Real-time MRI guidance for intra-arterial drug delivery in a patient with a brain tumor: Technical note

Michal Zawadzki, Jerzy Walecki, Boguslaw Kostkiewicz, Kacper Kostyra, Monica Pearl, Meiyappan Solaiyappan, Piotr Walczak, Miroslaw Janowski

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Article numbere014469
JournalBMJ Case Reports
Volume12
Issue number1
DOIs
StatePublished - Jan 1 2019

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Brain Neoplasms
Blood-Brain Barrier
Brain
Pharmaceutical Preparations
Intra Arterial Infusions
Butterflies
Drug Delivery Systems
Glioblastoma
Catheters
X-Rays
Therapeutics
Bevacizumab

Keywords

  • brain
  • intervention
  • malignant
  • mri
  • technique

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Real-time MRI guidance for intra-arterial drug delivery in a patient with a brain tumor : Technical note. / Zawadzki, Michal; Walecki, Jerzy; Kostkiewicz, Boguslaw; Kostyra, Kacper; Pearl, Monica; Solaiyappan, Meiyappan; Walczak, Piotr; Janowski, Miroslaw.

In: BMJ Case Reports, Vol. 12, No. 1, e014469, 01.01.2019.

Research output: Contribution to journalArticle

Zawadzki, Michal ; Walecki, Jerzy ; Kostkiewicz, Boguslaw ; Kostyra, Kacper ; Pearl, Monica ; Solaiyappan, Meiyappan ; Walczak, Piotr ; Janowski, Miroslaw. / Real-time MRI guidance for intra-arterial drug delivery in a patient with a brain tumor : Technical note. In: BMJ Case Reports. 2019 ; Vol. 12, No. 1.
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