Magnetic resonance-guided focused ultrasound (MRgFUS) has been used extensively to ablate brain tissue in movement disorders, such as essential tremor. At a lower energy, MRgFUS can disrupt the blood-brain barrier (BBB) to allow passage of drugs. This focal disruption of the BBB can target systemic medications to specific portions of the brain, such as for brain tumors. Current methods to bypass the BBB are invasive, as the BBB is relatively impermeable to systemically delivered antineoplastic agents. Multiple healthy and brain tumor animal models have suggested that MRgFUS disrupts the BBB and focally increases the concentration of systemically delivered antitumor chemotherapy, immunotherapy, and gene therapy. In animal tumor models, combining MRgFUS with systemic drug delivery increases median survival times and delays tumor progression. Liposomes, modified microbubbles, and magnetic nanoparticles, combined with MRgFUS, more effectively deliver chemotherapy to brain tumors. MRgFUS has great potential to enhance brain tumor drug delivery, while limiting treatment toxicity to the healthy brain.
Keywords: BBB = blood-brain barrier; BCNU = bis-chloroethylnitrosourea; BTB = blood-tumor barrier; DOX = doxorubicin; FUS = focused ultrasound; IL = interleukin; LeDOX = liposome-encapsulated DOX; LePTX = liposome-enhanced paclitaxel; MNP = magnetic nanoparticle; MR-guided; MRgFUS = MR-guided FUS; MT = magnetic targeting; SPION = superparamagnetic iron oxide nanoparticle; TMZ = temozolomide; USgFUS = ultrasound-guided FUS; blood-brain barrier; brain tumor; cLeDOX = cationic liposome–encapsulated doxorubicin; cMB = cationic microbubble; focused ultrasound; image-guided; targeted drug delivery.