New Brunswick, NJ – A leading neurosurgeon has performed the nation’s first laser-assisted brain surgery for a specific type of resistant brain tumor using technology so advanced that the patient went home the next day.

Shabbar F. Danish, M.D., Director, Stereotactic and Functional Neurosurgery and Assistant Professor at UMDNJ-Robert Wood Johnson Medical School (RWJMS) and Robert Wood Johnson University Hospital (RWJUH), used the Visualase, Inc., laser-assisted thermal ablation technique to operate on a patient with a recurring brain tumor after two previous surgeries and radiation did not permanently destroy the growth.

The technology is the latest addition to RWJUH and RWJMS’s growing expertise in the division of neuroscience. Dr. Danish specializes in the latest in stereotactic neurosurgery, which involves targeting small areas in the brain with techniques used to treat everything from Parkinson’s disease to brain tumors.

Susanna Denude of Riverdale, N.J., was diagnosed with an intracranial ependymoma, a tumor that grows from the cells that line the ventricles in the brain. While only six hospitals in the country offer laser-assisted thermal ablation, this is the first time in the nation that the treatment was used for an intracranial ependymoma, explains Dr. Danish.

“This is a tool for patients with tumors who have been told they do not have other options,” Dr. Danish says about laser-assisted thermal ablation. “This is also a viable option for patients who do not want radiation therapy or general anesthesia. Additionally, we can take their hospital stay from four to seven days down to 24 hours.”

The technique involves placing a laser directly into the tumor and then guiding the laser to perform thermal ablation, or killing it with heat, while leaving the surrounding areas of the brain untouched. The entry hole that is made through the skull is about the size of the end of a pen and requires just one stitch and a small bandage following the procedure.

“In order to find the exact spot where the tumor is located, we use a GPS system for the brain so that we can identify the exact target location during laser placement, load and then map out a path in the operating room,” says Dr. Danish.

After the laser is placed in the brain, the patient is moved to an MRI unit, where the operating team can observe in real time how the brain changes temperature with respect to the laser. “It uses a light energy in order to deliver the thermal therapy,” adds Dr. Danish. Only local anesthesia is used and the patient is able to go home the day after surgery.

“What we hope for Ms. Denude is that she goes on now to live a full life,” Dr. Danish says. “She’s a very active woman.”

To learn more about RWJUH, please visit www.rwjuh.edu. For a referral to a physician affiliated with RWJUH, please call 1-888-MD-RWJUH. Follow us on Twitter at www.rwjuh.edu/twitter and Facebook at www.rwjuh.edu/facebook.

To learn more about UMDNJ-Robert Wood Johnson Medical School, visit rwjms.umdnj.edu. Find our fan page on Facebook and follow us on Twitter @UMDNJ_RWJMS.

- 1917: Einstein proposes the theory of “stimulated emission,” by which a photon, or light particle, induces an atom to emit an identical photon.

- 1953: American physicist Charles Townes builds forerunner of the laser, a “maser,” for Microwave Amplification by Stimulated Emission of Radiation

- 1957: Gordon Gould, a doctoral student under Townes, coins the term “laser,” theorizing that light could be used to excite atoms into making a coherent beam of light. Later files a patent; legal dispute lasts nearly three decades.

- 1960: First laser, built by Theodore Maiman of Hughes Research Laboratories in California, becomes operational.

- 1961: Laser used for first time in surgery, to destroy retinal tumor.

- 1962: Invention of the semi-conducting diode laser, the mainstay of small commercial lasers today.

- 1969: Laser’s use in telemetry makes headlines. A beam bounced back by a mirror deployed by the Apollo 11 crew measures the distance between Earth and the Moon to within a few yards.

- 1971: Lasers enter the arts, with light shows and the awarding of the Nobel Prize to Dennis Gabor, a British-Hungarian, for holography.

- 1982: First Compact Disc player. First CD to be pressed is “52nd Street” by Billy Joel.

- 1991: First laser surgery to correct short-sightedness. Gulf War sees first use of laser-guided munitions.

- 1996: Toshiba sells first digital versatile disc (DVD) player.

- 2008: French neurosurgeons use fiberoptic laser and keyhole surgery to destroy brain cancer.

More on Dr. Alexandre Carpentier

Full article:
http://www.independent.co.uk/life-style/house-and-home/laser-a-timeline-1973907.html

Revolutionary Techniques in Neurosurgery:
A Q&A with Ravish Patwardhan, MD

Published Online: April 15, 2010 – 3:03:03 PM (CDT)
Ravish Patwardhan, MD, is the founder and director of the Comprehensive Neurosurgery Network (www.brainandspinecare.com), which “specializes in minimally invasive techniques for treating brain and spine problems.” Patwardhan has more than 12 years of experience in the neurosurgery industry and has published several peer reviewed studies on brain trauma, tumors, epilepsy, and spinal procedures. He is also a frequent speaker on the latest treatments and advances in brain and spinal surgeries.

