SURG-16. MAGNETIC RESONANCE-GUIDED LASER ABLATION FOR THE TREATMENT OF RECURRENT DURAL BASED TUMORS

Abstract

BACKGROUND: Magnetic resonance‐guided laser‐induced thermotherapy (MR‐LITT) is a minimally invasive technique that shows promise in neuro‐oncology due to its superiority in delivering precise minimally invasive thermal energy with minimal collateral damage. In this analysis we investigate initial data on MR‐LITT's effect on dural based lesions. METHODS: Five patients were identified with dural based lesions (4 meningiomas, 1 solitary fibrous tumor) with clear evidence of radiological progression. All patients received MR‐LITT and then a follow‐up MRI scan at 24 hours post treatment, at one month, and at each subsequent follow up visit. Local control of the ablated tumor was evaluated with radiographic follow up and symptomatic progression free survival was recorded. RESULTS: Five LITT treatments were performed on 5 patients with the average age of 65.2 years. The average tumor volume was 29.7 cm3 and ablation dosage was 12.4 Watts. On average, 80% of the pretreatment lesion volume was ablated. The mean follow‐up time was 59.3 weeks. In total, 2 patients (one with an anaplastic meningioma and one with a solitary fibrous tumor) had radiographic evidence of disease progression. In the observed time of the 3 patients with no progression there was a 52% reduction in tumor volume. There were no major perioperative complications. CONCLUSIONS: MR‐LITT is a promising technology for dural based tumor treatment. This initial study demonstrates that MR‐LITT is safe and offers several advantages over open surgical treatment. Randomized studies are needed to evaluate its role as a treatment adjunct.