Laser interstitial thermal therapy for brain metastases: Imaging guidelines for clinical trials and practice

Abstract

Laser interstitial thermal therapy (LITT) is a local surgical treatment for brain metastases (BM). Here, we present and discuss the main radiologic findings and challenges related to LITT-treated BM. Prior to LITT, imaging features are useful for prognostic stratification and patient selection, as well as treatment planning. During the LITT session, intra-procedural imaging is acquired immediately at the beginning of the procedure for tumor delineation, during the ablation to monitor treatment using MR thermometry, and immediately post-LITT to evaluate the ablated region. Images obtained during the LITT procedure are useful to estimate the extent of ablation, either by analyzing the real-time thermometry data or by comparing pre- and post-ablation images. In the months following LITT, follow-up scans exhibit characteristic imaging patterns for responding versus progressing lesions, which should be accounted for during post-LITT surveillance. In light of these patterns, and considering the strategies adopted by previous LITT studies, we propose dedicated criteria for local radiologic response and local radiologic progression in clinical trials, by adapting the RANO-BM criteria for local therapies to a “dual baseline” framework dedicated to LITT-treated BM. Finally, we provide suggestions for the adoption of standardized post-LITT imaging protocols based on the current consensus.

Diagnostic Terminology and Clinical Practice in Interstitial Ectopic Pregnancy: A Five-Year Clinical Audit
Sumi M Surendran, Irina Ramzan, Segun Oniyide +1
Cureus16 Oct 2026Peer-reviewedCC BYFull textGeneral medicineEurope PMC
Barriers and Facilitators Influencing Physiotherapists’ Adherence to Clinical Practice Guidelines and Return to Sport Criteria after Anterior Cruciate Ligament Reconstruction: A Qualitative Study in Austria.
International journal of sports physical therapy19 Oct 2026Peer-reviewedCC BY-NCFull textGeneral medicineEurope PMC
Evaluation of Large Language Model Concordance With AAOS Clinical Practice Guidelines for Carpal Tunnel Syndrome
Jonathan Spaan, John T. Streepy, Alexander L. Hornung +3
Hand (New York, N.Y.)27 Oct 2026Peer-reviewedLicence not statedFull textEpidemiology & public healthPMC
ERS/ESGE/ESTS clinical practice guidelines on endobronchial and oesophageal endosonography for the diagnosis and staging of lung cancer
Daniel Arnoldus Korevaar, Bojan Kovacevic, Efthymia Papadopoulou +22
European Respiratory Journal21 May 2026Peer-reviewedLicence not stated10 citedGeneral medicineOpenAlex
LLM-Based Extraction of Clinical Practice Guidelines into Structured Arguments
Robin Blouin, Karima Sedki, Jean-Baptiste Lamy
Studies in Health Technology and Informatics29 Jun 2026Peer-reviewedCC BY-NC 4.0Full textGeneral biology Epidemiology & public healthHAL

Cite

BibTeX RIS

BibTeX

@article{sanvito2026laser,
  title = {{Laser interstitial thermal therapy for brain metastases: Imaging guidelines for clinical trials and practice}},
  author = {Francesco Sanvito and Aden P Haskell-Mendoza and Eric C Leuthardt and Albert H Kim and Jingwen Yao and Alireza Mohammadi and Gene H Barnett and Noriko Salamon and Richard G Everson and Won Kim and Evan Calabrese and Benjamin M Ellingson and Peter E Fecci},
  journal = {Neuro-Oncology},
  year = {2026},
  month = may,
  doi = {10.1093/neuonc/noag130},
  url = {https://doi.org/10.1093/neuonc/noag130},
  note = {CC BY-NC 4.0},
}

RIS

TY  - JOUR
TI  - Laser interstitial thermal therapy for brain metastases: Imaging guidelines for clinical trials and practice
AU  - Francesco Sanvito
AU  - Aden P Haskell-Mendoza
AU  - Eric C Leuthardt
AU  - Albert H Kim
AU  - Jingwen Yao
AU  - Alireza Mohammadi
AU  - Gene H Barnett
AU  - Noriko Salamon
AU  - Richard G Everson
AU  - Won Kim
AU  - Evan Calabrese
AU  - Benjamin M Ellingson
AU  - Peter E Fecci
PY  - 2026
DA  - 2026/05/29
JO  - Neuro-Oncology
DO  - 10.1093/neuonc/noag130
UR  - https://doi.org/10.1093/neuonc/noag130
AB  - Laser interstitial thermal therapy (LITT) is a local surgical treatment for brain metastases (BM). Here, we present and discuss the main radiologic findings and challenges related to LITT-treated BM. Prior to LITT, imaging features are useful for prognostic stratification and patient selection, as well as treatment planning. During the LITT session, intra-procedural imaging is acquired immediately at the beginning of the procedure for tumor delineation, during the ablation to monitor treatment using MR thermometry, and immediately post-LITT to evaluate the ablated region. Images obtained during the LITT procedure are useful to estimate the extent of ablation, either by analyzing the real-time thermometry data or by comparing pre- and post-ablation images. In the months following LITT, follow-up scans exhibit characteristic imaging patterns for responding versus progressing lesions, which should be accounted for during post-LITT surveillance. In light of these patterns, and considering the strategies adopted by previous LITT studies, we propose dedicated criteria for local radiologic response and local radiologic progression in clinical trials, by adapting the RANO-BM criteria for local therapies to a “dual baseline” framework dedicated to LITT-treated BM. Finally, we provide suggestions for the adoption of standardized post-LITT imaging protocols based on the current consensus.
SN  - 1522-8517
SN  - 1523-5866
ER  -

Abstract

Related

Cite