Abstract
Lasers were invented in the middle of the 20th century, from the previous theoretical work of Einstein on the process of amplification of stimulated emission, and quickly became used in various devices for industrial, telecommunication and military applications. In the medical field, neurosurgeons were some of the first researchers to investigate the use of lasers for therapy in the 1960s, but were limited by cumbersome designs and the availability of lasers that could only operate in pulsed modes. As improved laser designs were introduced that allowed for continuous mode operation and other wavelengths, new medical techniques were developed and improved. Subsequently, in the early 1970s, Sutton introduced the concept of interstitial hyperthermia, which led to the development of a new technique called laser interstitial thermotherapy (LITT). LITT treatments consist of heating tumors with prolonged and moderate temperature elevations, inducing alteration of cell membranes and enzyme denaturation, leading to the formation of a selective zone of coagulation necrosis in the heated tissue without vaporization. The Nd-YAG and diode laser are the most frequent lasers used for LITT due to their optimum wavelength for absorption and heating in tissue. With the recent development and widespread availability of magnetic resonance imaging (MRI), laser fibers can be inserted stereotactically within the tumor and the treatment can be controlled in real-time. MR imaging allows for monitoring of the temperature elevation in the treated area and for prediction of the extent of induced necrosis based on the temperature history. Several clinical studies have been performed that show that the technique is now safe and allows for control of brain tumors metastases for which traditional treatments including radiosurgery have failed. Additional technical progress is now being performed on methods to treat tumors with larger diameters and with more complex shapes. Lastly, additional clinical studies are needed in larger patient populations to confirm the findings of the initial clinical trials.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bleier AR, Jolesz FA, Cohen MS, Weisskoff RM, Dalcanton JJ, Higuchi N, Feinberg DA, Rosen BR, McKinstry RC, Hushek SG (1991) Real-time magnetic resonance imaging of laser heat deposition in tissue. Magn Reson Med 21:132–137
Bown SG (1983) Phototherapy of tumours. World J Surg 7:700–701
Carpentier A, McNichols RJ, Stafford RJ, Itzcovitz J, Guichard JP, Reizine D, Delaloge S, Vicaut E, Payen D, Gowda A, George B (2008) Real-time magnetic resonance-guided laser thermal therapy for focal metastatic brain tumors. Neurosurgery 63(1 Suppl 1):ONS21-8, discussion ONS28–9
De Poorter J (1995) Noninvasive MRI thermometry with the proton resonance frequency method: study of susceptibility effects. Magn Reson Med 34:359–367
Devaux BC, Roux FX (1996) Experimental and clinical standards, and evolution of lasers in neurosurgery. Acta Neurochir (Wien) 138:1135–1147
Higuchi N, Bleier AR, Jolesz FA, Colucci VM, Morris JH (1992) Magnetic resonance imaging of the acute effects of interstitial neodymium:YAG laser irradiation on tissues. Invest Radiol 27:814–821
Isbert C, Ritz JP, Roggan A, Schuppan D, Ajubi N, Buhr HJ, Hohenberger W, Germer CT (2007) Laser-induced thermotherapy (LITT) elevates mRNA expression of connective tissue growth factor (CTGF) associated with reduced tumor growth of liver metastases compared to hepatic resection. Lasers Surg Med 39:42–50
Ivarsson K, Myllymäki L, Jansner K, Bruun A, Stenram U, Tranberg KG (2003) Heat shock protein 70 (HSP70) after laser thermotherapy of an adenocarcinoma transplanted into rat liver. Anticancer Res 23 (5A):3703–3712
Jolesz FA, Bleier AR, Jakab P, Ruenzel PW, Huttl K, Jako GJ (1988) MR imaging of laser-tissue interactions. Radiology 168:249–253
Kahn T, Bettag M, Ulrich F, Schwarzmaier HJ, Schober R, Fürst G, Mödder U (1994) MRI-guided laser-induced interstitial thermotherapy of cerebral neoplasms. J Comput Assist Tomogr 18 (4):519–532
Kahn T, Harth T, Kiwit JCW, Schwarzmaier HJ, Wald C, Mödder U (1998) In vivo MRI thermometry using a phase-sensitive sequence: preliminary experience during MRI-guided laser-induced interstitial thermotherapy of brain tumors. J Magn Reson Imaging 8:160–164
