Laser Interstitial Thermal Therapy (LITT)

clinical evaluation of a focused neurosurgical approach

Overview

Laser interstitial thermal therapy (LITT) is a neurosurgical approach that may be evaluated in selected brain tumor cases where standard surgical options present significant limitations.
Rather than replacing established treatment modalities, LITT is considered within a broader clinical context, based on tumor characteristics, prior therapy, and individual patient factors.

Discussion of this method typically arises when treatment decisions are complex and require careful reassessment of available options.

Clinical situations in which LITT may be evaluated

Brain tumors vary widely in their biological behavior and anatomical location.
In certain cases, surgical access is limited by proximity to critical brain structures or by previous interventions.

LITT may be discussed when:

• the lesion is located deep within the brain
• open resection carries a high functional risk
• prior surgery, radiation, or systemic therapy has already been performed
• alternative local control strategies need to be reviewed

The presence of a specific diagnosis alone does not determine suitability. Each case requires individual clinical analysis.

Principle of the method

The LITT approach is based on delivering controlled thermal energy directly within the target area.
Imaging is used throughout the process to assess positioning and to monitor tissue response during energy delivery.

This allows for localized impact while limiting exposure of surrounding brain tissue.
The technique is designed to support precision rather than radical tissue removal.

Procedural considerations

LITT is performed through a limited surgical access using stereotactic navigation.
A thin probe is advanced to the planned target area based on preoperative imaging.

During the procedure:

• probe positioning is verified using imaging data
• thermal effects are monitored in real time
• the treated zone is adjusted according to observed tissue response

In selected cases, tissue sampling may be performed as part of the same intervention.

Post-procedural recovery is often shorter compared to open surgical approaches, although outcomes depend on the overall clinical context.

Tumor types in which LITT may be discussed

Evaluation of LITT may be relevant in selected cases involving:

• low-grade gliomas
• certain high-grade gliomas, as part of a combined or palliative strategy
• metastatic brain lesions
• recurrent tumors following prior treatment
• specific pediatric or congenital central nervous system tumors

Final recommendations are made following multidisciplinary review, incorporating neurosurgical, neurological, oncological, and radiological perspectives.

How suitability for LITT is assessed

LITT is not selected based on technology availability alone. Assessment typically includes:

• detailed review of MRI and other imaging studies
• available histopathological data
• prior treatment history
• current neurological status
• overall treatment objectives

For patients facing complex decisions, particularly those seeking an independent clinical review, evaluation often begins with structured analysis of medical records and imaging studies.

Role of LITT within an overall treatment strategy

LITT is rarely considered as a standalone solution.
It may be evaluated as:

• part of a multimodal treatment plan
• a local control option in recurrent disease
• a supportive measure when standard approaches are limited

The purpose of consultation is to determine whether this approach has a justified role in the specific clinical scenario.

When consultation may be appropriate

Clinical consultation regarding LITT may be relevant when:

• recommended treatment options differ between specialists
• surgical risk is a major concern
• tumor location limits conventional approaches
• clarification of potential strategies is needed before proceeding

In many cases, this process allows patients and families to better understand which options warrant consideration and which do not.

Next step

Management of brain tumors requires balanced decision-making.
Careful clinical evaluation helps avoid unnecessary interventions while identifying options that may offer meaningful benefit.

Neurosurgical consultation focuses on clarifying possibilities, outlining limitations, and supporting informed decision-making.

Consultation and contact

📞 Phone: +972-73-374-6844
📧 Email: [email protected]
💬 WhatsApp: +972-52-337-3108