MRI-Guided Interstitial Laser Ablation for Intracranial Lesions: A Large Single-Institution Experience of 133 Cases

被引:53
作者
Kamath, Ashwin A. [1 ]
Friedman, Daniel D. [1 ]
Hacker, Carl D. [1 ,6 ,9 ]
Smyth, Matthew D. [1 ,2 ,11 ]
Limbrick, David D., Jr. [1 ,2 ,11 ]
Kim, Albert H. [1 ,3 ,4 ,8 ]
Hawasli, Ammar H. [1 ,6 ,11 ]
Leuthardt, Eric C. [1 ,5 ,6 ,7 ,8 ,9 ,10 ]
机构
[1] Washington Univ, Sch Med, Dept Neurol Surg, St Louis, MO USA
[2] Washington Univ, Sch Med, Dept Pediat, St Louis, MO 63110 USA
[3] Washington Univ, Sch Med, Dept Neurol, St Louis, MO 63110 USA
[4] Washington Univ, Sch Med, Dept Dev Biol, St Louis, MO USA
[5] Washington Univ, Dept Neurosci, St Louis, MO USA
[6] Washington Univ, Dept Biomed Engn, Sch Med, St Louis, MO USA
[7] Washington Univ, Sch Med, Dept Mech Engn & Mat Sci, St Louis, MO USA
[8] Washington Univ, Sch Med, Siteman Canc Ctr, St Louis, MO USA
[9] Washington Univ, Sch Med, Ctr Innovat Neurosci & Technol, St Louis, MO USA
[10] Washington Univ, Sch Med, Brain Laser Ctr, St Louis, MO USA
[11] St Louis Childrens Hosp, Dept Neurosurg, St Louis, MO 63178 USA
关键词
Laser ablation; Laser interstitial thermal therapy; Intracranial lesions; Survival; MRI; Brain tumors; THERMAL THERAPY;
D O I
10.1159/000485387
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background: Managing difficult-to-access lesions or surgically accessible lesions in fragile patients is a central problem in neurosurgery. MRI-guided interstitial laser ablation (ILA) is a minimally invasive option that may provide a safe means of treating these challenging patients. Objective: We aim to (1) evaluate safety, efficacy, and preliminary outcomes within a diverse and large series of ILA treatments; and (2) report technical details and operative trends that proved useful over time in the authors' experience and that may be of use to neurosurgeons who perform ILA. Methods: A retrospective evaluation of ILA patients was performed in terms of demographics, surgical techniques, and clinical outcomes. Results: A total of 133 intracranial lesions in 120 patients were treated with ILA, including glioblastomas (GBM), other gliomas, metastases, epilepsy foci, and radionecrosis. The rate of complications/unexpected readmission was 6.0%, and the mortality rate was 2.2%. With high-grade tumors, tumor volumes > 3 cm in diameter trended toward a higher rate of complication (p = 0.056). Median progression-free survival (PFS) and overall survival (OS) for recurrent GBM were 7.4 and 11.6 months, respectively. As a frontline treatment for newly diagnosed GBM, median PFS and OS were 5.9 and 11.4 months, respectively. For metastases, median PFS was not yet reached, and OS was 17.2 months. Conclusion: Our series suggests that ILA is a safe and efficacious treatment for a variety of intracranial pathologies, can be tailored to treat difficult-to-access lesions, and may offer a novel alternative to open craniotomy in properly selected patients. (c) 2018 The Author(s) Published by S. Karger AG, Basel.
引用
收藏
页码:417 / 428
页数:12
相关论文
共 16 条
[1]   Dose-Volume Response Relationship for Brain Metastases Treated with Frameless Single-Fraction Linear Accelerator-Based Stereotactic Radiosurgery [J].
Amsbaugh, Mark ;
Pan, Jianmin ;
Yusuf, Mehran B. ;
Dragun, Anthony ;
Dunlap, Neal ;
Guan, Timothy ;
Boling, Warren ;
Rai, Shesh ;
Woo, Shiao .
