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A stereotactic frame-based drill guide-aided setting for laser interstitial thermal therapy.

Markus F Oertel1,2, Lennart H Stieglitz3,4, Oliver Bozinov3,4,5

  • 1Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland. markus.oertel@usz.ch.

Acta Neurochirurgica
|May 13, 2021
PubMed
Summary

This study shows that combining a traditional stereotactic system with a new drill guide kit enables safe and accurate magnetic resonance imaging (MRI)-guided laser interstitial thermal therapy (MRIgLITT) for brain tumor treatment.

Keywords:
AblationInterstitial thermal therapyLaserStereotactic frameVisualase

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Area of Science:

  • Neurosurgery
  • Medical Technology
  • Oncology

Background:

  • Magnetic resonance imaging (MRI)-guided laser interstitial thermal therapy (MRIgLITT) is a recognized neurosurgical technique.
  • Existing methods have various indications and technical considerations.
  • This report details the novel use of a traditional stereotactic system with a new drill guide for MRIgLITT.

Purpose of the Study:

  • To describe the integration of a traditional Riechert-Mundinger (RM) stereotactic system with a novel drill guide kit for MRIgLITT.
  • To evaluate the feasibility and safety of this combined approach in a clinical setting.

Main Methods:

  • A stereotactic frame-based setup was created using an RM system, a drill guide kit, and a bone anchor screwing aid.
  • This apparatus was utilized with an MRIgLITT neuro-accessory kit and laser applicator.
  • The system was employed for stereotactic biopsy and subsequent MRIgLITT under intraoperative high-field MRI guidance in a brain tumor patient.

Main Results:

  • The feasibility of using the RM stereotactic apparatus and drill guide kit for MRIgLITT was successfully demonstrated.
  • Stereotactic biopsy and MRIgLITT were performed safely and easily in a neurooncological patient.
  • No technical issues or complications were encountered during the procedure.

Conclusions:

  • The combination of a traditional RM stereotactic system, a new drill guide, and intraoperative MRI offers a reliable method for neurosurgeons.
  • This approach facilitates accurate diagnosis via frame-based biopsy.
  • It enables stable and precise real-time MRIgLITT for brain tumor treatment.