Minimally Invasive, Maximally Targeted: MR-gLiTT as the Vanguard of Precision Neurosurgery

The field of modern neurosurgery is undergoing a profound paradigm shift. Today, the convergence of advanced neuroimaging, computational thermal modeling, and stereotactic surgical techniques has ushered in a new era: an era in which traditional surgery is increasingly being supplemented—and in some cases replaced—by the precision of light. At the forefront of this evolution is magnetic resonance-guided laser interstitial thermal therapy (MR-gLiTT), which represents an excellent example of precision medicine applied to the central nervous system. Thanks to MR-gLiTT, it is possible to perform patient-specific thermal ablation on deep and complex lesions with millimeter precision, all through a minimally invasive surgical approach that has minimal impact on healthy nervous tissue, significantly reducing the length of hospital stays and redefining clinical outcomes for patients. As this technology matures, the clinical and scientific community is tasked with evaluating its long-term efficacy, expanding its indications, and understanding its profound biological impact.To fully grasp the significance of this technological revolution, this Research Topic hosted in Frontiers in Medicine aims to bring together a comprehensive, reference-quality collection of cutting-edge studies dedicated to the current state and future prospects of MR-gLiTT as a pioneer in precision neurosurgery. Our goal for this dedicated issue is to assemble at least ten high-impact, peer-reviewed contributions that will serve as a definitive, multidisciplinary benchmark for neurosurgeons, neurologists and pediatric neurologists, neuro-oncologists, and biological data scientists worldwide. We invite clinicians, neuroscientists, researchers, and biomedical engineers to submit original research articles, reviews, technical notes, and other contributions that offer forward-looking perspectives on the subject. We are seeking contributions on various key topics, including, but not limited to:1) Innovations in epilepsy surgery: efficacy of MR-gLiTT in pediatric and adult epilepsy, targeting accuracy, and seizure-free rates.2) Clinical outcomes in neuro-oncology: long-term survival data, quality-of-life assessments, and comparative studies (LiTT vs. open surgery or SRS) for primary brain tumors, brain metastases, and radionecrosis.3) The theranostic and molecular interface: the integration of intraoperative biopsy with molecular profiling (precision oncology) and the role of LiTT in temporarily disrupting the blood-brain barrier to improve targeted drug delivery.4) Advanced imaging and surgical planning: the implementation of diffusion tensor imaging (DTI), functional magnetic resonance imaging (fMRI), and AI-based tractography to optimize laser trajectories and preserve the eloquent cortex.5) Technical and engineering innovations: next-generation laser fibers, advances in MRI thermometry.6) AI, Radiomics, and Radiogenomics: machine learning and deep learning applications for automated lesion segmentation, preoperative patient selection, prediction of ablative response, and non-invasive biological profiling.7) Biomarker-Guided Selection and Multi-Omics Integration: linking circulating tumor DNA (ctDNA), tissue-based molecular markers, and multi-omics profiling with surgical decision-making and post-ablation surveillance.8) Personalized Thermal Dosimetry and Risk Stratification: patient-specific biophysical modeling, AI-driven real-time thermal damage prediction, and advanced risk-stratification algorithms to minimize toxicity in eloquent networks. 9) Expanding Horizons Beyond Epilepsy and Oncology: novel applications in Functional Neurosurgery (e.g., movement disorders, pain management), and psychiatric conditions. Topic Editor Prof. Thomas Blauwblomme holds also a consultant contract for LITT procedures with the Visualase system from Medtronic. The other Topic Editors report no competing interests related to this Research Topic. Topic editors: Giuseppe Cinalli, Alessandro Consales, Thomas Blauwblomme Source: https://www.frontiersin.org/research-topics/84062/minimally-invasive-maximally-targeted-mr-glitt-as-the-vanguard-of-precision-neurosurgery