The blood brain barrier (BBB) prevents some drugs from successfully reaching the target
tumor. Focused Ultrasound (FUS) using microbubbles and neuro-navigator controlled sonication
is a non-invasive method of temporarily opening up the blood brain barrier to allow a greater
concentration of the drug to reach into the brain tumor. This may improve response and may
also reduce system side effects in the patient.
The primary purpose of this study is to evaluate the feasibility of safely opening the blood
brain barrier in children with progressive diffuse midline gliomas (DMG) treated with oral
etoposide using focused ultrasound with microbubbles and neuro-navigator-controlled
sonication.
For the purpose of the study, the investigators will be opening up the blood brain barrier
temporarily in one or two locations around the tumor using the non-invasive focused
ultrasound technology, and administrating oral etoposide in children with progressive diffuse
midline glioma.