Chapter 26 - Advanced imaging techniques and planning for laser interstitial thermal therapy

Abstract

Laser interstitial thermal therapy (LITT) is a minimally invasive intracranial treatment option with a range of clinical applications, made possible through modern imaging technology. LITT has proven success in both primary and metastatic brain tumours, particularly in recurrent lesions and those inaccessible to traditional open resection due to location, patient frailty or patient preference. Successful application of the modality begins with pre-operative magnetic resonance imaging (MRI) for patient selection and trajectory planning, along with additional advanced imaging techniques as appropriate. Intra-operatively, the laser probe is stereotactically placed within the target lesion with use of computerised tomography scans and MRI. Subsequent heating of the lesion is monitored in real time with continuous MR thermometry to ablate the target precisely and thoroughly with minimal damage to surrounding healthy tissue. This chapter discusses key roles and techniques for imaging technology in the administration of LITT.