Laser Interstitial Thermal Therapy (LITT) in Neuro-Oncology. Tim Lucas, MD, PhD Neurosurgery
|
|
- Myles Marshall
- 6 years ago
- Views:
Transcription
1 Laser Interstitial Thermal Therapy (LITT) in Neuro-Oncology Tim Lucas, MD, PhD Neurosurgery 2016
2 Laser Interstitial Thermal Therapy (LITT) in Neuro-Oncology Tim Lucas, MD, PhD Neurosurgery 2016
3 Financial Disclosures None Lucas Lab Funding sources T32 3
4 Outline Laser ablation background Mechanism of action Indications Outcomes 4
5 Evolution of LITT Chu and Dupuy,
6 Mechanism of action 6
7 Tissue effects following LITT 1 d 1 w Schulze et al., Acta Neurochir (Wein)
8 Real-Time Imaging of Ablation Site 1 Site 2 8
9 Real-Time Imaging of Ablation 9
10 Post-Ablation 10
11 Neurosurgical Indications Radiation Necrosis Epileptic Focus Metastasis Glioma Deep-seated lesion Peri-eloquent lesion Lesion resistant to alternative treatment modality (Radiotherapy) Glioma cont Patient preference for minimally-invasive approach Salvage therapy for lesions having reached toxic threshold of other modalities Clinical contraindications for open craniotomy 11
12 LITT Outcomes in Neuro-oncology LITT treated patients Median Overall Survival Dx Median Overall Survival Recur Median Overall Survival LITT Progression Free Survival Recurrent III / IV (n=66) Metastasis (n=25) Radiation Necrosis (n=28) % at 5.7 mos* 66.7% at 3 mos 11.4 n/a n/a n/a Local Control n/a n/a 75.6%* *Rao et al., 2014 Data in months Banerjee et al.,
13 Neuro-oncology investigations 1 st Author Yr Lx N Size max (cm) Outcome (MOS from time of treatment) Sugiyama 1990 riv stable at 12/34 mon; 1 died at 23 mon Acher 1991 II 8 NR NR Roux 1992 II Progression Kahn 1994 II-IV II: no progression ; III: progression Leonardi 1999 II-IV 24 NR II: PFS 16 mon; III: 10 mon; IV: 4 mon Schulze 2004 III-IV 8 NR NR Schwarzrmaier 2006 riv 2 large MOS mon Carpentier 2012 riv PFS 1 mon; MOS 10 mon Jethwa 2012 Mixed* 20 4 NR Sloan 2013 riv MOS 11 mon Mohammadi 2014 IV-rIV 34 NR PFS 5.1 mon MOS median overall survival; PFS progression free survival 13
14 Complication Rate of conventional craniotomy for recurrent glioma Recurrent glioma presents surgical challenges, including: prior craniotomy, fractionated radiotherapy, chemotherapy, antiangiogenic therapy Second craniotomy risks Overall complication rate 27% vs. 12.8% (OR 2.52; p<0.01) Hoover et al., 2013 JNS Periop complications rate 33% vs. 24% (p<0.01) Neurological decline (18% vs. 8%; p<0.01) Systemic infection (4.4% vs. 0%; p<0.0001) Chang et al. (Glioma Outcomes Investigators), 2003 JNS N=788; 499 (open crani) 14
15 Conclusions LITT is a method of image-guided stereotactic ablation of brain lesions LITT is safe, with acceptable risk profile LITT complements existing treatment modalities LITT is growing in provider utilization and patient awareness Additional prospective investigation is needed to evaluate comparative effectiveness Timothy.Lucas@uphs.upenn.edu 15
16 16
17 Complications of LITT 1 st author (year) complication Bettag (1991) Edema at margin Leonardi (1999) Carpentier (2012) Transient neurological decline; superficial infection; focal seizure Transient dysphasia; CSF leak; seizure Jethwa (2012) Sloan (2013). Phase I dose escalation trial Vascular injury (craniotomy); malignant edema (craniotomy), inaccurate laser placement (craniotomy), DI secondary to pituitary injury Vascular injury; hemiparesis; hemianopia; dysphasia A word about Neuroblate vs. Visualase 17
18 LITT Potential advantages Minimal blood loss (~1cc) Early mobilization (9/10 within 12 hrs; neuroblate phase I trial) Option of multiple treatments spread out in time Short length of hospital stay 18
19 Tissue coagulation in brain tumor models Brown, Phototherapy in tumors. World J Surg 1983; 7(6):700-9 Brown, The future of lasers in cancer therapy. Br J Hosp Med 1988;40:161 Schulze et al., Effects of laser-induced thermotherapy (LITT) on proliferation and apoptosis of glioma cells in rat brain transplantation tumors. Lasers Surg Med 2002;30:
20 Laser methodology Nd:YAG neodymium-doped yttrium aluminum garnet laser (λ = 1,064 nm) Continuous wave CO2 laser Diode laser (λ = nm) Varying range of power Close to local water absorption, allowing faster lx and sharp thermal gradients. Dosed in joules/s (W) 20
