{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:42:58Z","timestamp":1791657778484,"version":"4.3.4"},"reference-count":78,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"10","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,3,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Despite rapid adoption among many epilepsy centers across the United States, stereotactic magnetic resonance imaging (MRI) thermometry\u2013guided laser interstitial thermal therapy (LITT) is not universally available to treat medically refractory epilepsy in appropriately selected patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors present two cases in which patients with mesial temporal lobe epilepsy (MTLE)\u2014one with stereoelectroencephalography-proven left MTLE and one with right mesial temporal sclerosis\u2014were advised to undergo LITT by a multidisciplinary team, but an insurance provider refused preauthorization, prompting the use of radiofrequency ablation (RFA) instead. In each case, the authors utilized a disposable direct MRI guidance stereotactic frame and a commercially available RFA probe with direct thermistor measurements under general anesthesia. The hippocampus, amygdala, subiculum, and entorhinal cortex were targeted with two sequential trajectories through a single occipital twist drill hole, direct MRI guidance of trajectory control, and anatomical MRI between trajectories to judge ablation progress. No complications were observed. Patients were seizure free at the last follow-ups of 11 and 24 months. Two approximately parallel RFA trajectories yielded postablation volumes comparable to index single-trajectory LITT cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>In select cases, RFA can provide an alternative to LITT for treating focal epilepsy.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24543\">https:\/\/thejns.org\/doi\/10.3171\/CASE24543<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24543","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T02:59:44Z","timestamp":1741575584000},"source":"Crossref","is-referenced-by-count":3,"title":["Direct MRI-guided stereotactic radiofrequency thermal ablation for mesial temporal lobe epilepsy: illustrative cases"],"prefix":"10.3171","volume":"9","author":[{"given":"Salil","family":"Bhole","sequence":"first","affiliation":[{"name":"University of Illinois College of Medicine at Peoria, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Maccotta","sequence":"additional","affiliation":[{"name":"Department of Neurology, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane J.","family":"Aum","sequence":"additional","affiliation":[{"name":"Department of Neurology, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin H.","family":"Hinrichs","sequence":"additional","affiliation":[{"name":"Department of Neurology, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1bio A.","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Department of Neurology, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9565-4338","authenticated-orcid":true,"given":"Jon T.","family":"Willie","sequence":"additional","affiliation":[{"name":"Department of Neurology, Washington University School of Medicine, St. Louis, Missouri"},{"name":"Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"N Engl J Med","first-page":"311","article-title":"A randomized, controlled trial of surgery for temporal-lobe epilepsy","volume":"345","author":"Wiebe","year":"2001","unstructured":"Wiebe SBlume WTGirvin JPEliasziw M.A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med. 2001;345(5):311-318."},{"key":"bib2","series-title":"Front Neurol","article-title":"Resective, ablative and radiosurgical interventions for drug resistant mesial temporal lobe epilepsy: a systematic review and meta-analysis of outcomes","volume":"12","author":"Marathe","year":"2021","unstructured":"Marathe KAlim-Marvasti ADahele KResective, ablative and radiosurgical interventions for drug resistant mesial temporal lobe epilepsy: a systematic review and meta-analysis of outcomes. Front Neurol. 2021;12:777845."},{"issue":"4","key":"bib3","series-title":"Epilepsia","first-page":"831","article-title":"Comparison of minimally invasive and traditional surgical approaches for refractory mesial temporal lobe epilepsy: a systematic review and meta-analysis of outcomes","volume":"62","author":"Kohlhase","year":"2021","unstructured":"Kohlhase KZ\u00f6llner JPTandon NStrzelczyk ARosenow F.Comparison of minimally invasive and traditional surgical approaches for refractory mesial temporal lobe epilepsy: a systematic review and meta-analysis of outcomes. Epilepsia. 