TY - JOUR
T1 - Laser thermal therapy
T2 - Real-time MRI-guided and computer-controlled procedures for metastatic brain tumors
AU - Carpentier, Alexandre
AU - McNichols, Roger J.
AU - Stafford, R. Jason
AU - Guichard, Jean Pierre
AU - Reizine, Daniel
AU - Delaloge, Suzette
AU - Vicaut, Eric
AU - Payen, Didier
AU - Gowda, Ashok
AU - George, Bernard
PY - 2011/12/1
Y1 - 2011/12/1
N2 - Background and Objective We report the final results of a pilot clinical trial exploring the safety and feasibility of real-time magnetic resonance-guided laser-induced thermal therapy (MRgLITT) for treatment of resistant focal metastatic intracranial tumors. Study Design In patients with chemotherapy, whole-brain radiation, and radiosurgery resistant metastatic intracranial tumors, minimally invasive stereotaxic placement of a saline-cooled interstitial fiberoptic laser applicator under local anesthesia was followed by laser irradiation during continuous magnetic resonance imaging (MRI) scanning. A computer workstation extracted real-time temperature-sensitive information for feedback control over laser delivery. A total of 15 metastatic tumors were treated in 7 patients. Patients were followed with physical exam and imaging for 30 months. Results In all cases, the procedure was well tolerated, and patients were discharged home within 24ahours. Follow-up imaging at up to 30 months showed an acute increase in apparent lesion volume followed by a gradual and steady decrease. No tumor recurrence within thermal ablation zones was noted. Kaplan-Meier analysis indicated that the median survival was 19.8 months. Conclusion Real-time magnetic resonance (MR) guidance of laser-induced thermal therapy (LITT) offers a high level of control. This tool therefore enables a minimally invasive option for destruction and treatment of resistant focal metastatic intracranial tumors. MR-guided LITT appears to provide a safe and potentially effective treatment for recurrent focal metastatic brain disease. A larger phase II and III series would be of interest to quantify potential median survival advantage.
AB - Background and Objective We report the final results of a pilot clinical trial exploring the safety and feasibility of real-time magnetic resonance-guided laser-induced thermal therapy (MRgLITT) for treatment of resistant focal metastatic intracranial tumors. Study Design In patients with chemotherapy, whole-brain radiation, and radiosurgery resistant metastatic intracranial tumors, minimally invasive stereotaxic placement of a saline-cooled interstitial fiberoptic laser applicator under local anesthesia was followed by laser irradiation during continuous magnetic resonance imaging (MRI) scanning. A computer workstation extracted real-time temperature-sensitive information for feedback control over laser delivery. A total of 15 metastatic tumors were treated in 7 patients. Patients were followed with physical exam and imaging for 30 months. Results In all cases, the procedure was well tolerated, and patients were discharged home within 24ahours. Follow-up imaging at up to 30 months showed an acute increase in apparent lesion volume followed by a gradual and steady decrease. No tumor recurrence within thermal ablation zones was noted. Kaplan-Meier analysis indicated that the median survival was 19.8 months. Conclusion Real-time magnetic resonance (MR) guidance of laser-induced thermal therapy (LITT) offers a high level of control. This tool therefore enables a minimally invasive option for destruction and treatment of resistant focal metastatic intracranial tumors. MR-guided LITT appears to provide a safe and potentially effective treatment for recurrent focal metastatic brain disease. A larger phase II and III series would be of interest to quantify potential median survival advantage.
KW - MRI-guided thermal therapy
KW - laser-induced thermal therapy (LITT)
KW - magnetic resonance thermal imaging (MRTI)
KW - metastasis
KW - minimally invasive therapy
KW - tumor
UR - http://www.scopus.com/inward/record.url?scp=83755221052&partnerID=8YFLogxK
U2 - 10.1002/lsm.21138
DO - 10.1002/lsm.21138
M3 - Article
C2 - 22109661
AN - SCOPUS:83755221052
SN - 0196-8092
VL - 43
SP - 943
EP - 950
JO - Lasers in Surgery and Medicine
JF - Lasers in Surgery and Medicine
IS - 10
ER -