Recommended Citation
Bartlett S, Nagaraja TN, Griffith B, Farmer KG, Van Harn M, Haider S, Hunt RJ, Cabral G, Knight RA, Valadie OG, Brown SL, Ewing JR, and Lee IY. Persistent Peri-Ablation Blood-Brain Barrier Opening After Laser Interstitial Thermal Therapy for Brain Tumors. Cureus 2023; 15(4):e37397.
Document Type
Article
Publication Date
4-1-2023
Publication Title
Cureus
Abstract
Purpose: Laser interstitial thermal therapy (LITT) is a minimally invasive, image-guided, cytoreductive procedure to treat recurrent glioblastoma. This study implemented dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) methods and employed a model selection paradigm to localize and quantify post-LITT blood-brain barrier (BBB) permeability in the ablation vicinity. Serum levels of neuron-specific enolase (NSE), a peripheral marker of increased BBB permeability, were measured.
Methods: Seventeen patients were enrolled in the study. Using an enzyme-linked immunosorbent assay, serum NSE was measured preoperatively, 24 hours postoperatively, and at two, eight, 12, and 16 weeks postoperatively, depending on postoperative adjuvant treatment. Of the 17 patients, four had longitudinal DCE-MRI data available, from which blood-to-brain forward volumetric transfer constant (K(trans)) data were assessed. Imaging was performed preoperatively, 24 hours postoperatively, and between two and eight weeks postoperatively.
Results: Serum NSE increased at 24 hours following ablation (p=0.04), peaked at two weeks, and returned to baseline by eight weeks postoperatively. K(trans) was found to be elevated in the peri-ablation periphery 24 hours after the procedure. This increase persisted for two weeks.
Conclusion: Following the LITT procedure, serum NSE levels and peri-ablation K(trans) estimated from DCE-MRI demonstrated increases during the first two weeks after ablation, suggesting transiently increased BBB permeability.
PubMed ID
37182017
Volume
15
Issue
4
First Page
37397
Last Page
37397
