Focused Ultrasound-Mediated Blood-Brain Barrier Opening for Enhanced Drug Delivery in Diffuse Gliomas: A Systematic Review

Background/Objectives: The blood-brain barrier (BBB) severely limits the intratumoral delivery of systemically administered therapeutics in diffuse gliomas, including glioblastoma (GBM), contributing to the persistently poor prognosis of these tumors. Focused ultrasound (FUS) combined with microbubble agents enables transient, spatially targeted, and reversible BBB opening (BBBO), offering a non-invasive strategy to enhance drug delivery in this setting. Despite a rapidly growing body of clinical evidence, a systematic synthesis of outcomes across FUS platforms, drug regimens, and study designs is currently lacking. This systematic review aims to critically appraise the available clinical evidence on FUS-mediated BBBO for enhanced drug delivery in adult patients with diffuse gliomas.

Methods