What are the benefits of the Visualase laser probe technique, and do you believe it will become the standard for brain tumor eradication?

The best way to understand the Visualase laser system is to understand what it simplifies. Say a patient comes in with a brain tumor that is less than 2cm in diameter. While he or she is awake, a small area of the scalp is locally anesthetized, and a stab incision is made, with a small hole drilled in the precise trajectory to enter the middle of the tumor and run its length. The operating room portion ends here. The patient is transferred to the MRI suite, where the precise position is verified on MRI scan. Subsequently, the tumor is ablated in the MRI scanner, leaving a black hole where the tumor used to be. The probe is removed in the MRI scanner, and a previously placed stitch is tied, all while the patient is awake and responding, to ensure that no new problem has occurred. The entire procedure takes about an hour (5 minutes in the operating room and 45 minutes in the MRI suite).

The length of time of the procedure, avoidance of general anesthesia, shortened length of stay in the hospital (patients may go home the same day versus three days or more, following a typical craniotomy for tumor resection), reduced blood loss (a few drops), smaller incision size (stab incision), and subsequently less pain all result in a quicker recovery. Because this technology is so new, we’re learning more about it with each case. We learn about which tumors in which locations may or may not be amenable to treatment with laser ablation. Presently, though, laser ablation’s advantages appear to be its ability to treat deep brain tumors—which would destroy the brain if approached openly surgically—and to produce relatively instant results. This is opposed to waiting several weeks to see an MRI change for techniques like Gamma Knife.

John Theurer Cancer Center brings together leading neuro-oncology experts to present key trends

Oncologists from top cancer institutions provide overview on new neuro-oncology guidelines

HACKENSACK, N.J. (April 5, 2010) —John Theurer Cancer Center at Hackensack University Medical Center will bring together top neuro-oncologists from around the country a symposium to address new treatment updates and review management of complex cases across a broad array of neuro-oncology specialties.

The Sixth Annual Neuro-Oncology Symposium: Update of New Guidelines in Neuro-Oncology will take place on Friday, April 9. The program will feature neuro-oncology experts from leading cancer institutions, including M.D. Anderson Cancer Center, Memorial Sloan Kettering Cancer Center, Northwestern University Medical Center, and Arkansas Neuroscience Institute.

“John Theurer Cancer Center is dedicated to providing doctors and others in the medical community with the most up-to-date, innovative research in all fields of oncology, including neuro-oncology,” said Mark Pascal, M.D., Co- Chief, Neuro-Oncology, John Theurer Cancer Center. “For the sixth consecutive year, we are proud to bring together a group of highly esteemed oncologists to discuss the latest trends in our field.”

These neuro-oncology leaders will discuss an array of topics, including the latest in surgical techniques for complex intracranial meningiomas, quality of life measures for brain tumor patients, radiosurgery outcomes for benign and malignant spinal tumors and an update on exciting new cutting-edge treatments for glioblastoma.

Featured speakers include:

• Ossama Al-Mefty, M.D., F.A.C.S., Co-Director, Arkansas Neuroscience Institute
• Christina Meyers, Ph.D., A.B.P.P., Professor, Department of Neuro-Oncology and Leader, Section of Neuro-Psychology, M.D. Anderson Cancer Center
• Jeffrey Raizer, M.D., Associate Professor, Neuro-Oncology and Medical Director, Neuro-Oncology, Northwestern University Medical Center
• Yoshiya Yamada, M.D., Attending, Radiation Oncology, Memorial Sloan Kettering Cancer Center
• Mark Pascal, M.D., Co- Chief, Neuro-Oncology, John Theurer Cancer Center
• Viswanathan Rajaraman, M.D., Co-Chief, Neuro-Oncology, John Theurer Cancer Center

This symposium is part of John Theurer Cancer Center’s ongoing commitment to provide extraordinary care through research and innovation. The neuro-oncology division includes one of the largest neuro-radiology services in the tri-state area to detect brain tumors. They also participate in a number of clinical trials and invest in state-of-the-art technology to improve patient outcomes. Most recently, the neuro-oncology division became one of 20 cancer centers in the United States to offer MRI-guided laser interstitial thermal therapy (LITT). This highly-precise technology allows physicians to destroy only the targeted tissue, leaving healthy surrounding tissues unharmed.

