Magnetic resonance-guided laser interstitial thermal therapy for posterior fossa neoplasms

Omar Ashraf, Grant Arzumanov, Evan Luther, J. Tanner McMahon, James G. Malcolm, Samuel Mansour, Ian Y. Lee, Jon T. Willie, Ricardo J. Komotar, Shabbar F. Danish

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Magnetic resonance-guided laser interstitial thermal therapy (LITT) has been increasingly used to treat a number of intracranial pathologies, though its use in the posterior fossa has been limited to a few small series. We performed a multi-institutional review of targets in the posterior fossa, reporting the efficacy and safety profile associated with laser ablation in this region of the brain. Methods: A retrospective review of patients undergoing LITT in the posterior fossa was performed from August 2010 to March 2020. Patient demographic information was collected alongside the operative parameters and patient outcomes. Reported outcomes included local control of the lesion, postoperative complications, hospital length of stay, and steroid requirements. Results: 58 patients across four institutions underwent LITT in the posterior fossa for 60 tumors. The median pre-ablation tumor volume was 2.24 cm3. 48 patients (50 tumors) were available for follow-up. An 84% (42/50) overall local control rate was achieved at 9.5 months median follow up. There were two procedural complications, including insertional hemorrhage and laser misplacement and 12/58 (21%) patients developed new neurological deficits. There was one procedure related death. The median length of hospital stay was 1 day, with 20.7% of patients requiring discharge to a rehabilitation facility. Conclusions: LITT is an effective approach for treating pathology in the posterior fossa. The average target size is smaller than what has been reported in the supratentorial space. Care must be taken to prevent injury to surrounding structures given the close proximity of critical structures in this region.

Original languageEnglish (US)
Pages (from-to)533-542
Number of pages10
JournalJournal of neuro-oncology
Volume149
Issue number3
DOIs
StatePublished - Sep 1 2020

Keywords

  • Laser interstitial thermal therapy
  • Posterior fossa
  • Tumor ablation

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

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