Adapting Laser Interstitial Thermal Therapy (LITT) for the Treatment of Naturally Occurring Intracranial Tumors in Dogs.

Abstract

PURPOSE Laser interstitial thermal therapy (LITT) is a minimally invasive surgical intervention permitting thermal ablation of intracranial targets such as tumors, radiation necrosis or epileptogenic brain, including lesions that are deep, difficult to access or recurrent that would otherwise have few viable surgical options. Despite its advantages, LITT has several limitations, including restrictions on its effective treatment zone (approximately 3 cm) and a lack of specificity for tumor borders with healthy brain. Few viable animal models of appropriate size exist for studying LITT's impact on these disorders, or for optimizing the technology and obviating its current limitations. Pet dogs develop these same disorders at similar rates to humans. We hypothesized that LITT could be made feasible in dogs, creating a unique model for in vivo LITT research and development. EXPERIMENTAL DESIGN Canine cadaveric specimens and live dogs, including canine patients with spontaneously occurring intracranial gliomas, were used in this study. Commercially available equipment was used for neuronavigation (Curve, Brainlab) and to perform LITT (Neuroblate, Monteris Medical). RESULTS Canine cadavers and two end-of-life laboratory dogs allowed adaptation of the neuronavigation and LITT systems to dogs, with successful targeting and ablation of intracranial targets. Four canine patients with intracranial gliomas were subsequently successfully treated with these same technologies. CONCLUSIONS This work establishes a a unique canine model for in vivo LITT research and development using commercially available systems, as well as creating a viable cutting-edge therapeutic intervention for pet dogs with intracranial lesions.