Laser Interstitial Thermal Therapy (LITT)

The AHN Neurosurgery Department delivers state-of-the art care and treatment for those navigating brain cancer and brain tumors. Our focus is on providing tailored care for each patient and using the most minimally invasive procedures possible to achieve the best health outcomes.

Laser Interstitial Thermal Therapy (LITT) is a minimally invasive surgical technique used to ablate or destroy unwanted tissue, such as tumors, using heat generated by laser energy. Compared to traditional surgery, LITT typically results in smaller incisions, reduced pain, shorter hospital stays, and quicker recovery times.

LITT is commonly used to treat several types of tumors and conditions, including:

• Brain tumors: LITT can be used to treat both primary and metastatic brain tumors. To avoid collateral trauma to nearby vital structures, it is particularly useful for tumors that are deep-seated or located near critical structures and monitoring is possible to avoid trauma to nearby vital structures.
• Liver tumors: LITT can be used to treat primary liver cancers, such as hepatocellular carcinoma (HCC), as well as metastatic tumors that have spread to the liver from other parts of the body.
• Epilepsy: LITT can be used to treat epilepsy by targeting and destroying the specific areas of the brain that are causing seizures.
• Other conditions: LITT is also being investigated as a treatment for other conditions, such as prostate cancer, kidney cancer, and certain types of pain.

Why choose AHN for your treatment?

Our highly experienced team of neuro-oncologists (brain cancer specialists) and neurosurgeons (brain surgeons) performs treatments that are only available at the very best hospitals in the country. By choosing AHN for your care, you will find:

• Improved survival rates: We use aggressive treatments while making sure you are feeling as well as you can. Helping you live a longer, more comfortable life is our priority.
• Advanced technology: Sophisticated tools, such as genome analysis, allow us to understand how the tumor will respond to different treatments before we prescribe them. This means we can tailor treatment to your specific needs.
• Minimally invasive treatments: Many of our treatment options are outpatient procedures that involve a short recovery time. Instead of spending all of your time in a hospital, you can live your life and enjoy your family and friends.
• A collaborative approach: We discuss all of our patients in a weekly meeting with our brain cancer experts. You benefit from the combined experience of a team that includes neuro-oncologists, radiation oncologists, neurosurgeons, medical oncologists, and neuroradiologists. Because we are always up to date on your progress, we are able to give you the best possible care. Have appointments with several specialists in the same place and same appointment at our Brain Tumor Multi-Disciplinary Clinic.
• Robust support: We invite all patients with brain cancer to join our weekly support group to share feelings, discuss symptoms, and help one another cope. It may help you feel better during treatment and experience an improved state of mind.
• A convenient, after-hours cancer clinic: If you experience side effects from treatment, call your physician’s office first, then visit our After Hours Oncology Clinic, conveniently located at West Penn Hospital. We treat you quickly, without exposing your compromised immune system to the germs you may encounter at a traditional emergency room. Plus, our clinic is more affordable than a visit to the ER. And since our oncology specialists have access to your records, they may even be able to advise you over the phone and save you from making a trip.
• Clinical trials: If you meet the eligibility requirements, you may be able to participate in an experimental clinical trial. You could gain access to a groundbreaking treatment before it is widely available. Learn more about our clinical trial program.

What to expect for a LITT procedure

Before your LITT procedure, your AHN care team will provide detailed information and instructions on how to prepare. They will answer your questions and help you feel confident in the upcoming surgery.

LITT is done in at an AHN hospital because it requires specialized equipment and medical staff, so it will be performed in an operating room or an interventional radiology suite.

Prior to the procedure, a thorough medical evaluation will be conducted by your health care team to ensure you are a suitable candidate for LITT. This may involve blood tests, imaging scans (like MRI or CT), and a review of your medical history and medications.

LITT is performed under general anesthesia, meaning you will be asleep and won't feel pain during the procedure.

