Neurosurgery
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Multicenter Study
Laser Thermal Ablation for Metastases Failing Radiosurgery: A Multicentered Retrospective Study.
Radiosurgical failure following stereotactic radiosurgery for brain metastases can be attributed to tumor regrowth or radiation necrosis. MRI-guided laser thermal ablation (LTA) therapy has emerged as an option for treatment; however, previous literature demonstrates variable results across centers. ⋯ MRI-guided laser thermal ablation therapy serves as a viable alternative to traditional treatment options for metastatic brain lesions failing radiosurgery. Although this study is limited by size and is retrospective, LTA therapy may result in symptomatic improvement and a more prominent reduction in fluid-attenuated inversion-recovery signal for larger lesions.
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Glioblastoma is the most common primary brain tumor in adults. Standard therapy depends on patient age and performance status but principally involves surgical resection followed by a 6-wk course of radiation therapy given concurrently with temozolomide chemotherapy. ⋯ Radiotherapy dose intensification through hypofractionation and stereotactic radiosurgery is a promising strategy that has been explored to meet these challenges. We review the use of hypofractionated radiotherapy and stereotactic radiosurgery for patients with newly diagnosed and recurrent glioblastoma.
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In this review, we discuss the imaging features of diseases and conditions ranging from neoplastic to nonoperative post-treatment effects to unique conditions of the spine. Additionally, advanced imaging may increase diagnostic certainty in cases where conventional imaging characteristics of benign lesions and malignant pathology are variable.