TY - JOUR T1 - Real-time MRI guidance for intra-arterial drug delivery in a patient with a brain tumor: technical note JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2018-014469 VL - 12 IS - 1 SP - bcr-2018-014469 AU - Michal Zawadzki AU - Jerzy Walecki AU - Boguslaw Kostkiewicz AU - Kacper Kostyra AU - Monica Smith Pearl AU - Meiyappan Solaiyappan AU - Piotr Walczak AU - Miroslaw Janowski Y1 - 2019/01/01 UR - http://casereports.bmj.com/content/12/1/bcr-2018-014469.abstract N2 - Patients with malignant brain tumors have a poor prognosis. The blood–brain barrier (BBB) is considered a primary obstacle in therapeutic drug delivery to the brain. Intra-arterial (IA) delivery of therapeutic agents following osmotic BBB opening has been attempted for years, but high variability has limited its widespread implementation. It has recently been shown in animal studies that MRI is superior to X-ray for guiding IA infusions, as it allows direct visualization of the brain parenchyma supplied by the catheter and facilitates predictable drug targeting. Moreover, PET imaging has shown that IA rather than intravenous delivery of bevacizumab results in accumulation in the brain, providing a strong rationale for using the IA route. We present a patient with recurrent butterfly glioblastoma enrolled in a first-in-man MRI-guided neurointervention for targeted IA drug delivery. ER -