21 Mechanism of action Thermal reaction proportional to power applied by laser. Photons absorbed by tumor chromophores causing excitation and release of thermal energy. Extrinsic properties such as wavelength and intrinsic properties such as absorption coefficients determine extent to thermal ablation Thermally induced tissue necrosis occurs above 43deg C. 21
22 Procedure Laser inserted stereotactically into target tissue Laser activated in MRI scanner Temperature Map Modeled in real-time Ablation discontinued when desired lesion created 22
23 Complications of craniotomy for recurrent glioma Chang et al. (Glioma Outcomes Investigators), 2003 JNS N=788 23
24 Complications of craniotomy for recurrent glioma Chang et al. (Glioma Outcomes Investigators), 2003 JNS N=788 24
25 Visualase laser The details PhoTex 15 laser Class IV 15W continuous wave 980 nm diode laser, and Class II 670 nm red aiming beam for service purposes. Laser diffusing element is encased in an armored 400 um silica optical fiber. Nominal ocular hazard distance is 2.7 m 25
26 FLAIR FLAIR T1+ preop d0 intraop 2 mon 5 mon 26
27 27
28 28
29 29
30 Willie, et al., NS 2014;74(6):569-30
31 Outcomes: Litt for recurrent III/IV lesions Median Overall Survival from diagnosis: 20.9 months Median Overall Survival from recurrence: 11.4 months Median Overall Survival from LITT: 9.9 months Median Progression Free Survival: 4.5 months Total moderate-to-severe complication rate: 21.2% Total severe complication rate: 16.7% 31
SYSTEM OVERVIEW MINIMALLY INVASIVE ROBOTIC LASER THERMOTHERAPY
SYSTEM OVERVIEW MINIMALLY INVASIVE ROBOTIC LASER THERMOTHERAPY Software NeuroBlate Fusion Software is the exclusive software intelligence behind the NeuroBlate System. NeuroBlate Fusion allows neurosurgeons
More informationNOW WITH SYSTEM OVERVIEW MINIMALLY INVASIVE ROBOTIC LASER THERMOTHERAPY
NOW WITH SYSTEM OVERVIEW MINIMALLY INVASIVE ROBOTIC LASER THERMOTHERAPY Mini-Bolt Access Robotically Controlled Probe Driver MRI-Guided Laser Energy PRECISION AND CONFIDENCE DELIVERED THROUGH A MINIMALLY
More informationGliomas account for 28% of the nearly 70,000 primary
See the corresponding editorial in this issue (E2). Neurosurg Focus 37 (6):E1, 2014 AANS, 2014 Stereotactic laser ablation of high-grade gliomas Ammar H. Hawasli, M.D., Ph.D., 1 Albert H. Kim, M.D., Ph.D.,
More informationEPILEPSY 2018: UPDATE ON MODERN SURGICAL MANAGEMENT. Robert Kellogg, MD Advocate Children s Hospital Park Ridge, IL April 20, 2018
EPILEPSY 2018: UPDATE ON MODERN SURGICAL MANAGEMENT Robert Kellogg, MD Advocate Children s Hospital Park Ridge, IL April 20, 2018 No disclosures OBJECTIVES Brief history of epilepsy surgery Pre-operative
More informationReview Article Magnetic Resonance-Guided Laser Induced Thermal Therapy for Glioblastoma Multiforme: A Review
BioMed Research International, Article ID 761312, 9 pages http://dx.doi.org/10.1155/2014/761312 Review Article Magnetic Resonance-Guided Laser Induced Thermal Therapy for Glioblastoma Multiforme: A Review
More informationA Minimally Invasive Option for Patients Considering Brain Surgery
PATIENT S GUIDE A Minimally Invasive Option for Patients Considering Brain Surgery MINIMALLY INVASIVE ROBOTIC LASER THERMOTHERAPY Robotically Controlled Probe Driver Precise nature of the NeuroBlate System
More informationRadiation Therapy for Liver Malignancies
Outline Radiation Therapy for Liver Malignancies Albert J. Chang, M.D., Ph.D. Department of Radiation Oncology, UCSF March 23, 2014 Rationale for developing liver directed therapies Liver directed therapies
More informationTania Kaprealian, M.D. Assistant Professor UCLA Department of Radiation Oncology August 22, 2015
Tania Kaprealian, M.D. Assistant Professor UCLA Department of Radiation Oncology August 22, 2015 Most common brain tumor, affecting 8.5-15% of cancer patients. Treatment options: Whole brain radiation
More informationPHOTOTHERAPY: WHAT DO WE KNOW AND HOW DOES IT WORK? Suite 3/36 O'Riordan Street Alexandria, Sydney NSW Australia
PHOTOTHERAPY: WHAT DO WE KNOW AND HOW DOES IT WORK? Suite 3/36 O'Riordan Street Alexandria, Sydney NSW Australia 2015 02 8331 8933 info@infinity-led.com.au DOCTORATE IN HEALTH SCIENCE DEAKIN UNIVERSITY
More informationBrain metastases: changing visions
