guided RF-TC by Guenot et al in 2004, a handful of series have been published with experiences from different centers in Europe and Asia. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] These reports have utilized RF-TC techniques to address various pathologies causing refractory epilepsy. Given the safety profile and size of lesion created, as determined by Bourdillon et al in their in vivo and in vitro data, the SEEGguided RF-TC method may be an ideal technique for these lesions.…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency Thermocoagulation in Refractory Focal Epilepsy: The Montreal Neurological Institute Experience

Mirza

Hall

2020

Can. J. Neurol. Sci.

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Background: Radiofrequency thermocoagulation (RF-TC) is a minimally invasive ablative option for refractory focal epilepsy. Methods: A retrospective chart review was conducted of all patients who underwent stereoelectroencephalography (SEEG)-guided RF-TC at our institution. Results: Fourteen patients underwent robot-guided electrode implantation and subsequent RF-TC. After RF-TC, one of the three patients with PVNH was seizure free, one had 18 months of seizure freedom (Engel 2b), and one required temporal neocortical/PVNH resection (Engel 1a). One of the four patients with focal cortical dysplasia (FCD) was seizure free (Engel 1a), two attained seizure freedom after resection (Engel 1a and 1b), while one continues to have significant seizures (Engel 4b). One patient with cavernoma and low central area epileptogenic zone (EZ) did not benefit from RF-TC and is planned for resection. Two of the MRI-negative patients achieved seizure freedom for 3 months and 1 year, respectively, subsequently requiring resection (Engel 1a). One remains seizure free at 4 weeks. Three had seizure recurrence immediately (Engel 4b). With RF-TC alone, two patients (14%) achieved Engel 1a, two were seizure free at 1 year, one had 3 months of seizure freedom, while the rest had recurrence immediately or within a few weeks. 7/14 patients underwent secondary interventions after RF-TC. Overall, seven patients achieved Engel 1a or 1b, one each 2b and 3a, and five Engel 4b. Conclusion: At our institution, RF-TC is a safe ablative procedure for refractory focal epilepsy. It can serve as a segue to secondary interventions and appears promising in PVNH cases. Its role in MRI-negative cases is less clear.

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Stereotactic Radiofrequency Thermocoagulation of Hypothalamic Hamartoma Using Robotic Guidance (ROSA) Coregistered with O-arm Guidance—Preliminary Technical Note

Cited by 24 publications

References 28 publications

Surgical techniques: Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC)

Surgical techniques: Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC)

Stereotactic radiofrequency thermocoagulation and resective surgery for patients with hypothalamic hamartoma

Radiofrequency Thermocoagulation in Refractory Focal Epilepsy: The Montreal Neurological Institute Experience

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