Laser interstitial thermal therapy for deep-seated perivascular brain tumors is not associated with distal ischemia
Recommended Citation
Reese JC, Fadel HA, Pawloski JA, Samir M, Haider S, Komatar RJ, Luther E, Morell AA, Ivan ME, Robin AM, Kalkanis SN, and Lee IY. Laser interstitial thermal therapy for deep-seated perivascular brain tumors is not associated with distal ischemia. J Neurooncol 2024; 166(2):265-272.
Document Type
Article
Publication Date
1-1-2024
Publication Title
Journal of neuro-oncology
Abstract
PURPOSE: Laser interstitial thermal therapy (LITT) is a minimally invasive cytoreductive treatment option for brain tumors with a risk of vascular injury from catheter placement or thermal energy. This may be of concern with deep-seated tumors that have surrounding end-artery perforators and critical microvasculature. The purpose of this study was to assess the risk of distal ischemia following LITT for deep-seated perivascular brain tumors.
METHODS: A retrospective review of a multi-institution database was used to identify patients who underwent LITT between 2013 and 2022 for tumors located within the insula, thalamus, basal ganglia, and anterior perforated substance. Demographic, clinical and volumetric tumor characteristics were collected. The primary outcome was radiographic evidence of distal ischemia on post-ablation magnetic resonance imaging (MRI).
RESULTS: 61 LITT ablations for deep-seated perivascular brain tumors were performed. Of the tumors treated, 24 (39%) were low-grade gliomas, 32 (52%) were high-grade gliomas, and 5 (8%) were metastatic. The principal location included 31 (51%) insular, 14 (23%) thalamic, 13 (21%) basal ganglia, and 3 (5%) anterior perforated substance tumors. The average tumor size was 19.6 cm(3) with a mean ablation volume of 11.1 cm(3). The median extent of ablation was 92% (IQR 30%, 100%). Two patients developed symptomatic intracerebral hemorrhage after LITT. No patient had radiographic evidence of distal ischemia on post-operative diffusion weighted imaging.
CONCLUSION: We demonstrate that LITT for deep-seated perivascular brain tumors has minimal ischemic risks and is a feasible cytoreductive treatment option for otherwise difficult to access intracranial tumors.
Medical Subject Headings
Humans; Laser Therapy; Brain Neoplasms; Glioma; Magnetic Resonance Imaging; Retrospective Studies; Lasers
PubMed ID
38243083
ePublication
ePub ahead of print
Volume
166
Issue
2
First Page
265
Last Page
272
