Technological Adjuncts for Malignant Brain Tumor Surgery-Manish K. Aghi, MD, PhD, FAANS Video

Video Transcription

Video Summary

In this video, Manish Aghi from the University of California, San Francisco discusses MRI-guided convection-enhanced delivery (CED) of therapeutics to glioblastoma. He explains that traditional chemotherapy for brain tumors is limited by the blood-brain barrier and systemic toxicity. CED offers advantages over diffusion, as it uses a pressure gradient to distribute drugs, achieving a larger distribution volume. However, previous clinical trials have shown limited impact on patient survival. Aghi attributes this to limitations in catheter placement accuracy and the agent used. Real-time imaging during CED is crucial for accurate drug delivery. Aghi describes the steps involved in an integrated CED platform, including preoperative planning, software planning, cannula insertion, and drug infusion. He discusses two platforms: ClearPoint MRI interventions and brain lab catheters. Aghi also presents an example of a clinical trial using the ClearPoint platform, which delivered TOCA511 to 18 patients. Real-time adjustments were made to achieve comprehensive drug delivery and improved tumor coverage. The video highlights the importance of VD to VI ratios in measuring the success of the infusion.

Keywords

MRI-guided convection-enhanced delivery

therapeutics

glioblastoma

blood-brain barrier

systemic toxicity