Original Paper

Child's Nervous System

, Volume 29, Issue 11, pp 2089-2094

First online:

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

  • Zulma Tovar-SpinozaAffiliated withDepartment of Neurosurgery, SUNY Upstate Medical University Email author 
  • , David CarterAffiliated withDepartment of Neurosurgery, SUNY Upstate Medical University
  • , David FerroneAffiliated withDepartment of Neurosurgery, SUNY Upstate Medical University
  • , Yaman EksiogluAffiliated withDepartment of Neurology, SUNY Upstate Medical University
  • , Sean HuckinsAffiliated withDepartment of Neurosurgery, SUNY Upstate Medical University

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

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 ablation MRI guided Epilepsy