2021;62(4):831-845."},{"issue":"18","key":"bib4","series-title":"Neurology","first-page":"1669","article-title":"Systematic review and meta-analysis of standard vs selective temporal lobe epilepsy surgery","volume":"80","author":"Josephson","year":"2013","unstructured":"Josephson CBDykeman JFiest KMSystematic review and meta-analysis of standard vs selective temporal lobe epilepsy surgery. Neurology. 2013;80(18):1669-1676."},{"issue":"6","key":"bib5","series-title":"Neurosurgery","first-page":"569","article-title":"Real-time magnetic resonance-guided stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy","volume":"74","author":"Willie","year":"2014","unstructured":"Willie JTLaxpati NGDrane DLReal-time magnetic resonance-guided stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy. Neurosurgery. 2014;74(6):569-584."},{"issue":"3","key":"bib6","series-title":"Ann Neurol","first-page":"575","article-title":"Stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy","volume":"83","author":"Gross","year":"2018","unstructured":"Gross REStern MAWillie JTStereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy. Ann Neurol. 2018;83(3):575-587."},{"key":"bib7","series-title":"Front Surg","article-title":"Stereotactic laser ablation for medically intractable epilepsy: the next generation of minimally invasive epilepsy surgery","volume":"3","author":"LaRiviere","year":"2016","unstructured":"LaRiviere MJGross RE.Stereotactic laser ablation for medically intractable epilepsy: the next generation of minimally invasive epilepsy surgery. Front Surg. 2016;3:64."},{"key":"bib8","series-title":"Epilepsy Behav","first-page":"108529","article-title":"Patient preferences pertaining to treatment options for drug-resistant focal epilepsy","volume":"127","author":"Sinha","year":"2022","unstructured":"Sinha SRYang JCWallace MJGrover KJohnson FRReed SD.Patient preferences pertaining to treatment options for drug-resistant focal epilepsy. Epilepsy Behav. 2022;127:108529."},{"issue":"4","key":"bib9","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Inverse national trends of laser interstitial thermal therapy and open surgical procedures for refractory epilepsy: a nationwide inpatient sample-based propensity score matching analysis","volume":"48","author":"Sharma","year":"2020","unstructured":"Sharma MBall TAlhourani AInverse national trends of laser interstitial thermal therapy and open surgical procedures for refractory epilepsy: a nationwide inpatient sample-based propensity score matching analysis. Neurosurg Focus. 2020;48(4):E11."},{"issue":"7","key":"bib10","series-title":"Epilepsia","first-page":"1421","article-title":"Laser ablation for mesial temporal lobe epilepsy: surgical and cognitive outcomes with and without mesial temporal sclerosis","volume":"59","author":"Donos","year":"2018","unstructured":"Donos CBreier JFriedman ELaser ablation for mesial temporal lobe epilepsy: surgical and cognitive outcomes with and without mesial temporal sclerosis. Epilepsia. 2018;59(7):1421-1432."},{"issue":"2","key":"bib11","series-title":"Neurosurgery","first-page":"155","article-title":"The American Society for Stereotactic and Functional Neurosurgery position statement on laser interstitial thermal therapy for the treatment of drug-resistant epilepsy","volume":"90","author":"Wu","year":"2022","unstructured":"Wu CSchwalb JMRosenow JMMcKhann GM IINeimat JS; American Society for Stereotactic and Functional Neurosurgeons.The American Society for Stereotactic and Functional Neurosurgery position statement on laser interstitial thermal therapy for the treatment of drug-resistant epilepsy. Neurosurgery. 2022;90(2):155-160."},{"key":"bib12","series-title":"Epilepsy Behav Rep","first-page":"100471","article-title":"Network radiofrequency ablation for drug resistant epilepsy","volume":"16","author":"Shamim","year":"2021","unstructured":"Shamim DCheng JPearson CLandazuri P.Network radiofrequency ablation for drug resistant epilepsy. Epilepsy Behav Rep. 2021;16:100471."},{"issue":"8","key":"bib13","series-title":"Epilepsia","first-page":"2081","article-title":"Stereoelectroencephalography-guided radiofrequency ablation of the epileptogenic zone as a treatment and predictor of future success of further surgical intervention","volume":"64","author":"Shields","year":"2023","unstructured":"Shields JAGreven ACMShivamurthy VKNStereoelectroencephalography-guided radiofrequency ablation of the epileptogenic zone as a treatment and predictor of future success of further surgical intervention. Epilepsia. 2023;64(8):2081-2093."},{"issue":"1","key":"bib14","series-title":"Epilepsia","first-page":"85","article-title":"Stereo electroencephalography\u2013guided radiofrequency thermocoagulation (SEEG-guided RF-TC) in drug-resistant focal epilepsy: results from a 10-year experience","volume":"58","author":"Bourdillon","year":"2017","unstructured":"Bourdillon PIsnard JCatenoix HStereo electroencephalography\u2013guided radiofrequency thermocoagulation (SEEG-guided RF-TC) in drug-resistant focal epilepsy: results from a 10-year experience. Epilepsia. 2017;58(1):85-93."},{"issue":"8","key":"bib15","series-title":"Acta Neurochir","first-page":"1529","article-title":"Long-term seizure outcome after stereotactic amygdalohippocampectomy","volume":"156","author":"Vojt\u011bch","year":"2014","unstructured":"Vojt\u011bch ZMal\u00edkov\u00e1 HKr\u00e1msk\u00e1 LLong-term seizure outcome after stereotactic amygdalohippocampectomy. Acta Neurochir. 2014;156(8):1529-1537."},{"issue":"8","key":"bib16","series-title":"Acta Neurochir","first-page":"1291","article-title":"Stereotactic radiofrequency amygdalohippocampectomy in the treatment of mesial temporal lobe epilepsy","volume":"152","author":"Liscak","year":"2010","unstructured":"Liscak RMalikova HKalina MStereotactic radiofrequency amygdalohippocampectomy in the treatment of mesial temporal lobe epilepsy. Acta Neurochir. 2010;152(8):1291-1298."},{"issue":"10","key":"bib17","series-title":"Epilepsia","first-page":"1408","article-title":"Stereotactic amygdalohippocampotomy for the treatment of medial temporal lobe epilepsy","volume":"40","author":"Parrent","year":"1999","unstructured":"Parrent AGBlume WT.Stereotactic amygdalohippocampotomy for the treatment of medial temporal lobe epilepsy. Epilepsia. 1999;40(10):1408-1416."},{"issue":"3","key":"bib18","series-title":"NeuroImage","first-page":"968","article-title":"An automated labeling system for subdividing the human cerebral cortex on MRI scans into gyral based regions of interest","volume":"31","author":"Desikan","year":"2006","unstructured":"Desikan RSS\u00e9gonne FFischl BAn automated labeling system for subdividing the human cerebral cortex on MRI scans into gyral based regions of interest. NeuroImage. 2006;31(3):968-980."},{"issue":"3","key":"bib19","series-title":"Neuron","first-page":"341","article-title":"Whole brain segmentation: automated labeling of neuroanatomical structures in the human brain","volume":"33","author":"Fischl","year":"2002","unstructured":"Fischl BSalat DHBusa EWhole brain segmentation: automated labeling of neuroanatomical structures in the human brain. Neuron. 2002;33(3):341-355."},{"issue":"9","key":"bib20","series-title":"Magn Reson Imaging","first-page":"1323","article-title":"3D slicer as an image computing platform for the quantitative imaging network","volume":"30","author":"Fedorov","year":"2012","unstructured":"Fedorov ABeichel RKalpathy-Cramer J3D slicer as an image computing platform for the quantitative imaging network. Magn Reson Imaging. 2012;30(9):1323-1341."},{"key":"bib21","series-title":"Comput Methods Programs Biomed","first-page":"19","article-title":"Polymorph segmentation representation for medical image computing","volume":"171","author":"Pinter","year":"2019","unstructured":"Pinter CLasso AFichtinger G.Polymorph segmentation representation for medical image computing. Comput Methods Programs Biomed. 2019;171:19-26."},{"key":"bib22","series-title":"World Neurosurg","first-page":"527","article-title":"Surgical outcomes of laser interstitial thermal therapy for temporal lobe epilepsy: systematic review and meta-analysis","volume":"143","author":"Kerezoudis","year":"2020","unstructured":"Kerezoudis PParisi VMarsh WRSurgical outcomes of laser interstitial thermal therapy for temporal lobe epilepsy: systematic review and meta-analysis. World Neurosurg. 2020;143:527-536.e3."