Chao-Hung Kuo1, Abdullah H Feroze2, Sandra L Poliachik3, Jason S Hauptman4, Edward J Novotny5, Jeffrey G Ojemann4. 1. Department of Neurological Surgery, University of Washington, Seattle, Washington, USA; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: chaohungk@gmail.com. 2. Department of Neurological Surgery, University of Washington, Seattle, Washington, USA. 3. Department of Radiology, Seattle Children's Hospital, Seattle, Washington, USA; Department of Neurology, Seattle Children's Hospital, Seattle, Washington, USA. 4. Department of Neurological Surgery, University of Washington, Seattle, Washington, USA; Division of Neurosurgery, Seattle Children's Hospital, Seattle, Washington, USA. 5. Department of Neurology, University of Washington, Seattle, Washington, USA; Department of Neurology, Seattle Children's Hospital, Seattle, Washington, USA.
Abstract
BACKGROUND: Laser interstitial thermal therapy (LITT) is an alternative, less-invasive, and, in some circumstances, effective treatment for patients with intracranial pathology including epilepsy and some tumors. For intracranial lesions in eloquent areas, resection by conventional craniotomy proves often to be a challenge, including in the care of pediatric patients. Herein, we reviewed our experience with magnetic resonance imaging (MRI)-guided LITT as treatment for pediatric patients with intracranial lesions in eloquent areas and evaluate neurologic function and clinical outcomes. METHODS: We retrospectively reviewed consecutive patients with intracranial lesions in eloquent speech and motor areas who underwent MRI-guided LITT. Clinical evaluation, including neurologic function and neuropsychological testing, was conducted according to clinical considerations. MRI pre- and postoperative imaging was reviewed to compare the change of lesion size. RESULTS: Five pediatric patients received MRI-guided LITT of intracranial lesions in eloquent cortex. One patient experienced complications secondary to MRI-guided LITT, but neither was discharged with a neurologic deficit. CONCLUSIONS: For intracranial lesions in the eloquent cortex, conventional craniotomy with surgical resection is a challenge for neurosurgeons, especially pediatric patients. MRI-guided LITT provides a less-invasive and potentially effective option for treatment in the management of pediatric epilepsy and tumors.
BACKGROUND: Laser interstitial thermal therapy (LITT) is an alternative, less-invasive, and, in some circumstances, effective treatment for patients with intracranial pathology including epilepsy and some tumors. For intracranial lesions in eloquent areas, resection by conventional craniotomy proves often to be a challenge, including in the care of pediatric patients. Herein, we reviewed our experience with magnetic resonance imaging (MRI)-guided LITT as treatment for pediatric patients with intracranial lesions in eloquent areas and evaluate neurologic function and clinical outcomes. METHODS: We retrospectively reviewed consecutive patients with intracranial lesions in eloquent speech and motor areas who underwent MRI-guided LITT. Clinical evaluation, including neurologic function and neuropsychological testing, was conducted according to clinical considerations. MRI pre- and postoperative imaging was reviewed to compare the change of lesion size. RESULTS: Five pediatric patients received MRI-guided LITT of intracranial lesions in eloquent cortex. One patient experienced complications secondary to MRI-guided LITT, but neither was discharged with a neurologic deficit. CONCLUSIONS: For intracranial lesions in the eloquent cortex, conventional craniotomy with surgical resection is a challenge for neurosurgeons, especially pediatric patients. MRI-guided LITT provides a less-invasive and potentially effective option for treatment in the management of pediatric epilepsy and tumors.
Authors: Georgios P Skandalakis; Daniel R Rivera; Caroline D Rizea; Alexandros Bouras; Joe Gerald Jesu Raj; Dominique Bozec; Constantinos G Hadjipanayis Journal: Int J Hyperthermia Date: 2020-07 Impact factor: 3.914