University of Massachusetts Medical School Faculty Publications

UMMS Affiliation

Gene Therapy Center; Department of Microbiology and Physiological Systems; Department of Radiology; Department of Neurosurgery; Department of Medicine

Date

1-1-2013

Document Type

Article

Medical Subject Headings

Brain; Cone-Beam Computed Tomography; Convection; Drug Delivery Systems; Magnetic Resonance Imaging; Neuronavigation

Disciplines

Molecular and Cellular Neuroscience | Neurology | Neuroscience and Neurobiology | Radiology | Surgery | Therapeutics

Abstract

INTRODUCTION: Convection-enhanced delivery (CED) has been shown to be an effective method of administering macromolecular compounds into the brain that are unable to cross the blood-brain barrier. Because the administration is highly localized, accurate cannula placement by minimally invasive surgery is an important requisite. This paper reports on the use of an angiographic c-arm system which enables truly frameless multimodal image guidance during CED surgery.

METHODS: A microcannula was placed into the striatum of five sheep under real-time fluoroscopic guidance using imaging data previously acquired by cone beam computed tomography (CBCT) and MRI, enabling three-dimensional navigation. After introduction of the cannula, high resolution CBCT was performed and registered with MRI to confirm the position of the cannula tip and to make adjustments as necessary. Adeno-associated viral vector-10, designed to deliver small-hairpin micro RNA (shRNAmir), was mixed with 2.0 mM gadolinium (Gd) and infused at a rate of 3 mul/min for a total of 100 mul. Upon completion, the animals were transferred to an MR scanner to assess the approximate distribution by measuring the volume of spread of Gd.

RESULTS: The cannula was successfully introduced under multimodal image guidance. High resolution CBCT enabled validation of the cannula position and Gd-enhanced MRI after CED confirmed localized administration of the therapy.

CONCLUSION: A microcannula for CED was introduced into the striatum of five sheep under multimodal image guidance. The non-alloy 300 mum diameter cannula tip was well visualized using CBCT, enabling confirmation of the position of the end of the tip in the area of interest.

Rights and Permissions

Citation: J Neurointerv Surg. 2013 Jan 1;5(1):69-72. doi: 10.1136/neurintsurg-2011-010170. Epub 2011 Dec 22. Link to article on publisher's site

Comments

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ andhttp://creativecommons.org/licenses/by-nc/3.0/legalcode

Related Resources

Link to Article in PubMed

PubMed ID

22193239

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