Takeaway
Compared to the standard single-trajectory approach, two-trajectory laser ablation of medial temporal lobe (MTL) structures achieved a greater degree of ablated tissue and superior seizure outcomes in patients with medial temporal lobe epilepsy (mTLE).
Why this matters
Magnetic resonance imaging (MRI)-guided laser interstitial thermal therapy (LITT) is a potential option for patients with drug-resistant mTLE. Although anterior temporal lobectomy is the current gold standard, MRI-guided LITT is growing in popularity, being minimally invasive and achieving excellent seizure outcomes.
Optimization of laser trajectories is an important focus in LITT. In mTLE, for example, it is challenging to ablate all target tissues with a single laser due to the geometric orientation of the piriform cortex versus amygdalohippocampal structures.
It is possible that a two-trajectory approach could maximize the volume of ablated tissue in patients with mTLE.