{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:19:41Z","timestamp":1759936781958},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Maximal safe ablation of target structures during magnetic resonance\u2013guided laser interstitial thermal therapy (MRgLiTT) is critical to achieving good seizure outcome in patients with mesial temporal lobe epilepsy (mTLE). The authors sought to determine whether intraoperative physiological variables are associated with ablation volume during MRgLiTT.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Patients with mTLE who underwent MRgLiTT at our institution from 2014 to 2019 were retrospectively analyzed. Ablation volume was determined with volumetric analysis of intraoperative postablation MR images. Physiological parameters (systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial pressure [MAP], end-tidal carbon dioxide [ETCO<jats:sub>2<\/jats:sub>]) measured 40 minutes prior to ablation were analyzed. Univariate and multivariate regression analyses were performed to determine independent predictors of ablation volume.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Forty-four patients met the inclusion criteria. The median (interquartile range) ablation volume was 4.27 (2.92\u20135.89) cm<jats:sup>3<\/jats:sup>, and median ablation energy was 7216 (6402\u20138784) J. The median MAP, SBP, DBP, and ETCO<jats:sub>2<\/jats:sub> values measured during the 40-minute period leading up to ablation were 72.8 (66.2\u201381.5) mm Hg, 104.4 (96.4\u2013114.4) mm Hg, 62.4 (54.1\u201369.8) mm Hg, and 34.1 (32.0\u201336.2) mm Hg, respectively. In univariate analysis, only total laser energy (r = 0.464, p = 0.003) and 40-minute average ETCO<jats:sub>2<\/jats:sub> (r = \u22120.388, p = 0.012) were significantly associated with ablation volume. In multivariate analysis, only ETCO<jats:sub>2<\/jats:sub> \u2264 33 mm Hg (p = 0.001) was significantly associated with ablation volume.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Total ablation energy and ETCO<jats:sub>2<\/jats:sub>, but not blood pressure, may significantly affect ablation volume in mTLE patients undergoing MRgLiTT. Mild hypocapnia was associated with increased extent of ablation. Intraoperative monitoring and modulation of ETCO<jats:sub>2<\/jats:sub> may help improve extent of ablation, prediction of ablation volume, and potentially seizure outcome.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2021.9.jns211554","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T07:50:33Z","timestamp":1640937033000},"page":"427-433","source":"Crossref","is-referenced-by-count":3,"title":["Association of intraoperative end-tidal carbon dioxide level with ablation volume during magnetic resonance\u2013guided laser interstitial thermal therapy for mesial temporal lobe epilepsy"],"prefix":"10.3171","volume":"137","author":[{"given":"Brian Y.","family":"Hwang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Eremiev","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adhith","family":"Palla","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Mampre","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serban","family":"Negoita","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohannes K.","family":"Tsehay","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min Jae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"},{"name":"Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Coogan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon Y.","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William S.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"E366","DOI":"10.1093\/neuros\/nyz556","article-title":"Magnetic resonance imaging-guided laser interstitial thermal therapy for epilepsy: systematic review of technique, indications, and outcomes","volume":"86","author":"Youngerman BE","year":"2020","unstructured":"Youngerman BE, Save AV, McKhann GM. 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