Abstract

Adeno-associated virus (AAV) is a clinically useful gene delivery vehicle for treating neurological diseases. To deliver AAV to focal targets, direct infusion into brain tissue by convection-enhanced delivery (CED) is often needed due to AAV's limited penetration across the blood-brain-barrier and its low diffusivity in tissue. In this study, computational models that predict the spatial distribution of AAV in brain tissue during CED were developed to guide future placement of infusion catheters in recurrent brain tumors following primary tumor resection. The brain was modeled as a porous medium, and material property fields that account for magnetic resonance imaging (MRI)-derived anatomical regions were interpolated and directly assigned to an unstructured finite element mesh. By eliminating the need to mesh complex surfaces between fluid regions and tissue, mesh preparation was expedited, increasing the model's clinical feasibility. The infusion model predicted preferential fluid diversion into open fluid regions such as the ventricles and subarachnoid space (SAS). Additionally, a sensitivity analysis of AAV delivery demonstrated that improved AAV distribution in the tumor was achieved at higher tumor hydraulic conductivity or lower tumor porosity. Depending on the tumor infusion site, the AAV distribution covered 3.67–70.25% of the tumor volume (using a 10% AAV concentration threshold), demonstrating the model's potential to inform the selection of infusion sites for maximal tumor coverage.

References

1.
GuhaSarkar
,
D.
,
Neiswender
,
J.
,
Su
,
Q.
,
Gao
,
G.
, and
Sena-Esteves
,
M.
,
2017
, “
Intracranial AAV-IFN-β Gene Therapy Eliminates Invasive Xenograft Glioblastoma and Improves Survival in Orthotopic Syngeneic Murine Model
,”
Mol. Oncol.
,
11
(
2
), pp.
180
193
.10.1002/1878-0261.12020
2.
Ma
,
H.-I.
,
Hueng
,
D.-Y.
,
Shui
,
H.-A.
,
Han
,
J.-M.
,
Wang
,
C.-H.
,
Lai
,
Y.-H.
,
Cheng
,
S.-Y.
,
Xiao
,
X.
,
Chen
,
M.-T.
, and
Yang
,
Y.-P.
,
2014
, “
Intratumoral Decorin Gene Delivery by AAV Vector Inhibits Brain Glioblastomas and Prolongs Survival of Animals by Inducing Cell Differentiation
,”
Int. J. Mol. Sci.
,
15
(
3
), pp.
4393
4414
.10.3390/ijms15034393
3.
Meijer
,
D. H.
,
Maguire
,
C. A.
,
LeRoy
,
S. G.
, and
Sena-Esteves
,
M.
,
2009
, “
Controlling Brain Tumor Growth by Intraventricular Administration of an AAV Vector Encoding IFN-β
,”
Cancer Gene Ther.
,
16
(
8
), pp.
664
671
.10.1038/cgt.2009.8
4.
Eberling
,
J. L.
,
Jagust
,
W. J.
,
Christine
,
C. W.
,
Starr
,
P.
,
Larson
,
P.
,
Bankiewicz
,
K. S.
, and
Aminoff
,
M. J.
,
2008
, “
Results From a Phase I Safety Trial of hAADC Gene Therapy for Parkinson Disease
,”
Neurology
,
70
(
21
), pp.
1980
1983
.10.1212/01.wnl.0000312381.29287.ff
5.
Salegio
,
E. A.
,
Samaranch
,
L.
,
Jenkins
,
R. W.
,
Clarke
,
C. J.
,
Lamarre
,
C.
,
Beyer
,
J.
,
Kells
,
A. P.
, et al.,
2012
, “
Safety Study of Adeno-Associated Virus Serotype 2-Mediated Human Acid Sphingomyelinase Expression in the Nonhuman Primate Brain
,”
Hum. Gene Ther.
,
23
(
8
), pp.
891
902
.10.1089/hum.2012.052
6.
Su
,
X.
,
Kells
,
A. P.
,
Huang
,
E. J.
,
Lee
,
H. S.
,
Hadaczek
,
P.
,
Beyer
,
J.
