BACKGROUND: Surgical treatments for deep-seated intracranial lesions have been 
limited by morbidities associated with resection. Real-time magnetic resonance 
imaging-guided focused laser interstitial thermal therapy (LITT) offers a 
minimally invasive surgical treatment option for such lesions.
OBJECTIVE: To review treatments and results of patients treated with LITT for 
intracranial lesions at Washington University School of Medicine.
METHODS: In a review of 17 prospectively recruited LITT patients (34-78 years of 
age; mean, 59 years), we report demographics, treatment details, postoperative 
imaging characteristics, and peri- and postoperative clinical courses.
RESULTS: Targets included 11 gliomas, 5 brain metastases, and 1 epilepsy focus. 
Lesions were lobar (n = 8), thalamic/basal ganglia (n = 5), insular (n = 3), and 
corpus callosum (n = 1). Mean target volume was 11.6 cm, and LITT produced 93% 
target ablation. Patients with superficial lesions had shorter intensive care 
unit stays. Ten patients experienced no perioperative morbidities. Morbidities 
included transient aphasia, hemiparesis, hyponatremia, deep venous thrombosis, 
and fatal meningitis. Postoperative magnetic resonance imaging showed blood 
products within the lesion surrounded by new thin uniform rim of contrast 
enhancement and diffusion restriction. In conjunction with other therapies, LITT 
targets often showed stable or reduced local disease. Epilepsy focus LITT 
produced seizure freedom at 8 months. Preliminary overall median 
progression-free survival and survival from LITT in tumor patients were 7.6 and 
10.9 months, respectively. However, this small cohort has not been followed for 
a sufficient length of time, necessitating future outcomes studies.
CONCLUSION: Early peri- and postoperative clinical data demonstrate that LITT is 
a safe and viable ablative treatment option for intracranial lesions, and may be 
considered for select patients.