Magnetic Resonance-guided Laser interstitial thermal therapy (MR-gLiTT) in Pediatric Neurosurgery: italian perspective and literature review

Neurol Sci. 2025 May 6. doi: 10.1007/s10072-025-08213-8. Online ahead of print.

Abstract

Introduction: Magnetic Resonance-guided Laser interstitial Thermal Therapy (MR-gLiTT) has established itself as a minimally invasive neurosurgical approach for the treatment of various pediatric brain lesions, including tumors and epilepsy.

Research question: The work is likely to focus on evaluating the efficacy, safety and applicability of MR-gLiTT while investigating its potential to minimize surgical risks, shorten recovery time and improve patient outcomes.

Material and methods: This paper presents the results of a survey conducted in three leading italian pediatric hospitals to investigate the use of MR-gLiTT in pediatric patients with neurosurgical conditions. Data on patient demographics, primary diagnoses, MR-gLiTT parameters, perioperative complications and postoperative outcomes were collected and analysed.

Results: A total of 29 pediatric patients were included in the analysis. The median age at diagnosis was 36 months, with a predominance of males (58.6%). The most common indications were hypothalamic hamartomas (41.4%) and focal cortical dysplasia (24.1%). Perioperative complications were transient in nature (17.2%), with focal muscle weakness being the most frequent, while only one patient experienced a permanent hypoadrenocorticism. The average hospital stay was 6.48 days, with a mean follow-up duration of 23.12 months.

Discussion and conclusions: The adoption of MR-gLiTT in pediatric neurosurgery offers a promising minimally invasive approach with favorable outcomes. The efficacy in treating various pediatric neurological conditions is evident, suggesting its potential to reduce surgical risks, shorten hospital stays, and improve patient quality of life. Further clinical trials and prospective studies are required to fully understand the advantages of MR-gLiTT in pediatric neurosurgery.

Keywords: Hypothalamic Hamartoma; Laser interstitial thermal therapy; MR-gLiTT; Minimally invasive treatment; Neurosurgical survey.