Real-time MRI guidance for intra-arterial drug delivery in a patient with a brain tumor: technical note.
Michal ZawadzkiJerzy WaleckiBoguslaw KostkiewiczKacper KostyraMonica Smith PearlMeiyappan SolaiyappanPiotr WalczakMiroslaw JanowskiPublished in: BMJ case reports (2019)
Patients with malignant brain tumors have a poor prognosis. The blood-brain barrier (BBB) is considered a primary obstacle in therapeutic drug delivery to the brain. Intra-arterial (IA) delivery of therapeutic agents following osmotic BBB opening has been attempted for years, but high variability has limited its widespread implementation. It has recently been shown in animal studies that MRI is superior to X-ray for guiding IA infusions, as it allows direct visualization of the brain parenchyma supplied by the catheter and facilitates predictable drug targeting. Moreover, PET imaging has shown that IA rather than intravenous delivery of bevacizumab results in accumulation in the brain, providing a strong rationale for using the IA route. We present a patient with recurrent butterfly glioblastoma enrolled in a first-in-man MRI-guided neurointervention for targeted IA drug delivery.
Keyphrases
- drug delivery
- poor prognosis
- cancer therapy
- pet imaging
- contrast enhanced
- resting state
- magnetic resonance imaging
- white matter
- long non coding rna
- blood brain barrier
- case report
- functional connectivity
- diffusion weighted imaging
- cerebral ischemia
- primary care
- drug release
- computed tomography
- high dose
- magnetic resonance
- brain injury
- high resolution
- quality improvement
- low dose
- positron emission tomography
- drug induced
- adverse drug
- subarachnoid hemorrhage
- metastatic colorectal cancer