Patent Publication Number: US-2021187188-A1

Title: Front-loadable fluid transfer assemblies and related medical fluid transfer systems and methods

Description:
RELATED APPLICATIONS 
     This application claims the benefit of and priority to U.S. Provisional Patent Application Ser. No. 62/950,521 filed Dec. 19, 2019, and U.S. Provisional Patent Application Ser. No. 63/076,008 filed Sep. 9, 2020, the contents of which are hereby incorporated by reference as if recited in full herein. 
    
    
     FIELD OF THE INVENTION 
     The present invention relates generally to medical devices and systems and, more particularly, to devices and systems for delivering and/or withdrawing substances in vivo. 
     BACKGROUND 
     Various therapeutic and diagnostic procedures require that a substance be delivered (e.g., infused) into or aspirated from a prescribed region of a patient, such as to an intrabody target using a delivery device. It may be important or critical that the substance be delivered or removed with accuracy to the target region in the patient and without undue trauma to the patient. 
     SUMMARY 
     It should be appreciated that this Summary is provided to introduce a selection of concepts in a simplified form, the concepts being further described below in the Detailed Description. This Summary is not intended to identify key features or essential features of this disclosure, nor is it intended to limit the scope of the invention. 
     Embodiments of the invention are directed to front-loadable fluid transfer assemblies for transferring fluid to or from a subject. 
     Embodiments of the invention are directed to a surgical plunger assembly that includes: a stylet comprising opposing proximal and distal ends; a luer connector comprising an internal seal coupled to the stylet; and a support body coupled to the luer connector and extending above the distal end of the stylet. The support body encloses a sub-length of the stylet and the stylet is longitudinally moveable relative to the support body between first and second positions. In the first position, the proximal end of the stylet is closer to the luer connector than in the second position. 
     The plunger assembly can also include a plunger comprising a first segment coupled to or defined by the stylet and a second segment having a greater cross-sectional size that the first segment. The second segment can merge into an external plunger flange. The support body can enclose the first segment and at least a portion of the second segment and the first segment and the second segment can be longitudinally movable relative to the support body. With the plunger in a first position, the stylet is in the first position and the second segment of the stylet resides closer to the luer connector than when the stylet is in the second position. 
     The plunger assembly can further include a drive screw that resides at least partially in the support body and that is coupled to the proximal end of the stylet. 
     The plunger assembly can further include a collar that is coupled to the support body and the drive screw. The collar can be rotatable in clockwise and counterclockwise directions to translate the stylet. 
     The plunger assembly can further include a support tube residing inside the support body and coupled to the luer connector above the seal. The stylet can be slidably coupled to the support tube to retract and extend inside the support tube while the support body slidably retracts and extends in concert with the stylet about an outer wall of the support tube. 
     Embodiments of the invention are directed to a surgical plunger assembly that includes: a stylet having opposing proximal and distal ends; a luer connector having an internal seal residing adjacent the proximal end of the stylet; a support body coupled to the luer connector and extending above the distal end of the stylet; and a plunger with a first segment coupled to or defined by the stylet and a second segment having a greater cross-sectional size that the first segment. The second segment merges into an external plunger flange. The support body encloses the first segment and at least a portion of the second segment and the first segment and the second segment are longitudinally movable relative to the support body. With the plunger in a first position, the second segment resides closer to the luer connector than in a second position. 
     The stylet can have a length outside the support body that is in a range of 6 inches and 10 feet in one or both of the first and second positions. 
     The stylet can have a length outside the support body that is in a range of 6 inches and 10 feet when the plunger is in each of the first and second positions. 
     The stylet can be formed of an MM compatible material and can have a maximal outer diameter in a range of about 0.005 inches and about 0.020 inches. 
     The stylet can be formed of Nitinol. 
     The stylet can be formed of fused silica. 