Brain metastases: changing visions Roberto Spiegelmann, MD Baiona, 2014 Head, Stereotactic Radiosurgery Unit Dept of Neurosurgery, Chaim Sheba Medical Center Tel Hashomer, Israel The best current estimate
More informationCollection of Recorded Radiotherapy Seminars
IAEA Human Health Campus Collection of Recorded Radiotherapy Seminars http://humanhealth.iaea.org The Role of Radiosurgery in the Treatment of Gliomas Luis Souhami, MD Professor Department of Radiation
More informationPlace of surgery in diagnos1c and therapeu1c strategies: New challenges
Place of surgery in diagnos1c and therapeu1c strategies: New challenges Philippe Métellus M.D., Ph.D. Department of Neurosurgery, CHU Timone, Marseille, France Place of surgery in diagnos1c and therapeu1c
More informationMagnetic Resonance guided Laser Interstitial Thermal Therapy for medically intractable epilepsy
Magnetic Resonance guided Laser Interstitial Thermal Therapy for medically intractable epilepsy Alexander G. Weil, MD, FRCSC, FAANS, FACS 1,2 1 Division of Pediatric Neurosurgery, Department of Surgery,
More informationInvasive Evaluation for Epilepsy Surgery Lesional Cases NO DISCLOSURES. Mr. Johnson. Seizures at 29 Years of Age. Dileep Nair, MD Juan Bulacio, MD
Invasive Evaluation for Epilepsy Surgery Lesional Cases NO DISCLOSURES Dileep Nair, MD Juan Bulacio, MD Mr. Johnson Seizures at 29 Years of Age Onset of seizures at 16 years of age bed wetting episodes
More informationLaser interstitial thermal therapy (LITT) is a minimally
neurosurgical focus Neurosurg Focus 38 (3):E13, 2015 Renaissance of laser interstitial thermal ablation Symeon Missios, MD, 1 Kimon Bekelis, MD, 2 and Gene H. Barnett, MD, MBA 3 1 Department of Neurosurgery,
More informationSURGICAL MANAGEMENT OF BRAIN TUMORS
SURGICAL MANAGEMENT OF BRAIN TUMORS LIGIA TATARANU, MD, Ph D NEUROSURGICAL CLINIC, BAGDASAR ARSENI CLINICAL HOSPITAL BUCHAREST, ROMANIA SURGICAL INDICATIONS CONFIRMING HISTOLOGIC DIAGNOSIS REDUCING TUMOR
More informationFinancial Disclosures
Retinoblastoma Management: Update Jesse L. Berry, MD Associate Director, Ocular Oncology Service Associate Program Director USC/CHLA, Keck School of Medicine Financial Disclosures Research Support: Bright
More informationRadiation Necrosis 11/29/2016. Disclosure statement. Memorial Sloan Kettering Cancer Center
Radiation Necrosis Date: December 1 st, 2016 Wayne Quashie, MSN, CNS, ACNS-BC, AOCNS Clinical Nurse Specialist Neurology, Neurosurgery and Orthopedics www.mskcc.org Disclosure statement Presenter does
More informationIs it cost-effective to treat brain metastasis with advanced technology?
Is it cost-effective to treat brain metastasis with advanced technology? Cost-effectiveness analysis of whole brain RT, stereotactic radiosurgery and craniotomy in HA setting Lam, Tai-Chung, Choi CW Horace,
More informationUpdate on Pediatric Brain Tumors
Update on Pediatric Brain Tumors David I. Sandberg, M.D. Director of Pediatric Neurosurgery & Associate Professor Dr. Marnie Rose Professorship in Pediatric Neurosurgery Pre-talk Questions for Audience
More informationMALIGNANT GLIOMAS: TREATMENT AND CHALLENGES
MALIGNANT GLIOMAS: TREATMENT AND CHALLENGES DISCLOSURE No conflicts of interest to disclose Patricia Bruns APRN, CNS Givens Brain Tumor Center Abbott Northwestern Hospital October 12, 2018 OBJECTIVES THEN
More informationBrain Tumors. Andrew J. Fabiano, MD FAANS. Associate Professor of Neurosurgery Roswell Park Cancer Institute SUNY at Buffalo School of Medicine
Brain Tumors Andrew J. Fabiano, MD FAANS Associate Professor of Neurosurgery Roswell Park Cancer Institute SUNY at Buffalo School of Medicine Brain Tumors Brain Tumor Basics Types of Tumors Cases Brain
More informationClinical Trials for Adult Brain Tumors - the Imaging Perspective
Clinical Trials for Adult Brain Tumors - the Imaging Perspective Whitney B. Pope, M.D., Ph.D. Department of Radiology David Geffen School of Medicine at UCLA August 22, 2015 1 Disclosure of Financial Relationships
More informationLaser Ablation for Brain Tumors
Laser Ablation for Brain Tumors Gene H Barnett, MD, MBA Department of Neurosurgery Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center Taussig Cancer and Neurological Institutes Cleveland Clinic
