Pattern of technology diffusion in the adoption of stereotactic laser interstitial thermal therapy (LITT) in neuro-oncology

Reid A. Johnson, Truong H. Do, Elise F. Palzer, Samuel W. Cramer, Jacob T. Hanson, Jared D. Huling, Daniel G. Hoody, Abigail L. Rice, Amber N. Piazza, Madeleine A. Howard, Robert A. McGovern, Clark C. Chen

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Purpose: Understanding factors that influence technology diffusion is central to clinical translation of novel therapies. We characterized the pattern of adoption for laser interstitial thermal therapy (LITT), also known as stereotactic laser ablation (SLA), in neuro-oncology using the National Inpatient Sample (NIS) database. Methods: We identified patients age ≥ 18 in the NIS (2012–2018) with a diagnosis of primary or metastatic brain tumor that underwent LITT or craniotomy. We compared characteristics and outcomes for patients that underwent these procedures. Results: LITT utilization increased ~ 400% relative to craniotomy during the study period. Despite this increase, the total number of LITT procedures performed for brain tumor was < 1% of craniotomy. After adjusting for this time trend, LITT patients were less likely to have > 2 comorbidities (OR 0.64, CI95 0.51–0.79) or to be older (OR 0.92, CI95 0.86–0.99) and more likely to be female (OR 1.35, CI95 1.08–1.69), Caucasian compared to Black (OR 1.94, CI95 1.12–3.36), and covered by private insurance compared to Medicare or Medicaid (OR 1.38, CI95 1.09–1.74). LITT hospital stays were 50% shorter than craniotomy (IRR 0.52, CI95 0.45–0.61). However, charges related to the procedures were comparable between LITT and craniotomy ($1397 greater for LITT, CI95 $−5790 to $8584). Conclusion: For neuro-oncology indications, LITT utilization increased ~ 400% relative to craniotomy. Relative to craniotomy-treated patients, LITT-treated patients were likelier to be young, female, non-Black race, covered by private insurance, or with < 2 comorbidities. While the total hospital charges were comparable, LITT was associated with a shorter hospitalization relative to craniotomy.

Original languageEnglish (US)
Pages (from-to)417-424
Number of pages8
JournalJournal of neuro-oncology
Volume153
Issue number3
Early online dateJun 13 2021
DOIs
StatePublished - Jul 2021

Bibliographical note

Funding Information:
This study was supported in part by funding from MnDRIVE, a collaboration between the University of Minnesota and the State of Minnesota.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Ablation
  • LITT
  • Laser
  • National
  • Stereotactic
  • Technology

PubMed: MeSH publication types

  • Journal Article

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