“As we continue to grow, we are committed to adopting new innovations to enhance our neuro-oncology division, ultimately prolonging survival time while improving quality of life,” said Viswanathan Rajaraman, M.D., Co-Chief, Neuro-Oncology, John Theurer Cancer Center.

###

This conference is open to the public, but primarily for neuro and medical oncologists, neurologists, neurosurgeons, radiation therapists, neuro-radiologists and primary care physicians as well as other healthcare professionals involved in the treatment of brain and spinal tumor patients. The conference will be held from 7:30 am to 1:00 pm in the Hekemian Conference Center Auditorium located at Hackensack University Medical Center, 30 Prospect Ave., Hackensack, New Jersey. If you’re interested in attending please contact Bonnie LoGiudice at 201-996-4891 or blogiudiace@humed.com.

About John Theurer Cancer Center at Hackensack University Medical Center

John Theurer Cancer Center at Hackensack University Medical Center is New Jersey’s largest and most comprehensive center dedicated to the diagnosis, treatment, management, research, screenings, and preventive care as well as survivorship of patients with all types of cancer. The 15 specialized divisions covering the complete spectrum of cancer care have developed a close-knit team of medical, research, nursing, and support staff with specialized expertise that translates into more advanced, focused care for all patients. Each year, more people in the New Jersey/New York metropolitan area turn to the John Theurer Cancer Center for cancer care than to any other facility in New Jersey. Housed within a 775-bed not-for-profit teaching, tertiary care, and research hospital, John Theurer Cancer Center provides state-of-the-art technological advances, compassionate care, research innovations, medical expertise, and a full range of after care services that distinguish John Theurer Cancer Center from other facilities.

Real-Time Magnetic Resonance Imaging–Guided Focal Laser Therapy in Patients with Low-Risk Prostate Cancer

Excerpts below:

Abstract

Two patients with low-risk prostate cancer (PCa) were treated with outpatient in-bore magnetic resonance imaging (MRI)–guided focal laser ablation.

The tumor was identified on MRI. A laser fiber was delivered via a catheter inserted through a perineal template and guided to the target with MRI. The tissue temperature was monitored during laser ablation by MRI thermometry. Accumulated thermal damage was calculated in real time. Immediate post-treatment contrast-enhanced MRI confirmed devascularization of the target. No adverse events were noted. MRI-guided focal laser therapy of low-risk PCa is feasible and may offer a good balance between cancer control and side effects.

Once the catheter reached its target, the metal trocar was replaced by an optical fiber with a 1-cm-long cylindrically diffusing tip attached to a 980-nm diode laser (Visualase Inc, Houston, TX, USA).

During laser ablation, temperature was measured simultaneously on five 3-mm-thick image slices that covered the target volume (Fig. 5a). The thermometry scan was repeated every 6 s.

Fig. 5 (a) Tissue temperature map measured by magnetic resonance thermometry (echo planar imaging with multiphase; field of view: 25 × 25 cm; matrix 256 × 256; number of excitations: 1; repetition time: 545 ms; echo time: 20 ms; flip angle: 20°; slice thickness: 3 mm) during laser ablation; (b) a map of the tissue volume exceeding the threshold damage for coagulation was superimposed on the anatomical image, with the pink line measuring the maximum diameter of the ablated tissue.

The MRI thermometry software (Visualase, Inc, Houston, TX, USA) allowed us to monitor temperature at specific points in the tissue. The temperature at those points was used as a feedback to control the laser. During the laser heating, the temperatures at the border of the rectal wall and urethra were monitored and maintained at safe levels by shutting down the laser automatically when the temperature at these critical points exceeded 45 °C. Thermal damage was calculated using an Arrhenius formula. Temperature and damage maps were superimposed onto anatomic images (Fig. 5b). Once the desired volume of tissue destruction was achieved, laser power was stopped.

The patients were discharged home within 3 h. MR scans performed 2 wk post-treatment showed no evidence of complications with preservation of rectum and neurovascular bundles. No adverse effects were noted at ≤1 mo after treatment. Six-month follow-up biopsies are pending.

Outpatient MRI-guided FLT as used in the present study allows for visualization of the tumor; real-time guidance of the thermal device to the target; monitoring and control of the zone of ablation and surrounding tissue during treatment; and the ability to immediately confirm the success of the treatment and, if necessary, immediately repeat therapy. The required skills are common to other minimally invasive procedures, resulting in a short learning curve for the surgeon. Refinement of this outpatient procedure may result in an inexpensive, minimally invasive alternative to current active therapies. Further trials will be necessary to define the safety and oncologic efficacy of this therapy, but our early results are promising.

