title: Imaging of convection enhanced delivery of toxins in humans.
abstract: Drug delivery of immunotoxins to brain tumors circumventing the blood brain barrier is a significant challenge. Convection-enhanced delivery (CED) circumvents the blood brain barrier through direct intracerebral application using a hydrostatic pressure gradient to percolate therapeutic compounds throughout the interstitial spaces of infiltrated brain and tumors. The efficacy of CED is determined through the distribution of the therapeutic agent to the targeted region. The vast majority of patients fail to receive a significant amount of coverage of the area at risk for tumor recurrence. Understanding this challenge, it is surprising that so little work has been done to monitor the delivery of therapeutic agents using this novel approach. Here we present a review of imaging in convection enhanced delivery monitoring of toxins in humans, and discuss future challenges in the field.
authors: Division of Neurosurgery, Duke University Medical Center, Box 3807, Durham, NC 27710, USA. ankit.mehta@duke.edu
authors: Ankit I
authors: AI
authors: Mehta
authors: Bryan D
authors: BD
authors: Choi
authors: Raghu
authors: R
authors: Raghavan
authors: Martin
authors: M
authors: Brady
authors: Allan H
authors: AH
authors: Friedman
authors: Darell D
authors: DD
authors: Bigner
authors: Ira
authors: I
authors: Pastan
authors: John H
authors: JH
authors: Sampson
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001812:Blood-Brain Barrier / Q000378:metabolism; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D018481:Convection; D016503:Drug Delivery Systems / Q000379:methods*; D005682:Gadolinium / Q000008:administration & dosage; D005909:Glioblastoma / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D000922:Immunotoxins / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D008081:Liposomes; D008279:Magnetic Resonance Imaging; D014018:Tissue Distribution
chemical_list: D000970:Antineoplastic Agents; D000922:Immunotoxins; D008081:Liposomes; D005682:Gadolinium