title: Real-time in vivo imaging of the convective distribution of a low-molecular-weight tracer.
abstract: OBJECTIVE
  Convection-enhanced delivery (CED) is increasingly used to distribute therapeutic agents to locations in the central nervous system. The optimal application of convective distribution of various agents requires the development of imaging tracers to monitor CED in vivo in real time. The authors examined the safety and utility of an iodine-based low-molecular-weight surrogate tracer for computerized tomography (CT) scanning during CED.
  
  
  METHODS
  Various volumes (total volume range 90-150 microl) of iopamidol (MW 777 D) were delivered to the cerebral white matter of four primates (Macaca mulatta) by using CED. The distribution of this imaging tracer was determined by in vivo real-time and postinfusion CT scanning (< or = 5 days after infusion [one animal]) as well as by quantitative autoradiography (14C-sucrose [all animals] and 14C-dextran [one animal]), and compared with a mathematical model. Clinical observation (- 5 months) and histopathological analyses were used to evaluate the safety and toxicity of the tracer delivery. Real-time CT scanning of the tracer during infusion revealed a clearly definable region of perfusion. The volume of distribution (Vd) increased linearly (r2 = 0.97) with an increasing volume of infusion (V.). The overall Vd/Vi ratio was 4.1+/-0.7 (mean+/-standard deviation) and the distribution of infusate was homogeneous. Quantitative autoradiography confirmed the accuracy of the imaged distribution for a small (sucrose, MW 359 D) and a large (dextran, MW 70 kD) molecule. The distribution of the infusate was identifiable up to 72 hours after infusion. There was no clinical or histopathological evidence of toxicity in any animal.
  
  
  CONCLUSIONS
  Real-time in vivo CT scanning of CED of iopamidol appears to be safe, feasible, and suitable for monitoring convective delivery of drugs with certain features and low infusion volumes.
authors.affiliation: Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1414, USA.
authors.forename: David
authors.initials: D
authors.lastname: Croteau
authors.forename: Stuart
authors.initials: S
authors.lastname: Walbridge
authors.forename: Paul F
authors.initials: PF
authors.lastname: Morrison
authors.forename: John A
authors.initials: JA
authors.lastname: Butman
authors.forename: Alexander O
authors.initials: AO
authors.lastname: Vortmeyer
authors.forename: Dennis
authors.initials: D
authors.lastname: Johnson
authors.forename: Edward H
authors.initials: EH
authors.lastname: Oldfield
authors.forename: Russell R
authors.initials: RR
authors.lastname: Lonser
mesh_terms: D000818:Animals; D001345:Autoradiography / Q000379:methods; D001921:Brain / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000378:metabolism*; D003287:Contrast Media / Q000008:administration & dosage / Q000493:pharmacokinetics*; D018481:Convection; D005240:Feasibility Studies; D007479:Iopamidol / Q000008:administration & dosage / Q000493:pharmacokinetics*; D008253:Macaca mulatta; D008279:Magnetic Resonance Imaging; D008297:Male; D009994:Osmolar Concentration; D051381:Rats; D017207:Rats, Sprague-Dawley; D013997:Time Factors; D014018:Tissue Distribution; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D007479:Iopamidol