Acknowledgment

The authors would like to thank Drs. Ashok Gowda and Roger McNichols of Visualase Inc., Houston, Texas, USA, for generously supplying the laser and magnetic resonance thermometry system and for their technical support of this study.

Read the full article case study.

Epilepsy Pipeline 2010 San Francisco

Visualase Inc. Selected to Present at Epilepsy Conference Highlighting New and Promising Epilepsy Therapies. Epilepsy Pipeline Update 2010 to Take Place February 25-26 in San Francisco.

FOR IMMEDIATE RELEASE

Houston, TX  February 23, 2010 — Visualase Inc. announced today that Bill Hoffman will present an overview of Visualase’s MR Guided Focal Therapy Technology at the Epilepsy Pipeline Update 2010 conference, an in-depth, 2-day forum to be held February 25-26, 2010, at the Hyatt Embarcadero Hotel in San Francisco. The conference will feature a line up of leading innovators, clinical investigators and industry leaders who will offer insights into the discovery and development of pioneering drugs, biologics and devices for epilepsy with the goal of accelerating patient access to new treatments.  Visualase Inc. was selected to present by the Scientific and Business of Advisory Boards of the Epilepsy Therapy Project, a non-profit organization that supports the commercialization of new epilepsy therapies.

The conference will bring together emerging CNS companies and scientific entrepreneurs to present their strategies, product candidates and development programs to potential venture capital, private equity, pharma and biotech investors and partners.  Presenters will cover the most innovative therapies in development today for epilepsy.

# # #

Visualase, Inc. is focused in product development, clinical evaluations, manufacturing, and marketing of advanced image-guided laser technologies for thermal focal ablation markets.

The unprecedented level of precision and control afforded by the Visualase technology has made possible ablation of tissue in highly sensitive areas such as brain and prostate. Doctors are currently using the system for ablation of brain, prostate, liver, bone, and other solid tumors. For more information about the Visualase Technology and Visualase Inc., visit http://www.visualaseinc.com.

# # #

Visualase To Be Awarded $2.1 Million For Prostate Cancer Research.

Visualase Inc. was selected for a $2.1 million grant from the Cancer Prevention and Research Institute of Texas. The precision and control of the Visualase technology has made possible the ablation of tissue in areas such as brain and prostate.

Houston, TX  February 10, 2010 — Visualase Inc. announced today that it has been selected for a grant $2.1 million from the Cancer Prevention and Research Institute of Texas (CPRIT). On January 20, CPRIT Chief Science Officer Dr. Al Gilman, announced awards to 16 institutions based in Texas which are on the forefront of cancer research and treatment. Visualase is one of only two private companies to receive such a grant and stands with established cancer institutions such as The University of Texas M.D. Anderson Cancer Center, Baylor College of Medicine, and UT Health Science Centers, among others.

Visualase Technology. Brain image during treatment.

“We’re thrilled to be recognized by the Cancer Prevention and Research Institute of Texas and we’re looking forward to accelerating our efforts in providing patients in Texas and across North America with better treatment options for prostate cancer. Doctors Ashok Gowda and Roger McNichols deserve all of the credit for not only developing our technology, but also collaborating with health professionals to make an immediate impact on improving patient outcomes,” CEO Bill Hoffman said.

The focus of the grant will be continued clinical exploration of focal treatment of cancerous tumors in the prostate, a treatment which could significantly reduce the rate of side-effects associated with conventional “whole gland” treatments, including prostatectomy and whole gland irradiation. The clinical study to be funded by the grant will be lead by a team from M.D. Anderson Cancer Center.

The unprecedented level of precision and control afforded by the Visualase technology has made possible ablation of tissue in highly sensitive areas such as brain and prostate. Doctors are currently using the system for ablation of brain, prostate, liver, bone, and other solid tumors. For more information about the Visualase Technology and Visualase Inc., visit http://www.visualaseinc.com.

###

Prostate Cancer Research Projects

University of Chicago

Dr. Scott Eggener

“A Study to Evaluate Magnetic Resonance Thermal Image-guided Laser-Induced Thermal Therapy for Pinpoint destruction of Prostate Cancer.”

This human clinical trial, approved by the FDA, will test a treatment that can eliminate prostate cancer cells without damaging the surrounding tissues. The research team will evaluate the feasibility of a FDA-approved thermal therapy and feedback system (Visualase® Thermal Therapy System) for the treatment of biopsy confirmed and MR-imageable prostate lesions. This system has been used in humans for the treatment of brain, spine,thyroid, and liver cancers; however it has not yet been evaluated for the primary treatment of prostate cancer.