More informationIndex. C Cancer, Carcinoid syndrome, 413. D DCIS. See Ductal carcinoma in situ (DCIS) DEB-TACE. See Drug eluting beads-tace (DEB-TACE)
Index A Ablation, 179 199, 843 853 devices, 179, 199 liver tumors, 527 techniques, 516 Ablative radiation therapy, 456 Accelerated partial breast, 894, 896 898 Adaptive radiation therapy, 586, 598, 602
More information11/27/2017. Modern Treatment of Meningiomas. Disclosures. Modern is Better? No disclosures relevant to this presentation
Modern Treatment of Meningiomas Michael A. Vogelbaum MD, PhD Professor of Neurosurgery Cleveland Clinic Disclosures No disclosures relevant to this presentation IP and royalties related to drug and device
More informationEpilepsy Surgery, Imaging, and Intraoperative Neuromonitoring: Surgical Perspective
Epilepsy Surgery, Imaging, and Intraoperative Neuromonitoring: Surgical Perspective AC Duhaime, M.D. Director, Pediatric Neurosurgery, Massachusetts General Hospital Professor, Neurosurgery, Harvard Medical
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM LOW GRADE GLIOMAS CNS Site Group Low Grade Gliomas Author: Dr. Norm Laperriere 1. INTRODUCTION 3 2. PREVENTION 3 3. SCREENING
More informationHands-on: Lasers. NonAblative Rejuvenation
Hands-on: Lasers NonAblative Rejuvenation Anthony M. Rossi, MD Assistant Attending Memorial Sloan Kettering Cancer Center Assistant Professor Weill Cornell Medical College DISCLOSURE OF RELEVANT RELATIONSHIPS
More informationRadiotherapy approaches to pituitary tumors
Disclosures No relevant disclosures Radiotherapy approaches to pituitary tumors Pituitary Disorders: Advances in Diagnosis and Management Steve Braunstein, MD, PhD UCSF Department of Radiation Oncology
More informationDiffusion Tensor Imaging in brain tumours
Diffusion Tensor Imaging in brain tumours @MarionSmits, MD PhD Associate Professor of Neuroradiology Dept. of Radiology, Erasmus MC, Rotterdam (NL) Honorary Consultant and Reader UCLH National Hospital
More informationNeurosurgical Management of Brain Tumours. Nicholas Little Neurosurgeon RNSH
Neurosurgical Management of Brain Tumours Nicholas Little Neurosurgeon RNSH General Most common tumours are metastatic 10x more common than primary Incidence of primary neoplasms is 20 per 100000 per year
More informationSmall and Big Operations: New Tools of the Trade for Brain Tumors. Disclosure. Incidence of Childhood Cancer
Small and Big Operations: New Tools of the Trade for Brain Tumors Nalin Gupta MD PhD Chief, Division of Pediatric Neurosurgery Departments of Neurosurgery and Pediatrics University of California San Francisco
More informationPatterns of Brain Tumor Recurrence Predicted From DTI Tractography
Patterns of Brain Tumor Recurrence Predicted From DTI Tractography Anitha Priya Krishnan 1, Isaac Asher 2, Dave Fuller 2, Delphine Davis 3, Paul Okunieff 2, Walter O Dell 1,2 Department of Biomedical Engineering
More informationNO MORE NEWS AN EVIDENCE BASED APPROACH ON LASERS IN SKIN OF COLOR PATIENTS DR. EDUARDO WEISS, M.D., FAAD
NO MORE NEWS AN EVIDENCE BASED APPROACH ON LASERS IN SKIN OF COLOR PATIENTS DR. EDUARDO WEISS, M.D., FAAD KEY POINTS Hispanics/Latinos are the fastest growing segment of the skin of color population Use
More informationUp to date literature at your disposal to discover the benefits of laser dentistry
Up to date literature at your disposal to discover the benefits of laser dentistry For further information contact info@doctor-smile.com +39-0444-349165 Dipartimento di Scienze e Tecnologie Biofisiche
More informationEPILEPSY. New Ideas about an Old Disease. Gregory D. Cascino, MD
EPILEPSY New Ideas about an Old Disease Gregory D. Cascino, MD Disclosure Research-Educational Grants Neuro Pace, Inc. American Epilepsy Society American Academy of Neurology Neurology (Associate Editor)
More informationOtolaryngologist s Perspective of Stereotactic Radiosurgery
Otolaryngologist s Perspective of Stereotactic Radiosurgery Douglas E. Mattox, M.D. 25 th Alexandria International Combined ORL Conference April 18-20, 2007 Acoustic Neuroma Benign tumor of the schwann
More informationThe Management of Advanced Stage Hepatocellular Carcinoma
The Management of Advanced Stage Hepatocellular Carcinoma Pierce K.H Chow MD PhD Professor, Duke-NUS Graduate Medical School Singapore Senior Consultant Surgeon, National Cancer Center Singapore Senior
