Innovative laser tool to burn away brain tumors

The Monteris Neuroblate system.

Monteris has developed the The NeuroBlate System, which essentially is a probe that provides laser, thermo energy to the brain, in combination with other hardware and software used with an existing MRI scanner.

A rendering of part of the Monteris NeuroBlate system

John Schellhorn is the President and CEO of Monteris Medical and has had an expansive career in the medical device space. He shared in an interview about the NeuroBlate System, which has been FDA cleared and on the market since April of 2014, and the unmet need it fills when it comes to neurological surgeries and the ability to ablate (treat with lethal heat) lesions or tumors.

Can you discuss how this technology works?
Our system is an MRI compatible neurosurgical ablation tool – what that means in English is that we use an MRI to give us precise thermal images of tissue that we are targeting to destroy in the brain. Counter intuitively we don’t need the MRI to see the lesions, we can use per-operative images, but the MRI can give us a very precise level of temperature detail at the pixel level.

We are able to guide a laser catheter, smaller than a number two pencil eraser, into the area of interest. We are able to manipulate that probe with our MRI compatible robot. We fire the laser and take a thermal map of the area and incorporate it into our proprietary software. We can then very precisely target the ablation to the exact contours of the lesion.

Real-time MRI scan monitoring during the procedure

Normally with neurological surgeries, you would only take an MRI scan after the procedure is over for confirmation of what you’ve done. In our case, we are using it in real-time and getting a continuous feedback loop on exactly the extent of the lesion ablation, which allows the surgeon to have no doubt about how much of the lesion he or she has destroyed or how much is left.

Five years ago, in neurosurgery this capability would have been considered preposterous.

What has been the challenge with neurosurgery in the past that this technology addresses?
The problem hasn’t always been that you couldn’t use a laser but it was that you couldn’t see what you were doing, and in the brain you only want to destroy the part that’s target and preserve the rest of it because you need it. We are now able to operate safely and consistently in areas of the brain that surgeons are either reluctant to operate on, afraid to operate on or simply won’t operate in because of the substantial collateral damage that occurs.

We are able to target our trajectories precisely enough that we can avoid eloquent tissue, and this is a significant advance for patients who would have had no surgical options previously.

the Monteris NeuroBlate system.
Detail of the Monteris NeuroBlate system.

Throughout clinical trials how have you been able to establish NeuroBlate’s efficacy?
With our patients, most of them are going home the next day with just a stitch or two in their head, which is extraordinary when you think about craniotomies, at a minimum it’s three to four days and there are other complications with blood loss and infection. We know our surgeons are getting great results because they keep coming back to the technology. But we feel the next phase is to not only continue with the rapid commercialization of the system, but the company is invested in a clinical trials that will scientifically prove the efficacy of this technology. We are embarking in those right now. We now have 40 installations of the systems in the U.S., and we will grow that expansively this year.

Where did the motivation for this company and particular technology come from?
The company’s founder, Dr. Mark Torchia, PhD, Director of Clinical Research at the University of Manitoba, observed patients back in the mid-80s with brain tumors and they would have very few options available to them and survival rates were low. He saw that lasers were beginning to be prominent in medicine, and he speculated at the time that lasers could be used in a minimally invasive way to ablate tumors from the inside out. The problem at the time was that there was no way to measure the efficacy of what you were doing. It wasn’t until the early 2000’s that there was better MRI technology and systems like Brainlab that we got the ability for more accurate navigation. Once these technologies were developed, Torchia started raising seed money. It’s been a long process toward development before we had a product available in 2014.