,
Bringas
,
J.
, et al.,
2009
, “
Safety Evaluation of AAV2-GDNF Gene Transfer Into the Dopaminergic Nigrostriatal Pathway in Aged and Parkinsonian Rhesus Monkeys
,”
Hum. Gene Ther.
,
20
(
12
), pp.
1627
1640
.10.1089/hum.2009.103
7.
Bobo
,
R. H.
,
Laske
,
D. W.
,
Akbasak
,
A.
,
Morrison
,
P. F.
,
Dedrick
,
R. L.
, and
Oldfield
,
E. H.
,
1994
, “
Convection-Enhanced Delivery of Macromolecules in the Brain
,”
Proc. Natl. Acad. Sci. U. S. A
,
91
(
6
), pp.
2076
2080
.10.1073/pnas.91.6.2076
8.
Mehta
,
A. M.
,
Sonabend
,
A. M.
, and
Bruce
,
J. N.
,
2017
, “
Convection-Enhanced Delivery
,”
Neurotherapeutics
,
14
(
2
), pp.
358
371
.10.1007/s13311-017-0520-4
9.
Pierson
,
E. E.
,
Keifer
,
D. Z.
,
Asokan
,
A.
, and
Jarrold
,
M. F.
,
2016
, “
Resolving Adeno-Associated Viral Particle Diversity With Charge Detection Mass Spectrometry
,”
Anal. Chem.
,
88
(
13
), pp.
6718
6725
.10.1021/acs.analchem.6b00883
10.
Lee
,
J. H.
,
Lee
,
J. E.
,
Kahng
,
J. Y.
,
Kim
,
S. H.
,
Park
,
J. S.
,
Yoon
,
S. J.
,
Um
,
J. Y.
, et al.,
2018
, “
Human Glioblastoma Arises From Subventricular Zone Cells With Low-Level Driver Mutations
,”
Nature
,
560
(
7717
), pp.
243
247
.10.1038/s41586-018-0389-3
11.
Casanova
,
F.
,
Carney
,
P. R.
, and
Sarntinoranont
,
M.
,
2014
, “
Effect of Needle Insertion Speed on Tissue Injury, Stress, and Backflow Distribution for Convection-Enhanced Delivery in the Rat Brain
,”
Plos One
,
9
(
4
), p.
e94919
.10.1371/journal.pone.0094919
12.
Sampson
,
J. H.
,
Raghavan
,
R.
,
Brady
,
M. L.
,
Provenzale
,
J. M.
,
Herndon
,
J. E.
, II
,
Croteau
,
D.
,
Friedman
,
A. H.
, et al.,
2007
, “
Clinical Utility of a Patient-Specific Algorithm for Simulating Intracerebral Drug Infusions
,”
Neuro Oncol.
,
9
(
3
), pp.
343
353
.10.1215/15228517-2007-007
13.
Kim
,
J. H.
,
Mareci
,
T. H.
, and
Sarntinoranont
,
M.
,
2010
, “
A Voxelized Model of Direct Infusion Into the Corpus Callosum and Hippocampus of the Rat Brain: Model Development and Parameter Analysis
,”
Med. Biol. Eng. Comput.
,
48
(
3
), pp.
203
214
.10.1007/s11517-009-0564-7
14.
Netti
,
P. A.
,
Travascio
,
F.
, and
Jain
,
R. K.
,
2003
, “
Coupled Macromolecular Transport and Gel Mechanics: Poroviscoelastic Approach
,”
AIChE J.
,
49
(
6
), pp.
1580
1596
.10.1002/aic.690490621
15.
Chen
,
Z. J.
,
Broaddus
,
W. C.
,
Viswanathan
,
R. R.
,
Raghavan
,
R.
, and
Gillies
,
G. T.
,
2002
, “
Intraparenchymal Drug Delivery Via Positive-Pressure Infusion: Experimental and Modeling Studies of Poroelasticity in Brain Phantom Gels
,”
IEEE Trans. Biomed. Eng.
,
49
(
2
), pp.
85
96
.10.1109/10.979348
16.
Kalyanasundaram
,
S.
