Neurosurgical Techniques for Disruption of the Blood-Brain Barrier for Glioblastoma Treatment.
Authors: Rodriguez A, Tatter SB, Debinski W
The blood-brain barrier remains a main hurdle to drug delivery to the brain. The prognosis of glioblastoma remains grim despite current multimodal medical management. We review neurosurgical technologies that disrupt the blood-brain barrier (BBB). We will review superselective intra-arterial mannitol infusion, focused ultrasound, laser interstitial thermotherapy, and non-thermal irreversible electroporation (NTIRE). These technologies can lead to transient BBB and blood-brain tumor barrier disruption and allow for the potential of more effective local drug delivery. Animal studies and preliminary clinical trials show promise for achieving this goal.
Introduction
Purpose
Drug delivery with BBB opening
Study Objective
To review neurosurgical technologies that transiently disrupt the blood–brain barrier—including superselective intra-arterial mannitol infusion, focused ultrasound, laser interstitial thermotherapy, and non-thermal irreversible electroporation—to enable improved local drug delivery for glioblastoma.
Animal model / Human subject
Not specified
Disease model
glioblastoma
MRI or image guidance method
MRI
Targeted brain region(s)
Sites With Glioblastoma
Cargo name and characteristics
lipid-encased perfluorocarbon gas approximately 1–5 µm in diameter
Route of administration
intravenous
Outcomes and Safety
Summary of Outcomes
Neurosurgical techniques (superselective intra-arterial mannitol, focused ultrasound, laser interstitial thermotherapy, and non-thermal irreversible electroporation) transiently disrupt the blood–brain and blood–brain tumor barriers to enhance local drug delivery, showing promise in animal models and early clinical trials.
Duration of biological effect
Not specified in the provided text
Safety-related matter
No safety concerns or adverse effects are mentioned in the provided text.
Brain Region
Ultrasound Parameters
Ultrasound instrument
Not specified
FUS Frequency
1 Hz
FUS Intensity
150-950 W
FUS Mode
pulsed
Pulse duration
10 ms
Duration of a single FUS session
20-30s
Focal Characteristics
Not specified
Treatment frequency
Not specified in text
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