The Latest in Laser Interstitial Thermal Therapy

Published: Jan 25, 2021

Laser interstitial thermal therapy is an emerging technique used to treat epilepsy and primary and metastatic brain tumors with a small incision as opposed to open surgery.  Additionally, this technology can be used to treat lesions that are hard to reach with conventional surgery. In 2014, Tampa General was the first hospital in Florida and one of the first in the region to introduce the MRI-guided laser ablation technology. Now, Tampa General is one of only a few hospitals in Florida to offer the Visualase System, the most advanced LIIT technology available.

Laser interstitial thermal therapy (LITT) is minimally invasive, requiring only a 2-millimeter incision in the scalp. Surgeons use real-time MRI to guide a small laser catheter through the hole to the brain. The catheter is heated to temperatures high enough to destroy tumors or brain malformations. LITT can also target lesions responsible for epileptic seizures and Parkinson’s disease. Because the procedure is guided by MRI images, it is highly precise. Surgeons destroy only the targeted tissue, leaving healthy surrounding tissues unharmed (< 1 mm or in the sub-millimeter range).

“We use MRI technology to place cursors on the edges of the tumor or lesion to specify where the heat should be,” says Dr. Yarema Bezchlibnyk, MD, PhD, Co-Director of Tampa General Hospital’s Comprehensive Epielpsy Program and the Movement Disorders Neuromodulation Center. “It creates a color-coded heat map that shows the targeted tissue turning from blue [cold] to red [hot].”

LITT is especially beneficial for patients who do not respond to stereotactic radiosurgery or have radiation necrosis. Neurosurgeons at Tampa General have used the Neuroblasts System to successfully treat 20 patients.

Because the laser procedure delivers no (ionizing) radiation, the procedure can be repeated multiple times and there is no need for a brain flap. Patients experience little to no pain and the probe site heals quickly with minimal scarring. Most patients recover and are discharged after a one-night hospital stay with few complications.