{"entity":{"id":"idea-bio2-robotic-convection-delivery","kind":"idea","name":"Robot-placed catheters and live imaging for drug infusion into brain tumours","aka":[],"tldr":"Pumping drugs slowly through fine tubes into a brain tumour can bypass the barrier, but the fluid often leaks away. Robotic placement and live scans would show where it actually goes.","summary":"Convection-enhanced delivery has repeatedly failed in trials, and post-hoc analyses attribute much of the failure to catheter placement and unmonitored backflow rather than to the drug. Robotic stereotactic placement, co-infused imaging tracers and intraoperative MRI make distribution measurable, and chronic implanted port systems permit repeat infusions on an outpatient basis.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (The brain: barrier and sanctuary): Stupp et al., Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma (NEJM 2005)","url":"https://doi.org/10.1056/NEJMoa043330"}],"tags":[],"related":[],"cancers":["glioblastoma"],"sections":[],"technologies":["robotic-surgery","mri","litt"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["blood-brain-barrier"],"trials":[],"people":["michael-weller","roger-stupp"],"bottlenecks":["b-brain-delivery","b-negative-results","b-surgery-radiation-innovation"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Distribution-verified convection delivery achieves target coverage of over 80% of the intended volume in most patients, and coverage correlates with local control, which would show past failures were delivery failures.","rationale":"No convection trial has reported per-patient coverage as a primary endpoint, so the field has never separated drug failure from delivery failure. Every other interventional field improved once delivery was imaged, as with catheter ablation and endovascular therapy.","test":"A device-focused study with co-infused tracer and MRI quantification of coverage for each infusion, reporting the distribution of coverage before any efficacy claim.","maturity":"early-clinical","actor":"engineering","cost":"medium","horizonYears":6},"route":"/ideas/idea-bio2-robotic-convection-delivery/","neighbours":{"cancer":[{"id":"glioblastoma","kind":"cancer","name":"Glioma & glioblastoma","route":"/cancers/glioblastoma/"}],"technology":[{"id":"litt","kind":"technology","name":"Laser interstitial thermal therapy (LITT)","route":"/technologies/litt/"},{"id":"mri","kind":"technology","name":"MRI","route":"/technologies/mri/"},{"id":"robotic-surgery","kind":"technology","name":"Robotic & minimally invasive surgery","route":"/technologies/robotic-surgery/"}],"term":[{"id":"blood-brain-barrier","kind":"term","name":"Blood-brain barrier (BBB)","route":"/terms/blood-brain-barrier/"}],"person":[{"id":"michael-weller","kind":"person","name":"Michael Weller","route":"/people/michael-weller/"},{"id":"roger-stupp","kind":"person","name":"Roger Stupp","route":"/people/roger-stupp/"}],"bottleneck":[{"id":"b-negative-results","kind":"bottleneck","name":"Failures are hidden","route":"/bottlenecks/b-negative-results/"},{"id":"b-surgery-radiation-innovation","kind":"bottleneck","name":"Surgery and radiotherapy cure most, get least","route":"/bottlenecks/b-surgery-radiation-innovation/"},{"id":"b-brain-delivery","kind":"bottleneck","name":"The brain: barrier and sanctuary","route":"/bottlenecks/b-brain-delivery/"}]}}