Operational workflow and clinical application of non-intraoperative magnetic resonance imaging-guided laser interstitial thermal therapy in epilepsy surgery
LIU Zhiyuan
SUN Weijin
SU Wenlong
DING Haoran
MA Kaiqiang
LIU Zhao
LU Dongshuang
ZHANG Yao
WANG Xiongfei
ZHOU Jian
LUAN Guoming
GUAN Yuguang
Abstract：Objective To explore the feasibility and operational workflow experience of non-intraoperative magnetic resonance-guided laser interstitial thermal therapy(nMRgLITT)in the treatment of drug-resistant epilepsy(DRE).Methods Clinical data of 28 patients who underwent nMRgLITT were analyzed retrospectively.In the absence of intraoperative MRI,the surgical workflow was systematically summarized,including target planning,optical fiber implantation,patient transfer arrangements,ablation strategies,troubleshooting,and postoperative management,and corresponding optimization strategies were proposed.Results All 28 procedures were successfully completed.Perioperative safety was favorable,with only 3 cases(3/28,10.7%)experiencing transient neurological symptoms that resolved completely,and no severe complications occurred.Postoperative follow-up was obtained in 27 patients,while 1 patient was lost to follow-up.Postoperative follow-up evaluation of 27 evaluable patients showed that 22(22/27,81.5%)achieved International League Against Epilepsy(ILAE)class 1(seizure-free),and 1(1/27,3.7%)achieved ILAE class 2(only aura)and 4(4/27,14.8%)achieved ILAE≥class 3(still experiencing seizures).Conclusions In the context of limited access to intraoperative MRI,nMRgLITT offers a viable alternative.By optimizing the procedural workflow,the safety and precision of the operation can be enhanced,providing a reliable minimally invasive treatment option for patients with DRE.
Keywords：epilepsydrug resistantlaser interstitial thermal therapynon-intraoperative magnetic resonance-guidedminimally invasive therapy
Publication Date：2025-12-20
Online Publishing Date：2026-01-16(First online date of this platform, not the publication date of the document)
Pages：6( 705-710 )