title: A robust MRI-compatible system to facilitate highly accurate stereotactic administration of therapeutic agents to targets within the brain of a large animal model.
abstract: Achieving accurate intracranial electrode or catheter placement is critical in clinical practice in order to maximise the efficacy of deep brain stimulation and drug delivery respectively as well as to minimise side-effects. We have developed a highly accurate and robust method for MRI-guided, stereotactic delivery of catheters and electrodes to deep target structures in the brain of pigs. This study outlines the development of this equipment and animal model. Specifically this system enables reliable head immobilisation, acquisition of high-resolution MR images, precise co-registration of MRI and stereotactic spaces and overall rigidity to facilitate accurate burr hole-generation and catheter implantation. To demonstrate the utility of this system, in this study a total of twelve catheters were implanted into the putamen of six Large White Landrace pigs. All implants were accurately placed into the putamen. Target accuracy had a mean Euclidean distance of 0.623 mm (standard deviation of 0.33 mm). This method has allowed us to accurately insert fine cannulae, suitable for the administration of therapeutic agents by convection-enhanced delivery (CED), into the brain of pigs. This study provides summary evidence of a robust system for catheter implantation into the brain of a large animal model. We are currently using this stereotactic system, implantation procedure and animal model to develop catheter-based drug delivery systems that will be translated into human clinical trials, as well as to model the distribution of therapeutic agents administered by CED over large volumes of brain.
authors.affiliation: Department of Neurosurgery, Frenchay Hospital, Bristol, UK.
authors.forename: E
authors.initials: E
authors.lastname: White
authors.forename: M
authors.initials: M
authors.lastname: Woolley
authors.forename: A
authors.initials: A
authors.lastname: Bienemann
authors.forename: D E
authors.initials: DE
authors.lastname: Johnson
authors.forename: M
authors.initials: M
authors.lastname: Wyatt
authors.forename: G
authors.initials: G
authors.lastname: Murray
authors.forename: H
authors.initials: H
authors.lastname: Taylor
authors.forename: S S
authors.initials: SS
authors.lastname: Gill
mesh_terms: D000818:Animals; D002408:Catheters, Indwelling; D007103:Immobilization / Q000295:instrumentation / Q000379:methods; D008279:Magnetic Resonance Imaging; D038361:Neuronavigation / Q000295:instrumentation* / Q000379:methods*; D012149:Restraint, Physical / Q000295:instrumentation / Q000379:methods; D025321:Surgery, Computer-Assisted; D013552:Swine