,
Calhoun
,
V. D.
, and
Leong
,
K. W.
,
1997
, “
A Finite Element Model for Predicting the Distribution of Drugs Delivered Intracranially to the Brain
,”
Am. J. Physiol.
,
273
(
5
), pp.
R1810
R1821
.10.1152/ajpregu.1997.273.5.R1810
17.
Kim
,
J. H.
,
Astary
,
G. W.
,
Chen
,
X.
,
Mareci
,
T. H.
, and
Sarntinoranont
,
M.
,
2009
, “
Voxelized Model of Interstitial Transport in the Rat Spinal Cord Following Direct Infusion Into White Matter
,”
ASME J. Biomech. Eng.
,
131
(
7
), p.
071007
.10.1115/1.3169248
18.
Rosenbluth
,
K. H.
,
Eschermann
,
J. F.
,
Mittermeyer
,
G.
,
Thomson
,
R.
,
Mittermeyer
,
S.
, and
Bankiewicz
,
K. S.
,
2012
, “
Analysis of a Simulation Algorithm for Direct Brain Drug Delivery
,”
Neuroimage
,
59
(
3
), pp.
2423
2429
.10.1016/j.neuroimage.2011.08.107
19.
Magdoom
,
K. N.
,
Pishko
,
G. L.
,
Kim
,
J. H.
, and
Sarntinoranont
,
M.
,
2012
, “
Evaluation of a Voxelized Model Based on DCE-MRI for Tracer Transport in Tumor
,”
ASME J. Biomech. Eng.
,
134
(
9
), p.
091004
.10.1115/1.4007096
20.
Giudice
,
J. S.
,
Alshareef
,
A.
,
Wu
,
T.
,
Gancayco
,
C. A.
,
Reynier
,
K. A.
,
Tustison
,
N. J.
,
Druzgal
,
T. J.
, and
Panzer
,
M. B.
,
2020
, “
An Image Registration-Based Morphing Technique for Generating Subject-Specific Brain Finite Element Models
,”
Ann. Biomed. Eng.
,
48
(
10
), pp.
2412
2424
.10.1007/s10439-020-02584-z
21.
Ji
,
S.
,
Ford
,
J. C.
,
Greenwald
,
R. M.
,
Beckwith
,
J. G.
,
Paulsen
,
K. D.
,
Flashman
,
L. A.
, and
McAllister
,
T. W.
,
2011
, “
Automated Subject-Specific, Hexahedral Mesh Generation Via Image Registration
,”
Finite Elem. Anal. Des.
,
47
(
10
), pp.
1178
1185
.10.1016/j.finel.2011.05.007
22.
Zhou
,
Z.
,
Li
,
X.
,
Domel
,
A. G.
,
Dennis
,
E. L.
,
Georgiadis
,
M.
,
Liu
,
Y.
,
Raymond
,
S. J.
, et al.,
2022
, “
The Presence of the Temporal Horn Exacerbates the Vulnerability of Hippocampus During Head Impacts
,”
Front. Bioeng. Biotechnol.
,
10
, p.
754344
.10.3389/fbioe.2022.754344
23.
Zhou
,
Z.
,
Li
,
X.
, and
Kleiven
,
S.
,
2020
, “
Biomechanics of Periventricular Injury
,”
J. Neurotrauma
,
37
(
8
), pp.
1074
1090
.10.1089/neu.2019.6634
24.
Li
,
X.
,
Zhou
,
Z.
, and
Kleiven
,
S.
,
2021
, “
An Anatomically Detailed and Personalizable Head Injury Model: Significance of Brain and White Matter Tract Morphological Variability on Strain
,”
Biomech. Model. Mechanobiol.
,
20
(
2
), pp.
403
431
.10.1007/s10237-020-01391-8
25.
Kim
,
J. H.
,
Astary
,
G. W.
,
Kantorovich
,
S.
,
Mareci
,
T. H.
,
Carney
,
P. R.
, and
Sarntinoranont
,
M.
,
2012
, “
Voxelized Computational Model for Convection-Enhanced Delivery in the Rat Ventral Hippocampus: Comparison With In Vivo MR Experimental Studies
,”
Ann. Biomed. Eng.
