Convection-enhanced delivery with controlled catheter movement increased the volume dispersed compared to a stationary catheter, with diminishing returns at retraction rates above 0.3–0.35 mm/min.
Controlled catheter retraction during convection-enhanced delivery in a computational model increases the volume of therapeutic dispersion and provides a more even concentration distribution compared to a stationary catheter.
Abstract Convection‐enhanced delivery (CED) is an investigational method for delivering therapeutics directly to the brain for the treatment of glioblastoma. However, it has not become a common clinical therapy due to an inability of CED treatments to deliver therapeutics in a large enough tissue volume to fully saturate the target region. We have recently shown that the combination of controlled catheter movement and constant pressure infusions can be used to significantly increase volume dispersed ( V d ) in an agarose gel brain tissue phantom. In the present study, we develop a computational model to predict V d achieved by various retraction rates with both constant pressure and constant flow rate infusions. An increase in V d is achieved with any movement rate, but increase in V d between successive movement rates drops off at rates above 0.3–0.35 mm/min. Finally, we found that infusions with retraction result in a more even distribution in concentration level compared to the stationary catheter, suggesting a potential increased ability for moving catheters to have a therapeutic impact regardless of the required therapeutic concentration level.
Mehta et al. (2022) studied Glioblastoma. Convection-enhanced delivery with controlled catheter movement vs. Stationary catheter was evaluated on Volume dispersed (Vd) and concentration distribution. Convection-enhanced delivery with controlled catheter movement increased the volume dispersed compared to a stationary catheter, with diminishing returns at retraction rates above 0.3–0.35 mm/min.