     Other embodiments are directed to an intrabody fluid transfer system that includes: a cannula assembly with a proximal end with a luer connector and having a longitudinally opposing distal end with an open channel extending therethrough; and a plunger assembly coupled to the cannula assembly. The plunger assembly can have a stylet that extends in the open channel of the cannula assembly to position a distal end of the stylet adjacent the distal end of the cannula assembly. The open channel and the stylet cooperate to define a fluid channel extending from the distal end of the cannula assembly, optionally having a length in a range of about 1 cm to about 30 cm. 
     With the plunger in a first position associated with a ready to intake fluid or a fully injected position, the distal end of the stylet can extend flush with or out of the distal end of the cannula assembly. 
     Fluid can be held for dispensing to a patient in the fluid channel at a location between the distal end of the cannula assembly and a medial portion of the cannula assembly. 
     The plunger assembly can further include a luer connector with an internal seal residing adjacent the stylet. The luer connector of the plunger assembly can be attached to the luer connector of the cannula assembly. The plunger assembly can also include a support body coupled to the luer connector of the plunger assembly and extending above the distal end of the stylet and a plunger having a first segment coupled to or defined by the stylet and a second segment having a greater cross-sectional size that the first segment. The second segment can merge into an external plunger flange. The support body can enclose the first segment and at least a portion of the second segment and the first segment and the second segment can be longitudinally movable relative to the support body. With the plunger in a first position, the second segment can reside closer to the luer connectors than in a second position. 
     The intrabody fluid transfer assembly can further include a drive screw that resides at least partially in the support body and that is coupled to the proximal end of the stylet. 
     The intrabody fluid transfer assembly can further include a collar that is coupled to the support body and the drive screw. The collar can be rotatable in clockwise and counterclockwise directions to translate the stylet. 
     The intrabody fluid transfer assembly can further include a support tube residing inside the support body and coupled to the luer connector above the seal. The stylet can be slidably coupled to the support tube to retract and extend inside the support tube while the support body slidably retracts and extends in concert with the stylet about an outer wall of the support tube. 
     The stylet can have a length outside the support body that is in a range of 6 inches and 10 feet when the plunger is in each of the first and second positions. 
     The stylet can be formed of an MRI compatible material and can have a maximal outer diameter in a range of about 0.005 inches and about 0.020 inches. 
     The stylet can be formed of Nitinol. 
     The stylet can be formed of fused silica. 
     Other embodiments are directed to methods for transferring fluid into or from a subject. The methods include: providing a cannula assembly having a luer connector on a proximal end thereof and having a longitudinally opposing distal end; and providing a plunger assembly that is coupleable to or coupled to the cannula assembly. The plunger assembly has a stylet extending from the proximal end to a position proximate, flush with or beyond the distal end of the cannula assembly. The methods further include creating a vacuum by withdrawing the stylet relative to the distal end of the cannula assembly; and intaking target fluid into the distal end of the cannula assembly in response to the vacuum created by the stylet and the cannula assembly. 
     The methods can also include placing the cannula assembly with the plunger assembly coupled thereto and holding the fluid into a trajectory guide of a surgical navigation system whereby a proximal end portion of the plunger assembly is above the trajectory guide and the distal end of the cannula assembly and stylet are in a body of a patient and transferring the fluid into the patient. 
     The fluid can include stem cells. 
     The method can further include delivering the fluid to an intrabrain target site for the transferring step. 
     It is noted that aspects of the invention described with respect to one embodiment may be incorporated in a different embodiment although not specifically described relative thereto. That is, all embodiments and/or features of any embodiment can be combined in any way and/or combination. Applicant reserves the right to change any originally filed claim or file any new claim accordingly, including the right to be able to amend any originally filed claim to depend from and/or incorporate any feature of any other claim although not originally claimed in that manner. These and other objects and/or aspects of the present invention are explained in detail below. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a top perspective view of an example cannula assembly according to embodiments of the present invention. 
         FIG. 2  is a top view of an example plunger assembly according to embodiments of the present invention. 
