MR-Guided Laser Therapy

  • P. Steiner
Part of the Medical Radiology book series (MEDRAD)


Laser-induced thermotherapy (LITT), which was first described by Bown in 1983, destroys tissues with near-infrared, continuous-wave laser energy which is directed into a tissue volume through one or more interstitially implanted optical fibres. So far, LITT has been used to treat unresectable, localised human tumours in the brain (Jolesz 1995), head and neck (Ohyama et al. 1988), liver and breast (Amin et al. 1993; Harries et al. 1994). The central problem of interstitial laser treatments is the inability to predict size and geometry of the thermal lesions due to inherent tissue heterogeneities enhanced by the variability of blood flow and tissue perfusion. Effective and reliable LITT does, however, mandate a means to assure laser coverage of the entire lesion without damage to healthy surrounding tissues. This requires on-line monitoring of laser-induced energy distribution during application. Ultrasound has shown some promise in this regard.


Laser Fibre Magnetic Resonance Unit Percutaneous Laser Disc Decompression Percutaneous Laser Ablation Interstitial Laser Photocoagulation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Amin Z, Donald JJ, Masters A, Kant R, Steger AC, Bown SG, Lees WR (1993) Hepatic metastases: interstitial laser photocoagulation with real-time US monitoring and dynamic CT evaluation of treatment. Radiology 187:339–347PubMedGoogle Scholar
  2. Botnar R, Steiner P, Erhart P, Debatin JF, von Schulthess GK (1977) Absolute temperature quantification in near real-time with an open 0.5 Tesla interventional MR-scanner. In: Proceedings of the International Society of Magnetic Resonance in Medicine 1997. Society of Magnetic Resonance in Medicine, Berkeley, Calif, p. 1957Google Scholar
  3. Bown SG (1983) Phototherapy of tumors. World J Surg 7:700–709PubMedCrossRefGoogle Scholar
  4. Choy DSJ, Ascher PW, Ranu HS, et al (1992) Percutaneous laser disc decompression. A new therapeutic modality. Spine 17:949–956PubMedCrossRefGoogle Scholar
  5. Chung AH, Hynynen K, Colucci V, Oshio K, Cline HE, Jolesz FA (1996) Optimisation of spoiled gradient-echo phase imaging for in vivo localisation of a focused ultrasound beam. Magn Reson Med 36:745–752PubMedCrossRefGoogle Scholar
  6. Cline HE, Hynynen K, Hardy CJ, Watkins RD, Schenck JF, Jolesz FA (1994) MR temperature mapping of focused ultrasound surgery. Magn Reson Med 31:628–636PubMedCrossRefGoogle Scholar
  7. Cline HE, Hynynen K, Schneider E, Hardy CJ, Maier SE, Watkins RD, Jolesz FA (1996) Simultaneous magnetic resonance phase and magnitude temperature maps in muscle. Magn Reson Med 35:309–315PubMedCrossRefGoogle Scholar
  8. Dachman AH, McGehee JA, Beam TE, Burris JA, Powell DE (1990) US-guided percutaneous laser ablation of liver tissue in a chronic pig model. Radiology 176:129–133PubMedGoogle Scholar
  9. Delannoy J, Chen CN, Turner R, Levin L, LeBihan D (1991) Noninvasive temperature imaging using diffusion MRI. Magn Reson Med 19:333–339PubMedCrossRefGoogle Scholar
  10. de Poorter J, de Wagter C, de Deene Y, Thomsen C, Ståhlberg F, Achten E (1995) Noninvasive MRI thermometry with the proton resonance frequency method: in vivo results in human muscle. Magn Reson Med 33:74–81PubMedCrossRefGoogle Scholar
  11. Dumoulin CL, Souza SP, Darrow RD (1993) Realtime position monitoring of invasive devices using magnetic resonance. Magn Reson Med 29:411–415PubMedCrossRefGoogle Scholar
  12. Fried MP, Morrison PR, Hushek SG, Kernahan GA, Jolesz FA (1996) Dynamic T1-weighted magnetic resonance imaging of interstitial laser photocoagulation in the liver: observation on in vivo temperature sensitivity. Lasers Surg Med 18:410–419PubMedCrossRefGoogle Scholar
  13. Harries SA, Amin Z, Smith MEF, et al (1994) Interstitial laser photocoagulation as a treatment for breast cancer. Br J Surg 81:1617–1619PubMedCrossRefGoogle Scholar
  14. Hendrich C, Jakob PM, Breitling T, Schäfer A, Berden A, Haase A, Siebert WE (1996) Kernspintomographische Messung der Temperaturverteilung in Knorpelgewebe nach Lasertherapie. Orthopäde 25:17–20PubMedGoogle Scholar
