title: The role of magnetic resonance-guided laser ablation in neurooncology.
abstract: BACKGROUND
  The use of magnetic resonance-guided laser-induced thermal therapy (MR-LITT) as a minimally invasive method of treating intra-cranial pathology is a rapidly growing field. The use of MR-LITT in neurooncology has shown promising results; however, there has been no review to date of the current literature.
  
  
  METHODS
  A review of the published literature regarding MR-LITT in neurooncology was performed. Studies on PubMed were included if at least one patient with a cerebral tumour or radiation necrosis was treated using quantitative MR thermography-guided LITT, as well as if either safety or outcomes were discussed.
  
  
  RESULTS
  In treating recurrent Grade-III and -IV gliomas, we found improved median overall survival of 20.9 months from diagnosis of recurrence, which is comparable with that of 18.9 months for high-dose-rate brachytherapy and 24.4 months for repeated open surgery. Median progression-free survival (PFS) of recurrent glioma is noted to be 4.5 months. For metastatic lesions, we found a median overall survival (OS) to vary between 9.0 and 19.8 months with a PFS between 3.8 and 8.5 months. Current literature reports median OS in similar patients to lie between 7.0 and 28.6 months. Severe complication rates (with permanent deficits) are found to be between 12 and 16.7%, comparable with 11% found in literature for open surgery.
  
  
  CONCLUSIONS
  The current literature shows that MR-LITT is safe and shows promising local tumour control rates. Larger randomised studies are warranted to further investigate this adjuvant therapy in the treatment of recurrent high-grade gliomas and metastases.
authors: Department of Neurological Surgery, The University of Miami Miller School of Medicine , Miami, FL , USA.
authors: Christopher
authors: C
authors: Banerjee
authors: Brian
authors: B
authors: Snelling
authors: Michael H
authors: MH
authors: Berger
authors: Ashish
authors: A
authors: Shah
authors: Michael E
authors: ME
authors: Ivan
authors: Ricardo J
authors: RJ
authors: Komotar
mesh_terms: D001921:Brain / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
keywords: MR-LITT; brain tumours; laser-induced thermotherapy; minimally invasive neurosurgery