         FIG. 3  is an assembled view of the plunger and cannula assemblies shown in  FIGS. 1 and 2  forming a fluid transfer assembly according to embodiments of the present invention. 
         FIG. 4  is an enlarged partial view of a proximal end portion of the assembled components shown in  FIG. 3 . 
         FIG. 5A  is a side perspective view of a proximal end portion of the cannula assembly shown in  FIG. 1  and a distal end of the plunger assembly shown in  FIG. 2  in a first assembly configuration. 
         FIG. 5B  shows the proximal end portion of the cannula assembly shown in  FIG. 5A  with the plunger assembly shown in a further assembled state relative to  FIG. 5A . 
         FIG. 6A  illustrates the luer connector of the cannula assembly of  FIG. 1  attached to the luer connector of the plunger assembly of  FIG. 2  after further insertion from the configuration shown in  FIG. 5B  according to embodiments of the present invention. 
         FIG. 6B  is a greatly enlarged end perspective view of a distal end of the assembled device shown in  FIG. 3 . 
         FIG. 7  is a side perspective view of a proximal end portion of the assembled device shown in  FIG. 3  with the plunger in position for actuation for intaking fluid at the distal end thereof according to embodiments of the present invention. 
         FIG. 8  is a side perspective view of the proximal end portion of the assembled device shown in  FIG. 7  with the plunger in a second position for actuation for dispensing/injecting fluid at the distal end thereof according to embodiments of the present invention. 
         FIG. 9A  is an enlarged distal end perspective view of the assembled device shown when in the position of  FIG. 7 . 
         FIG. 9B  is an enlarged distal end perspective view of the assembled device shown when in the position of  FIG. 8 . 
         FIG. 10A  is an enlarged partial proximal end perspective view of another example of a plunger assembly according to embodiments of the present invention. 
         FIG. 10B  is a partial section view of an internal interface of support tubing and plunger wire shown in the plunger assembly shown in  FIG. 10A  according to embodiments of the present invention. 
         FIG. 10C  is a partial section view of the plunger assembly shown in  FIG. 10A  according to embodiments of the present invention. 
         FIG. 11  is an enlarged partial perspective view of another embodiment of a plunger assembly according to embodiments of the present invention. 
         FIG. 12  is a greatly enlarged section view of a segment of the proximal end portion of the plunger assembly shown in  FIG. 11 . 
         FIG. 13  is a schematic illustration of a medical intrabody fluid transfer system operable in an image guided surgical navigation system according to embodiments of the present invention. 
         FIG. 14  is an enlarged partial section view of an example cannula and plunger assembly shown in  FIG. 3 , held by a trajectory guide for intrabody placement according to embodiments of the present invention. 
         FIG. 15  is a flow chart of exemplary actions that can be carried out according to embodiments of the present invention. 
     
    
    
     DETAILED DESCRIPTION 
     The present invention now is described more fully hereinafter with reference to the accompanying drawings, in which some embodiments of the invention are shown. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art. 
     Like numbers refer to like elements throughout. In the figures, the thickness of certain lines, layers, components, elements or features may be exaggerated for clarity. The terms “FIG.” and “Fig.” are used interchangeably with the word “Figure” in the specification and/or figures. 
     The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items. 
     Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the specification and relevant art and should not be interpreted in an idealized or overly formal sense unless expressly so defined herein. Well-known functions or constructions may not be described in detail for brevity and/or clarity. 
     It will be understood that when an element is referred to as being “on”, “attached” to, “connected” to, “coupled” with, “contacting”, etc., another element, it can be directly on, attached to, connected to, coupled with or contacting the other element or intervening elements may also be present. In contrast, when an element is referred to as being, for example, “directly on”, “directly attached” to, “directly connected” to, “directly coupled” with or “directly contacting” another element, there are no intervening elements present. It will also be appreciated by those of skill in the art that references to a structure or feature that is disposed “adjacent” another feature may have portions that overlap or underlie the adjacent feature. 
