Mayo Clinic uses laser interstitial thermal therapy for brain tumors

A Minimally Invasive Approach to Brain Tumor Treatment

Laser interstitial thermal therapy offers a minimally invasive alternative to traditional open brain surgery for carefully selected patients, utilizing targeted heat from a laser probe to destroy abnormal tissue.

According to Terry Burns, M.D., Neurosurgery, Mayo Clinic, Rochester, Minnesota, the specialized technique allows some individuals with specific brain tumors to leave the hospital as early as the next day.

Moving Beyond the Traditional Craniotomy

When a patient receives a brain tumor diagnosis, physicians typically begin by obtaining tissue through a biopsy and surgically removing as much of the mass as safely possible. Traditional open surgery requires a craniotomy, a procedure where a surgeon opens the skull to reach the brain. During a craniotomy, care teams sometimes keep patients awake to monitor speech and cognitive functions while mapping areas that control critical movements.

However, open surgery remains impractical for certain tumors due to their size, depth, or location in difficult-to-reach areas of the brain. Terry Burns, M.D. notes that laser therapy may also be considered when previous treatments, such as radiation therapy, leave imaging abnormalities that make it difficult to distinguish between a recurrent tumor and treatment-related changes.

Real-Time MRI Guidance and Precision Targeting

During laser interstitial thermal therapy, the neurosurgical team creates a small incision and guides a thin laser probe directly into the targeted tumor.

Medical professionals rely on MRI guidance to position the probe accurately and monitor the treatment zone. Once the laser is activated, thermal energy heats the tissue while minimizing thermal injury to adjacent healthy brain structures.

Patient Candidacy and Accelerated Recovery

Physicians may utilize this minimally invasive approach for gliomas, which originate in the brain or spinal cord, as well as tumors that have spread to the brain from cancer elsewhere in the body. The technique is frequently evaluated when these conditions progress despite standard therapy. Before placing the probe, surgical teams may perform a biopsy to allow for molecular and pathology testing.

Recovery times following laser therapy are often shorter than those associated with open operations because the incision is significantly smaller. Depending on overall health, tumor size, and tumor location, many patients discharge from the hospital the following day.

Clinical Limitations and Comprehensive Care Plans

Despite its advantages, laser therapy features distinct clinical limitations. The technique works best for smaller, well-defined areas. Medical teams may occasionally use multiple lasers or stage treatments over time, but the procedure is generally unsuitable for large, diffuse, or irregularly shaped tumors. It is also avoided when localized swelling could complicate recovery or when surgeons require a larger tissue sample for proper diagnosis and management.

Potential risks mirror those of other brain procedures and include bleeding, infection, swelling, seizures, and new neurologic symptoms that depend on the treated region. Because the method relies on controlled heat, careful preoperative planning is mandatory to protect surrounding brain tissue.

For aggressive brain tumors, laser therapy usually functions as one component of a comprehensive treatment strategy. Depending on individual diagnostic findings, care plans may incorporate additional surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, clinical trials, or routine follow-up imaging.