title: The use of MRI-guided laser-induced thermal ablation for epilepsy.
abstract: OBJECTIVE
  Epilepsy surgery is constantly researching for new options for patients with refractory epilepsy. MRI-guided laser-induced thermal ablation for epilepsy is an exciting new minimally invasive technology with an emerging use for lesionectomy of a variety of epileptogenic focuses (hypothalamic hamartomas, cortical dysplasias, cortical malformations, tubers) or as a disconnection tool allowing a new option of treatment without the hassles of an open surgery.
  
  
  METHODS
  MRI-guided laser interstitial thermal therapy (MRgLITT) is a procedure for destroying tissue-using heat. To deliver this energy in a minimally invasive fashion, a small diameter fiber optic applicator is inserted into the lesion through a keyhole stereotactic procedure. The thermal energy induces damage to intracellular DNA and DNA-binding structures, ultimately leading to cell death. The ablation procedure is supervised by real-time MRI thermal mapping and confirmed by immediate post-ablation T1 or FLAIR MRI images.
  
  
  RESULTS
  The present report includes an overview of the development and practice of an MR-guided laser ablation therapy known as MRI-guided laser interstitial thermal therapy (MRgLITT). The role of modern image-guided trajectory planning in MRgLITT will also be discussed, with particular emphasis on the treatment of refractory epilepsy using this novel, minimally invasive technique.
  
  
  CONCLUSIONS
  MRI-guided laser-induced thermal ablation for epilepsy is an exciting new minimally invasive technology that finds potential new applications every day in the neurosurgical field. It certainly brings a new perspective on the way we practice epilepsy surgery even though long-term results should be properly collected and analyzed.
authors.affiliation: Department of Neurosurgery, SUNY Upstate Medical University, 604 Jacobsen Hall, 750 E Adams St, Syracuse, NY, 13210, USA, tovarspz@upstate.edu.
authors.forename: Zulma
authors.initials: Z
authors.lastname: Tovar-Spinoza
authors.forename: David
authors.initials: D
authors.lastname: Carter
authors.forename: David
authors.initials: D
authors.lastname: Ferrone
authors.forename: Yaman
authors.initials: Y
authors.lastname: Eksioglu
authors.forename: Sean
authors.initials: S
authors.lastname: Huckins
mesh_terms: D055011:Ablation Techniques / Q000295:instrumentation / Q000379:methods*; D002648:Child; D004827:Epilepsy / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*