Minimally invasive stereotactic tumor ablation is a viable option for the 
treatment of benign and malignant intracranial lesions. Although surgical 
excision constitutes first-line therapy for various brain pathologies, it can 
cause irreversible neurologic deficits. Additionally, many patients who may 
benefit from surgery do not qualify as surgical candidates due to multiple 
comorbidities. Recent advancements in laser interstitial thermal therapy, namely 
the ability to monitor ablation in real-time under MR imaging, have improved the 
safety and efficacy of the procedure. MRI-guided laser interstitial thermal 
therapy is currently used as a minimally invasive treatment for brain 
metastases, radiation necrosis, glioma, and epilepsy. This article will discuss 
the principles, suggested indications, complications, and imaging 
characteristics of MRI-guided laser interstitial thermal therapy as they pertain 
to the treatment of brain pathology.