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Laser thermal therapy: real-time MRI-guided and computer-controlled procedures for metastatic brain tumors.
Lasers Surg Med. 2011 Dec; 43(10):943-50.LS

Abstract

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.

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Authors+Show Affiliations

Carpentier A
Department of Neurosurgery, Hopital Lariboisiere and Pitié Salpetriere, Assistance Publique - Hôpitaux de Paris, France. alexandre.carpentier@psl.aphp.fr
McNichols RJ
No affiliation info available
Stafford RJ
No affiliation info available
Guichard JP
No affiliation info available
Reizine D
No affiliation info available
Delaloge S
No affiliation info available
Vicaut E
No affiliation info available
Payen D
No affiliation info available
Gowda A
No affiliation info available
George B
No affiliation info available

MeSH

AdenocarcinomaBrain NeoplasmsBreast NeoplasmsFeasibility StudiesFemaleHumansLaser TherapyLasers, SemiconductorLung NeoplasmsMagnetic Resonance Imaging, InterventionalMiddle AgedPilot ProjectsPostoperative ComplicationsSurgery, Computer-AssistedSurvival AnalysisTreatment Outcome

Pub Type(s)

Clinical Trial, Phase I
Journal Article

Language

eng

PubMed ID

22109661

Clinical Trial Links

Clinical trial which this article describes

Citation

Carpentier, Alexandre, et al. "Laser Thermal Therapy: Real-time MRI-guided and Computer-controlled Procedures for Metastatic Brain Tumors." Lasers in Surgery and Medicine, vol. 43, no. 10, 2011, pp. 943-50.
Carpentier A, McNichols RJ, Stafford RJ, et al. Laser thermal therapy: real-time MRI-guided and computer-controlled procedures for metastatic brain tumors. Lasers Surg Med. 2011;43(10):943-50.
Carpentier, A., McNichols, R. J., Stafford, R. J., Guichard, J. P., Reizine, D., Delaloge, S., Vicaut, E., Payen, D., Gowda, A., & George, B. (2011). Laser thermal therapy: real-time MRI-guided and computer-controlled procedures for metastatic brain tumors. Lasers in Surgery and Medicine, 43(10), 943-50. https://doi.org/10.1002/lsm.21138
Carpentier A, et al. Laser Thermal Therapy: Real-time MRI-guided and Computer-controlled Procedures for Metastatic Brain Tumors. Lasers Surg Med. 2011;43(10):943-50. PubMed PMID: 22109661.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laser thermal therapy: 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, Y1 - 2011/11/22/ PY - 2011/10/05/accepted PY - 2011/11/24/entrez PY - 2011/11/24/pubmed PY - 2012/7/28/medline SP - 943 EP - 50 JF - Lasers in surgery and medicine JO - Lasers Surg Med VL - 43 IS - 10 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 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. SN - 1096-9101 UR - https://www.unboundmedicine.com/medline/citation/22109661/Laser_thermal_therapy:_real_time_MRI_guided_and_computer_controlled_procedures_for_metastatic_brain_tumors_ L2 - https://doi.org/10.1002/lsm.21138 DB - PRIME DP - Unbound Medicine ER -