     Spatially relative terms, such as “under,” “below,” “lower,” “over,” “upper” and the like, may be used herein for ease of description to describe one element or feature&#39;s relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is inverted, elements described as “under” or “beneath” other elements or features would then be oriented “over” the other elements or features. Thus, the exemplary term “under” can encompass both an orientation of “over” and “under”. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Similarly, the terms “upwardly,” “downwardly,” “vertical,” “horizontal” and the like are used herein for the purpose of explanation only unless specifically indicated otherwise. 
     The term “about,” as used herein with respect to a value or number, means that the value or number can vary by +/−twenty percent (20%). 
     The term “monolithic” means that the component (e.g., inner capillary tube or needle) is formed of a single uniform material. 
     The term “MRI visible” means that a device is visible, directly or indirectly, in an MRI image. The visibility may be indicated by the increased SNR of the MM signal proximate to the device (the device can act as an MRI receive antenna to collect signal from local tissue) and/or that the device actually generates MRI signal itself, such as via suitable hydro-based coatings and/or fluid (typically aqueous solutions) filled channels or lumens. 
     The term “MRI compatible” means that a device is safe for use in an MM environment and/or can operate as intended in an MRI environment without generating MR signal artifacts, and, as such, if residing within the high-field strength region of the magnetic field, is typically made of a non-ferromagnetic MM compatible material(s) suitable to reside and/or operate in a high magnetic field environment. 
     The term “high-magnetic field” refers to field strengths above about 0.5T (Tesla), typically above 1.0T, and more typically between about 1.5T and 10T. 
     The term “near real time” refers to both low latency and high frame rate. Latency is generally measured as the time from when an event occurs to display of the event (total processing time). For tracking, the frame rate can range from between about 100 fps to the imaging frame rate. In some embodiments, the tracking is updated at the imaging frame rate. For near “real-time” imaging, the frame rate is typically between about 1 fps to about 20 fps, and in some embodiments, between about 3 fps to about 7 fps. The low latency required to be considered “near real time” is generally less than or equal to about 1 second. In some embodiments, the latency for tracking information is about 0.01 s, and typically between about 0.25-0.5 s when interleaved with imaging data. Thus, with respect to tracking, visualizations with the location, orientation and/or configuration of a known intrabody device can be updated with low latency between about 1 fps to about 100 fps. With respect to imaging, visualizations using near real time MR image data can be presented with a low latency, typically within between about 0.01 ms to less than about 1 second, and with a frame rate that is typically between about 1-20 fps. Together, the system can use the tracking signal and image signal data to dynamically present anatomy and one or more intrabody devices in the visualization in near real-time. In some embodiments, the tracking signal data is obtained and the associated spatial coordinates are determined while the MR image data is obtained and the resultant visualization(s) with the intrabody device (e.g., stylet) and the near RT MR image(s) are generated. 
     The term “sterile,” as used herein, means that a device, kit, and/or packaging meets or exceeds U.S./Federal Drug Administration and/or other regulatory medical/surgical cleanliness guidelines, and typically is free from live bacteria or other microorganisms. 
     Embodiments of the present invention can be utilized with various diagnostic or interventional devices and/or therapies to any desired internal region of an object using any suitable imaging modality, typically an MRI and/or in an MRI scanner or MM interventional suite. However, CT or other imaging modalities may be used. The object can be any object, and may be particularly suitable for animal and/or human subjects for e.g., animal studies and/or veterinarian or human treatments. Some embodiments deliver therapies to the spine. Some embodiments deliver therapies to treat or stimulate a desired region of the sympathetic nerve chain. Other uses, inside or outside the brain, nervous system or spinal cord, include stem cell placement, gene therapy or drug delivery for treating physiological conditions, chemotherapy, drugs including replicating therapy drugs. Some embodiments can be used to treat tumors. 
