Utilizing personalized stereotactic frames for laser interstitial thermal ablation of posterior fossa and mesiotemporal brain lesions: a single-institution series
Utilizing personalized stereotactic frames for laser interstitial thermal ablation of posterior fossa and mesiotemporal brain lesions: a single-institution series
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DOI：
10.3171/2016.7.focus16207
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发表时间：
2016-10-01
影响因子：
4.1
通讯作者：
Kim, Albert H.
中科院分区：
文献类型：
--
作者：
Dadey, David Y. A.;Kamath, Ashwin A.;Kim, Albert H.
目的：深部病灶间质热疗时，立体定向引导下的激光探头插入精度受到限制。本研究的目的是评估定制的STarFix 3D打印立体定向平台的可行性，以引导激光探针插入到近中颞和后颅窝target.METHODS的作者进行了回顾性分析5例患者（12-55岁）与激光间质热治疗（LITT），其中STarFix平台用于探针插入。将骨基准植入每个患者的颅骨中，随后的CT扫描用于指导每个平台的设计并结合所需的治疗轨迹。一旦生成，平台就被安装在患者的颅骨上，并用于在手术期间定位激光探针。通过术中MRI监测激光探针的放置和LITT手术。围手术期及随访期间进行MRI检查，以识别和监测靶病灶的变化。所有患者均完成了热消融，无术中并发症。在4例有症状病变的患者中，2例症状完全缓解，1例报告症状较基线改善。结论：定制的立体定向平台无缝纳入作者先前建立的LITT工作流程，并允许准确的治疗交付。
OBJECTIVE The precision of laser probe insertion for interstitial thermal therapy of deep-seated lesions is limited by the method of stereotactic guidance. The objective of this study was to evaluate the feasibility of customized STarFix 3D-printed stereotactic platforms to guide laser probe insertion into mesiotemporal and posterior fossa targets.METHODS The authors conducted a retrospective review of 5 patients (12-55 years of age) treated with laser interstitial thermal therapy (LITT) in which STarFix platforms were used for probe insertion. Bone fiducials were implanted in each patient's skull, and subsequent CT scans were used to guide the design of each platform and incorporate desired treatment trajectories. Once generated, the platforms were mounted on the patients' craniums and used to position the laser probe during surgery. Placement of the laser probe and the LITT procedure were monitored with intraoperative MRI. Perioperative and follow-up MRI were performed to identify and monitor changes in target lesions.RESULTS Accurate placement of the laser probe was observed in all cases. For all patients, thermal ablation was accomplished without intraoperative complications. Of the 4 patients with symptomatic lesions, 2 experienced complete resolution of symptoms, and 1 reported improved symptoms compared with baseline.CONCLUSIONS Customized stereotactic platforms were seamlessly incorporated into the authors' previously established LITT workflow and allowed for accurate treatment delivery.