},{"issue":"1","key":"bib23","series-title":"Epilepsia","first-page":"101","article-title":"Better object recognition and naming outcome with MRI-guided stereotactic laser amygdalohippocampotomy for temporal lobe epilepsy","volume":"56","author":"Drane","year":"2015","unstructured":"Drane DLLoring DWVoets NLBetter object recognition and naming outcome with MRI-guided stereotactic laser amygdalohippocampotomy for temporal lobe epilepsy. 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Front Neurol. 2021;12:777845."},{"issue":"4","key":"bib3","series-title":"Epilepsia","first-page":"831","article-title":"Comparison of minimally invasive and traditional surgical approaches for refractory mesial temporal lobe epilepsy: a systematic review and meta-analysis of outcomes","volume":"62","author":"Kohlhase","year":"2021","unstructured":"Kohlhase KZ\u00f6llner JPTandon NStrzelczyk ARosenow F.Comparison of minimally invasive and traditional surgical approaches for refractory mesial temporal lobe epilepsy: a systematic review and meta-analysis of outcomes. Epilepsia. 2021;62(4):831-845."},{"issue":"18","key":"bib4","series-title":"Neurology","first-page":"1669","article-title":"Systematic review and meta-analysis of standard vs selective temporal lobe epilepsy surgery","volume":"80","author":"Josephson","year":"2013","unstructured":"Josephson CBDykeman JFiest KMSystematic review and meta-analysis of standard vs selective temporal lobe epilepsy surgery. 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Ann Neurol. 2018;83(3):575-587."},{"key":"bib7","series-title":"Front Surg","article-title":"Stereotactic laser ablation for medically intractable epilepsy: the next generation of minimally invasive epilepsy surgery","volume":"3","author":"LaRiviere","year":"2016","unstructured":"LaRiviere MJGross RE.Stereotactic laser ablation for medically intractable epilepsy: the next generation of minimally invasive epilepsy surgery. Front Surg. 2016;3:64."},{"key":"bib8","series-title":"Epilepsy Behav","first-page":"108529","article-title":"Patient preferences pertaining to treatment options for drug-resistant focal epilepsy","volume":"127","author":"Sinha","year":"2022","unstructured":"Sinha SRYang JCWallace MJGrover KJohnson FRReed SD.Patient preferences pertaining to treatment options for drug-resistant focal epilepsy. Epilepsy Behav. 2022;127:108529."},{"issue":"4","key":"bib9","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Inverse national trends of laser interstitial thermal therapy and open surgical procedures for refractory epilepsy: a nationwide inpatient sample-based propensity score matching analysis","volume":"48","author":"Sharma","year":"2020","unstructured":"Sharma MBall TAlhourani AInverse national trends of laser interstitial thermal therapy and open surgical procedures for refractory epilepsy: a nationwide inpatient sample-based propensity score matching analysis. 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Epilepsia. 2018;59(7):1421-1432."},{"issue":"2","key":"bib11","series-title":"Neurosurgery","first-page":"155","article-title":"The American Society for Stereotactic and Functional Neurosurgery position statement on laser interstitial thermal therapy for the treatment of drug-resistant epilepsy","volume":"90","author":"Wu","year":"2022","unstructured":"Wu CSchwalb JMRosenow JMMcKhann GM IINeimat JS; American Society for Stereotactic and Functional Neurosurgeons.The American Society for Stereotactic and Functional Neurosurgery position statement on laser interstitial thermal therapy for the treatment of drug-resistant epilepsy. Neurosurgery. 2022;90(2):155-160."},{"key":"bib12","series-title":"Epilepsy Behav Rep","first-page":"100471","article-title":"Network radiofrequency ablation for drug resistant epilepsy","volume":"16","author":"Shamim","year":"2021","unstructured":"Shamim DCheng JPearson CLandazuri P.Network radiofrequency ablation for drug resistant epilepsy. Epilepsy Behav Rep. 2021;16:100471."},{"issue":"8","key":"bib13","series-title":"Epilepsia","first-page":"2081","article-title":"Stereoelectroencephalography-guided radiofrequency ablation of the epileptogenic zone as a treatment and predictor of future success of further surgical intervention","volume":"64","author":"Shields","year":"2023","unstructured":"Shields JAGreven ACMShivamurthy VKNStereoelectroencephalography-guided radiofrequency ablation of the epileptogenic zone as a treatment and predictor of future success of further surgical intervention. 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