     The term “substance,” as used herein, refers to a liquid for treating or facilitating diagnosis of a condition and can include bions, stem cells or other target cells to site-specific regions in the body, such as neurological, nerves or other target sites and the like. In some embodiments, stem cells and/or other rebuilding cells or products can be delivered into spine, brain or cardiac tissue, such as a heart wall via a minimally invasive MRI guided procedure, while the heart is beating (i.e., not requiring a non-beating heart with the patient on a heart-lung machine). Examples of known stimulation treatments and/or target body regions are described in U.S. Pat. Nos. 6,708,064; 6,438,423; 6,356,786; 6,526,318; 6,405,079; 6,167,311; 6,539,263; 6,609,030 and 6,050,992, the contents of which are hereby incorporated by reference as if recited in full herein. 
     The term “fluid” with respect to fluid being withdrawn from a subject refers to soft tissue, foreign matter, biological matter including cellular material and liquid in a subject. 
     The term “infusion” and derivatives thereof refers to the delivery of a substance (which can be a single substance or a mixture) at a relatively slow rate so that the substance can infuse about a target region. Thus, the term “infusate” refers to a substance so delivered. 
     The term “semi-rigid” refers to devices that have sufficient rigidity to have a self-supporting fixed shape (typically straight tubular or cylindrical shapes) in the absence of applied bending forces but have sufficient flexibility to be able to bend or deflect without breaking in response to forces applied during insertion into or removal from a trajectory guide (see, for example,  1250   t ,  FIG. 4 ), then return to its original self-supporting shape upon removal of the applied force(s). 
     The term “flexible” means that the device(s) does not have sufficient rigidity to have a fixed shape without support and can be rolled, coiled, folded for example. 
     The subject can be any subject, and may be particularly suitable for animal and/or human subjects for e.g., animal studies and/or veterinarian or human treatments. 
     Some embodiments aspirate fluid from a target intrabody region such as, for example, a brain. For example, aspiration of fluid from a target structure can debulk it. Debulking the structure can relieve pressure on the surrounding areas. This can be desirable as it can be performed in a less invasive manner than surgical resection. See, U.S. patent application Ser. No. 16/217,222, the contents of which are hereby incorporated by reference as if recited in full herein. 
     Embodiments of the invention can deliver therapies to the spine. 
     Embodiments of the invention can deliver therapies to treat or stimulate a desired region of the sympathetic nerve chain. Other uses, inside or outside the brain, nervous system or spinal cord, include stem cell placement, gene therapy or drug delivery for treating physiological conditions, chemotherapy, drugs including replicating therapy drugs. Some embodiments can be used to treat a patient with one or more tumors. 
     Embodiments of the present invention will now be described in further detail below with reference to the figures.  FIG. 1  illustrates an exemplary cannula assembly  10 . The cannula assembly  10  is configured for intrabody fluid transfer.  FIG. 2  illustrates an exemplary plunger assembly  100 .  FIG. 3  illustrates the plunger assembly  100  coupled to the cannula assembly  10  to define a transfer assembly  200 . When assembled, the plunger assembly  100  extends entirely through the cannula assembly  10 . A distal end  100   d  of the plunger assembly  100  can reside proximate to, such as inward a distance of about 1 mm relative to the distal end  10   d , flush with and/or extend out beyond the distal end  10   d  of the cannula assembly  10  and a proximal end  100   p  of the plunger assembly  100  extends beyond a proximal end  10   p  of the cannula assembly  10 . The distal end  100   d  of the plunger assembly  100  can be configured to extend a short distance, such as less than 1 mm, typically such as a distance in a range of about 0-0.5 mm, beyond the distal end  10   d  of the cannula assembly in a ready to load and/or fully dispensed position. The proximal end  10   p  of the cannula assembly  10  can comprise a luer connector  11 . 
     In some embodiments, the plunger assembly  100  is configured to cooperate with the cannula assembly  10 , allowing the assembled device  200  to be “front loaded”. The purpose of front loading the cannula assembly  10  is to load a target fluid into a delivery device to minimize and/or not create any “dead space”. The term “dead space” refers to a situation where an undesirable amount of drug is left in a syringe or lumen of the cannula, after a delivery such as an infusion is complete. This can be particularly undesirable where a target drug for delivery is in limited supply such as comprising stem cells and/or where a cell sample obtained from a patient is very small. 
     Referring to  FIGS. 2-4 , as shown, the plunger assembly  100  includes a support body  106  that can optionally be cylindrical (or other shape such as a polygonal or triangular shape) and comprises a luer hub  105  on a distal end thereof. The plunger assembly  100  can also include a plunger support flange  108  on an opposing proximal end. 
     The plunger assembly  100  can also include a plunger flange  110  that defines the proximal end  100   p  of the plunger assembly  100 . 
     As is also shown, the plunger assembly  100  comprises a long stylet  101 . The long stylet  101  is elongate and has a length L (in a longitudinal direction) that is greater than a length of the support body  106 . Typically, the plunger cannula assembly  100  extends an overall length L that can be greater than an overall length L of the cannula assembly  10 , such as in a range of about 1 foot to about 10 feet including about 1.5 feet, about 2 feet, about 2.5 feet, about 3 feet, about 3.5 feet, about 4 feet, about 4.5 feet, about 5 feet, about 5.5 feet, about 6 feet, about 6.5 feet, about 7 feet, about 7.5 feet, about 8 feet, about 8.5 feet, about 9 feet, about 9.5 feet and about 10 feet. If sufficiently long, the plunger assembly  100  can be actuated from outside a bore  1350   b  of a magnet  1350  of an Mill Scanner  1220  ( FIG. 13 ) allowing efficient delivery during an image-guided surgical procedure. 
     The stylet  101  can be configured to fit any target inner diameter of a respective cannula assembly  10 . The plunger assembly  100  can have sufficient flexibility to be able to change in shape from a linear configuration to a curved configuration as shown with respect to  FIG. 2  and  FIG. 3 . 
     The cannula assembly  10  may have an inner diameter in a range of about 0.008 inches to about 0.021 inches, which may be particularly suitable for certain infusion uses. 
     When an operator pulls back on the plunger  102 , the stylet  101  travels back as well creating a vacuum that evacuates/sucks a fluid such as a drug from a distal end  10   d  of cannula assembly  10  into the cannula assembly  10  about the stylet  101 . Typically, the “front-loaded” drug resides upstream of the distal end  10   d  of the cannula assembly  10  a distance corresponding to a stroke distance of the plunger  102  and/or a distance in a range of 1 cm to about 30 cm or a range of about 5 cm to about 15 cm. The distance can be, for example, about 1 cm, about 2 cm, about 3 cm, about 4 cm, about 5 cm, about 6 cm, about 7 cm, about 8 cm, about 9 cm, about 10 cm, about 11 cm, about 12 cm, about 13 cm, about 14 cm, about 15 cm, about 16 cm, about 17 cm, about 18 cm, about 19 cm, about 20 cm, about 21 cm, about 22 cm, about 23 cm, about 24 cm, about 25 cm, about 26 cm, about 27 cm, about 28 cm, about 29 cm and about 30 cm. The stroke travel distance is below the luer connector  11  and/or luer hub  105  and/or support body  106 , more typically between the distal end  10   d  of the cannula assembly  10  and a medial location  10   m  of the cannula assembly  10 . 
     When the plunger  102  is moved forward toward the distal end  10   d  of the cannula assembly  10 , the stylet  101  pushes the fluid, e.g., drug, out of the cannula assembly  10  into a target location such as the brain or heart, for example. 
     Referring to  FIGS. 5A, 5B, 6A and 6B , the plunger assembly  100  can attach to the cannula assembly  10  by inserting the stylet  101  into the proximal end  10   p  of the cannula assembly  10  and threading/pushing the stylet  101  forward to the distal end  10   d  of the cannula assembly  10 , then the plunger assembly  100  can be coupled to (typically locked onto) the cannula assembly  10  at the luer connector  11  ( FIG. 6A ), similar to a syringe. When fully seated, the distal end  100   d  of the plunger assembly  100  can reside at a distal end  10   d  of the cannula assembly  10 , and can protrude a distance in a range of about 0-0.5 mm ( FIG. 6B ) in some particular embodiments. 
