gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Efficacy assessment of convection enhanced paclitaxel delivery utilizing specialized MRI sequences and FET-PET

Untersuchung der Effizienz von konvektions-basierter Paclitaxelgabe mit Hilfe spezieller MRT-Sequenzen und FET-PET

Meeting Abstract

  • corresponding author Philipp Tanner - Neurochirurgische Klinik der Ludwig-Maximilians-Universität, Klinikum Großhadern, München
  • F. W. Kreth - Neurochirurgische Klinik der Ludwig-Maximilians-Universität, Klinikum Großhadern, München
  • M. Holtmannspötter - Abteilung für Neuroradiologie der Ludwig-Maximilians-Universität, Klinikum Großhadern, München
  • G. Poepperl - Klinik für Nuklearmedizin der Ludwig-Maximilians-Universität, Klinikum Großhadern, München
  • W. Rachinger - Neurochirurgische Klinik der Ludwig-Maximilians-Universität, Klinikum Großhadern, München
  • R. Goldbrunner - Neurochirurgische Klinik der Ludwig-Maximilians-Universität, Klinikum Großhadern, München

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.07.06

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0217.shtml

Veröffentlicht: 23. April 2004

© 2004 Tanner et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Convection enhanced delivery (CED) is a novel method of intraparenchymal drug application which is currently used in several brain tumour trials. An active pressure gradient is used in CED by a permanent infusion into the tumour tissue that presumably should result in larger distribution volumes than passive diffusion. Up until now there have been no established methods of demonstrating the extent of convection, and of monitoring the efficacy of convention enhanced paclitaxel delivery. Based on the data of our current phase II paclitaxel CED study, the value of several MRI sequences - and FET- PET to visualize convection - was investigated.

Methods

In our current phase II paclitaxel study, to date 8 cycles of CED have been performed. Paclitaxel is administered for 120 hours into the tumour with a constant flow rate of 0.3 ml/h and a concentration of 0.5 mg paclitaxel/ ml. MR imaging was performed using Siemens Symphony 1.5 Tesla. Diffusion weighted images were obtained at day 4 and day 6 and used to calculate the water ADC maps. These sequences showed a hyperintense signal, which is believed to illustrate the convection wave. Conventional T1 contrast enhanced imaging was obtained on day 28 using the same imaging device. Additionally FET PET scans were performed 24 hours after the day 28 MRT scan with a Siemens ICAT EXACT HR+ scanner. Image analyses was performed by overlaying the 3 different imaging modalities using the BrainLAB Cranial iPlan Software. The correlation between these overlays was evaluated.

Results

In all patients the ADC maps revealed the hyperintense ring presumed to be the convection wave. The extent and the shape of this ring corresponded well with hypointense areas seen in the day 28 contrast enhanced T1 images. Additionally, in cases of residual tumour, the zones of high FET uptake were located at the outer perimeter of the ADC enhancing ring. The inner dark zone seen in the ADC maps correlated well with reduced FET uptake and also hypointensity (presumably necrotic areas) in T1 images.

Conclusions

These data indicates that the convection wave can be visualized by diffusion weighted imaging as well as ADC maps. Overlay of FET-PET proved to be very valuable in interpreting changes in contrast uptake. Combination of diffusion weighted images, ADC maps, contrast enhanced T1 weighted imaging and FET-PET seems to be a suitable imaging modality for CED.