This system allows delivery of laser energy while the patient is simultaneously being imaged by an MRI unit. The system’s real-time MR thermal imaging (MRTI) provides information on the thermal dose delivered to the target, resulting in a more precise and controlled delivery which has not been possible with other cancer removal therapies. The researchers hypothesize the system can be a practical and feasible treatment for low-risk localized prostate cancer and allow patients to avoid the complications associated with radical whole-gland therapy. This clinical trial will take up to 2 years. PFC Funding Partners-The Longest Day of Golf Chicago and the University of Chicago Foundation.

The laser is compatible with the Visualase Thermal Therapy System, which incorporates advanced MRI-thermal image guidance and novel cooled laser applicator technology for real-time monitoring and control of the ablation process.  The new PhoTex30 Diode Laser and Visualase cooled laser applicators allow creation of large ablation zones (up to 3cm in diameter) from a single probe in approximately 2 minutes.  Multiple probes can be used simultaneously to cover larger areas of tissue in the same short exposure time.  .

Visualase uses light energy to destroy unwanted tissue through a process called Laser-induced interstitial thermotherapy (LITT). In this treatment, laser fibers are directed to targeted areas in the body, often tumor tissue. Laser light is delivered through the probe which raises the temperature to lethal levels in the targeted tissue.  As more physicians become trained on the Visualase technology, lasers may have an increased impact on many types of tumor therapy.  Doctors are currently using the system for ablation of brain, prostate, liver, bone, and other solid tumors.

PhoTex30 Diode Laser System

For more information about the PhoTex30 Diode Laser Series and Visualase Inc., visit http://www.visualaseinc.com.
For news and events about Visualase Inc., visit http://www.visualaseinc.com/news/

Contact

Andres Schulz
Media and Marketing

Visualase Inc.
8058 El Rio Street
Houston, Texas 77054

With more than 500 people diagnosed a day in the U.S., it’s critical we unite to fight brain tumors. Help us fund promising research to improve quality of life and get to a cure faster!

Last year, 1000 participants helped to raise $200,000 to fund innovative research for brain tumor treatments and support services for brain tumor patients and their families. Join those whose lives have been touched by brain tumors; meet patients, families, and friends, celebrate life, and honor the memory of those lost. All ages are welcome.

Visit the website.

New surgical technique uses laser energy to destroy brain tumors

Novel approach is minimally invasive and precise
04:20 PM CDT on Wednesday, October 7, 2009
Wendy Rigby / KENS 5

Perez has had one surgery to remove the tumor, but now the cancer has returned. This time, Dr. John Floyd, a U.T. Health Science Center neurosurgeon, is trying something different.

In an operating room at St. Luke’s Baptist Hospital, the doctor secured an anchor in the outside of the skull. Then, using what’s called neuro-navigation for precision, he slid a catheter several inches inside the head. That catheter houses a laser that can zap the cells growing out of control and threatening Perez’ life.

After the catheter was in place, the patient was moved to an MRI suite, where real-time images showed the doctors the area they were treating.

“Now we have another surgical technique which is minimally invasive and excellent for recurrences,” Floyd said.

While the two-step procedure took several hours, the heating and killing of the tumor took less than five minutes.

“In fighting brain cancer and brain tumors, we need everything that’s available at our disposal to be able to win the battle,” commented Dr. David Jimenez, head of the neurosurgery department at UTHSC.

Full article and video at News5

Visualase will be holding a seminar for physicians interested in the Visualase technology. Neurosurgeons that have used Visualase will present case studies and will be available for QnA. Please RSVP if you like to attend. There is limited capacity for this event.

Ray Turner, 33, a Medical University of South Carolina neurosurgeon, performed the first laser brain surgery in the hospital’s history, only the 10th performed in the United States and the 30th in the world. “It’s exhilarating,” he said Thursday. “This is what we want to do in medicine, stay on the cutting edge.”

Rare laser brain surgery a first at MUSC – The Post And Courier Charleston, SC

30 Minute Brain Surgery – WCIV ABC News 4 Charleston, SC

1. GBM Guide – MGH Brain Tumor Center

   Dec 2, 2005 … A patient guide. by John W. Henson, M.D., MGH Brain Tumor Center … The exact name and grade of the tumor determine treatment options, …
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Watching Tumors Die

Thursday, April 2, 2009
By Sarah Petrie

Above, from left: Kamran Ahrar, M.D., and R. Jason Stafford, Ph.D., discuss an upcoming spinal surgery that will use the Visualase technology. They’ll be able to watch the tumor fully die in near real time during the procedure. Depending on where the tumor is located, the patient may or may not be awake during the procedure.