More informationPEDIATRIC ORBITAL TUMORS RADIOTHERAPY PLANNING
PEDIATRIC ORBITAL TUMORS RADIOTHERAPY PLANNING ANATOMY ANATOMY CONT ANATOMY CONT. ANATOMY CONT. EYE OF A CHILD Normal tissue tolerance doses (in conventional #) TD 5/5 TD 50/5 Endpoint Gy Gy Optic nerve
More informationPrimary brain tumours and cerebral metastases workshop
Primary brain tumours and cerebral workshop 22.4.16 Summary of workshop group discussions on the content of the scope Scope section Title: Primary brain tumours and cerebral Who the guideline is for People
More informationStereotactic Body Radiation Therapy and Radiofrequency Ablation 2014 Masters of Minimally Invasive Surgery
Stereotactic Body Radiation Therapy and Radiofrequency Ablation 2014 Masters of Minimally Invasive Surgery Matthew Hartwig, M.D. Duke Cancer Institute Case Presentation I: Patient ER 74 y/o male with A1A
More informationRegional Neuro-Oncology Service Information Evening
Regional Neuro-Oncology Service Information Evening Dr Tom Flannery Information Evening hosted by Brainwaves NI, in partnership with the Northern Ireland Regional Neuro-Oncology Multi Disciplinary Team.
More informationLOW GRADE ASTROCYTOMAS
LOW GRADE ASTROCYTOMAS This article was provided to us by David Schiff, MD, Associate Professor of Neurology, Neurosurgery, and Medicine at University of Virginia, Charlottesville. We appreciate his generous
More informationLasers in Gastroenterology, Otorhinolaryngology & Pulmonology
Lasers in Gastroenterology, Otorhinolaryngology & Pulmonology Eloise Anguluan Laser-Tissue Interactions Fall Semester 2016 Gastroenterology the branch of medicine which deals with disorders of the stomach
More informationChina Medical Technologies, Inc.
China Medical Technologies, Inc. China Medical Technologies, Inc. (CMT) is a high-tech enterprise, trading on Nasdaq with the ticker CMED. We currently conduct our operations principally through our wholly-owned
More informationCold Laser Program ML830
Cold Laser Program ML830 The Microlight ML830 Cold Laser, started everything 25 years ago. It was developed in 1985, by leading european doctors and engineers. The laser was brought to the USA in 1990,
More informationfmri and Tractography in Preoperative Neurosurgical Planning Ronald L. Wolf, M.D., Ph.D. University of Pennsylvania Medical Center
fmri and Tractography in Preoperative Neurosurgical Planning Ronald L. Wolf, M.D., Ph.D. University of Pennsylvania Medical Center Acknowledgements/Disclosures Radiology Ragini Verma Birkan Tunc Sumei
More informationThe Role of Radiation Therapy in the Treatment of Brain Metastases. Matthew Cavey, M.D.
The Role of Radiation Therapy in the Treatment of Brain Metastases Matthew Cavey, M.D. Objectives Provide information about the prospective trials that are driving the treatment of patients with brain
More informationMANAGEMENT N OF PRIMARY BRAIN TUMOURS IN THE ELDERLY
MANAGEMENT N OF PRIMARY BRAIN TUMOURS IN THE ELDERLY Meningioma, Glioma, Lymphoma Cornu Ph, Keime-Guibert F, Hoang-Xuan K, Pierga JY, Delattre JY Neuro-oncology Group of Pitie-Salpetriere hospital-paris-france
More informationUCSF Uveal Melanoma Program: Outcomes with Proton Beam Radiation Therapy Kavita K. Mishra, M.D., M.P.H. UCSF Comprehensive Cancer Center
Disclosures UCSF Uveal Melanoma Program: Outcomes with Proton Beam Radiation Therapy No disclosures Kavita K. Mishra, M.D., M.P.H. UCSF Comprehensive Cancer Center UCSF Uveal Melanoma Program: Ocular Melanoma
More informationBrain and Spine Tumors
Brain and Spine Tumors Andrew J. Fabiano, MD FAANS Associate Professor of Neurosurgery Roswell Park Cancer Institute SUNY at Buffalo School of Medicine Brain Tumors Brain Tumor Basics Types of Tumors Cases
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM BRAIN METASTASES CNS Site Group Brain Metastases Author: Dr. Norm Laperriere Date: February 20, 2018 1. INTRODUCTION
More informationIntroduction to Lasers
Introduction to Lasers Mastership with the Academy of Laser Dentistry In-Office Laser Consultant for LVI Course Outcome Hygienists will be able to know: Understand Laser Physics Define which lasers can
More informationInnovative Multimodal Imaging Techniques in Brain Tumor Clinical Trials
