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Abstract #4145

MR Guided CED of a Novel Therapeutic for Parkinsons Disease: The Importance of Imaging Feedback

Alastair J Martin 1 , Krystof Bankiewicz 2 , John Bringas 2 , Chad Christine 3 , Marin Thompson 2 , Janine Beyer 2 , and Paul Larson 2

1 Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States, 2 Neurological Surgery, UCSF, San Francisco, CA, United States, 3 Neurology, UCSF, San Francisco, CA, United States

MR guidance is used to monitor convection enhanced delivery of a novel gene therapy agent (AAV2-hAADC) in patients with Parkinsons disease. The therapeutic is infused bilaterally into the putamen and targeting is performed with intra-operative MR guidance. Two infusions are performed in each putamen in order to maximize coverage of the anatomic structure. Continuous infusion monitoring with MR imaging revealed sub-optimal distributions such as reflux along the cannula tract and shunting along vascular channels. Detection of these effects permitted adjustments to infusion strategy, including changing cannula depth and aborting ineffective infusions.

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