Nielsen Silas H, Skjøth-Rasmussen Jane, Larsen Vibeke A, Carlsen Jonathan F, Larsson Henrik B W, Christoffersen Christina, Rasmussen Rune, Hansen Adam E
Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Danish Comprehensive Cancer Center, Brain Tumor Center, Copenhagen, Denmark.
Neurooncol Adv. 2025 Jul 9;7(1):vdaf148. doi: 10.1093/noajnl/vdaf148. eCollection 2025 Jan-Dec.
MR-guided laser interstitial thermal therapy (LITT) is a minimally invasive neurosurgical treatment used for managing brain tumors and drug-resistant epilepsy. This study investigates the temporal pattern of blood-brain barrier (BBB) permeability following LITT in patients with tumors and epilepsy.
Twenty-three patients undergoing LITT (11 with brain tumors, 12 with non-tumor epilepsy) were enrolled. Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) and blood levels of glial fibrillary acidic protein (GFAP) were used to assess BBB permeability one day before and on days 1, 15, 30, and 45 post-LITT.
Quantitative analysis using DCE-MRI demonstrated significant increases in perilesional BBB permeability on days 15, 30, and 45 postoperatively ( < .005), with no notable changes on the first postoperative day. The findings were robust with regards to region of interest selection, showing consistent increases in BBB permeability in patients with both brain tumors and epilepsy. Additionally, GFAP levels peaked significantly above baseline on the first postoperative day, maintaining elevated levels through day 45.
Quantitative DCE-MRI and GFAP blood levels demonstrate a prolonged window of increased perilesional BBB permeability following LITT, potentially enhancing the delivery and efficacy of therapeutic agents in patients with brain tumors.
磁共振引导激光间质热疗（LITT）是一种用于治疗脑肿瘤和耐药性癫痫的微创神经外科治疗方法。本研究调查了肿瘤和癫痫患者接受LITT后脑血屏障（BBB）通透性的时间模式。
招募了23名接受LITT治疗的患者（11名患有脑肿瘤，12名患有非肿瘤性癫痫）。在LITT术前一天以及术后第1、15、30和45天，使用动态对比增强磁共振成像（DCE-MRI）和胶质纤维酸性蛋白（GFAP）的血药浓度来评估BBB通透性。
使用DCE-MRI进行的定量分析表明，术后第15、30和45天病变周围BBB通透性显著增加（<0.005），术后第一天无明显变化。这些发现对于感兴趣区域的选择是可靠的，表明脑肿瘤和癫痫患者的BBB通透性均持续增加。此外，GFAP水平在术后第一天显著高于基线水平，并在第45天保持升高。
定量DCE-MRI和GFAP血药浓度表明，LITT术后病变周围BBB通透性增加的窗口延长，这可能会提高脑肿瘤患者治疗药物的递送和疗效。
