Design and Characterization of Pressure Monitoring and Insertion system for Intraparenchymal Convection Enhanced Delivery.
Design and Characterization of Pressure Monitoring and Insertion system for Intraparenchymal Convection Enhanced Delivery.
复制标题
用于实质内对流增强输送的压力监测和插入系统的设计和表征。
DOI：
10.1109/embc40787.2023.10341013
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Vitale,Flavia
中科院分区：
文献类型：
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作者：
Michiels,Jakob;Vitale,Flavia
神经系统疾病是重大的社会和经济负担。常见的药物疗法通常只能控制症状且疗效有限。脑实质内对流增强递送（IP CED）是一种直接脑部递送治疗药物的神经外科技术。目前，IP CED的主要应用是胶质母细胞瘤的靶向化疗和基因治疗。虽然 IP CED 比全身方法具有优势，但由于目标解剖结构的覆盖率不足、低达 21%、输注持续时间超过 2 小时以及脱靶效应，其益处可能会大大降低。解决 IP CED 的局限性需要对相关流体动力学和操作参数进行彻底研究和优化。在这项工作中，我们介绍了低成本、开源和全自动 CED 插管插入控制和压力监测系统的设计、制造和表征。使用这些自动化 CED 控制系统，我们研究了压力、插入速度和流速对多个结果变量的影响，包括脑模型中 CED 输注期间的回流、体积分布和输注云形态。临床相关性 — CED 压力特性可能能够暗示反流事件，并可以为临床医生提供有关正在进行的输注的有价值的实时信息，而无需昂贵的医学成像模式。
Neurological disorders are a significant societal and economic burden. Common pharmacological therapies often can only manage symptoms and have limited efficacy. Intraparenchymal convection enhanced delivery (IP CED) is a neurosurgical technique for direct brain delivery of therapeutics. Currently, the main applications of IP CED are targeted chemotherapy for glioblastoma and gene therapy. While IP CED has advantages over systemic approaches, its benefits can be drastically reduced by inadequate coverage as low as 21% of target anatomy, excessive infusion durations greater than 2 hours, and off-target effects. Addressing the limitations of IP CED requires thorough investigation and optimization of the relevant fluid dynamic and operational parameters. In this work, we present the design, fabrication, and characterization of low-cost, open-source, and fully automated CED cannula insertion control and pressure-monitoring systems. Using these automated CED control systems, we investigate the effects of pressure, insertion velocity, and flow rates on several outcome variables, including reflux, volume distribution, and infusion cloud morphology during CED infusions in brain phantoms.Clinical Relevance— CED pressure properties may be able to implicate reflux incidents and could provide clinicians with valuable, real-time information regarding ongoing infusions without the need for costly medical imaging modalities.