Predicting and optimizing the territory of blood-brain barrier opening by superselective intra-arterial cerebral infusion under dynamic susceptibility contrast MRI guidance

Miroslaw Janowski; Piotr Walczak; Monica S Pearl

doi:10.1177/0271678X15615875

Predicting and optimizing the territory of blood-brain barrier opening by superselective intra-arterial cerebral infusion under dynamic susceptibility contrast MRI guidance

J Cereb Blood Flow Metab. 2016 Mar;36(3):569-75. doi: 10.1177/0271678X15615875. Epub 2015 Nov 5.

Authors

Miroslaw Janowski¹, Piotr Walczak², Monica S Pearl³

Affiliations

¹ Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Cellular Imaging Section and Vascular Biology Program, Institute for Cell Engineering, Johns Hopkins University, Baltimore, MD, USA NeuroRepair Department, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland Department of Neurosurgery, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
² Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Cellular Imaging Section and Vascular Biology Program, Institute for Cell Engineering, Johns Hopkins University, Baltimore, MD, USA Department of Radiology, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland.
³ Division of Interventional Neuroradiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Interventional Neuroradiology, Children's National Medical Center, Washington, DC, USA msmit135@jhmi.edu.

Abstract

Interventional neuroradiology techniques are minimally invasive and allow for superselective drug delivery to specific brain regions. The passage of most agents, however, is impaired by the blood-brain barrier (BBB). Despite its discovery over 40 years ago, hyperosmotic BBB opening (BBBO) remains highly variable, preventing its widespread implementation. Here, we report on a technique that enables the prediction and optimization of the BBBO territory. We found that the microcatheter tip position and the speed of hyperosmolar mannitol injection, both major determinants of the targeted territory, can be modulated in real-time as guided by trans-catheter perfusion MRI.

Keywords: Blood–brain barrier opening; MRI; intra-arterial; mannitol.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Animals
Blood-Brain Barrier / metabolism*
Brain / blood supply*
Infusions, Intra-Arterial
Magnetic Resonance Angiography / methods*
Mannitol / administration & dosage*
Osmolar Concentration
Rabbits

Substances

Mannitol

Abstract

Publication types

MeSH terms

Substances

Grants and funding