       FIG. 7  illustrates the plunger/cannula assembly  200  in a ready to intake configuration with the plunger flange  110  adjacent the support body flange  108  and the first segment  102   a  of the plunger  102  having a shorter length inside the support body  106  than the position shown in  FIG. 8 , with the second segment  102   b  residing closer to the seal  103  and luer hub  105  in the ready to intake configuration:  FIGS. 7, 9A  versus the retracted and loaded position shown in  FIGS. 8 ;  9 B (the latter having the stylet  101  retracted from the distal end  10   d  of the cannula assembly). 
     When in the configuration shown in  FIG. 8 , the assembly  200  can be inserted through a stereotactic guidance system such as a trajectory guide  1250   t  ( FIG. 14 ) with the plunger flange  110  accessible to move up and down relative to a patient and the fluid F delivered to or obtained from a patient using the assembly  200 . 
     The plunger assembly  100  can be provided in a kit assembled to the cannula assembly  10 . 
     The plunger assembly  100  can be provided as a separate component in a package with or in a different package from the cannula assembly  10 . 
     The drug can be provided separate from the plunger assembly  10  and/or cannula assembly  100  and is typically loaded onsite prior to delivery. 
     In some embodiments, for MRI conditional use (safe for use about an MRI Scanner room with magnets generating a magnetic field, but cannot be inserted during active MRI scanning), the stylet  101  can comprise Nitinol wire. In some embodiments, for MRI-safe use (safe for use in an MRI Scanner room even during scanning), the stylet  101  can comprise fused silica. 
     In some embodiments, for CT or other imaging modalities other materials may be used, preferably biocompatible and inert with respect to the target drug or fluid. 
     The stylet  101  defines or is attached to a plunger  102 . The plunger  102  and stylet  101  are longitudinally extendable and retractable (as a unit/in concert) relative to the cannula assembly  10  and/or a luer hub  105  attached to the plunger assembly  100 . 
     An internal seal  103  can reside at the luer hub  105 . The internal seal  103  can define a fluid-tight seal about a segment of the stylet  101  defining a segment of the plunger  102   w . The segment of the plunger defined by the stylet  101  can be a small diameter wire  102   w.    
     In some embodiments, at least an elongate segment of the stylet  101  that resides in a distal and medial (intrabody) portion of the cannula assembly  10  can be solid (have a solid core) and have an outer diameter in a range of about 0.005 inches and about 0.020 inches. 
     The plunger  102  can comprise a first segment  102   a  that merges into a longitudinally extending second segment  102   b . The second segment  102   b  can have a greater cross-sectional size relative to the first segment  102   a  inside a support body  106 . The second segment  102   b  can snugly slidably engage the support body  106  but is not required to be fluidly sealed thereto. The support body  106  can be configured to support the plunger  102  including at least part of segments  102   a ,  102   b  during actuation to inhibit buckling. 