  15. Huch-Böni RA, Sulser T, Jochum W, Romanowski B, Debatin JF, Krestin GP (1997) Laser ablation-induced changes in the prostate: findings at endorectal MR imaging with histologic correlation. Radiology 202:232–237Google Scholar
  16. Jolesz FA (1995) MR-guided thermal ablation of brain tumors. Am J Neuroradiat 16:49–52Google Scholar
  17. Jolesz FA, Bleier AR, Jakab P, Ruenzel PW, Huttl K, Jako GJ (1988) MR imaging of laser-tissue interactions. Radiology 168:249–253PubMedGoogle Scholar
  18. Kahn T, Schwabe B, Bettag M, et al (1996) Mapping of the cortical motor hand area with functional MR imaging and MR imaging-guided laser-induced interstitial thermotherapy of brain tumors. Radiology 200:149–157PubMedGoogle Scholar
  19. Kuroda K, Abe K, Tsutsumi S, Ishihara Y, Suzuki Y, Sato K (1993) Water proton magnetic resonance spectroscopic imaging. Biomed Thermol 13:43–62Google Scholar
  20. Leung DA, Debatin JF, Wildermuth S, et al (1995) Real-time biplanar needle tracking for interventional MR imaging procedures. Radiology 197:485–488PubMedGoogle Scholar
  21. Matsumoto R, Oshio K, Jolesz FA (1992) Monitoring of laser and freezing induced ablation in the liver with Tl-weighted MR-imaging. J Magn Reson Imaging 2:555–562PubMedCrossRefGoogle Scholar
  22. Matsumoto R, Mulkern RV, Hushek SG, Jolesz FA (1994) Tissue temperature monitoring for thermal interventional therapy: comparison of Tl-weighted MR sequences. J Magn Reson Imaging 4:65–70PubMedCrossRefGoogle Scholar
  23. Mumtaz H, Hall-Craggs MA, Wotherspoon A, et al (1996) Laser therapy for breast cancer: MR imaging and histopathologic correlation. Radiology 200:651–658PubMedGoogle Scholar
  24. Nelson TR, Tung SM (1987) Temperature dependence of proton relaxation times in vitro. Magn Reson Imaging 5:189–199PubMedCrossRefGoogle Scholar
  25. Ohyama M, Nobori T, Moriyama I, Furuta S, Shima T (1988) Laserthermia on head and neck malignancies: experimental and clinical studies. Acta Otolaryngol Suppl (Stockh) 458:7–12CrossRefGoogle Scholar
  26. Pignoli E, Marchesini R, Curti L, Sichirollo AE, Tomatis S, Musumeci R (1995) Potential and limitations of magnetic resonance imaging for real-time monitoring of interstitial laser phototherapy. Acad Radiol 2:741–747PubMedCrossRefGoogle Scholar
  27. Quigley MR, Maroon JC, Shih T, Elrifai A, Lesiecki ML (1994) Laser discectomy. Comparison of systems. Spine 19:319–322PubMedCrossRefGoogle Scholar
  28. Schenck JF, Jolesz A, Roemer PB, et al (1995) Superconducting open-configuration MR imaging system for image-guided therapy. Radiology 195:805–814PubMedGoogle Scholar
  29. Schoenenberger AW, Steiner P, Debatin JF, et al (1997) Realtime monitoring of laser discectomies with a super-conducting, open-configuration MR system. Am J Roentgenol (in press)Google Scholar
  30. Silverman SG, Collick BD, Figueira MR, et al (1995) Interactive MR-guided biopsy in an open-configuration MR imaging system. Radiology 197:175–181PubMedGoogle Scholar
  31. Steiner P, Schoenenberger AW, Penner EA, Erhart P, Debatin JF, von Schulthess GK, Kacl GM (1996a) Interaktive stereotaktische Interventionen im supraleitenden, offenen 0.5-Tesla-MR-Tomographen. RoFo Fortschr Geb Röntgenstr Neuen Bildgeb Verfahr 165:276–280PubMedCrossRefGoogle Scholar
  32. Steiner P, Schoenenberger AW, Erhart P, Penner EA, von Schulthess GK, Debatin JF (1996b) Optimization of MR sequences for detecting laser-induced tissue changes Radiology 201:389Google Scholar
  33. Vogl TJ, Mack MG, Müller PK, et al (1995a) MR-guided laserinduced thermotherapy of tumors of the head and neck region: first clinical results. RoFo Fortschr Geb Röntgenstr Neuen Bildgeb Verfahr 163:505–514PubMedCrossRefGoogle Scholar
  34. Vogl TJ, Müller PK, Hammerstingl R, et al (1995b) Malignant liver tumors treated with MR imaging-guided laserinduced thermotherapy: technique and prospective results. Radiology 196:257–265PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • P. Steiner
    • 1
  1. 1.MR Center, Institute of Diagnostic RadiologyZurich University HospitalZurichSwitzerland

Personalised recommendations