Abstract
Convection-enhanced delivery (CED) of substances in the central nervous system (CNS) overcomes many of the limitations of other CNS delivery strategies. CED is becoming a more frequent treatment option in the management of brain tumors and in clinical trials for gene therapy in patients with neurodegenerative disease. Benefits of this technology include more efficient delivery of large volumes of infusate and increased coverage of the target structure compared with diffusion-driven delivery. In this chapter, we describe the biophysical principles of convective flow, CED methodology, and modifications we have made to the CED process to make it more effective. For example, we developed a reflux-resistant infusion cannula that allows increased infusion rates to be used. We also describe our efforts to visualize the CED process in vivo, using the magnetic resonance imaging contrast agent gadoteridol and real-time intraoperative magnetic resonance imaging. We believe that this image-guided CED platform will prove useful in translational neuroscience efforts.
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