Raghavan Raghu, Brady Martin L, Rodríguez-Ponce María Inmaculada, Hartlep Andreas, Pedain Christoph, Sampson John H
Therataxis, LLC, Baltimore, Maryland 21210-2415, USA.
Neurosurg Focus. 2006 Apr 15;20(4):E12. doi: 10.3171/foc.2006.20.4.7.
Convection-enhanced delivery (CED) is the continuous injection under positive pressure of a fluid containing a therapeutic agent. This technique was proposed and introduced by researchers from the US National Institutes of Health (NIH) by the early 1990s to deliver drugs that would otherwise not cross the blood-brain barrier into the parenchyma and that would be too large to diffuse effectively over the required distances were they simply deposited into the tissue. Despite the many years that have elapsed, this technique remains experimental because of both the absence of approved drugs for intraparenchymal delivery and the difficulty of guaranteed delivery to delineated regions of the brain. During the first decade after the NIH researchers founded this analytical model of drug distribution, the results of several computer simulations that had been conducted according to more realistic assumptions were also published, revealing encouraging results. In the late 1990s, one of the authors of the present paper proposed the development of a computer model that would predict the distribution specific to a particular patient (brain) based on obtainable data from radiological images. Several key developments in imaging technology and, in particular, the relationships between image-obtained quantities and other parameters that enter models of the CED process have been required to implement this model. Note that delivery devices need further development. In the present paper we review key features of CED as well as modeling of the procedure and indulge in informed speculation on optimizing the direct delivery of therapeutic agents into brain tissue.
对流增强递送（CED）是在正压下持续注射含有治疗剂的流体。这项技术是由美国国立卫生研究院（NIH）的研究人员在20世纪90年代初提出并引入的，用于递送那些否则无法穿过血脑屏障进入实质组织，且如果简单沉积在组织中会因体积太大而无法在所需距离上有效扩散的药物。尽管已经过去了许多年，但由于缺乏用于实质内递送的获批药物以及难以保证递送至大脑的划定区域，这项技术仍处于实验阶段。在美国国立卫生研究院的研究人员建立了这种药物分布分析模型后的第一个十年里，根据更现实假设进行的几次计算机模拟结果也已发表，显示出令人鼓舞的结果。在20世纪90年代后期，本文的一位作者提议开发一种计算机模型，该模型将根据从放射图像获得的可获取数据预测特定患者（大脑）的分布情况。为了实现这个模型，成像技术需要几个关键的发展，特别是图像获得的量与进入CED过程模型的其他参数之间的关系。请注意，递送装置需要进一步发展。在本文中，我们回顾了CED的关键特征以及该过程的建模，并对优化治疗剂向脑组织的直接递送进行了有根据的推测。
