MRI Guided Laser Ablation

The Visualase™ system is designed to work in conjunction with MRI (Magnetic Resonance Imaging) scanners to enable real-time monitoring and precise targeting during the laser ablation procedure.

Here’s how the Visualase™ system typically connects with MRI scanners:

1.

Image Guidance: the Visualase™ system uses advanced imaging technology, typically MRI, to visualise the patient’s brain anatomy and identify the target area for the laser ablation treatment. This is crucial for accurate¹ and safe placement of the laser probe.

3.

Temperature Feedback: the Visualase™ system employs MRI to monitor the temperature changes in the target area caused by the laser ablation.^4-8 This feedback helps to ensure that the treatment is effective in destroying the targeted tissue while avoiding overheating or damage to adjacent critical structures.^9,10

2.

Real-time Monitoring: during the procedure, the MRI scanner continues to monitor the targeted area in real-time. This allows neurosurgeons to visualise the effects of the laser treatment and make any necessary adjustments to optimise treatment outcomes while minimising damage to surrounding healthy brain tissue.^2,3

4.

Treatment Control: the combination of Visualase™ with MRI allows neurosurgeons to have precise control over the procedure. They can visualise the treatment area, assess the progression of the ablation, and adjust the laser parameters accordingly, all in real-time.^4-8

Overall, the integration of the Visualase^™ device with MRI scanners provides neurosurgeons with a powerful and minimally invasive tool to treat specific brain conditions such as epilepsy and brain tumours with greater precision¹, reduced risk, and potentially shorter recovery times for patients.^11,12

Visualase™ + MRI scanners compatibility

The compatibility of the Visualase™ system may depend on factors such as the system’s hardware, software capabilities, and imaging protocols.

Visualase™ system compatibility chart - Revised for software version 3.4

The Visualase™ System software workstation is compatible with select MRI systems. Currently, these include:

General Electric^™* systems up to 3T
Philips^™* systems up to 3T
Siemens^™* systems up to 3T

Review the table below for full specs.

GE ILT requires a long network cable to be run from the MRI control room to the MRI equipment room.
Siemens Access-i is enabled on N4 E11E+SP01 but it has been Medtronic’s field experience that SMB is still active. Customers may choose which network interface to use with understanding that Access-i is the preferred communication method.
Siemens Access-i is required for all NX software versions which requires customers to purchase an additional Access-i package, including software license & network router, from Siemens.

Download compatibility chart

Download

Technical consideration

Laser usage and safety

Every facility or institution utilizing the laser device is encouraged to adopt an ongoing laser training and safety program. Such programs are outlined in the latest revision of the ANSI Standard Z136.3 for the Safe Use of the Lasers in Health Care facilities. Individuals planning to use the system are actively encouraged to attend laser orientation and education sessions to achieve progressive levels of operational proficiency.

Clinical support and training

Ensure the staff is properly trained, as accuracy and safety of the Visualase™ System depends on the precise control and monitoring of ablation in real-time. Also, ensure the facility or institution is properly equipped to handle an adverse surgical event.

Medtronic has clinical support representatives available to assist with Visualase™ procedures and provide training.

Contact your local account representative using the form below, to request clinical support and/or training.

Installation and calibration

The Visualase™ system should only be assembled and installed by a Medtronic Service Representative. Contact Medtronic Technical Support to schedule installation.

Integration with existing infrastructure

Check out the Visualase^™ prospect checklist to evaluate if your current surgical navigation system and MRI imaging capabilities will integrate well with the Visualase™ MRI-guided laser ablation system.

MRI safety information

The Visualase^™ MRI-guided laser ablation system is MR unsafe. Keep the Visualase^™ system outside the MR system room. Do not exceed 5 gauss (0.5 mT). It presents a projectile hazard.

Setting up the equipment

Before beginning any therapy, all persons involved should be familiar with the proper operation and use of each of the Visualase^™ system components including the VCLAS, the diode laser, the coolant pump, and the Visualase^™ workstation. Before beginning therapy, the VCLAS should be surgically inserted into the patient by a physician.