History books show that surgeons began removing cancerous tumors as early as the second century. Zoom ahead to 2009, take away the scalpels, scars and side effects that typically accompany surgery, and trade them for a tiny laser beam that zaps cancer dead on the spot. It sounds like science fiction, but our researchers and clinicians are among the first in the nation to investigate a new procedure that does just this … and more.

“It’s called laser-induced thermal therapy, and the basic theory is that the laser heats the tumor to a certain temperature to kill it,” explains Jeffrey Weinberg, M.D., associate professor in Neurosurgery, who’s conducting a clinical trial to test the effectiveness of this procedure on patients with metastatic brain tumors.
How hot is too hot for a cancerous tumor? Sixty degrees Celsius, in most cases.

“The clinical trial targets patients with otherwise inoperable tumors or those for whom other treatments failed,” Weinberg says. “This is possible because tissues surrounding the tumor aren’t harmed or affected with this procedure — an advantage over other types of brain surgeries for cancer, including radiosurgery.”

Delivering laser energy using a device only millimeters in diameter, the procedure leaves a scar no bigger than your thumb. Plus, there should be no side effects for this less-invasive surgery, which takes only a few hours from start to finish. “The laser portion should only take a few minutes, and patients will experience no swelling and little pain,” Weinberg adds.

Other forms of what also is known as ablation therapy already are in practice, killing tumors using heat, cold or electricity. So what makes this particular procedure so revolutionary? The physician actually watches the tumor die in real time, according to Kamran Ahrar, M.D., associate professor in Interventional Radiology, who has performed the procedure on a few patients with bone and spinal tumors as part of a similar clinical trial.

Weinberg agrees this is the biggest advantage of this method over other forms of treatment. “Patients don’t have to wait weeks or months for tests to confirm if the entire tumor is gone, as is the case with most surgeries. Instead, using this technology, we can convert magnetic resonance imaging into a color picture that indicates the temperature of the tissue,” he says. “This allows us to know exactly when the tumor is hot enough to fully die.”

How does it work?

Houston-based company Visualase Inc., which sells the technology, approached M. D. Anderson in 2000 for help with developing the tool. “For this procedure to be successful, the doctors must know the precise location and distribution of temperature in the tumor and that’s where the physicists come in the picture,” explains R. Jason Stafford, Ph.D., assistant professor in Imaging Physics, and lead consultant on the Visualase technology development for M. D. Anderson.

In other words, a stereotactic navigation system, “like a GPS for your brain” as Weinberg puts it, pinpoints the exact location and size of the tumor. After the surgeon drills a hole and sends the specially designed fiber directly to the tumor, the laser is activated, thus heating the tumor. Doing it in the MRI allows clinicians to monitor temperatures within the tissue. “Temperature as well as predicted regions of complete treatment are color-coded on a screen, giving us the ability to adjust or retreat a certain area, as needed,” Stafford adds.

And at M. D. Anderson, this entire procedure can be performed in one room, unlike at other institutions that also are researching the procedure. We have a dedicated intra-operative MRI suite, which is safer for patients than moving them to different locations to complete the procedure.

Burning out brain tumors: new procedure shows promise

Posted: Apr 20, 2009 5:59 PM CDT Updated: Apr 28, 2009 11:51 AM CDT
By Carolyn Roy, KSLA News 12

SHREVEPORT, LA (KSLA) – A Shreveport neurosurgeon has taken brain surgery for the removal of tumors to a whole new level, finding a way to obliterate a tumors, with much less risk.  A Many, Louisiana woman was the first patient in the U.S. to have the procedure done.

Karen Mowad … has been through surgery, chemotherapy and radiation…, but when the cancer spread to her brain, she came to Dr. Ravish Patwardhan of the Comprehensive Neurosurgery Network.

The Shreveport neurosurgeon had to open her skull to remove that tumor.  It’s the kind of surgery that leaves a big scar and comes with serious risks and a longer recovery time.  But by the time another tumor appeared last fall, Dr. Patwardhan had a new tool to try: a laser probe, and he was looking for a patient willing to be the first.  “We offered her both options,” says Dr. Patwardhan. “We said, ‘Look, you’ll be the first one in, really, North America to have this tumor re-sected for a metastatic brain tumor.  If you’re interested in it, we can do this. It involves making a small opening and going in and burning it.”  The alternative was another open operation.  Mowad was in.

