Doctors treat brain tumors in children with ultrasound

Canadian doctors have successfully used MRI-guided ultrasound to deliver chemotherapy to an inoperable brain tumor in a child – a world-first.

This is the start of a groundbreaking clinical trial at the Sunnybrook Health Science Center and Hospital for Sick Children in Toronto that researchers and doctors are hoping could open doors. door to better treatment of late-stage childhood tumors.

The procedure was performed on a patient with diffuse pontine glioma (DIPG), which is the most common form of brain tumor in children under 15 years of age.

Dr Nir Lipsman, co-principal investigator of the study and director of Sunnybrook’s Harquail Center for Neuromodulation, said: “DIPG is a severe pediatric brain tumor that is inoperable due to its location. its in the brain stem.

“Focused ultrasound is an innovative and non-invasive approach to more effectively deliver chemotherapy directly to the tumor. Our hope is that this continued research will bring us closer to enhancing treatments to help change the course of the disease.”

DIPG affects the brain stem, specifically the area that regulates involuntary actions like swallowing, heart rate, and even breathing. Although radiation therapy can prolong the time, DIPG is considered a late-stage diagnosis.

That’s what the researchers are hoping to challenge with this clinical trial.

Their new treatment works by using low-intensity ultrasound to address the blood-brain barrier.

The blood-brain barrier is a protective network of closely spaced cells located between the capillaries in the brain and other soft tissues of the brain. This network of cells protects the brain from harmful substances and toxins.

But when something goes wrong inside the brain, such as a tumor, the blood-brain barrier becomes a barrier for doctors hoping to deliver treatments to the affected areas.

That’s where the ultrasound comes in.

Using the power of sound waves, the researchers were able to open a temporary door in this wall around the brain to allow treatment to get through that otherwise wouldn’t be able to penetrate the barrier.

This new clinical trial, which included 10 patients aged 5-18 years with DIPG, is seeking to establish the safety and feasibility of this procedure in children.

It builds on previous research conducted by Sunnybrook. In 2015, researchers successfully used focused ultrasound to deliver chemotherapy to an adult patient’s brain tumor for the first time.

So what is the process like?

Patients lie inside a magnetic resonance imaging machine, wearing a helmet specially designed to deliver sound waves to precise areas of the brain without surgery, as doctors monitor their progress with scans Magnetic Resonance.

Microscopic bubbles smaller than red blood cells are injected intravenously into the bloodstream. Focused sound waves cause these microscopic bubbles to vibrate, widening the space between the cells that make up the blood-brain barrier and opening temporary holes through which chemotherapy doses can be delivered directly. into the brain.

This gap in the blood-brain barrier opens only temporarily – about 12 hours after treatment, the blood-brain barrier closes on its own.

If this clinical trial is successful, it could offer hope to children facing a diagnosis of end-stage DIPG.

Dr James Rutka, co-principal investigator and director of Arthur and Sonia, said: “Current treatments for DIPG are limited to radiation, which can slow tumor progression for a period of time. time, but no longer lasting effects.” Labatt Brain Tumor Research Center, said in the release. “Focused ultrasound technology is a promising drug delivery strategy that is helping us penetrate the blood-brain barrier in a novel way. Conducting this trial will help us develop new and innovative treatment pathways for children with DIPG.”


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