Review articleLaser neurosurgery: A systematic analysis of magnetic resonance-guided laser interstitial thermal therapies

- Differences between systems are probe design, delivery, cooling, and wavelength.
- Epilepsy is the most common indication for Visualase therapy.
- Brain mass is the most common indication for NeuroBlate therapy.
- NeuroBlate group is nearly twice as old as the Visualase group.

Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a novel minimally invasive modality that uses heat from laser probes to destroy tissue. Advances in probe design, cooling mechanisms, and real-time MR thermography have increased laser utilization in neurosurgery. The authors perform a systematic analysis of two commercially available MRgLITT systems used in neurosurgery: the Visualase® thermal therapy and NeuroBlate® Systems. Data extraction was performed in a blinded fashion. Twenty-two articles were included in the quantitative synthesis. A total of 223 patients were identified with the majority having undergone treatment with Visualase (n = 154, 69%). Epilepsy was the most common indication for Visualase therapy (n = 8 studies, 47%). Brain mass was the most common indication for NeuroBlate therapy (n = 3 studies, 60%). There were no significant differences, except in age, wherein the NeuroBlate group was nearly twice as old as the Visualase group (p < 0.001). Frame, total complications, and length-of-stay (LOS) were non-significant when adjusted for age and number of patients. Laser neurosurgery has evolved over recent decades. Clinical indications are currently being defined and will continue to emerge as laser technologies become more sophisticated. Head-to-head comparison of these systems was difficult given the variance in indications (and therefore patient population) and disparate literature.