Laser Interstitial Thermal Therapy for Brain Metastases and Radiation Necrosis

Laser interstitial thermal therapy (LITT) is a minimally invasive ablation technique that is emerging as a potential treatment for a wide array of surgical disorders. In the field of neurosurgery, applications range from refractory epilepsy to intracranial tumors not amenable to standard resection techniques. In patients with brain metastases or cerebral radiation necrosis (CRN), studies suggest that LITT is an effective, minimally invasive management strategy. In addition, current evidence suggests that LITT may be performed without confirmation of a diagnosis as it is effective for the management of both disease processes. Though the findings from these studies are promising, further studies demonstrating the indications and limitations of this therapy are warranted before treatment guidelines are developed. This chapter reviews the history of LITT, the associated operative technique for delivery, and the current evidence for its application to brain metastases and CRN.