CUREUS, 2016, 8 (04)
[2]   Utilizing personalized stereotactic frames for laser interstitial thermal ablation of posterior fossa and mesiotemporal brain lesions: a single-institution series [J].
Dadey, David Y. A. ;
Kamath, Ashwin A. ;
Smyth, Matthew D. ;
Chicoine, Michael R. ;
Leuthardt, Eric C. ;
Kim, Albert H. .
NEUROSURGICAL FOCUS, 2016, 41 (04)
[3]   Minimally Invasive Transsulcal Resection of Intraventricular and Periventricular Lesions Through a Tubular Retractor System: Multicentric Experience and Results [J].
Eliyas, Javed Khader ;
Glynn, Ryan ;
Kulwin, Charles G. ;
Rovin, Richard ;
Young, Ronald ;
Alzate, Juan ;
Pradilla, Gustavo ;
Shah, Mitesh V. ;
Kassam, Amin ;
Ciric, Ivan ;
Bailes, Julian .
WORLD NEUROSURGERY, 2016, 90 :556-564
[4]   Resting state network estimation in individual subjects [J].
Hacker, Carl D. ;
Laumann, Timothy O. ;
Szrama, Nicholas P. ;
Baldassarre, Antonello ;
Snyder, Abraham Z. ;
Leuthardt, Eric C. ;
Corbetta, Maurizio .
NEUROIMAGE, 2013, 82 :616-633
[5]   Postoperative Stereotactic Radiosurgery Without Whole-Brain Radiation Therapy for Brain Metastases: Potential Role of Preoperative Tumor Size [J].
Hartford, Alan C. ;
Paravati, Anthony J. ;
Spire, William J. ;
Li, Zhongze ;
Jarvis, Lesley A. ;
Fadul, Camilo E. ;
Rhodes, C. Harker ;
Erkmen, Kadir ;
Friedman, Jonathan ;
Gladstone, David J. ;
Hug, Eugen B. ;
Roberts, David W. ;
Simmons, Nathan E. .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2013, 85 (03) :650-655
[6]   Stereotactic laser ablation of high-grade gliomas [J].
Hawasli, Ammar H. ;
Kim, Albert H. ;
Dunn, Gavin P. ;
Tran, David D. ;
Leuthardt, Eric C. .
NEUROSURGICAL FOCUS, 2014, 37 (06)
[7]   Magnetic Resonance Imaging-Guided Focused Laser Interstitial Thermal Therapy for Intracranial Lesions: Single-Institution Series [J].
Hawasli, Ammar H. ;
Bagade, Swapnil ;
Shimony, Joshua S. ;
Miller-Thomas, Michelle ;
Leuthardt, Eric C. .
NEUROSURGERY, 2013, 73 (06) :1007-1017
[8]   Renaissance of laser interstitial thermal ablation [J].
Missios, Symeon ;
Bekelis, Kimon ;
Barnett, Gene H. .
NEUROSURGICAL FOCUS, 2015, 38 (03)
[9]   A Novel Data-Driven Approach to Preoperative Mapping of Functional Cortex Using Resting-State Functional Magnetic Resonance Imaging [J].
Mitchell, Timothy J. ;
Hacker, Carl D. ;
Breshears, Jonathan D. ;
Szrama, Nick P. ;
Sharma, Mohit ;
Bundy, David T. ;
Pahwa, Mrinal ;
Corbetta, Maurizio ;
Snyder, Abraham Z. ;
Shimony, Joshua S. ;
Leuthardt, Eric C. .
NEUROSURGERY, 2013, 73 (06) :969-982
[10]   The role of laser interstitial thermal therapy in enhancing progression-free survival of difficult-to-access high-grade gliomas: a multicenter study [J].
Mohammadi, Alireza M. ;
Hawasli, Ammar H. ;
Rodriguez, Analiz ;
Schroeder, Jason L. ;
Laxton, Adrian W. ;
Elson, Paul ;
Tatter, Stephen B. ;
Barnett, Gene H. ;
Leuthardt, Eric C. .
CANCER MEDICINE, 2014, 3 (04) :971-979