| Laser thermal therapy: Real-time MRI-guided and computer-controlled procedures for metastatic brain tumors. | |
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MedLine Citation:
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PMID: 22109661 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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 24 hours. 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. Lasers Surg. Med. © 2011 Wiley Periodicals, Inc. |
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Authors:
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Alexandre Carpentier; Roger J McNichols; R Jason Stafford; Jean-Pierre Guichard; Daniel Reizine; Suzette Delaloge; Eric Vicaut; Didier Payen; Ashok Gowda; Bernard George |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-22 |
Journal Detail:
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Title: Lasers in surgery and medicine Volume: - ISSN: 1096-9101 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8007168 Medline TA: Lasers Surg Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Wiley Periodicals, Inc. |
Affiliation:
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Department of Neurosurgery, Hopital Lariboisiere and Pitié Salpetriere, Assistance Publique - Hôpitaux de Paris, Paris, France; Advanced Surgical Technologies Research Team, Université Paris VI, Paris, France. alexandre.carpentier@psl.aphp.fr. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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