Does the Modified Arrhenius Model Reliably Predict Area of Tissue Ablation After Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Pediatric Lesional Epilepsy?.
Citation: Operative Neurosurgery. 21(4):265-269, 2021 09 15.PMID: 34270761Institution: MedStar Washington Hospital CenterDepartment: Neurosurgery ResidencyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Epilepsy | *Laser Therapy | Child | Epilepsy/dg [Diagnostic Imaging] | Epilepsy/su [Surgery] | Humans | Lasers | Magnetic Resonance Spectroscopy | Reproducibility of Results | Retrospective StudiesYear: 2021Abstract: BACKGROUND: Commercial magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) systems utilize a generalized Arrhenius model to estimate the area of tissue damage based on the power and time of ablation. However, the reliability of these estimates in Vivo remains unclear.CONCLUSION: TDE reliability is variably consistent across tissue types, particularly in smaller or periventricular lesions. Further investigation is needed to understand the accuracy of this emerging minimally invasive technique. Copyright (c) Congress of Neurological Surgeons 2021.METHODS: A single-center retrospective review of pediatric patients undergoing MRgLITT for lesional epilepsy was performed. The area of each lesion was measured on both TDE and intraoperative postablation, postcontrast T1 magnetic resonance images using ImageJ. Lesions requiring multiple ablations were excluded. The strength of the correlation between TDE and postlesioning measurements was assessed via linear regression.OBJECTIVE: To determine the accuracy and precision of the thermal damage estimate (TDE) calculated by commercially available MRgLITT systems using the generalized Arrhenius model.RESULTS: A total of 32 lesions were identified in 19 patients. After exclusion, 13 pairs were available for analysis. Linear regression demonstrated a strong correlation between estimated and actual ablation areas (R2 = .97, P < .00001). The TDE underestimated the area of ablation by an average of 3.92% overall (standard error (SE) = 4.57%), but this varied depending on the type of pathologic tissue involved. TDE accuracy and precision were highest in tubers (n = 3), with average underestimation of 2.33% (SE = 0.33%). TDE underestimated the lesioning of the single hypothalamic hamartoma in our series by 52%. In periventricular nodular heterotopias, TDE overestimated ablation areas by an average of 13% (n = 2).Originally published: Operative Neurosurgery. 2021 Jul 16Fiscal year: FY2022Fiscal year of original publication: FY2022Digital Object Identifier: ORCID:- Cobourn, Kelsey D Fayed, Islam:
- https://orcid.org/0000-0002-7771-0700 https://orcid.org/0000-0002-4183-4744 https://orcid.org/0000-0002-7771-0700 https://orcid.org/0000-0002-4183-4744 Cobourn, Kelsey D Fayed, Islam:
- https://orcid.org/0000-0002-7771-0700 https://orcid.org/0000-0002-4183-4744 https://orcid.org/0000-0002-7771-0700 https://orcid.org/0000-0002-4183-4744
| Item type | Current library | Collection | Call number | Status | Date due | Barcode |
|---|---|---|---|---|---|---|
| Journal Article | MedStar Authors Catalog | Article | 34270761 | Available | 34270761 |
BACKGROUND: Commercial magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) systems utilize a generalized Arrhenius model to estimate the area of tissue damage based on the power and time of ablation. However, the reliability of these estimates in Vivo remains unclear.
CONCLUSION: TDE reliability is variably consistent across tissue types, particularly in smaller or periventricular lesions. Further investigation is needed to understand the accuracy of this emerging minimally invasive technique. Copyright (c) Congress of Neurological Surgeons 2021.
METHODS: A single-center retrospective review of pediatric patients undergoing MRgLITT for lesional epilepsy was performed. The area of each lesion was measured on both TDE and intraoperative postablation, postcontrast T1 magnetic resonance images using ImageJ. Lesions requiring multiple ablations were excluded. The strength of the correlation between TDE and postlesioning measurements was assessed via linear regression.
OBJECTIVE: To determine the accuracy and precision of the thermal damage estimate (TDE) calculated by commercially available MRgLITT systems using the generalized Arrhenius model.
RESULTS: A total of 32 lesions were identified in 19 patients. After exclusion, 13 pairs were available for analysis. Linear regression demonstrated a strong correlation between estimated and actual ablation areas (R2 = .97, P < .00001). The TDE underestimated the area of ablation by an average of 3.92% overall (standard error (SE) = 4.57%), but this varied depending on the type of pathologic tissue involved. TDE accuracy and precision were highest in tubers (n = 3), with average underestimation of 2.33% (SE = 0.33%). TDE underestimated the lesioning of the single hypothalamic hamartoma in our series by 52%. In periventricular nodular heterotopias, TDE overestimated ablation areas by an average of 13% (n = 2).
English