,
40
(
9
), pp.
2043
2058
.10.1007/s10439-012-0566-8
26.
Magdoom
,
K. N.
,
Pishko
,
G. L.
,
Rice
,
L.
,
Pampo
,
C.
,
Siemann
,
D. W.
, and
Sarntinoranont
,
M.
,
2014
, “
MRI-Based Computational Model of Heterogeneous Tracer Transport Following Local Infusion Into a Mouse Hind Limb Tumor
,”
PLoS One
,
9
(
3
), p.
e89594
.10.1371/journal.pone.0089594
27.
Pishko
,
G. L.
,
Astary
,
G. W.
,
Mareci
,
T. H.
, and
Sarntinoranont
,
M.
,
2011
, “
Sensitivity Analysis of an Image-Based Solid Tumor Computational Model With Heterogeneous Vasculature and Porosity
,”
Ann. Biomed. Eng.
,
39
(
9
), pp.
2360
2373
.10.1007/s10439-011-0349-7
28.
Messaritaki
,
E.
,
Rudrapatna
,
S. U.
,
Parker
,
G. D.
,
Gray
,
W. P.
, and
Jones
,
D. K.
,
2018
, “
Improving the Predictions of Computational Models of Convection-Enhanced Drug Delivery by Accounting for Diffusion non-Gaussianity
,”
Front. Neurol.
,
9
, p.
1092
.10.3389/fneur.2018.01092
29.
Vidotto
,
M.
,
Pederzani
,
M.
,
Castellano
,
A.
,
Pieri
,
V.
,
Falini
,
A.
,
Dini
,
D.
, and
De Momi
,
E.
,
2021
, “
Integrating Diffusion Tensor Imaging and Neurite Orientation Dispersion and Density Imaging to Improve the Predictive Capabilities of CED Models
,”
Ann. Biomed. Eng.
,
49
(
2
), pp.
689
702
.10.1007/s10439-020-02598-7
30.
Linninger
,
A. A.
,
Somayaji
,
M. R.
,
Erickson
,
T.
,
Guo
,
X.
, and
Penn
,
R. D.
,
2008
, “
Computational Methods for Predicting Drug Transport in Anisotropic and Heterogeneous Brain Tissue
,”
J. Biomech.
,
41
(
10
), pp.
2176
2187
.10.1016/j.jbiomech.2008.04.025
31.
Ivasyk
,
I.
,
Morgenstern
,
P. F.
,
Wembacher-Schroeder
,
E.
, and
Souweidane
,
M. M.
,
2017
, “
Influence of an Intratumoral Cyst on Drug Distribution by Convection-Enhanced Delivery: Case Report
,”
J. Neurosurg.: Pediatr.
,
20
(
3
), pp.
256
260
.10.3171/2017.5.PEDS1774
32.
Morgenstern
,
P. F.
,
Zhou
,
Z.
,
Wembacher-Schröder
,
E.
,
Cina
,
V.
,
Tsiouris
,
A. J.
, and
Souweidane
,
M. M.
,
2019
, “
Clinical Tolerance of Corticospinal Tracts in Convection-Enhanced Delivery to the Brainstem
,”
J. Neurosurg.
,
131
(
6
), pp.
1812
1818
.10.3171/2018.6.JNS18854
33.
Floyd
,
J.
,
Phillips
,
W.
,
Goins
,
B.
,
Bao
,
A.
, and
Brenner
,
A.
,
2015
, “
Atnt-03first in Human Study of Rhenium Nanoliposomes for Intratumoral Therapy of Glioma
,”
Neuro-oncology
,
17
(
Suppl 5
), pp.
v10.3
v10
.10.1093/neuonc/nov205.03
34.
Wembacher-Schroeder
,
E.
,
Kerstein
,
N.
,
Bander
,
E. D.
,
Pandit-Taskar
,
N.
,
Thomson
,
R.