Kangasniemi M, McNichols R, Bankson JA, Gowda A, Price RE, Hazle JD (2004) Thermal therapy of canine cerebral tumors using a 980 nm diode laser with MR temperature-sensitive imaging feedback. Lasers Surg Med 35:41–50
Kickhefel A, Roland J, Weiss C, Schick F (2010) Accuracy of real-time MR temperature mapping in the brain: a comparison of fast sequences. Phys Med XX:1–10
Kou L, Labrie D, Chylek P (1993) Refractive indices of water and ice in the 0.65-2.5 μm spectral range. Appl Opt 32:3531–3540
Menovsky T, Beek JF, Van Gemert MJC, Roux FX, Bown SG (1996) Interstitial laser thermotherapy in neurosurgery: a review. Acta Neurochir (Wien) 138:1019–1026
Mordon S, Brunetaud JM (1992) Bases physiques des applications thérapeutiques des lasers. Neurochirurgie 38:203–207
Roux FX, Merienne L, Devaux B, Leriche B, Ciocola C (1992a) Les lasers YAG en neurochirurgie. Neurochirurgie 38:229–234
Roux FX, Merienne L, Fallet-Bianco C, Beuvon F, Devaux B, Leriche B, Cioloca C (1992b) La thermothérapie interstitielle laser stéréotaxique. Une alternative dans la prise en charge thérapeutique de certaines tumeurs cérébrales. Neurochirurgie 38:238–244
Salcman M, Samaras GM (1981) Hyperthermia for braintumors:biophysical rationale. Neurosurgery 9:327–335
Sapareto SA, Dewey WC (1984) Thermal dose determination in cancer therapy. Int J Radiat Oncol Biol Phys 10 (6):787–800
Schatz SW, Bown SG, Wyman DR, Groves JT, Wilson BC (1992) Low power interstitial Nd:YAG laser photocoagulation in normal rabbit brain. Lasers Med Sci 7:433–439
Schober R, Bettag M, Sabel M, Ulrich F, Hessel S (1993) Fine structure of zonal changes in experimental Nd:YAG laser-induced interstitial hyperthermia. Lasers Surg Med 13:234–241
Schulze CP, Kahn T, Harth T, Schwurzmaier HJ, Schober R (1998) Correlation of neuropathologic findings and phase-based MRI temperature maps in experimental laser-induced interstitial thermotherapy. J Magn Reson Imaging 8:115–120
Schulze PC, Vitzthum HE, Goldammer A, Schneider JP, Schober R (2004) Laser-induced thermotherapy of neoplastic lesions in brain – underlying tissue alterations, MRI-monitoring and clinical applicability. Acta Neurochir (Wien) 146:803–812, Review article
Schwabe B, Kahn T, Harth T, Ulrich F, Schwarzmaier HJ (1997) Laser-induced thermal lesions in the human brain: short- and long-term appearance on MRI. J Comput Assist Tomogr 21 (5):818–825
Stafford RJ, Fuentes D, Elliott AA, Weinberg JS, Ahrar K (2010) Laser-induced thermal therapy for tumor ablation. Crit Rev Biomed Eng 38(1):79–100
Stellar S (1968) Laser studies on nervous system tissue, neoplasms and related biological systems. Proc Virchow Med Soc 26 (Suppl):416–442
Sugiyama K, Sakai T, Fujishima I, Ryu H, Uemura K, Yokoyama T (1990) Stereotactic interstitial laser-hyperthermia using Nd-YAG laser. Stereotact Funct Neurosurg 54–55:501–505
Sutton C (1971) Tumor hyperthermia in the treatment of malignant gliomas of the brain. Trans Ann Neurol Assoc 96:195–199
Tracz RA, Wyman DR, Little PB, Towner RA, Stewart WA, Schatz SW, Pennock PW, Wilson BC (1992) Magnetic resonance imaging of interstitial laser photocoagulation in brain. Lasers Surg Med 12:165–173
Vogl, Mack, Roggan, Straub, Eichler, Müller, Knappe, Felix, Vogl TJ, Mack MG, Roggan A, Straub R, Eichler KC, Müller PK, Knappe V, Felix R (1998) Internally cooled power laser for MR-guided interstitial laser-induced thermotherapy of liver lesions: initial clinical results. Radiology 209(2):381–385
Yung JP, Shetty A, Elliott A, Weinberg JS, McNichols RJ, Gowda A, Hazle JD, Stafford RJ (2010) Quantitative comparison of thermal dose models in normal canine brain. Med Phys 37(10):5313–5321
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media B.V.
About this chapter
Cite this chapter
Beccaria, K., Canney, M.S., Carpentier, A.C. (2012). Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Brain Tumors. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 5. Tumors of the Central Nervous System, vol 5. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2019-0_20
Download citation
DOI: https://doi.org/10.1007/978-94-007-2019-0_20
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-2018-3
Online ISBN: 978-94-007-2019-0
eBook Packages: MedicineMedicine (R0)