Laser-induced Interstitial Thermotherapy University Hospital Johann ...

Information about LITT
The use of local thermal effect in the tumor
region forms the basis for this new minimal-
invasive therapeutic procedure. Since the
development of MRI-guided laser-induced
Interstitial ThermoTherapy (LITT), it is possible
to target the laser exactly on the tissue volume
to be treated. Due to comparably high
penetrability of photons and the possibility of
complication-free transfer of energy through
guide-light, Laser of Near Infrared Region (NIR)
is used for LITT. Above all we use the Nd:YAG-
Laser (1,064 nm), which has a wide clinical use.
The energy is applied to the target tissue using
special laser applicators. The energy of laser
light is absorbed, which causes heating of the
tissue. The heat causes
coagulation (destruction)
of tumor tissue and the
edge around it. In order
to make the advantages
of the effect and
accuracy of the therapy
useful, all the factors contributing to the success
of therapy must co-ordinate with one another.
For this, it is necessary to calculate the exact
duration and output of the laser. Therefore under
certain circumstances more laser applicators
and more cycles of therapy, may be required
depending on size, number and location of the
lesion to be treated. These parameters are
adapted individually according to the illness. In
practise a temperature of about 60 to 110° C is
achieved in the tumor tissue. This differentiates
LITT from the classical hyperthermia.
It is scientifically proven that local resection or
destruction of liver metastases prolongs the life
of patients and chemotherapy is then to be
preferred.
Metastasis in segment 8, native
MRI before LITT
Metastasis in segment 8, native
MRI after LITT. The metastasis
and the edge around is fully
coagulated.
Metastasis in segment 8,
contrast-enhanced MRI before
LITT
Metastasis in segment 8,
contrast-enhanced MRI after
LITT
Indications:
1. LITT of liver tumours
• Maximum number: 5 lesions
• Maximum diameter: 50 mm
• Residual metastases in patients who have already
undergone liver resection.
• Progress of metastases despite chemotherapy
• Bilobar metastases (involvement of both lobes of
liver)
• Patients who are contraindicated for operation
• Patients who are primarily inoperable can be
brought to an operable situation with LITT
(metastases in both liver lobes)
• LITT as alternative therapy for patients who
refuse surgical resection and systemic or local
chemotherapy.
2. LITT of lung metastases and lung tumors
3. LITT of soft tissue tumors
• Residual tumors
• Head and neck region
• Upper abdomen
• Retroperitoneum
• Lymph node metastases
• Head and neck region
• Upper abdomen
• Retroperitoneum
4. Special indications
• Kidney tumors
• Prostate tumors
• Other soft tissue tumors