Real-time magnetic resonance-guided laser thermal therapy for focal metastatic brain tumors

Neurosurgery
Alexandre CarpentierBernard George

Abstract

We report the initial results of a pilot clinical trial exploring the safety and feasibility of the first real-time magnetic resonance-guided laser-induced thermal therapy of treatment-resistant focal metastatic intracranial tumors. Patients with resistant metastatic intracranial tumors who had previously undergone chemotherapy, whole-brain radiation therapy, and radiosurgery and who were recused from surgery were eligible for this trial. Under local anesthesia, a Leksell stereotactic head frame was used to insert a water-cooled interstitial fiberoptic laser applicator inside the cranium. In the bore of a magnetic resonance imaging (MRI) scanner, laser energy was delivered to heat the tumor while continuous MRI was performed. A computer workstation extracted temperature-sensitive information to display images of laser heating and computed estimates of the thermal damage zone. Posttreatment MRI scans were used to confirm the zone of thermal necrosis, and follow-up was performed at 7, 15, 30, and 90 days after treatment. In all cases, the procedure was well tolerated without secondary effect, and patients were discharged to home within 14 hours after the procedure. Follow-up imaging showed an acute increase in apparent lesion vol...Continue Reading

Citations

Nov 26, 2010·Medical Physics·Joshua P YungR Jason Stafford
Jun 6, 2012·Advances in Urology·Pierre ColinNacim Betrouni
Jun 3, 2016·Frontiers in Surgery·Douglas A Hardesty, Peter Nakaji
Nov 17, 2020·Frontiers in Oncology·Fuxing ZuoJinghai Wan

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