Laser Interstitial Thermal Therapy (LITT) [Neurosurgery Wiki]

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===== Laser Interstitial Thermal Therapy (LITT) =====

**Laser Interstitial Thermal Therapy (LITT)** is a minimally invasive neurosurgical technique that uses laser-induced heat to thermally ablate intracranial or spinal lesions under real-time magnetic resonance imaging (MRI) guidance.

While MRI is not absolutely required, effective and safe LITT—especially in the brain—relies on real-time MRI guidance. Alternative imaging lacks the precision and feedback necessary for delicate intracranial procedures.

===== Magnetic resonance image-guided laser interstitial thermal therapy. =====

[[Magnetic resonance image-guided laser interstitial thermal therapy]]

==== 🧪 Mechanism of Action ====
- A **laser fiber** is inserted stereotactically into the target lesion.
- The laser emits **infrared energy**, which heats and destroys tissue via **coagulative necrosis**.
- **MRI thermometry** is used during the procedure to monitor temperature distribution in real time and ensure precise thermal ablation while avoiding damage to adjacent healthy tissue.

==== 🧠 Clinical Applications ====
- **Brain metastases** (especially post-radiation or deep-seated)
- **Radiation necrosis**
- **Gliomas** (low- and high-grade)
- **Epilepsy surgery** (e.g., mesial temporal lobe sclerosis)
- Occasionally used in **spinal tumors** and **abscesses**

==== ⚖️ Advantages ====
- Minimally invasive (percutaneous)
- Real-time thermal monitoring
- Shorter recovery compared to open surgery

==== ⚠️ Limitations ====
- Not suitable for large or irregularly shaped lesions
- Risk of thermal injury to nearby eloquent structures
- Lack of long-term randomized controlled trial data for many indications

==== 🔖 Synonyms ====
- Stereotactic laser ablation
- MR-guided laser interstitial therapy (MRgLITT)

> 🧷 Tag: `LITT` `minimally_invasive` `thermal_ablation` `neurosurgery`