{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:31:49Z","timestamp":1789716709570,"version":"4.0.1"},"reference-count":37,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2007,7]]},"abstract":"<jats:p>\u2713Recent preclinical studies have demonstrated that convection-enhanced delivery (CED) can be used to perfuse the brain and brainstem with therapeutic agents while simultaneously tracking their distribution using coinfusion of a surrogate magnetic resonance (MR) imaging tracer. The authors describe a technique for the successful clinical application of this drug delivery and monitoring paradigm to the brainstem. Two patients with progressive intrinsic brainstem lesions (one with Type 2 Gaucher disease and one with a diffuse pontine glioma) were treated with CED of putative therapeutic agents mixed with Gd\u2013diethylenetriamene pentaacetic acid (DTPA). Both patients underwent frameless stereotactic placement of MR imaging\u2013compatible outer guide\u2013inner infusion cannulae. Using intraoperative MR imaging, accurate cannula placement was confirmed and real-time imaging during infusion clearly demonstrated progressive filling of the targeted region with the drug and Gd-DTPA infusate. Neither patient had clinical or imaging evidence of short- or long-term infusate-related toxicity. Using this technique, CED can be used to safely perfuse targeted regions of diseased brainstem with therapeutic agents. Coinfused imaging surrogate tracers can be used to monitor and control the distribution of therapeutic agents in vivo. Patients with a variety of intrinsic brainstem and other central nervous system disorders may benefit from a similar treatment paradigm.<\/jats:p>","DOI":"10.3171\/jns-07\/07\/0190","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T12:54:27Z","timestamp":1201179267000},"page":"190-197","source":"Crossref","is-referenced-by-count":117,"title":["Real-time image-guided direct convective perfusion of intrinsic brainstem lesions"],"prefix":"10.3171","volume":"107","author":[{"given":"Russell R.","family":"Lonser","sequence":"first","affiliation":[{"name":"Surgical Neurology Branch and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E.","family":"Warren","sequence":"additional","affiliation":[{"name":"Neuro-Oncology Branch, National Cancer Institute;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Butman","sequence":"additional","affiliation":[{"name":"Section of Neuroradiology, Diagnostic Radiology Department and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zenaide","family":"Quezado","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Surgical Services, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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