OptiLITT: A Computer-Assisted Planning System for Dual-Fiber Laser Interstitial Thermal Therapy using Cylindrical Ablation Optimization

Laser Interstitial Thermal Therapy (LITT) is a minimally invasive neurosurgical technique in which a stereotactically-implanted fiber delivers thermal energy to ablate intracranial lesions. Existing computer-assisted planning systems optimize trajectories against a one-dimensional line abstraction, then approximate the ablation zone as a fixed-radius cylinder post-hoc to estimate coverage. Trajectories selected as optimal under this model are not guaranteed to remain optimal once the cylindrical extent is applied, which introduces a mismatch between predicted and true ablation coverage. This may also underestimate spillover into surrounding healthy tissue. We present OptiLITT, a treatment planning system that represents the laser probe as a cylindrical ablation volume from the onset of optimization, jointly solving dual-fiber placement, lesion coverage, and healthy-tissue spillover as a single coupled problem. All planning parameters are exposed through a user-configurable graphical user interface supporting intraoperative refinement between planning stages.