LITT

LITT, or laser interstitial thermal therapy, is a minimally invasive procedure that uses a thin laser fiber to heat and destroy abnormal tissue inside the brain. The fiber is passed through a small skull opening, and the entire ablation is done inside an MRI scanner so the surgeon can monitor temperature in real time. It is used for certain tumors, recurrent tumors, and radiation necrosis.

LITT is minimally invasive and avoids a craniotomy, and real-time MRI monitoring is used to protect healthy tissue. It is still brain surgery and carries risks, including swelling, bleeding, seizures, infection, and heat injury to nearby structures, which can cause temporary or lasting neurologic problems. In published series, complication rates have generally been lower than with open surgery, but no procedure is risk-free.

A craniotomy removes a section of skull to reach and physically remove tissue. LITT works through an opening only a few millimeters wide and destroys tissue with heat rather than removing it. LITT usually means a shorter hospital stay and faster recovery, but it suits smaller, well-defined targets, while open surgery may be needed for large tumors or those causing significant pressure.

Most people stay in the hospital about one to two days and return to normal activities within roughly a week, often much sooner than after open brain surgery. A headache from mild swelling at the treated area is the most common early symptom. Full healing continues over weeks to months as the body resorbs the treated tissue. Individual recovery varies.

A tumor called inoperable usually means open surgery is too risky given its location or the patient's health. Options can include stereotactic radiosurgery, systemic therapies such as chemotherapy, targeted drugs or immunotherapy, clinical trials, and, in selected cases, LITT, which can sometimes reach deep targets through a small opening. The right choice depends on the tumor and the individual and is decided case by case.

Yes. Radiation necrosis is an area of dead, inflamed tissue that can develop after radiation and can cause symptoms. LITT is used to treat symptomatic radiation necrosis, including in patients whose brain metastases were previously treated with stereotactic radiosurgery. It can also help in situations where it is difficult to tell radiation necrosis apart from recurrent tumor.

LITT tends to work best on smaller, roughly spherical targets, often those less than about three centimeters across. Larger tumors, irregularly shaped lesions, and tumors causing significant pressure that needs immediate relief are frequently better treated with open surgery or other approaches. Size is only one factor; location and proximity to critical structures also shape whether LITT is appropriate.

The treated tissue is not removed from the brain. The laser destroys it in place, and over the following weeks and months the body gradually breaks it down and resorbs it. This is why the treated area can look larger on scans soon after the procedure and tends to shrink over time, and why follow-up imaging is used to track the change.

Yes. For brain tumor treatment, LITT is typically performed under general anesthesia, meaning you are asleep and do not feel pain during the procedure. The procedure commonly takes two to five hours from start to finish, though the laser ablation itself often takes only minutes. Most people go home within a day or two afterward.