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Characterizing Focused-Ultrasound Mediated Drug Delivery to the Heterogeneous Primate Brain In Vivo with Acoustic Monitoring.

Authors: Wu SY, Sanchez CS, Samiotaki G, Buch A, Ferrera VP, Konofagou EE

Focused ultrasound with microbubbles has been used to noninvasively and selectively deliver pharmacological agents across the blood-brain barrier (BBB) for treating brain diseases. Acoustic cavitation monitoring could serve as an on-line tool to assess and control the treatment. While it demonstrated a strong correlation in small animals, its translation to primates remains in question due to the anatomically different and highly heterogeneous brain structures with gray and white matteras well as dense vasculature. In addition, the drug delivery efficiency and the BBB opening volume have never been shown to be predictable through cavitation monitoring in primates. This study aimed at determining how cavitation activity is correlated with the amount and concentration of gadolinium delivered through the BBB and its associated delivery efficiency as well as the BBB opening volume in non-human primates. Another important finding entails the effect of heterogeneous brain anatomy and vasculature of a primate brain, i.e., presence of large cerebral vessels, gray and white matter that will also affect the cavitation activity associated with variation of BBB opening in different tissue types, which is not typically observed in small animals. Both these new findings are critical in the primate brain and provide essential information for clinical applications.

Introduction

Purpose Drug delivery with BBB opening
Study Objective To determine how acoustic cavitation activity correlates with the amount and concentration of gadolinium delivered across the blood–brain barrier, delivery efficiency, and BBB opening volume in non-human primates, and how primate brain anatomical and vascular heterogeneity affects these relationships.
Animal model / Human subject non-human primate, rhesus macaque, 8–20 years, male
Disease model healthy
MRI or image guidance method Stereotaxis-based targeting using a previously developed stereotactic method. Target defined by a targeting vector (focus and trajectory) with incidence angle estimated from the 3D skull surface extracted from pre-Gd T1-weighted MRI; targets and outcomes registered to individual stereotactically-aligned images (IST) using FSL FLIRT.
Targeted brain region(s) Caudate, Putamen
Target coordinates Not provided

Outcomes and Safety

Summary of Outcomes 0.5 MHz FUS with microbubbles opened the BBB in NHPs, where cavitation dose predicted delivery volume and gray matter showed 3x higher opening probability.
Duration of biological effect 1 h
Safety-related matter No edema or hemorrhage detected by MRI at the tested pressures.

Brain Region

Ultrasound Parameters

Ultrasound instrument H-107, Sonic Concepts
FUS Frequency 0.5 MHz
FUS Intensity 0.6 MPa
FUS Pressure not reported
FUS Mode pulsed
Pulse duration 10 ms
Duration of a single FUS session 120 s
Focal Characteristics focal depth: 62.6 mm
Treatment frequency multiple sessions

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