Convection-enhanced drug delivery: Increased efficacy and magnetic resonance image monitoring

Yael Mardor*, Ofer Rahav, Yacov Zauberman, Zvi Lidar, Aharon Ocherashvilli, Dianne Daniels, Yiftach Roth, Stephan E. Maier, Arie Orenstein, Zvi Ram

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

86 Scopus citations

Abstract

Convection-enhanced drug delivery (CED) is a novel approach to directly deliver drugs into brain tissue and brain tumors. It is based on delivering a continuous infusion of drugs via intracranial catheters, enabling convective distribution of high drug concentrations over large volumes of the target tissue while avoiding systemic toxicity. Efficient formation of convection depends on various physical and physiologic variables. Previous convection-based clinical trials showed significant diversity in the extent of convection among patients and drugs. Monitoring convection has proven to be an essential, yet difficult task. The current study describes the application of magnetic resonance imaging for immediate assessment of convection efficiency and early assessment of cytotoxic tissue response in a rat brain model. Immediate assessment of infusate distribution was obtained by mixing Gd-diethylenetriaminepentaacetic acid in the infusate prior to infusion. Early assessment of cytotoxic tissue response was obtained by subsequent diffusion-weighted magnetic resonance imaging. In addition, the latter imaging methodologies were used to establish the correlation between CED extent and infusate's viscosity. It was found that low-viscosity infusates tend to backflow along the catheter track, whereas high-viscosity infusates tend to form efficient convection. These results suggest that CED formation and extent may be significantly improved by increasing the infusate's viscosities, thus increasing treatment effects.

Original languageEnglish
Pages (from-to)6858-6863
Number of pages6
JournalCancer Research
Volume65
Issue number15
DOIs
StatePublished - 1 Aug 2005

Funding

FundersFunder number
National Institute of Neurological Disorders and StrokeR01NS039335

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