# Robot-placed catheters and live imaging for drug infusion into brain tumours

Source: https://onco.cc/ideas/idea-bio2-robotic-convection-delivery/  
OnCo record `idea-bio2-robotic-convection-delivery` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- 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.
- Proposed 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

## Sources

- Bottleneck evidence (The brain: barrier and sanctuary): Stupp et al., Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma (NEJM 2005): https://doi.org/10.1056/NEJMoa043330

## Connected records

- cancers: [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/)
- technologies: [Laser interstitial thermal therapy (LITT)](https://onco.cc/technologies/litt/), [MRI](https://onco.cc/technologies/mri/), [Robotic & minimally invasive surgery](https://onco.cc/technologies/robotic-surgery/)
- terms: [Blood-brain barrier (BBB)](https://onco.cc/terms/blood-brain-barrier/)
- people: [Michael Weller](https://onco.cc/people/michael-weller/), [Roger Stupp](https://onco.cc/people/roger-stupp/)
- bottlenecks: [Failures are hidden](https://onco.cc/bottlenecks/b-negative-results/), [Surgery and radiotherapy cure most, get least](https://onco.cc/bottlenecks/b-surgery-radiation-innovation/), [The brain: barrier and sanctuary](https://onco.cc/bottlenecks/b-brain-delivery/)

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