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Neurosurgeons Use MRI-Guided Lasers To Destroy Tumors

Posted by samzenpus on from the laser-brained dept.

breadboy21 writes "In the seemingly perpetual battle to rid this planet of cancer, a team of neurosurgeons from Washington University are using a new MRI-guided high-intensity laser probe to 'cook' brain tumors that would otherwise be completely inoperable. According to Dr. Eric C. Leuthardt, this procedure 'offers hope to certain patients who had few or no options before,' with the laser baking the cancer cells deep within the brain while leaving the good tissue around it unmarred. The best part, however, is that this is already moving beyond the laboratory, with a pair of doctors at Barnes-Jewish Hospital using it successfully on a patient last month. Regrettably, just three hospitals at the moment are equipped with the Monteris AutoLITT device, but if we know anything about anything related to lasers, it'll be everywhere in no time flat."

9 of 70 comments (clear)

  1. Meanwhile by Dunbal · · Score: 2, Informative

    It's a good thing that great advances are being made in very specialized areas of medicine. Meanwhile, the leading killer world-wide is still heart disease which receives disproportionately inadequate funding despite recent progress in PTCA stenting, etc. Machines like this may grab funding dollars and headlines, but they don't save very many lives.

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    Seven puppies were harmed during the making of this post.
    1. Re:Meanwhile by Dunbal · · Score: 5, Informative

      but it isn't the major killer worldwide,

            Yeah, that's why in the very last paragraph of the linked page you provided it's listed as the #1 killer worldwide.

            As a second year med student please take some advice from this attending physician: while there are certain ways in which the data is sliced demographically that ends up presenting other pathologies as number one, the overall aggregate data clearly states that heart disease is #1 worldwide with 7.2 million cases per year. Right there at the bottom of the page where it says "World". Picking and choosing data is an error that is committed very often nowadays - people try to create "meta-analyses" that demonstrate their pet theory but conveniently leave out all the studies that fail to support their theories. This is bad science. Don't do it. Either look at all of the data, or make sure that have have the right tools to evaluate your special subset of data in the context of the big picture.

            I agree that stenting is a stop-gap at best, and long term patient compliance with CAD medications will always be a challenge. The future, as you say, lies in prevention and raising awareness of the real causes of CAD: Smoking, sedentarism/obesity, diet and lastly genetics.

            Good luck in your studies.

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      Seven puppies were harmed during the making of this post.
  2. a better article by roman_mir · · Score: 4, Informative

    this text is better in that it explains that first, a hole is drilled in the scull, then MRI is used to image the brain and these images help to insert a probe that's similar to a pencil in shape into the tumor through the brain, so it looks like this will go through other brain tissue first, and then this device discharges what basically amounts to heat and cooks the tumor.

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    You can't handle the truth.
    1. Re:a better article by nbauman · · Score: 4, Informative

      It is a better article, mostly because it doesn't have the gushing enthusiasm of the Endgaget story (Technology nyphomaniac: Never met a technology I didn't immediately fall in love with.)

      I used to write about medical lasers for a few years, and I learned one important lesson:

      Don't believe it until they have a randomized, controlled trial that shows patients who get the laser treatment actually do better than the patients who don't. (It doesn't do any good to remove a tumor if the tumor comes back right away.) A lot of laser treatments didn't look too good after the controlled trials.

      (It is true that there are some procedures that are so rare that they can't do a randomized controlled trial.)

      This system looks like it might be useful in certain not-too-common situations where you can't reach the tumor with anything else. It's like, when you're working on a car, having an offset screwdriver that can reach a blind screw that's hard to reach any other way. It's FDA approved for brain surgery so it passed some kind of review.

      There are other ways of doing it. Notice that WUSL also offers a gamma knife http://plexus.wustl.edu/surgery/neuro/website.nsf/WV/23077ADDD22341B28625729F00713CFC which focuses 201 radiation sources on a small spherical target. Brain surgeons are clever.

      A lot of times, a $50 cautery can do just as good a job as a $100,000 laser.

      This isn't rocket science.

      The fundamental problem is, sadly, those cancers they mentioned are inevitably fatal, within 6 months to a few years. The main purpose of surgery is to make your last few years more comfortable, like when they remove a tumor that's near the optic nerve threatening to make you blind. There are some benign brain tumors that can be cured, though. "Benign" is a relative term when something's growing in your brain. You want to get it out.

    2. Re:a better article by pz · · Score: 2, Informative

      this text is better in that it explains that first, a hole is drilled in the scull, then MRI is used to image the brain and these images help to insert a probe that's similar to a pencil in shape into the tumor through the brain, so it looks like this will go through other brain tissue first, and then this device discharges what basically amounts to heat and cooks the tumor.

      The same is already done in the clinic using an RF probe to induce localized heating. Gamma knives (see the plethora of other comments) do the same by concentrated radiation damage, although the MRI is done beforehand (and a CT ... I once asked a neurosurgeon I work with why use both, and he replied that neither method is as accurate as one might hope, so they combine techniques to reduce measurement errors).

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      Put my fist through my alarm clock with its ding-dong death inside my ear. - The Blackjacks.
  3. has been around for a bit by Trepidity · · Score: 3, Informative

    There've been experimental uses of this kind of thing since the 1990s. The AutoLITT system mentioned in this mini-article, and Visualase are two commercial systems. There've been some preliminary clinical trials as well.

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    10 PRINT CHR$(205.5+RND(1)); : GOTO 10
  4. Re:Gamma Knife by icegreentea · · Score: 2, Informative

    This is nothing like the gamma knife, aside from that it uses radiation. They're using an MRI to guide a physical probe through the brain to the tumor where the probe then does a thermal discharge. So instead of shooting intersecting deathrays (very cool stuff by the way), they're sending a guided killbot that gets right up close.

  5. Re:Damn by Znork · · Score: 2, Informative

    How do they get the lasers only to burn the cancer cells and not burn tissue on the way to the cancer cells?

    It's not an external laser, it's a probe emits the laser beam from one side. So you still need to stick the probe into the brain until you get to the parts you want to light up.

  6. Re:So, let me get this straight by Anonymous Coward · · Score: 2, Informative

    The majority of people who get cancer are already 40+, past the age where they would be having new children. Unless you plan to kill the children of people who get cancer, keeping treatment from the patients will make any difference.