LITT: Laser Ablation for Brain Tumors & Radiation Necrosis
LITT delivers heat from a laser fiber the width of a spaghetti strand, inserted through a 4-mm opening in the skull and steered to the target with robotic or frame-based guidance. Inside the MRI scanner, temperature is monitored in real time and the lesion is ablated precisely while surrounding tissue is protected. Most patients go home the next day with a single stitch.
LITT is ideal for lesions that are deep, previously radiated, or in patients who cannot tolerate a conventional craniotomy.
Who it is for
- Recurrent brain metastases after radiosurgery
- Radiation necrosis
- Deep-seated or difficult-to-access gliomas
- Selected newly diagnosed glioblastoma (often with subsequent radiation)
- Epilepsy foci such as mesial temporal sclerosis or hypothalamic hamartoma
Why we use it
- Minimally invasive: 4-mm opening
- Real-time MRI thermal monitoring
- Overnight stay, rapid return to systemic therapy
- Reaches lesions unsafe for open surgery
- Can also provide tissue for diagnosis
How the procedure is done
- Trajectory planning on high-resolution MRI.
- Under general anesthesia, a 4-mm hole is drilled and the laser catheter placed with navigated or robotic guidance.
- In the MRI suite, the laser heats the target while thermal maps confirm the treated zone.
- The catheter is removed and the incision closed with one stitch.
Recovery
Home the next day; mild headache for a few days; steroids for a short period to control swelling.
Risks, stated plainly
Swelling, temporary neurological deficit, bleeding, infection; incomplete ablation of larger lesions. Dr. Daggubati reviews the specific risks for your situation in person before any decision is made.
Preparing for this surgery
Dr. Daggubati has written detailed guides for this procedure covering medications to stop, prehabilitation, the day of surgery, and a week-by-week recovery timeline.
Common questions
How does LITT compare to radiosurgery?
Radiosurgery works well for untreated lesions. LITT is the option when a lesion regrows after radiation or when necrosis and recurrence cannot be distinguished, because it treats both and provides tissue.