title: Magnetic Resonance-Guided Laser Ablation for the Treatment of Recurrent Dural-Based Lesions: A Series of Five Cases.
abstract: OBJECTIVE
  Magnetic resonance-guided laser-induced thermotherapy (MR-LITT) is a minimally invasive technique that shows promise in neuro-oncology because of its superiority in delivering precise minimally invasive thermal energy with minimal collateral damage. In this analysis, we investigate initial data on the effect of MR-LITT on dural-based lesions.
  
  
  METHODS
  Five patients were identified with dural-based lesions (4 meningiomas, 1 solitary fibrous tumor) with clear evidence of radiologic progression. In all 5 cases, the tumors were localized to the lateral convexity or paramedian locations in the supratentorial space. All patients received MR-LITT and then a follow-up magnetic resonance imaging scan at 24 hours after treatment, at 1 month, and at each subsequent follow-up visit. Local control of the ablated tumor was evaluated with radiographic follow-up and symptomatic progression-free survival was recorded.
  
  
  RESULTS
  Five LITT treatments were performed on 5 patients with an average age of 65.2 years. The average tumor volume was 29.7 cm3and ablation dosage was 12.4 W. On average, 80% of the pretreatment lesion volume was ablated. The mean follow-up time was 59.3 weeks. In total, 2 patients (1 with an anaplastic meningioma and 1 with a solitary fibrous tumor) had radiographic evidence of disease progression. In the observed time of the 3 patients with no progression, there was a 52% reduction in tumor volume. There were no major perioperative complications.
  
  
  CONCLUSIONS
  MR-LITT is a promising technology for dural-based lesion treatment. This initial study demonstrates that MR-LITT is safe and offers several advantages over open surgical treatment. Randomized studies are needed to evaluate its role as a treatment adjunct.
authors.affiliation: Department of Neurological Surgery, The Sylvester Comprehensive Cancer Center, Miami, Florida, USA; Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Ivan
authors.affiliation: Department of Neurological Surgery, The Sylvester Comprehensive Cancer Center, Miami, Florida, USA; Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Roberto Jose
authors.initials: RJ
authors.lastname: Diaz
authors.affiliation: Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Berger
authors.affiliation: Department of Neurological Surgery, The Sylvester Comprehensive Cancer Center, Miami, Florida, USA; Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, Florida, USA. Electronic address: Gregory.Basil@gmail.com.
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Basil
authors.affiliation: Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Osiason
authors.affiliation: Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Plate
authors.affiliation: Visualase, Inc., Miami, Florida, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Wallo
authors.affiliation: Department of Neurological Surgery, The Sylvester Comprehensive Cancer Center, Miami, Florida, USA; Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Komotar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
keywords: Brain tumors; Dural-based lesions; Laser-induced thermotherapy; Magnetic resonance-guided laser-induced thermotherapy; Meningiomas; Minimally invasive neurosurgery