Innovative Multimodal Imaging Techniques in Brain Tumor Clinical Trials Benjamin M. Ellingson, Ph.D. Assistant Professor of Radiology, Biomedical Physics, and Bioengineering Brain Tumor Imaging Laboratory
More informationGlioblastoma (GBM) is the most common malignant. focus Neurosurg Focus 41 (4):E12, 2016
neurosurgical focus Neurosurg Focus 41 (4):E12, 2016 Laser interstitial thermal therapy for newly diagnosed and recurrent glioblastoma Jonathan G. Thomas, MD, 1 Ganesh Rao, MD, 1 Yvonne Kew, MD, PhD, 2
More informationImaging for suspected glioma
Imaging for suspected glioma 1.1.1 Offer standard structural MRI (defined as T2 weighted, FLAIR, DWI series and T1 pre- and post-contrast volume) as the initial diagnostic test for suspected glioma, unless
More informationIntroduction to Neurosurgical Subspecialties:
Introduction to Neurosurgical Subspecialties: Tumor and Skull Base Neurosurgery Brian L. Hoh, MD 1 and Gregory J. Zipfel, MD 2 1 University of Florida, 2 Washington University Tumor / Skull Base Neurosurgery
More informationMRI Applications in Radiation Oncology:
MRI Applications in Radiation Oncology: Physician s Perspective Jeff Olsen, MD Department of Radiation Oncology Washington University, St. Louis, MO Disclosures Washington University has research and service
More informationPercutaneous Laser Discectomy: Experience and Long Term Follow-Up
Percutaneous Laser Discectomy: Experience and Long Term Follow-Up P.P.M. Menchetti, G. Canero, and W. Bini Abstract The classical microsurgical approach in the treatment of herniated nucleus pulposus (HNP)
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM MENINGIOMA CNS Site Group Meningioma Author: Dr. Norm Laperriere Date: February 20, 2018 1. INTRODUCTION 3 2. PREVENTION
More informationSelecting the Optimal Treatment for Brain Metastases
Selecting the Optimal Treatment for Brain Metastases Clinical Practice Today CME Co-provided by Learning Objectives Upon completion, participants should be able to: Understand the benefits, limitations,
More informationMehmet Ufuk ABACIOĞLU Neolife Medical Center, İstanbul, Turkey
Updated Oncology 2015: State of the Art News & Challenging Topics CURRENT STATUS OF STEREOTACTIC RADIOSURGERY IN BRAIN METASTASES Mehmet Ufuk ABACIOĞLU Neolife Medical Center, İstanbul, Turkey Bucharest,
More informationCase Scenario 1. 2/15/2011 The patient received IMRT 45 Gy at 1.8 Gy per fraction for 25 fractions.
Case Scenario 1 1/3/11 A 57 year old white female presents for her annual mammogram and is found to have a suspicious area of calcification, spread out over at least 4 centimeters. She is scheduled to
More informationChallenging Paediatric Brain Tumours. ASP Belfast March 2017 Dr Jane Pears Consultant Paediatric Oncologist, Dublin
Challenging Paediatric Brain Tumours ASP Belfast March 2017 Dr Jane Pears Consultant Paediatric Oncologist, Dublin Overview (i) Paediatric malignancy (ii) Central nervous system tumours (iii) Diffuse Intrinsic
More informationNext Generation Technologies for Intra-Operative Tumor Detection. Pramod Butte, MBBS, PhD
Next Generation Technologies for Intra-Operative Tumor Detection Pramod Butte, MBBS, PhD Background It is estimated that 40,000 new cases of primary brain tumors. More than 350,000 persons are living with
More informationLaryngeal Preservation Using Radiation Therapy. Chemotherapy and Organ Preservation
1 Laryngeal Preservation Using Radiation Therapy 1903: Schepegrell was the first to perform radiation therapy for the treatment of laryngeal cancer Conventional external beam radiation produced disappointing
More informationLife after ARUBA: Management of Unruptured Brain Arteriovenous Malformations (AVMs)
Life after ARUBA: Management of Unruptured Brain Arteriovenous Malformations (AVMs) Eric L. Zager, MD University of Pennsylvania Department of Neurosurgery No Disclosures Brain AVMs Incidence ~1 in 100,000
More informationLaser in Neurosurgery, Angioplasty & Cardiology
Laser in Neurosurgery, Angioplasty & Cardiology EECS Gwangju Institute of Science and Technology, Korea Seungmin Lee 20161023 What is neurosurgery? Neurosurgery deals with diseases of the central nervous
More informationSpecialised Services Policy: CP22. Stereotactic Radiosurgery
