NICE has been notified about this procedure and it is part of its work programme. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
Status In progress
Process IP
ID number 1730
Description MRI-guided laser interstitial thermal therapy (MRgLITT) is a less invasive treatment than open surgery. Preoperatively, an MRI scan is done to identify the part of the brain causing the seizures and to identify the entry location for the laser catheter. The procedure is usually done under general anaesthesia with the patient lying on an MRI couch. A small burr hole is made in the skull and a fine fibreoptic laser catheter is inserted into the target area under stereotactic guidance. Continuous real-time MRI scanning is done to allow visualisation of the exact target area and the surrounding tissue, and to monitor the temperature in the brain during the procedure. Under computer guidance, laser energy is applied to the target area. The laser is switched off and removed when temperatures have reached levels sufficient to cause coagulation necrosis (usually 460C to 600C) and the target tissue has been ablated. After the procedure, an MRI is done to verify lesion location and volume of the tissue ablated. The aim is to precisely ablate the target tissue and to minimise damage to the surrounding area. MRgLITT has most commonly been used for patients with a well-defined epileptogenic focus, especially in the temporal lobe, but can be used elsewhere in the brain.

Provisional Schedule

Expected publication 26 February 2020

Timeline

Key events during the development of the guidance:

Date Update
24 October 2019 - 21 November 2019 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance