MRI-Guided Neurosurgical Laser Ablation
Washington University neurosurgeons are among the first in the nation to use an MRI-guided, high-intensity laser probe designed especially for the treatment of inoperable brain tumors. At Washington University, use of this technology was pioneered by neurosurgeon Eric Leuthardt, MD, Director of the Brain Laser Center and Director of the Center for Innovation in Neuroscience and Technology.
The probe, called the Monteris NeuroBlate® System MRI-guided laser probe, is used to "cook" cancer cells deep within the brain while leaving surrounding brain tissue undamaged. Patients who are candidates for this procedure will have a small burr hole the diameter of a pencil drilled through their skull. Neurosurgeons then use real-time MR imaging to guide the probe through the brain and into the tumor. Once inside the tumor, the laser discharges highly focused thermal energy to coagulate and kill cancer cells. The MRI-directed positioning of the later occurs in real time so the discharge of energy to the tumor leaves the healthy surrounding brain tissue undamaged. The technology is FDA-approved for neurosurgical procedures.
The Monteris NeuroBlate® System MRI-guided laser probe is passed through a hole in the skull to deliver laser therapy to heat and coagulate the tumor (right). Images courtesy of Monteris Medical Inc.
Several types of brain tumors can be treated with the Monteris system:
- Glial tumors, including gliomas
- Anaplastic astrocytomas
- Glioblastoma multiforme
- Metastatic cancers that have spread to the brain from other regions of the body
- Some radiation-resistant tumors
- Radiation necrosis due to prior radiation therapy
- Cause of epilepsy such as mesial temporal lobe epilepsy
Typically, tumors treated by the Monteris laser probe are in hard-to-reach regions of the brain such as the basal ganglia, thalamus and insula, although patients with cancer in other areas may also be considered for a number of clinical reasons. Follow-up MRI studies of the tumor typically begin to show evidence of tumor death immediately after the surgery. The patient’s recovery usually takes several days but is generally much quicker than with open surgery.
Patients may not be eligible for treatment with the Monteris NeuroBlate® System if either of the following applies:
- Patient is unable to get an MRI (e.g., patient has a pacemaker or other metal in their body).
- Patient's tumor is located in an area that, if treated, could cause other significant neurological impairment (e.g., tumors in the brainstem).
If taking Avistan, patients will be required to stop taking the medication prior to treatment with the Monteris NeuroBlate System.
For more information, contact Caroline Graham, RN, in the Department of Neurosurgery, at (314) 362-9087.
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Contact: Caroline Graham
Adult Referring Physicians
Contact: Caroline Graham
Center for Advanced Medicine
4921 Parkview Place, Suite 6C
St. Louis, Missouri 63110