AUTHOR=Prezelski Kayla , Keiser Megan , Stein Joel M. , Lucas Timothy H. , Davidson Beverly , Gonzalez-Alegre Pedro , Vitale Flavia TITLE=Design and Validation of a Multi-Point Injection Technology for MR-Guided Convection Enhanced Delivery in the Brain JOURNAL=Frontiers in Medical Technology VOLUME=3 YEAR=2021 URL=https://www.frontiersin.org/journals/medical-technology/articles/10.3389/fmedt.2021.725844 DOI=10.3389/fmedt.2021.725844 ISSN=2673-3129 ABSTRACT=

Convection enhanced delivery (CED) allows direct intracranial administration of neuro-therapeutics. Success of CED relies on specific targeting and broad volume distributions (VD). However, to prevent off-target delivery and tissue damage, CED is typically conducted with small cannulas and at low flow rates, which critically limit the maximum achievable VD. Furthermore, in applications such as gene therapy requiring injections of large fluid volumes into broad subcortical regions, low flow rates translate into long infusion times and multiple surgical trajectories. The cannula design is a major limiting factor in achieving broad VD, while minimizing infusion time and backflow. Here we present and validate a novel multi-point cannula specifically designed to optimize distribution and delivery time in MR-guided intracranial CED of gene-based therapeutics. First, we evaluated the compatibility of our cannula with MRI and common viral vectors for gene therapy. Then, we conducted CED tests in agarose brain phantoms and benchmarked the results against single-needle delivery. 3T MRI in brain phantoms revealed minimal susceptibility-induced artifacts, comparable to the device dimensions. Benchtop CED of adeno-associated virus demonstrated no viral loss or inactivation. CED in agarose brain phantoms at 3, 6, and 9 μL/min showed >3x increase in volume distribution and 60% time reduction compared to single-needle delivery. This study confirms the validity of a multi-point delivery approach for improving infusate distribution at clinically-compatible timescales and supports the feasibility of our novel cannula design for advancing safety and efficacy of MR-guided CED to the central nervous system.