Surgeons can better monitor the delivery of gene therapy to the brain by using real-time MRIs. Credit: Courtesy of The Ohio State University Wexner Medical Center
Researchers at the Ohio State Gene Therapy Institute, Wexner Medical Center and College of Medicine are studying the use of real-time magnetic resonance imaging, or RT-MRIs, during gene therapy of the brain to enhance the safety and efficacy of surgery.
Gene therapy is a technique that modifies a person’s genes to treat or cure disease, either by replacing the disease-causing gene with a healthy copy, inactivating a disease-causing gene that doesn’t work or introducing a new or modified gene to help treat the disease, according to the FDA.
Dr. Russell Lonser, professor and chair of the Department of Neurological Surgery and co-author of the study, said RT-MRIs play a crucial role in monitoring the precise delivery of gene therapy, ensuring proper treatment in the targeted area. He said RT-MRI use is a “game changer.”
“Before we had to do [the surgery] blindly,” Lonser said. “We just put the cannula in, we infused, we didn’t know where the therapy was going. Now we have the ability to actually see where it’s going, and make sure that we’re actually treating what we need to treat.”
Cannulas are thin tubes inserted into a vein or body cavity to administer medicine, drain fluid or insert a surgical instrument.
According to the study, RT-MRI use also allows surgeons to ensure accurate placement of the cannula.
Dr. Asad Akhter, a sixth-year neurosurgery resident at Ohio State and first author of the study, said the therapeutic gene — the gene used to correct disease-causing genes — is infused into the brain at the same time the RT-MRI is being performed, allowing surgeons to track the exact position of the gene therapy and add the appropriate amount of infused particles.
“Taking an MRI every two to five minutes during the surgery, we can see that the gene therapy that we are infusing is localized to the appropriate side,” Akhter said.
According to the study, previous gene therapy trials that did not use image-tracking technology like RT-MRIs demonstrated a lack of efficacy “linked to minimal perfusion of the target area.”
Perfusion is the process of oxygenated blood being delivered to the body’s tissues. RT-MRIs allow surgeons to monitor this process as it’s happening and if it is occurring adequately or not.
“Alternatively, gene therapy trials using real-time image assessment demonstrate efficacy is directly related to the perfused portion of the target structure,” the study said.
According to Lonser, the use of real-time MRIs with gene therapy can be used for several neurological disorders, including Parkinson’s, Alzheimer’s and tumors.
“We are having a meeting in March where 50 neurosurgeons from around the world will be coming to discuss how we make this broader and implement it internationally,” Lonser said.