, and
Souweidane
,
M. M.
,
2021
, “
Evaluation of a Patient-Specific Algorithm for Predicting Distribution for Convection-Enhanced Drug Delivery Into the Brainstem of Patients With Diffuse Intrinsic Pontine Glioma
,”
J. Neurosurg. Pediatr.
,
28
(
1
), pp.
34
42
.10.3171/2020.11.PEDS20571
35.
Yushkevich
,
P. A.
,
Piven
,
J.
,
Hazlett
,
H. C.
,
Smith
,
R. G.
,
Ho
,
S.
,
Gee
,
J. C.
, and
Gerig
,
G.
,
2006
, “
User-Guided 3D Active Contour Segmentation of Anatomical Structures: Significantly Improved Efficiency and Reliability
,”
Neuroimage
,
31
(
3
), pp.
1116
1128
.10.1016/j.neuroimage.2006.01.015
36.
Chen
,
X.
, and
Sarntinoranont
,
M.
,
2007
, “
Biphasic Finite Element Model of Solute Transport for Direct Infusion Into Nervous Tissue
,”
Ann. Biomed. Eng.
,
35
(
12
), pp.
2145
2158
.10.1007/s10439-007-9371-1
37.
Ewing
,
J. R.
,
Nagaraja
,
T. N.
,
Aryal
,
M. P.
,
Keenan
,
K. A.
,
Elmghirbi
,
R.
,
Bagher-Ebadian
,
H.
,
Panda
,
S.
, et al.,
2015
, “
Peritumoral Tissue Compression is Predictive of Exudate Flux in a Rat Model of Cerebral Tumor: An MRI Study in an Embedded Tumor
,”
NMR Biomed.
,
28
(
11
), pp.
1557
1569
.10.1002/nbm.3418
38.
Truskey
,
G.
,
Yuan
,
F.
, and
Katz
,
D.
,
2009
, “
Transport Phenomena in Biological Systems
,”
Pearson Prentice Hall
,
Hoboken, NJ
, pp.
339
342
.
39.
Gupta
,
S.
,
Soellinger
,
M.
,
Boesiger
,
P.
,
Poulikakos
,
D.
, and
Kurtcuoglu
,
V.
,
2009
, “
Three-Dimensional Computational Modeling of Subject-Specific Cerebrospinal Fluid Flow in the Subarachnoid Space
,”
ASME J. Biomech. Eng.
,
131
(
2
), p.
021010
.10.1115/1.3005171
40.
Seisenberger
,
G.
,
Ried
,
M. U.
,
Endreß
,
T.
,
Büning
,
H.
,
Hallek
,
M.
, and
Bräuchle
,
C.
,
2001
, “
Real-Time Single-Molecule Imaging of the Infection Pathway of an Adeno-Associated Virus
,”
Science
,
294
(
5548
), pp.
1929
1932
.10.1126/science.1064103
41.
Horowitz
,
E. D.
,
Rahman
,
K. S.
,
Bower
,
B. D.
,
Dismuke
,
D. J.
,
Falvo
,
M. R.
,
Griffith
,
J. D.
,
Harvey
,
S. C.
, and
Asokan
,
A.
,
2013
, “
Biophysical and Ultrastructural Characterization of Adeno-Associated Virus Capsid Uncoating and Genome Release
,”
J. Virol.
,
87
(
6
), pp.
2994
3002
.10.1128/JVI.03017-12
42.
Nicholson
,
C.
, and
Syková
,
E.
,
1998
, “
Extracellular Space Structure Revealed by Diffusion Analysis
,”
Trends Neurosci.
,
21
(
5
), pp.
207
215
.10.1016/S0166-2236(98)01261-2
43.
MacManus
,
D. B.
,
Menichetti
,
A.
,
Depreitere
,
B.
,
Famaey
,
N.
,
Vander Sloten
,
J.
, and
Gilchrist
,
M.
,
2020
, “
Towards Animal Surrogates for Characterising Large Strain Dynamic Mechanical Properties of Human Brain Tissue
,”
Brain Multiphys.
,
1
, p.
100018
.10.1016/j.brain.2020.100018
44.
