title: Laser neurosurgery: A systematic analysis of magnetic resonance-guided laser interstitial thermal therapies.
abstract: Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a novel minimally invasive modality that uses heat from laser probes to destroy tissue. Advances in probe design, cooling mechanisms, and real-time MR thermography have increased laser utilization in neurosurgery. The authors perform a systematic analysis of two commercially available MRgLITT systems used in neurosurgery: the Visualase® thermal therapy and NeuroBlate® Systems. Data extraction was performed in a blinded fashion. Twenty-two articles were included in the quantitative synthesis. A total of 223 patients were identified with the majority having undergone treatment with Visualase (n=154, 69%). Epilepsy was the most common indication for Visualase therapy (n=8 studies, 47%). Brain mass was the most common indication for NeuroBlate therapy (n=3 studies, 60%). There were no significant differences, except in age, wherein the NeuroBlate group was nearly twice as old as the Visualase group (p<0.001). Frame, total complications, and length-of-stay (LOS) were non-significant when adjusted for age and number of patients. Laser neurosurgery has evolved over recent decades. Clinical indications are currently being defined and will continue to emerge as laser technologies become more sophisticated. Head-to-head comparison of these systems was difficult given the variance in indications (and therefore patient population) and disparate literature.
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Carlito
authors.initials: C
authors.lastname: Lagman
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Lawrance K
authors.initials: LK
authors.lastname: Chung
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Panayiotis E
authors.initials: PE
authors.lastname: Pelargos
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Nolan
authors.initials: N
authors.lastname: Ung
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Timothy T
authors.initials: TT
authors.lastname: Bui
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Seung J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Brittany L
authors.initials: BL
authors.lastname: Voth
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, United States; Department of Radiation Oncology UCLA, University of California, Los Angeles, Los Angeles, CA, United States. Electronic address: iyang@mednet.ucla.edu.
authors.forename: Isaac
authors.initials: I
authors.lastname: Yang
mesh_terms: D001932:Brain Neoplasms / Q000601:surgery*; D004827:Epilepsy / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*
keywords: Brain neoplasms; Epilepsy; Glioma; Lasers; Neoplasm metastasis; Review