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Neurosurgery Clinics of North America Jan 2021The previous decade has seen an expansion in the use of laser interstitial thermal therapy (LITT) for a variety of pathologies. LITT has been used to treat both newly... (Review)
Review
The previous decade has seen an expansion in the use of laser interstitial thermal therapy (LITT) for a variety of pathologies. LITT has been used to treat both newly diagnosed and recurrent glioblastoma (GBM), especially in deep-seated, difficult-to-access lesions where open resection is otherwise infeasible or in patients who would not tolerate craniotomy. This review aims to describe the current state of the technology and operative technique, as well as summarize the outcomes data and future research regarding LITT as a treatment of GBM.
Topics: Brain Neoplasms; Glioblastoma; Humans; Laser Therapy; Minimally Invasive Surgical Procedures; Stereotaxic Techniques; Treatment Outcome
PubMed: 33223019
DOI: 10.1016/j.nec.2020.08.006 -
Neurosurgery Clinics of North America Oct 2020Laser interstitial thermal therapy is a minimally invasive surgical alternative to craniotomy that uses laser light through a fiber optic probe placed within a target...
Laser interstitial thermal therapy is a minimally invasive surgical alternative to craniotomy that uses laser light through a fiber optic probe placed within a target lesion to create thermal tissue damage, resulting in cellular death. It is used in neuro-oncology to treat inaccessible lesions and obviate morbidity in high-risk patients. Overall complication rates and outcome measures are comparable with those seen in radiation and/or craniotomy. Laser interstitial thermal therapy can be an effective option for recurrent brain metastases. Prospective, randomized trials must be performed to evaluate the efficacy of laser interstitial thermal therapy as a primary treatment for brain metastases.
Topics: Brain; Brain Neoplasms; Humans; Laser Therapy; Minimally Invasive Surgical Procedures; Treatment Outcome
PubMed: 32921350
DOI: 10.1016/j.nec.2020.06.004 -
Neurosurgical Focus Dec 2014Evolving research has demonstrated that surgical cytoreduction of a high-grade glial neoplasm is an important factor in improving the prognosis of these difficult... (Review)
Review
Evolving research has demonstrated that surgical cytoreduction of a high-grade glial neoplasm is an important factor in improving the prognosis of these difficult tumors. Recent advances in intraoperative imaging have spurred the use of stereotactic laser ablation (laser interstitial thermal therapy [LITT]) for intracranial lesions. Among other targets, laser ablation has been used in the focal treatment of high-grade gliomas (HGGs). The revived application of laser ablation for gliomas parallels major advancements in intraoperative adjuvants and groundbreaking molecular advances in neuro-oncology. The authors review the research on stereotactic LITT for the treatment of HGGs and provide a potential management algorithm for HGGs that incorporates LITT in clinical practice.
Topics: Brain Neoplasms; Glioma; Humans; Laser Therapy; Stereotaxic Techniques
PubMed: 25434378
DOI: 10.3171/2014.9.FOCUS14471 -
Neurosurgery Clinics of North America Jan 2016Laser ablation is an emerging, minimally invasive treatment for selected children with intractable focal epilepsy with improved procedural morbidity. Data for children... (Review)
Review
Laser ablation is an emerging, minimally invasive treatment for selected children with intractable focal epilepsy with improved procedural morbidity. Data for children lag similar studies in adults, but the hope is for near-equivalent seizure-control rates and improved neuropsychological outcome when compared with standard open surgical resection. The approach seems particularly beneficial when dealing with deep, focal lesions, such as hypothalamic hamartomas or hippocampal sclerosis.
Topics: Brain; Child; Epilepsy; Hamartoma; Humans; Hypothalamic Diseases; Laser Therapy; Neurosurgical Procedures; Seizures; Treatment Outcome
PubMed: 26615109
DOI: 10.1016/j.nec.2015.08.006 -
Endokrynologia Polska 2023The incidence of papillary thyroid microcarcinoma has been increasing worldwide. However, the optimal management strategy remains a topic of discussion and varies from... (Review)
Review
The incidence of papillary thyroid microcarcinoma has been increasing worldwide. However, the optimal management strategy remains a topic of discussion and varies from an active follow-up to a thyroidectomy. New thermoablation techniques for selected cases seem to be sufficiently effective but minimally invasive. One of the newest thermoablation methods is ultrasound-guided percutaneous laser ablation. There are already some data showing promising results of this method in the management of papillary thyroid microcarcinomas. In this article, we review recent papers and conclude on the current status of the ultrasound-guided percutaneous laser ablation technique for the management of papillary thyroid microcarcinomas.
Topics: Humans; Thyroid Neoplasms; Laser Therapy; Lasers; Ultrasonography, Interventional; Retrospective Studies
PubMed: 36704979
DOI: 10.5603/EP.a2023.0005 -
Neurosurgery Dec 2016Recurrent malignant glioma continues to be a clinical challenge, and repeat surgery is an option in only select patients. Stereotactic laser ablation, a new minimally... (Review)
Review
UNLABELLED
Recurrent malignant glioma continues to be a clinical challenge, and repeat surgery is an option in only select patients. Stereotactic laser ablation, a new minimally invasive technique, can be used as an alternative to surgery. We review the current literature on laser ablation for recurrent malignant gliomas as well as discuss practical and theoretical advantages and disadvantages of this emerging technique in comparison with repeat surgery or radiation. We also discuss the potential for laser ablation to augment adjuvant therapies, namely, chemotherapy, radiation, and immunotherapy.
ABBREVIATIONS
BBB, blood-brain barrierBVZ, bevacizumabHGG, high-grade gliomaLITT, laser interstitial thermotherapyTMZ, temozolomide.
