Fluid flow rates in human peritumoural oedema

Five patients with various types of brain tumours were infused with x-ray contrast material in a schedule designed to maintain a constant plasma concentration of tracer over a period of 3 hours. CT scans from an equatorial section of the tumour were taken at frequent intervals the first hour; then at 2 and 3 hours, and when possible up to 14 hours. Two different mathematical models-1. simple diffusion, and 2. transport by bulk flow plus diffusion were used to analyze the changes in tracer amount along profiles placed radially from the tumour center into the oedematous white matter. We found that the simple diffusion model could not account for the spread of contrast material in 3 cases. Adding bulk flow transport gave a very good fit to the measurements, also for the late scans. This model gave bulk flow rates of 0.0005 to 0.005 ml cm-2 min-1 for the extratumoural tissue close to the tumour, and values from 0.25 to 0.55 for the extracellular space in this region. We conclude that the peritumoural tissue is "perfused" by oedema fluid at relatively high flow rates and that this flow transports tracer and other components of plasma into the extracellular space.