Advanced treatments
At the forefront of neuro-oncology innovation, we combine advanced imaging and surgical technology to deliver safer, more precise treatments. Our expert team treats complex brain and spinal conditions with confidence, minimizing risk, promoting recovery, and ensuring each patient receives personalized care.
Center for Surgical Innovation
The Center for Surgical Innovation (CSI) is a state-of-the-art surgical center located at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire. There are only a handful of similar centers throughout the United States that have both a magnetic resonance imaging (MRI) and computed tomography (CT) scanner in the operating room.
Precision and minimally invasive treatments
The ability to have intraoperative imaging—before, during, and after brain surgery—greatly improves the precision and safety of surgery. Additionally, imaging during surgery allows your surgeon to ensure that all the desired tumor has been removed before waking you up from surgery. The CSI also enables your neurosurgeon to perform minimally invasive tumor treatments, such as MRI-guided laser interstitial thermal therapy (LITT). In a LITT procedure, your surgeon inserts a laser fiber into the tumor and heat is used to destroy the tumor.
Explore our treatments
Adult Neurofibromatosis Clinic
About our Adult Neurofibromatosis Clinic
We offer a focused, multidisciplinary, and specialized clinic for patients with neurofibromatosis (NF), which includes neuro-oncology, neurosurgery, neuro-ophthalmology, genetics, and neuropsychology. We offer our patients with NF comprehensive and focused care to monitor and treat conditions and tumors associated with NF.
Advanced brain mapping
What is advanced brain mapping?
Some brain tumors are located in or near brain structures that are essential for important neurologic function, such as speech, vision, movement, or sensation. Our team specializes in managing these complex tumors to provide safe and effective care for patients. The team includes neuro-radiologists specializing in functional brain imaging techniques, in addition to neurosurgeons, neurologists, and neuro-anesthesiologists who have expertise in mapping these important brain regions in the operating room.
Why is advanced brain mapping important?
Our multidisciplinary team ensures that you are offered safe and effective surgery, balancing aggressive tumor treatment with high functional and quality of life outcomes.
Advanced brain tumor imaging
What is advanced brain tumor imaging?
Patients with brain tumors will frequently have an MRI of the brain. In addition to a standard or routine brain MRI, our dedicated neuro-radiology team performs advanced imaging for brain tumors.
Why is advanced brain tumor imaging important?
This imaging provides more information to the treatment team about the tumor itself (MRI spectroscopy or perfusion), as well as functional brain imaging that offers insights into the localization of brain functions, such as speech, movement, vision, and their connections. This functional brain imaging is particularly useful to our surgical team in determining the safest approach or surgical plan. It is used in the operating room at the time of surgery.
Analyzing molecular pathology of brain tumors
What is the molecular pathology of a brain tumor?
The advanced technology of our molecular pathology laboratory enables our team to perform sophisticated tests for diagnosing and characterizing brain tumors. Immunohistochemistry, cytogenetic testing, molecular profiling, and genomic sequencing are integral to our clinical practice.
Florescence-guided neurosurgery
What is fluorescence-guided neurosurgery (FGN)?
We have been a leading research institution in North America in studying fluorescence-guided neurosurgery, which selectively tags brain tumor tissue with a fluorescent dye.
How does FGN work?
The dye causes the tumor to fluoresce, allowing it to be visualized by the surgeon during tumor removal. This technology enables your surgeon to visually identify normal and cancerous tissues.
Why is FGN important?
FGN can improve the accuracy of tumor removal while preserving normal brain tissue.
GammaTile® therapy
What is this GammaTile therapy?
GammaTile therapy is a form of radiation therapy called brachytherapy. During this therapy, your provider implants a small radiation source during surgery. It delivers radiation directly to the area where a brain tumor has been removed, helping prevent tumor regrowth.
How does GammaTile therapy work?
During surgery, small radiation tiles are placed in the space where the tumor was removed. These tiles deliver targeted radiation to eliminate any remaining cancer cells while minimizing exposure and potential damage to surrounding healthy tissues. The treatment begins immediately after surgery, offering fast and effective therapeutic benefit.
Why is this GammaTile therapy important?
GammaTile therapy offers a radiation option for patients with newly diagnosed or recurrent brain metastases, glioblastoma, and recurrent meningiomas. It can be especially beneficial for patients who live far from a radiation facility since treatment continues after discharge. Patients can return home without special precautions, and the implanted tiles do not need to be removed, making this a convenient treatment option. Dartmouth Health and Dartmouth Cancer Center are a designated GammaTile Center of Excellence.
Laser interstitial thermal therapy
What is laser interstitial thermal therapy (LITT)?
Laser interstitial thermal therapy (LITT) is a minimally invasive surgical technique used to treat primary brain tumors like glioblastoma, brain metastases, treatment-related radiation necrosis, and neurological conditions such as epilepsy.
How does LITT work?
During the surgery, your neurosurgeon implants a laser fiber into the tumor through a small incision. Using MRI technology as a guide, your neurosurgeon carefully directs the laser to heat and destroy the targeted tissue, such as a tumor, without harming surrounding healthy tissues.
Why is LITT important?
LITT is used for patients with brain tumors that are difficult to reach with open surgery, patients who have undergone multiple prior surgeries, or those who may not tolerate traditional surgery techniques due to health risks. Dartmouth Cancer Center is one of the few centers in northern New England that performs this procedure.
Multidisciplinary Skull Base Clinic
About our Multidisciplinary Skull Base Clinic
Both benign and cancerous tumors may affect the skull base and include common tumors such as meningiomas, schwannomas, and pituitary tumors, as well as rare tumors such as chordoma or esthesioneuroblastoma.
These tumors can be challenging to treat and are frequently associated with critical neurologic structures such as cranial nerves. We have a multidisciplinary team composed of:
- Neurosurgery
- Neuro-otology
- Neuro-radiology
- Rhinology
- Ophthalmology
- Radiation oncology
Surgical treatment of these tumors includes open surgery and minimally invasive techniques such as keyhole and endoscopic surgery.
Radiation therapy
What is radiation therapy?
Your provider uses radiation therapy as an important part of treatment for both benign (non-cancerous) and cancerous brain tumors. Your provider may use radiation therapy alone or following other treatments, such as surgery. The Brain Tumor Program at DCC supports patients with brain and spinal cord tumors at the time of first diagnosis or recurrence, guided by a dedicated team of radiation oncologists.
How does radiation therapy work?
In addition to conventional types of radiation therapy, patients may be evaluated for treatment using the Trilogy system to deliver stereotactic radiosurgery. This treatment combines high-definition X-ray and CT imaging with precise radiation delivery shaped to the tumor boundaries, minimizing exposure to surrounding healthy brain tissue.
Why is radiation therapy important?
Radiation therapy is used to treat both cancerous brain tumors, such as glioblastoma or brain metastases, and non-cancerous tumors, including meningiomas and acoustic neuromas. Patients can receive treatment close to home at our centers in St. Johnsbury, Vermont, and Lebanon, Keene and Manchester, New Hampshire, ensuring access to advanced care throughout the region.