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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.

Authors+Show Affiliations

Department of Neurosurgery, Hopital Lariboisiere and Pitié Salpetriere, Assistance Publique - Hôpitaux de Paris, France. alexandre.carpentier@psl.aphp.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase I
Journal Article

Language

eng

PubMed ID

22109661

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 -