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MR-guided laser-induced thermotherapy of head and neck tumors

Interstitial laser-induced thermotherapy (LITT) is a recently developed, minimally invasive technique for local tumor destruction within solid organs. Low-power laser, with delivery of light energy through thin optical fibers, results in a well-defined area of coagulative necrosis. Thus, laser can destroy tumor by direct heating, while greatly limiting damage to surrounding structures. Experimental work has shown that a well defined area of coagulative necrosis is obtained around the fiber tip, with minimal damage to surrounding structures. Pilot clinical studies have demonstrated that this technique is practical for the palliation hepatic tumors. The success of LITT is dependent on delivering the optical fibers to the target area, real time monitoring of the effects of the treatment and subsequent evaluation of the extent of thermal damage. The key to achieving these objectives is the imaging methods used. The magnetic resonance (MR) findings of LITT in the experimental setting have been described, but the clinical role of MRI during and after LITT has been only described in a small series of patients.