Specialised Services Policy: CP22 Document Author: Assistant Director of Planning Executive Lead: Director of Planning ad Performance Approved by: Management Group Issue Date: 01 July 2015 Review Date:
More informationSUCCESSFUL TREATMENT OF METASTATIC BRAIN TUMOR BY CYBERKNIFE: A CASE REPORT
SUCCESSFUL TREATMENT OF METASTATIC BRAIN TUMOR BY CYBERKNIFE: A CASE REPORT Cheng-Ta Hsieh, 1 Cheng-Fu Chang, 1 Ming-Ying Liu, 1 Li-Ping Chang, 2 Dueng-Yuan Hueng, 3 Steven D. Chang, 4 and Da-Tong Ju 1
More informationSurgery for Medically Refractory Focal Epilepsy
Surgery for Medically Refractory Focal Epilepsy Seth F Oliveria, MD PhD The Oregon Clinic Neurosurgery Director of Functional Neurosurgery: Providence Brain and Spine Institute Portland, OR Providence
More informationSCIENTIFIC PROGRAMME SNOLA UPDATE ON NEURO- ONCOLOGY th March
SCIENTIFIC PROGRAMME SNOLA UPDATE ON NEURO- ONCOLOGY 2016 24th March 13h 13h45 pathology case case parasellar meningeoma case : posterior fossa pediatric tumor 13h45 16h Imaging for CNS lymphomas Parasellar
More informationEndovenous Laser Ablation
Endovenous Laser Ablation 132 nm Wavelength with Clear Tip Technology vs. 147 nm Wavelength Similarities and Differences 132nm and 147nm Both wavelengths are mid-infrared Water is the primary chromophore
More informationHypofractionated Radiotherapy for breast cancer: Updated evidence
2 rd Bangladesh Breast Cancer Conference, Dhaka, December 2017 Hypofractionated Radiotherapy for breast cancer: Updated evidence Tabassum Wadasadawala Associate Professor of Radiation Oncology Tata Memorial
More informationSelected radiosurgery cases from the Rotating Gamma Institute Debrecen, Hungary
Selected radiosurgery cases from the Rotating Gamma Institute Debrecen, Hungary László Bognár M.D., Ph.D., József G. Dobai M.D., Gábor Csiky and Imre Fedorcsák M.D., Ph.D. Department of Neurosurgery, Medical
More informationDOES RADIOTHERAPY TECHNIQUE / DOSE / FRACTIONATION REALLY MATTER? YES
DOES RADIOTHERAPY TECHNIQUE / DOSE / FRACTIONATION REALLY MATTER? YES Marco Krengli Radiotherapy, Department of Translational Medicine, University of Piemonte Orientale A. Avogadro THE STANDARD OF CARE
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM ANAPLASTIC GLIOMAS CNS Site Group Anaplastic Gliomas Author: Dr. Norm Laperriere Date: February 20, 2018 1. INTRODUCTION
More informationTreatment of Leg Telangiectasia (Spider Veins) with Magma Long Pulse ND - Laser 1064 nm Case Study
Clinical Study Treatment of Leg Telangiectasia (Spider Veins) with Magma Long Pulse ND - Laser 1064 nm Case Study Sharona Levi-Friedman CRA, E. Krieger MD, Formatk Systems Ltd. Tirat- Carmel, Israel. 1.
More informationRadioterapia no Tratamento dos Gliomas de Baixo Grau
Radioterapia no Tratamento dos Gliomas de Baixo Grau Dr. Luis Souhami University Montreal - Canada Low Grade Gliomas Relatively rare Heterogeneous, slow growing tumors WHO Classification Grade I Pilocytic
More informationModeling origin and natural evolution of low-grade gliomas
Modeling origin and natural evolution of low-grade gliomas Mathilde Badoual Paris Diderot University, IMNC lab 2nd HTE workshop: Mathematical & Computer Modeling to study tumors heterogeneity in its ecosystem,
More informationHepatocellular Carcinoma: Transplantation, Resection or Ablation?
Hepatocellular Carcinoma: Transplantation, Resection or Ablation? Roberto Gedaly MD Chief, Abdominal Transplantation Transplant Service Line University of Kentucky Nothing to disclose Disclosure Objective
More informationUpdated Imaging for Novel Pancreatic Cancer Therapy. Desiree E. Morgan, MD FSCBTMR Professor and Vice Chair Education
Updated Imaging for Novel Pancreatic Cancer Therapy Desiree E. Morgan, MD FSCBTMR Professor and Vice Chair Education Disclosures I have no financial disclosures relevant to the educational content of this
More informationGeneral Identification. Name: 江 X X Age: 29 y/o Gender: Male Height:172cm, Weight: 65kg Date of admission:95/09/27
General Identification Name: 江 X X Age: 29 y/o Gender: Male Height:172cm, Weight: 65kg Date of admission:95/09/27 Chief Complaint Sudden onset of seizure for several minutes Present illness This 29-year
More informationWhere are we with radiotherapy for biliary tract cancers?
