Catheter placement selection for convection-enhanced delivery of therapeutic agents to brain tumors

Abstract

Background: Convection-enhanced delivery (CED) of therapeutic agents to brain tumors allows clinicians to bypass the blood-brain barrier (BBB) to infuse virus therapy, biological, or chemotherapy directly into a brain tumor through convection. However, the effectiveness of infusions via CED may depend on catheter placement. Methods: This study used diffusion maps from magnetic resonance imaging (MRI) of human brain tumors and computational fluid dynamics (CFD) simulations to assess therapy volume distribution percentages based on catheter placement locations. Results: The primary outcome showed differences in volume distribution based on the catheter placement location. Total tumor volume filled ranged from 144.40 mm3 to 317.98 mm3. Percent filled of tumor volume ranged from 2.87% to 6.32%. Conclusions: The selection of the location for catheter placement using the region with the highest volume filled may provide optimal therapeutic effect.  The researchers conclude that CFD may provide guidance for catheter placement in CED of therapeutic agents.