The procedure, marries the precision of navigation tools … with an MRI-guided laser probe developed by Visualase out of Houston. “What this does is you just have to make a hole that will take you to the middle of the tumor, burn the tumor and then the tumor will essentially evaporate.  It’s actually done in the MRI suite, so when the probe is confirmed to be in the correct position in the MRI suite what you do then is heat it and you can watch it directly on the MRI scanner what area is being heated using the program.  After that you can do another MRI scan, since the patient is already there to show the tumor is gone.  So you have instant gratification.”

The procedure leaves behind a small pinpoint incision, comparable to that size of the tip of a pencil.  Karen Mowad was able to stay awake through the procedure, and felt no significant discomfort.  In addition to avoiding the risks related to anesthesia, the laser ablation probe is thin and slides through the brain with much less disturbance.  It allows the surgeon to reach even deep tumors with far less risk, like the brain swelling that comes with conventional procedures.

“It’s so much simpler and easier on the patient than a conventional procedure,” says Dr. Patwardhan.   It’s also faster, and it appears to be just as effective, if not more so.  Mowad’s surgery came at the end of one week.  She was back at work by the beginning of the next.  (Please note Visualase is effective in ablating tumors. It is not a cure for cancer.) Six months later, there is still no sign of the tumor.  “The number of people who make it out one year with a metastatic brain tumor is very low,” explains Dr. Patwardhan.  “She’s actually functioning and working, which is incredible.”

“It’s because of a lot of what I’ve been through, you know, I want other people not to be afraid of this.”

Since Mowad became the first patient in North America to undergo the procedure, several others have followed.  For now, Dr. Patwardhan says they’re reserving the laser treatment for brain tumors as a last resort, as long as patients’ conditions meet certain criteria.  “It’s restricted for tumors where you can go into them, which are tumors that are not extraordinarily hard, but there are quite a few tumors that are amenable to this treatment, so that’s nice.”

Click here to view the embedded video.

Click here to view the embedded video.

“World first: Lasers used in keyhole surgery for brain cancer” – Agence France-Presse

Paris, France August 29th, 2008 – Visualase technology used to successfully treat brain tumors, as reported by AFP and the Telegraph (UK).

Read: AFP article | Telegraph article

Paris hospital hosts pioneering laser brain surgery

Saturday 30 August 2008 – A French team of neurosurgeons claims top have successfully tested a combination of new techniques, including fibre-optic lasers, in treating brain cancer through ultra-keyhole surgery.

Read: France24

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Books › “Brain Tumor Treatment”

Late Effects of Treatment for Brain Tumors (Cancer Treatment and Research) by Stewart Goldman and Christopher D. Turner (Hardcover – Aug 31, 2009)

Excerpt – Table of Contents: “… II Medical Late Effects of Brain Tumor Treatment 8 Neurological Complications in Adults 113 Michelle Monje and Patrick …”Surprise me! See a random page in this book.

Blood-brain barrier disruption for the treatment of malignant brain tumors: the national program.: An article from: Journal of Neuroscience Nursing by Nancy D. Doolittle, Annie Petrillo, Susan Bell, and Pamela Cummings (Digital – Jul 28, 2005) – HTML

2009 Conquering Cancer – The Empowered Patient’s Complete Reference to Brain Tumors – Diagnosis, Treatment Options, Prognosis (Two CD-ROM Set) by PM Medical Health News (CD-ROM – Jan 8, 2009)

Angiogenesis in Brain Tumors (Cancer Treatment and Research) by Matthias Kirsch and Peter McL. Black (Hardcover – Feb 29, 2004)

Brain Tumors: Practical Guide to Diagnosis and Treatment (Neurological Disease and Therapy) by Joachim M. Baehring and Joseph M. Piepmeier (Hardcover – Oct 3, 2006)

Excerpt – page 40: “… Treatment of children with newly diag- nosed brain stem gliomas with intravenous recombinant … biology and treatment of brain tumors. Neuroimaging Clin N Am 2002; 12(4):525-536. …”Surprise me! See a random page in this book.

Brain Tumors in Children: Principles of Diagnosis and Treatment (The International Review of Child Neurology) by Michael E. Cohen and Patricia Kressel, M.D. Duffner (Hardcover – April 1994)

Benign Tumors in the Third Ventricle of the Brain: Diagnosis and Treatment by Walter Edward Dandy (Hardcover – 1991)

Laser Ablation of Liver Metastases from Colorectal Cancer with MR Thermometry: 5-Year Survival

Purpose

To determine technical success, technique effectiveness, complications, and survival after laser ablation of liver metastases from colorectal cancer.

