Imaging Changes and Clinical Outcome after MR-Guided Laser Interstitial Thermal Therapy
Lottem Bergman1, Ariel Agur1, Segev Gabay1
1Department of Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel.
Stereotactic and Functional Neurosurgery
|October 27, 2025
Summary
MR-guided laser interstitial thermal therapy (MRgLITT) shows initial lesion enlargement post-ablation, followed by decrease. Metastatic brain lesions treated with MRgLITT achieve good local control, especially when smaller than 4cc.
Area of Science:
- Neurosurgery
- Oncology
- Medical Imaging
Background:
- MR-guided laser interstitial thermal therapy (MRgLITT) is a minimally invasive treatment for deep brain lesions.
- Post-ablation imaging changes and long-term outcomes of MRgLITT are not fully understood.
Purpose of the Study:
- To evaluate clinical outcomes and temporal volume changes after MRgLITT for brain tumors.
- To characterize imaging dynamics following MRgLITT procedures.
Main Methods:
- Retrospective analysis of adult patients undergoing MRgLITT for brain tumors (primary and metastatic) from 01/2020 to 06/2024.
- Lesion volumes and diameters measured using Brainlab Elements on post-contrast T1-weighted MRI.
- Assessment of local control at last follow-up.
Main Results:
- 32 lesions in 29 patients (21 metastatic, 11 gliomas) were analyzed with a mean follow-up of 23.4 months.
- Lesion volumes increased by ~250% in the first month post-ablation before gradually decreasing.
- Local control was achieved in 76% of metastatic lesions, particularly those <4cc and <16mm; nodular enhancement at 3 months predicted local failure.
Conclusions:
- MRgLITT offers effective local control for metastatic brain lesions, warranting early follow-up consideration.
- The characteristic post-ablation imaging includes initial enlargement followed by shrinkage.
- Persistent enlargement or nodular enhancement at 3 months post-MRgLITT suggests potential local failure.
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