Magnetic resonance imaging-guided laser interstitial thermal therapy (LITT) is a 
minimally invasive treatment modality with recent increasing use to ablate brain 
tumors. When originally introduced in the late 1980s, the inability to precisely 
monitor and control the thermal ablation limited the adoption of LITT in 
neuro-oncology. Popularized as a means of destroying malignant hepatic and renal 
metastatic lesions percutaneously, its selective thermal tumor destruction and 
preservation of adjacent normal tissues have since been optimized for use in 
neuro-oncology. The progress made in real-time thermal imaging with MRI, laser 
probe design, and computer algorithms predictive of tissue kill has led to the 
resurgence of interest in LITT as a means to ablate brain tumors. Current LITT 
systems offer a surgical option for some inoperable brain tumors. We discuss the 
origins, principles, current indications, and future directions of MRI-guided 
LITT in neuro-oncology.