For more information, read the Visualase™ manual

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Medical education for the Visualase™ system

Access on-demand procedural videos, webinars, and more at Medtronic Academy.

Visit Medtronic Academy

Know the indications

Could your patient be eligible for potentially life-changing surgery using the Visualase™ syst

View indications

MRI guidelines &Manuals

The Visualase™ system

Checklist: Visualase Implementation Program

Agenda: Visualase Implementation Program

Technical Checklist: Visualase Implementation Program

Better support

We can help you find a treatment option that is right for your patient. Our team is here to support you with the information you need to make the most informed decisions for your patient’s care.

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Brief statement:

See the device manual for detailed information regarding the instructions for use, indications, contraindications, warnings, precautions and potential adverse events. For further information, contact your local Medtronic representative and/or consult the Medtronic website at www.medtronic.eu.

Ashraf O, Patel NV, Hanft S, Danish SF. Laser-induced thermal therapy in neuro-oncology: a review. World Neurosurgery. 2018;112:166-177. doi:10.1016/j.wneu.2018.01.123.
Kangasniemi M, McNichols RJ, Bankson JA, Gowda A, Price RE, Hazle JD. Thermal therapy of canine cerebral tumors using a 980 nm diode laser with MR temperature-sensitive imaging feedback. Lasers Surg Med. 2004;35(1):41-50. doi:10.1002/lsm.20069.
Fayed I, Sacino MF, Gaillard WD, Keating RF, Oluigbo CO. Mr-guided laser interstitial thermal therapy for medically refractory lesional epilepsy in pediatric patients: experience and outcomes. Pediatr Neurosurg. 2018;53(5):322-329. doi:10.1159/000491823.
Graham SJ, Chen L, Leitch M, et al. Quantifying tissue damage due to focused ultrasound heating observed by MRI. Magn Reson Med. 1999;41(2):321-328. doi:10.1002/(SICI)1522-2594(199902)41:2<321::AID-MRM16>3.0.CO;2-9.
Sherar MD, Moriarty JA, Kolios MC, et al. Comparison of thermal damage calculated using magnetic resonance thermometry, with magnetic resonance imaging post-treatment and histology, after interstitial microwave thermal therapy of rabbit brain. Phys Med Biol. 2000;45(12):3563-3576. doi:10.1088/0031-9155/45/12/304.
Youngerman BE, Save AV, McKhann GM. Magnetic resonance imaging-guided laser interstitial thermal therapy for epilepsy: systematic review of technique, indications, and outcomes. Neurosurg. 2020;86(4):E366-E382. doi:10.1093/neuros/nyz556.
Kang JY, Sperling MR. Magnetic resonance imaging-guided laser interstitial thermal therapy for treatment of drug-resistant epilepsy. Neurotherapeutics. 2017;14(1):176-181. doi:10.1007/s13311-016-0498-3.
Franzini A, Moosa S, Servello D, et al. Ablative brain surgery: an overview. International Journal of Hyperthermia. 2019;36(2):64-80. doi:10.1080/02656736.2019.1616833.
De Poorter J, De Wagter C, De Deene Y, Thomsen C, Ståhlberg F, Achten E. Noninvasive MRI thermometry with the proton resonance frequency (PRF) method: in vivo results in human muscle. Magn Reson Med. 1995;33(1):74-81. doi:10.1002/mrm.1910330111
Kangasniemi M, McNichols RJ, Bankson JA, Gowda A, Price RE, Hazle JD. Thermal therapy of canine cerebral tumors using a 980 nm diode laser with MR temperature-sensitive imaging feedback. Lasers Surg Med. 2004;35(1):41-50. doi:10.1002/lsm.20069
Kang JY, Wu C, Tracy J, et al. Laser interstitial thermal therapy for medically intractable mesial temporal lobe epilepsy. Epilepsia. 2016;57(2):325-334. doi:10.1111/epi.13284.
Waseem H, Osborn KE, Schoenberg MR, et al. Laser ablation therapy: An alternative treatment for medically resistant mesial temporal lobe epilepsy after age 50. Epilepsy & Behavior. 2015;51:152-157. doi:10.1016/j.yebeh.2015.07.022.