Child's Nervous System

, Volume 29, Issue 11, pp 2089–2094

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

  • Zulma Tovar-Spinoza
  • David Carter
  • David Ferrone
  • Yaman Eksioglu
  • Sean Huckins
Original Paper

DOI: 10.1007/s00381-013-2169-6

Cite this article as:
Tovar-Spinoza, Z., Carter, D., Ferrone, D. et al. Childs Nerv Syst (2013) 29: 2089. doi:10.1007/s00381-013-2169-6

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.

Keywords

Laser ablationMRI guidedEpilepsy

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Zulma Tovar-Spinoza
    • 1
  • David Carter
    • 1
  • David Ferrone
    • 1
  • Yaman Eksioglu
    • 2
  • Sean Huckins
    • 1
  1. 1.Department of NeurosurgerySUNY Upstate Medical UniversitySyracuseUSA
  2. 2.Department of NeurologySUNY Upstate Medical UniversitySyracuseUSA