Where are we with radiotherapy for biliary tract cancers? Professor Maria A. Hawkins Associate Professor in Clinical Oncology MRC Group Leader/Honorary Consultant Clinical Oncologist CRUK MRC Oxford Institute
More informationOncological Management of Brain Tumours. Anna Maria Shiarli SpR in Clinical Oncology 15 th July 2013
Oncological Management of Brain Tumours Anna Maria Shiarli SpR in Clinical Oncology 15 th July 2013 Outline General considerations of Primary Brain Tumours: epidemiology, pathology, presentation. Diagnosis
More informationLasers in Urology. Laser Tissue Interaction, November 28 th, Qureshi, Muhammad Mohsin. Biomedical in vivo Opto-scopy Laboratory
Laser Tissue Interaction, November 28 th, 2016 Lasers in Urology Qureshi, Muhammad Mohsin Gwangju Institute of Science and Technology Biomedical in vivo Opto-scopy Laboratory 2 Content Introduction to
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM EPENDYMOMA Last Revision Date July 2015 1 CNS Site Group Ependymoma Author: Dr. Norm Laperriere 1. INTRODUCTION 3 2.
More informationPrior Authorization Review Panel MCO Policy Submission
Prior Authorization Review Panel MCO Policy Submission A separate copy of this form must accompany each policy submitted for review. Policies submitted without this form will not be considered for review.
More informationOligodendrogliomas & Oligoastrocytomas
Oligodendrogliomas & Oligoastrocytomas ABOUT THE AMERICAN BRAIN TUMOR ASSOCIATION Founded in 1973, the American Brain Tumor Association (ABTA) was the first national nonprofit organization dedicated solely
More informationAchieving Clinically Proven Treatment Results With Photodynamic Therapy (PDT) and PHOTOFRIN (porfimer sodium) for Injection
Achieving Clinically Proven Treatment Results With Photodynamic Therapy () and PHOTOFRIN (porfimer sodium) for Injection PHOTOFRIN (porfimer sodium) IS INDICATED FOR Palliation of patients with completely
More informationTreatment results of proton beam therapy with chemo-radiotherapy for stage I-III esophageal cancer
Treatment results of proton beam therapy with chemo-radiotherapy for stage I-III esophageal cancer Nobukazu Fuwa 1, Akinori Takada 2 and Takahiro Kato 3 1;Departments of Radiology, Hyogo Ion Beam Medical
More informationRadiotherapy What are our options and what is on the horizon. Dr Kevin So Specialist Radiation Oncologist Epworth Radiation Oncology
Radiotherapy What are our options and what is on the horizon Dr Kevin So Specialist Radiation Oncologist Epworth Radiation Oncology Outline Advances in radiotherapy technique Oligo - disease Advancements
More informationStress Wave Focusing Transducers
UCRL-K-130697 PREPRINT Stress Wave Focusing Transducers Steven R. Visuri, Richard A. London, Luiz Da Silva This paper was prepared for submittal to Optical Society of America, Spring Topical Meetings Orlando,
More informationNon-invasive Neurosurgery using MR guided Focused Ultrasound
Non-invasive Neurosurgery using MR guided Focused Ultrasound About InSightec Founded in 1999, headquarters Haifa, Israel US offices in Dallas, Texas Asian offices in Beijing, China, and Tokyo, Japan Develop
More informationLymphocyte Predominant Hodgkin s Lymphoma. Case Presentation. How would you treat the patient?
Lymphocyte Predominant Hodgkin s Lymphoma Wei Ai, MD, PhD Assistant Clinical Professor University of California, San Francisco January 2010 Case Presentation 32 yo male, diagnosed with stage IIIA lymphocyte
More informationStereotactic Diffusion Tensor Tractography For Gamma Knife Stereotactic Radiosurgery
Disclosures The authors of this study declare that they have no commercial or other interests in the presentation of this study. This study does not contain any use of offlabel devices or treatments. Stereotactic
More informationPhotocoagulation of disciform macular lesions
British Journal of Ophthalmology, 1979, 63, 669-673 Photocoagulation of disciform macular lesions with krypton laser A. C. BIRD AND R. H. B. GREY From the Institute of Ophthalmology, Moorfields Eye Hospital,
More informationTHE EFFECTIVE OF BRAIN CANCER AND XAY BETWEEN THEORY AND IMPLEMENTATION. Mustafa Rashid Issa
THE EFFECTIVE OF BRAIN CANCER AND XAY BETWEEN THEORY AND IMPLEMENTATION Mustafa Rashid Issa ABSTRACT: Illustrate malignant tumors that form either in the brain or in the nerves originating in the brain.
More informationPresentation Product & clinics
Presentation Product & clinics Design What s Long Pulse Nd:YAG? medium YAG (Yuttrium Aluminum Garnet : Y 3 Al 5 O 12 ) + Nd 3+ The Wavelength Penetrates All kind of Hair removal Each laser possesses specific
More information