Convective distribution of macromolecules in the primate brain demonstrated using computerized tomography and magnetic resonance imaging
Autor: | Edward H. Oldfield, Robert L. Dedrick, Alexander T. Yordanov, Cynthia Sung, Kayhan Garmestani, Tung T. Nguyen, Stuart Walbridge, Yashdip S. Pannu, Markus Beitzel, Martin W. Brechbiel |
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Rok vydání: | 2003 |
Předmět: |
Gadolinium DTPA
Contrast Media Iopanoic Acid computer.software_genre Voxel In vivo Albumins Hounsfield scale medicine Animals Distribution (pharmacology) Tissue Distribution Serum Albumin Volume of distribution medicine.diagnostic_test business.industry Osmolar Concentration Brain Serum Albumin Bovine Magnetic resonance imaging Macaca mulatta Magnetic Resonance Imaging Drug delivery Autoradiography Tomography Tomography X-Ray Computed Nuclear medicine business computer |
Zdroj: | Journal of Neurosurgery. 98:584-590 |
ISSN: | 0022-3085 |
Popis: | Object. Convection-enhanced delivery (CED), the delivery and distribution of drugs by the slow bulk movement of fluid in the extracellular space, allows delivery of therapeutic agents to large volumes of the brain at relatively uniform concentrations. This mode of drug delivery offers great potential for the treatment of many neurological disorders, including brain tumors, neurodegenerative diseases, and seizure disorders. An analysis of the treatment efficacy and toxicity of this approach requires confirmation that the infusion is distributed to the targeted region and that the drug concentrations are in the therapeutic range. Methods. To confirm accurate delivery of therapeutic agents during CED and to monitor the extent of infusion in real time, albumin-linked surrogate tracers that are visible on images obtained using noninvasive techniques (iopanoic acid [IPA] for computerized tomography [CT] and Gd—diethylenetriamine pentaacetic acid for magnetic resonance [MR] imaging) were developed and investigated for their usefulness as surrogate tracers during convective distribution of a macromolecule. The authors infused albumin-linked tracers into the cerebral hemispheres of monkeys and measured the volumes of distribution by using CT and MR imaging. The distribution volumes measured by imaging were compared with tissue volumes measured using quantitative autoradiography with [14C]bovine serum albumin coinfused with the surrogate tracer. For in vivo determination of tracer concentration, the authors examined the correlation between the concentration of the tracer in brain homogenate standards and CT Hounsfield units. They also investigated the long-term effects of the surrogate tracer for CT scanning, IPA-albumin, on animal behavior, the histological characteristics of the tissue, and parenchymal toxicity after cerebral infusion. Conclusions. Distribution of a macromolecule to clinically significant volumes in the brain is possible using convection. The spatial dimensions of the tissue distribution can be accurately defined in vivo during infusion by using surrogate tracers and conventional imaging techniques, and it is expected that it will be possible to determine local concentrations of surrogate tracers in voxels of tissue in vivo by using CT scanning. Use of imaging surrogate tracers is a practical, safe, and essential tool for establishing treatment volumes during high-flow interstitial microinfusion of the central nervous system. |
Databáze: | OpenAIRE |
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