Topics: Brain Neoplasms; Chemoradiotherapy, Adjuvant; Combined Modality Therapy; Cytoreduction Surgical Procedures; Glioma; Humans; Imaging, Three-Dimensional; Immunotherapy; Laser Therapy; Neoplasm Recurrence, Local; Stereotaxic Techniques
PubMed: 27861324
DOI: 10.1227/NEU.0000000000001442 -
Journal of the American Society For... Mar 2022A Schwarzschild reflective objective with a numerical aperture of 0.3 and working distance of 10 cm was used for laser ablation sampling of tissue for off-line mass...
A Schwarzschild reflective objective with a numerical aperture of 0.3 and working distance of 10 cm was used for laser ablation sampling of tissue for off-line mass spectrometry. The objective focused the laser to a diameter of 5 μm and produced 10 μm ablation spots on thin ink films and tissue sections. Rat brain tissue sections 50 μm thick were ablated in transmission geometry, and the ablated material was captured in a microcentrifuge tube containing solvent. Proteins from ablated tissue sections were quantified with a Bradford assay, which indicated that approximately 300 ng of protein was captured from a 1 mm area of ablated tissue. Areas of tissue ranging from 0.01 to 1 mm were ablated and captured for bottom-up proteomics. Proteins were extracted from the captured tissue and digested for liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis for peptide and protein identification.
Topics: Animals; Brain Chemistry; Chromatography, Liquid; Laser Therapy; Lasers; Proteins; Proteomics; Rats; Tandem Mass Spectrometry
PubMed: 35104132
DOI: 10.1021/jasms.1c00306 -
Lasers in Medical Science Sep 2023In recent years, an increasing number of scientists have focused on conducting experiments on laser ablation of bone tissue. The purpose of this study was to summarize... (Review)
Review
In recent years, an increasing number of scientists have focused on conducting experiments on laser ablation of bone tissue. The purpose of this study was to summarize the prognosis of tissue and the extent of thermal damage in past hard tissue ablation experiments, and review the evidence for the feasibility of laser osteotomy in surgery. An electronic search of PubMed, China National Knowledge Infrastructure (CNKI), and Web of Science (WOS) for relevant English-language articles published through June 2023 was conducted. This review includes 48 literature reports on laser ablation of hard tissues from medical and biological perspectives. It summarizes previous studies in which the ideal ablation rate, depth of ablation, and minimal damage to bone tissue and surrounding soft tissues were achieved by changing the laser type, optimizing the laser parameter settings, or adding adjuvant devices. By observing their post-operative healing and inflammatory response, this review aims to provide a better understanding of pulsed laser ablation of hard tissues. Previous studies suggest that laser osteotomy has yielded encouraging results in bone resection procedures. We believe that low or even no thermal damage can be achieved by experimentally selecting a suitable laser type, optimizing laser parameters such as pulse duration and frequency, or adding additional auxiliary cooling devices. However, the lack of clinical studies makes it difficult to conclusively determine whether laser osteotomy is superior in clinical applications.
Topics: Prognosis; Laser Therapy; Bone and Bones; Osteotomy; China
PubMed: 37676517
DOI: 10.1007/s10103-023-03868-1 -
Journal of Biophotonics Sep 2022Femtosecond lasers are capable of precise ablation that produces surgical dissections in vivo. The transverse and axial resolutions of the laser damage inside the bulk...
Femtosecond lasers are capable of precise ablation that produces surgical dissections in vivo. The transverse and axial resolutions of the laser damage inside the bulk are important parameters of ablation. The transverse resolution is routinely quantified; but the axial resolution is more difficult to measure and is less commonly performed. Using a 1040-nm, 400-fs pulsed laser, and a 1.4-NA objective, we performed ablation inside agarose and glass, producing clear, and persistent damage spots. Near the ablation threshold of both media, we found that the axial resolution is similar to the transverse resolution. We also ablated neuron cell bodies and fibers in Caenorhabditis elegans and demonstrate submicrometer resolution in both the transverse and axial directions, consistent with our results in agarose and glass. Using simple yet rigorous methods, we define the resolution of laser ablation in transparent media along all directions.
Topics: Animals; Caenorhabditis elegans; Laser Therapy; Lasers; Sepharose
PubMed: 35583201
DOI: 10.1002/jbio.202200042 -
Current Opinion in Urology May 2014Focal laser ablation (FLA) is an emerging treatment paradigm for prostate cancer that aims to successfully eradicate disease while also reducing the risk of side-effects... (Review)
Review
PURPOSE OF REVIEW
Focal laser ablation (FLA) is an emerging treatment paradigm for prostate cancer that aims to successfully eradicate disease while also reducing the risk of side-effects compared with whole-gland therapies.
RECENT FINDINGS
Preclinical and phase I clinical trials for low-risk prostate cancer have shown that FLA produces accurate, predictable, and reproducible ablation zones with negligible injury to the surrounding tissues. Because FLA is magnetic resonance compatible, the procedure can be monitored with real-time feedback to optimize targeted treatment of cancerous foci and minimize quality-of-life side-effects. The oncologic efficacy of MRI-guided FLA is currently being evaluated in ongoing phase II clinical trials.
SUMMARY
FLA is a well tolerated and feasible therapy for low-risk prostate cancer, and the oncologic efficacy of this treatment modality is currently under investigation in phase II clinical trials at several institutions.
Topics: Animals; Humans; Laser Therapy; Magnetic Resonance Imaging, Interventional; Male; Organ Sparing Treatments; Predictive Value of Tests; Prostatic Neoplasms; Surgery, Computer-Assisted; Treatment Outcome
PubMed: 24625427
DOI: 10.1097/MOU.0000000000000044