The duration of a LITT procedure can vary depending on the size, location, and number of areas being treated. Generally, the procedure itself can take several hours. To precisely guide the laser, a stereotactic frame might be temporarily placed on your head (while already asleep). This frame helps your neurosurgeon navigate to the exact target area in your brain. Then, a very small incision (typically less than half a centimeter) will be made in your scalp. A small hole, called a burr hole, will be drilled into your skull. Through this hole, a thin, flexible catheter containing the laser fiber will be carefully guided into the target tissue in your brain. This guidance is usually done in real-time using neuronavigation. Once the laser fiber is in place, the laser is activated in the MRI suite. The heat generated by the laser destroys the abnormal tissue. During this phase, your doctors will continuously monitor the temperature and the extent of tissue destruction in surrounding structures using MRI imaging to ensure precision and minimize damage to healthy tissue.

LITT procedure recovery

Following the procedure, you will be taken to a recovery area for monitoring before being moved to a hospital room for further observation. Recovery may take several weeks, and your AHN care team will provide specific postoperative instructions.

LITT procedure FAQs

A LITT procedure is an innovative procedure that destroys abnormal tissue or tumors in your brain. That can create a lot of questions. Your AHN care team is here to help, but we’ve also provided some answers to patients’ frequently asked questions to help you get some basic information. 

What is the success rate of Laser Interstitial Thermal Therapy?

The success rate of LITT can vary depending on the specific condition being treated, the size and location of the lesion, and individual patient factors. For instance, in the treatment of certain brain tumors, LITT can achieve significant tumor destruction. For drug-resistant epilepsy, it can lead to a reduction or cessation of seizures for a notable percentage of patients. However, "success" can be defined in different ways (e.g., complete tumor ablation, seizure freedom, symptom improvement), and it's important to discuss the expected outcomes for your specific situation with your medical team. They can provide statistics most relevant to your diagnosis based on current research and clinical experience.

What are the disadvantages of LITT?

While LITT offers many advantages, potential disadvantages include:

• Limited applicability: It's not suitable for all types of tumors or lesions, especially very large ones or those in critical eloquent areas of the brain where even minimal thermal spread could cause significant damage.
• Thermal spread risk: Although MRI guidance helps to monitor temperature and minimize this, there's always a risk of unintended thermal damage to healthy surrounding brain tissue.
• Cost and accessibility: As a specialized procedure, it may not be available at all medical centers, and the cost can be a factor depending on insurance coverage.
• Multiple treatments: In some cases, more than one LITT session may be required to fully treat a lesion.
• Learning curve for surgeons: The precision required for LITT means that surgeon experience is an important factor.

What is LITT used for?

LITT is primarily used to treat certain conditions within the brain that are difficult to access through traditional open surgery or where a minimally invasive approach is preferred. Its main applications include:

• Brain tumors: Treating various types of brain tumors, including gliomas (e.g., glioblastoma, astrocytoma) and metastatic tumors, especially those that are recurrent or located deep within the brain.
• Epilepsy: Ablating specific brain regions (epileptogenic foci) responsible for drug-resistant epilepsy, particularly for focal seizures originating from an identifiable source.
• Radiation necrosis: In some cases, LITT can be used to treat areas of brain tissue damaged by previous radiation therapy.

What are the side effects of LITT?

The side effects of LITT are generally milder and less frequent than those associated with open brain surgery, but they can occur. Common temporary side effects may include:

• Headache: Mild to moderate headaches are common due to the procedure.
• Nausea and vomiting: Can occur as a reaction to anesthesia or changes in intracranial pressure.
• Fatigue: Feeling tired is a normal part of recovering from any surgical procedure.
• Swelling: Localized swelling at the incision site or within the brain around the treatment area.

More serious, but less common, side effects can include:

• Neurological deficits: Depending on the treated area, patients might experience temporary or, in rare cases, permanent neurological changes such as weakness, speech difficulties, or visual disturbances.
• Bleeding (hemorrhage): As with any invasive procedure in the brain, there is a risk of bleeding.
• Infection: While sterile techniques are used, infection is a rare potential complication.
• Seizures: Especially in patients being treated for epilepsy, there can be a temporary increase in seizure activity post-procedure.
• Incomplete ablation: The targeted tissue may not be completely destroyed, requiring further treatment.

Contact us

To schedule an appointment or learn more about AHN neuroscience services, call 412-359-6200 in Pittsburgh or 814-452-7575 in Erie.