Laser interstitial thermal therapy (LITT) is a minimally invasive procedure used to treat a variety of intracranial lesions. Utilization of robotic assistance with stereotactic procedures has gained attention due to potential for advantages over conventional techniques. The authors report the first case in which robot-assisted MRI-guided LITT was used to treat radiation necrosis in the posterior fossa, specifically within the cerebellar peduncle. The use of a stereotactic robot allowed the surgeon to perform LITT using a trajectory that would be extremely difficult with conventional arc-based techniques. A 60-year-old man presented with facial weakness and brainstem symptoms consistent with radiation necrosis. He had a history of anaplastic astrocytoma that was treated with CyberKnife radiosurgery 1 year prior to presentation, and he did well for 11 months until his symptoms recurred. The location and form of the lesion precluded excision but made the patient a suitable candidate for LITT. The location and configuration of the lesion required a trajectory for LITT that was too low for arc-based stereotactic navigation, and thus the ROSA robot (Medtech) was used. Using preoperative MRI acquisitions, the lesion in the posterior fossa was targeted. Bone fiducials were used to improve accuracy in registration, and the authors obtained an intraoperative CT image that was then fused with the MR image by the ROSA robot. They placed the laser applicator and then ablated the lesion under real-time MR thermometry. There were no complications, and the patient tolerated the procedure well. Postoperative 2-month MRI showed complete resolution of the lesion, and the patient had some improvement in symptoms.
机构:
Dartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USADartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USA
Bekelis, Kimon
;
Badwan, Tarek A.
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Dartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USADartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USA
Badwan, Tarek A.
;
Desai, Atman
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Dartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USADartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USA
Desai, Atman
;
Roberts, David W.
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Dartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USA
Dartmouth Hitchcock Med Ctr, Dept Neurol, Hanover, NH USA
Dartmouth Coll, Hitchcock Med Ctr, Dartmouth Med Sch, Hanover, NH 03756 USADartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USA
机构:
Hop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Univ Paris 06, Adv Surg Technol Res Team, Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Carpentier, Alexandre
;
Chauvet, Dorian
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Hop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Chauvet, Dorian
;
Reina, Vincent
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Hop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Reina, Vincent
;
Beccaria, Kevin
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Hop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Univ Paris 06, Adv Surg Technol Res Team, Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Beccaria, Kevin
;
Leclerq, Delphine
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Univ Paris 06, Hop La Pitie Salpetriere, AP HP, Dept Neuroradiol, Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Leclerq, Delphine
;
McNichols, Roger J.
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Biotex Inc, Houston, TX USAHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
McNichols, Roger J.
;
Gowda, Ashok
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Biotex Inc, Houston, TX USAHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Gowda, Ashok
;
Cornu, Philippe
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Hop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Cornu, Philippe
;
Delattre, Jean-Yves
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Hop La Pitie Salpetriere, AP HP, Dept Neurooncol, F-75013 Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
机构:
Dartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USADartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USA
Bekelis, Kimon
;
Badwan, Tarek A.
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h-index: 0
机构:
Dartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USADartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USA
Badwan, Tarek A.
;
Desai, Atman
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h-index: 0
机构:
Dartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USADartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USA
Desai, Atman
;
Roberts, David W.
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机构:
Dartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USA
Dartmouth Hitchcock Med Ctr, Dept Neurol, Hanover, NH USA
Dartmouth Coll, Hitchcock Med Ctr, Dartmouth Med Sch, Hanover, NH 03756 USADartmouth Hitchcock Med Ctr, Neurosurg Sect, Hanover, NH USA
机构:
Hop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Univ Paris 06, Adv Surg Technol Res Team, Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Carpentier, Alexandre
;
Chauvet, Dorian
论文数: 0引用数: 0
h-index: 0
机构:
Hop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Chauvet, Dorian
;
Reina, Vincent
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h-index: 0
机构:
Hop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Reina, Vincent
;
Beccaria, Kevin
论文数: 0引用数: 0
h-index: 0
机构:
Hop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Univ Paris 06, Adv Surg Technol Res Team, Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Beccaria, Kevin
;
Leclerq, Delphine
论文数: 0引用数: 0
h-index: 0
机构:
Univ Paris 06, Hop La Pitie Salpetriere, AP HP, Dept Neuroradiol, Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Leclerq, Delphine
;
McNichols, Roger J.
论文数: 0引用数: 0
h-index: 0
机构:
Biotex Inc, Houston, TX USAHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
McNichols, Roger J.
;
Gowda, Ashok
论文数: 0引用数: 0
h-index: 0
机构:
Biotex Inc, Houston, TX USAHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Gowda, Ashok
;
Cornu, Philippe
论文数: 0引用数: 0
h-index: 0
机构:
Hop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France
Cornu, Philippe
;
Delattre, Jean-Yves
论文数: 0引用数: 0
h-index: 0
机构:
Hop La Pitie Salpetriere, AP HP, Dept Neurooncol, F-75013 Paris, FranceHop La Pitie Salpetriere, AP HP, Dept Neurosurg, F-75013 Paris, France