Magnetic resonance thermometry-guided laser-induced thermal therapy for intracranial neoplasms:  initial experience.
BACKGROUND
Laser-induced thermal therapy is a promising tool in the neurosurgeon's armamentarium. This methodology has seen a resurgence in application as a result of advances in technology.


OBJECTIVE
To report our initial experience with the procedure after treating 20 consecutive patients, the largest series to date.


METHODS
Patients were selected for laser therapy if they had failed conventional therapies, were unable to tolerate an open cranial procedure, or the tumor was deemed otherwise inoperable. In this series, 980-nm diode laser catheters were placed stereotactically in the operating room. The patients were then transferred to the magnetic resonance imaging suite for thermal ablation.


RESULTS
A total of 31 laser applicators were placed in 20 patients with intracranial neoplasms. The majority of patients (17 of 20) had prior treatment for their tumors. The overall accuracy of laser insertion was 83.9%, improving with increased experience. The average lesion volume treated was 7.0 ± 9.0 cm2. With the use of damage estimates from the software provided, the treatment continued until the entire tumor had been irreversibly ablated. The average length of hospitalization was 2.27 days, with the majority of patients going home on postoperative day 1. Complications occurred in 4 patients, typically in those who were in poor health preoperatively.


CONCLUSIONS
Laser-induced thermal therapy is an intuitive procedure for treating difficult intracranial neoplasms. As with any other procedure, patient selection and lesion selection are important factors in determining outcome.
Department of Neurosurgery, UMDNJ--New Jersey Medical School, Newark, New Jersey 08901, USA. pinakin.jethwa.md@gmail.com
Pinakin R
PR
Jethwa
James C
JC
Barrese
Ashok
A
Gowda
Anil
A
Shetty
Shabbar F
SF
Danish
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D053685:Laser Therapy / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted / Q000379:methods; D055815:Young Adult