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Childs Nerv Syst. 2013 Nov;29(11):2089-94. doi: 10.1007/s00381-013-2169-6. Epub 2013 Jun 4.

The use of MRI-guided laser-induced thermal ablation for epilepsy.

Author information

1
Department of Neurosurgery, SUNY Upstate Medical University, 604 Jacobsen Hall, 750 E Adams St, Syracuse, NY, 13210, USA, tovarspz@upstate.edu.

Abstract

PURPOSE:

Epilepsy surgery is constantly researching for new options for patients with refractory epilepsy. MRI-guided laser-induced thermal ablation for epilepsy is an exciting new minimally invasive technology with an emerging use for lesionectomy of a variety of epileptogenic focuses (hypothalamic hamartomas, cortical dysplasias, cortical malformations, tubers) or as a disconnection tool allowing a new option of treatment without the hassles of an open surgery.

METHODS:

MRI-guided laser interstitial thermal therapy (MRgLITT) is a procedure for destroying tissue-using heat. To deliver this energy in a minimally invasive fashion, a small diameter fiber optic applicator is inserted into the lesion through a keyhole stereotactic procedure. The thermal energy induces damage to intracellular DNA and DNA-binding structures, ultimately leading to cell death. The ablation procedure is supervised by real-time MRI thermal mapping and confirmed by immediate post-ablation T1 or FLAIR MRI images.

RESULTS:

The present report includes an overview of the development and practice of an MR-guided laser ablation therapy known as MRI-guided laser interstitial thermal therapy (MRgLITT). The role of modern image-guided trajectory planning in MRgLITT will also be discussed, with particular emphasis on the treatment of refractory epilepsy using this novel, minimally invasive technique.

CONCLUSION:

MRI-guided laser-induced thermal ablation for epilepsy is an exciting new minimally invasive technology that finds potential new applications every day in the neurosurgical field. It certainly brings a new perspective on the way we practice epilepsy surgery even though long-term results should be properly collected and analyzed.

PMID:
23732793
DOI:
10.1007/s00381-013-2169-6
[Indexed for MEDLINE]
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