Materials and Methods

Eighty-seven consecutive patients (65 men and 22 women; mean age, 62.8 years) with 180 liver metastases from colorectal carcinoma were included between 1998 and 2005. They underwent laser ablation with magnetic resonance (MR) thermometry in 170 sessions. Indications for laser ablation were locally unresectable tumors (16.1%), metastases in both liver lobes (34.5%), and refusal of surgery and/or general contraindications to surgery (49.4%). Technical success, technique effectiveness, and complication and survival rates were evaluated retrospectively.

Results

Technical success was achieved in 178 of 180 sessions (99%). Follow-up after 24–48 hours demonstrated an effectiveness rate of 85.6%. Local tumor progression rate was 10% after 6 months. Major complications included large pleural effusion, large subcapsular hematoma, abscess, large pneumothorax, pleuritis with fever, intrahepatic hemorrhage, and biloma. Mean survival from the time of diagnosis of the primary tumor was 50.6 months for all patients treated (95% CI, 44.9–56.3 months). Median survival time was 54 months and survival rates were 95.7% at 1 year, 86.2% at 2 years, 72.4% at 3 years, 50.1% at 4 years, and 33.4% at 5 years. The mean survival time after the first treatment was 31.1 months (95% CI, 26.9–35.3 months).

Conclusions

Laser ablation of liver metastases of colorectal cancer with MR thermometry appears safe and efficacious. Although the results are encouraging, direct comparison with other ablative modalities in a prospective clinical trial would be necessary to definitely show one modality is superior.

Source:
Journal of Vascular and Interventional Radiology, Volume 20, Issue 2, Pages 225-234 (February 2009)

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Books › “Brain Tumor”

	Curveball: When Life Throws You a Brain Tumor by Liz Holzemer (Paperback – April 16, 2009)
	Living with a Brain Tumor: Dr. Peter Black’s Guide to Taking Control of Your Treatment by Peter Black (Paperback – Oct 31, 2006) Excerpt – page 3: “… a recurring dream of a large gathering of all the brain tumor patients I have ever seen. At least half the people …”Surprise me! See a random page in this book.
	Damn The Statistics, I Have a Life to Live!: Coping with a Brain Tumor My Personal Story by Harry Wolf (Paperback – Sep 11, 2003) Excerpt – page 4: “… The MRI of my head showed a one-centimeter tumor, the size of an M&M®, in the left hemisphere, the speech and motor area, of my brain. It showed that half my brain had swelled because of …”Surprise me! See a random page in this book.
	Guerilla Guide to Brain Tumors: Shameless Dirty Tricks to beat the system and STAY ALIVE! by Skip Goebel (Paperback – Oct 26, 2007) Excerpt – page 1: “… The Brain Tumor Warrior Manifesto / am evolution. 1 am the progenitor of …”Surprise me! See a random page in this book.
	Brain Tumors: Leaving the Garden of Eden–A Survival Guide to Diagnosis, Learning the Basics, Getting Organized, and Finding Your Medical Team by Paul M. Zeltzer (Paperback – Dec 15, 2004) Excerpt – page 23: “… CHAPTER I Have a Brain Tumor Newly diagnosed brain tumor patients are like people who don’t …”Surprise me! See a random page in this book.
	I Had Brain Surgery, What’s Your Excuse? by Suzy Becker (Hardcover – Dec 10, 2003) Excerpt – page 30: “… a nice offer, and coming from someone who’d had a brain tumor-that was one of the first things Bruce had told …”Surprise me! See a random page in this book.
	Brain Tumors: Finding the Ark. Meeting the Challenges of Treatment Choices, Side Effects, Childrens Issues, Healthcare Costs and Long Term adjustment by Paul M. Zeltzer (Paperback – April 1, 2006)
	100 Q&A About Brain Tumors (100 Questions & Answers) by Virginia Stark-Vance (Paperback – Sep 25, 2003)
	Brain Surgeon: A Doctor’s Inspiring Encounters with Mortality and Miracles by Keith Black and Arnold Mann (Hardcover – Mar 25, 2009) Excerpt – page 3: “… an MRI scan revealed what appeared to be a large tumor in his brain. I was scheduled to remove it in the morning. …”Surprise me! See a random page in this book
	.Searching for Normal, My Life with a Brain Tumor by Mikki Baker (Paperback – Jan 31, 2008)
	Surviving Terminal Cancer: Clinical Trials, Drug Cocktails, and Other Treatments Your Oncologist Won’t Tell You About by Ben A. Williams (Paperback – Aug 25, 2002) Excerpt – page 9: “… I know that, at the time of this conversation, a brain tumor was growing inside my head. …”Surprise me! See a random page in this book.
	Brain Tumors (Diseases and Disorders) by Arda Darakjian Clark (Library Binding – Mar 10, 2006)