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Case series
Perfusion-guided endovascular super-selective intra-arterial infusion for treatment of malignant brain tumors
  1. Stephen R Chen1,
  2. Melissa M Chen2,
  3. Chibawanye Ene3,
  4. Frederick F Lang3,
  5. Peter Kan4
  1. 1Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  2. 2Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  3. 3Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  4. 4Neurosurgery, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
  1. Correspondence to Dr Peter Kan, Neurosurgery, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA; ptkan{at}


Background Survival for glioblastoma remains very poor despite decades of research, with a 5-year survival of only 5%. The technological improvements that have revolutionized treatment of ischemic stroke and brain aneurysms have great potential in providing more precise and selective delivery of cancer therapeutic agents to brain tumors.

Methods We describe for the first time the use of perfusion guidance to enhance the precision of endovascular super-selective intra-arterial (ESIA) infusions of mesenchymal stem cells loaded with Delta-24 (MSC-D24) in the treatment of glioblastoma (NCT 03896568).

Results MRI imaging, which best defines the location of the tumor, is co-registered and fused with the patient’s position using cone beam CT, resulting in optimal vessel selection and confirmation of targeted delivery through volumetric perfusion imaging.

Conclusions This technique of perfusion guided-ESIA injections (PG-ESIA) enhances our ability to perform targeted super-selective delivery of therapeutic agents for brain tumors.

  • angiography
  • brain
  • intervention
  • neoplasm
  • tumor

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  • Twitter @s0schen, @PeterKa80460001

  • Contributors SRC, PK and FFL conceived the study. SRC, MMC and PK analyzed the data. SRC, PK and CE wrote the paper.

  • Funding This study was supported by the National Cancer Institute (1R01CA214749, 1R01CA247970 P30CA016672 and 2P50CA127001), The University of Texas MD Anderson Moon Shots ProgramTM, The Broach Foundation for Brain Cancer Research, The Elias Family Fund, The Priscila and Jason Hiley Fund, The Baumann Family/Curefest Fund, The Jim and Pam Harris Fund, The Gene Pennebaker Brain Cancer Fund, The Schneider Memorial Cancer Research Fund, The Sweet Family Cancer Research Fund, The Dr Marnie Rose Foundation, The Gold Family Memorial Fund, and The Sorenson Foundation (all to FFL).

  • Competing interests SRC has received consulting fees. FFL is a patent holder and grant recipient. PK is on the editorial board of JNIS.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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