Levin
,
V. A.
,
Fenstermacher
,
J. D.
, and
Patlak
,
C. S.
,
1970
, “
Sucrose and Inulin Space Measurements of Cerebral Cortex in Four Mammalian Species
,”
Am. J. Physiol.-Legacy Content
,
219
(
5
), pp.
1528
1533
.10.1152/ajplegacy.1970.219.5.1528
45.
Syková
,
E.
, and
Nicholson
,
C.
,
2008
, “
Diffusion in Brain Extracellular Space
,”
Physiol. Rev.
,
88
(
4
), pp.
1277
1340
.10.1152/physrev.00027.2007
46.
Laske
,
D. W.
,
Youle
,
R. J.
, and
Oldfield
,
E. H.
,
1997
, “
Tumor Regression With Regional Distribution of the Targeted Toxin TF-CRM107 in Patients With Malignant Brain Tumors
,”
Nat. Med.
,
3
(
12
), pp.
1362
1368
.10.1038/nm1297-1362
47.
Wright
,
J. F.
,
Le
,
T.
,
Prado
,
J.
,
Bahr-Davidson
,
J.
,
Smith
,
P. H.
,
Zhen
,
Z.
,
Sommer
,
J. M.
,
Pierce
,
G. F.
, and
Qu
,
G.
,
2005
, “
Identification of Factors That Contribute to Recombinant AAV2 Particle Aggregation and Methods to Prevent Its Occurrence During Vector Purification and Formulation
,”
Mol. Ther.
,
12
(
1
), pp.
171
178
.10.1016/j.ymthe.2005.02.021
48.
Rey
,
J. A.
,
Ewing
,
J. R.
, and
Sarntinoranont
,
M.
,
2021
, “
A Computational Model of Glioma Reveals Opposing, Stiffness-Sensitive Effects of Leaky Vasculature and Tumor Growth on Tissue Mechanical Stress and Porosity
,”
Biomech. Model. Mechanobiol.
,
20
(
5
), pp.
1981
2000
.10.1007/s10237-021-01488-8
49.
Debinski
,
W.
, and
Tatter
,
S. B.
,
2009
, “
Convection-Enhanced Delivery for the Treatment of Brain Tumors
,”
Expert Rev. Neurother.
,
9
(
10
), pp.
1519
1527
.10.1586/ern.09.99
50.
Sakka
,
L.
,
Coll
,
G.
, and
Chazal
,
J.
,
2011
, “
Anatomy and Physiology of Cerebrospinal Fluid
,”
Eur. Ann. Otorhinolaryngol., Head Neck Dis.
,
128
(
6
), pp.
309
316
.10.1016/j.anorl.2011.03.002
51.
Guo
,
L.
,
Li
,
Z.
,
Lyu
,
J.
,
Mei
,
Y.
,
Vardakis
,
J. C.
,
Chen
,
D.
,
Han
,
C.
,
Lou
,
X.
, and
Ventikos
,
Y.
,
2019
, “
On the Validation of a Multiple-Network Poroelastic Model Using Arterial Spin Labeling MRI Data
,”
Front. Comput. Neurosci.
,
13
, p.
60
.10.3389/fncom.2019.00060
52.
Kothari
,
P.
,
De
,
B. P.
,
He
,
B.
,
Chen
,
A.
,
Chiuchiolo
,
M. J.
,
Kim
,
D.
,
Nikolopoulou
,
A.
, et al.,
2017
, “
Radioiodinated Capsids Facilitate In Vivo Non-Invasive Tracking of Adeno-Associated Gene Transfer Vectors
,”
Sci. Rep.
,
7
(
1
), p.
39594
.10.1038/srep39594
53.
Fiandaca
,
M. S.
,
Varenika
,
V.
,
Eberling
,
J.
,
McKnight
,
T.
,
Bringas
,
J.
,
Pivirotto
,
P.
,
Beyer
,
J.
, et al.,
2009
, “
Real-Time MR Imaging of Adeno-Associated Viral Vector Delivery to the Primate Brain
,”
Neuroimage
,
47
(
Suppl 2
), pp.
T27
T35
.10.1016/j.neuroimage.2008.11.012
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