     At least a portion of the first segment  102   a  and a portion of the second segment  102   b  can reside in the support body  106  when in a fully extended position with the distal end  100   d  outside the distal end  10   d  of the cannula assembly ( FIGS. 7, 9A ) and when in a retracted position for loading/intaking fluid ( FIGS. 8, 9B ). Thus, the second segment  102   b  can travel longitudinally with respect to the support body  106  but does not travel below the internal seal  103  and/or luer hub  105  ( FIG. 7 ). The stroke distance “d”, between the maximal extended and retracted operative positions, e.g., a location to intake/load fluid relative to a fully assembled position ( FIG. 7 ), can be a distance in a range of about 1 cm to about 30 cm or a range of about 5 cm to about 15 cm, depending on a desired amount of fluid to be loaded into the flow channel  10   f  of the assembled device  200  ( FIGS. 3, 7, 8 ). The flow channel  10   f  may have an annular segment defined by the stylet and cannula assembly. The stroke distance can be, for example, about 1 cm, about 2 cm, about 3 cm, about 4 cm, about 5 cm, about 6 cm, about 7 cm, about 8 cm, about 9 cm, about 10 cm, about 11 cm, about 12 cm, about 13 cm, about 14 cm, about 15 cm, about 16 cm, about 17 cm, about 18 cm, about 19 cm, about 20 cm, about 21 cm, about 22 cm, about 23 cm, about 24 cm, about 25 cm, about 26 cm, about 27 cm, about 28 cm, about 29 cm and about 30 cm. 
     The distal end of the stylet  101  can travel  1 : 1  with the plunger  102  proximal end and pull fluid in to the cannula  10  in a 1:1 ratio, e.g., 1 cm of plunger travel can intake fluid a distance of 1 cm. 
     The stylet  101  and the cannula assembly  10  can be sized and configured to create a vacuum and intake the fluid using the vacuum to front load the cannula assembly  10 . The differential between the inner diameter of the cannula  10  and the outer diameter of the stylet  101  to create a desirable vacuum can be in arrange of about 0.0005 inches and 0.10 inches, for example. 
     The cannula assembly  10  can comprise an inner tube  10   t  of continuous length and may have a constant inner diameter, at least over a major portion of a length thereof. In some embodiments, the inner tube can be one continuous piece of material, typically of either PEEK or fused silica glass that extends from the distal end  10   d  to the connector  11 . 
     Referring to  FIG. 1 , the stylet  101  can cooperate with the inner tube  10   t  and define a flow channel  10   f  ( FIG. 9A ). The flow channel  10   f  can have an outer diameter that can be in a range about 0.005 inches and about 0.020 inches, in a range of 100 μm to about 750 μm, such as about 200 μm, or in a range of about 0.20 mm to about 0.05 mm, such as about 0.20 mm or about 0.053 mm. 
     The inner tube  10   t  can comprise fused silica glass or PEEK or other material. The stylet  101  and inner tube  10   t  can be substantially, if not totally, inert and sterile, so as not to chemically interact with any target fluid in the flow lumen  10   f  ( FIG. 9A ). 
     Referring to  FIGS. 1, 6B, 9B , the cannula assembly  10  can comprise an outer tube  12  that can be closely spaced to the inner surface of the outer wall of the inner tube  10   t  to inhibit reverse flow and/or provide a fluid-resistant interface to inhibit flow therebetween. 
     Referring to  FIG. 10A , the plunger assembly  100  can comprise graduated indicia of depth/distance on the support body  106 . The support flange  108  can also include a flange  108  that has an outer perimeter  108   p  with long sides  1081  connected by shorter sides  108   s . The shorter sides  108   s  can define finger gripping surfaces. A lock member  118  such as a thumbscrew can be provided on at least one of the long sides  108 . The shorter sides  108   s  can be arcuate while the longer sides may be planar. The shorter sides  108   s  can comprise ridges  108   r . The lock member  118  can be configured to directly couple to an outer surface  102   s  of the second segment  102   b  of the plunger  102  inside the support body  106 .  FIGS. 10B and 10C  illustrate that the second segment  102   b  of the plunger  102  can comprise a sleeve  102   s  with a longitudinally extending channel  102   c . The channel  102   c  can extend above a proximal end portion  101   p  of the stylet  101 . The proximal end portion  101   p  of the stylet  101  can be affixed to the channel  102   c  so that the sleeve  102   s  (plunger wire outer body) and style  101  slide in concert. 
       FIGS. 10B and 10   c  illustrate that the plunger assembly  100  can further include a support tube  1101  that resides between the seal  103  of the luer hub  105  and the plunger flange  110  and encases a portion of the stylet  101 . The support tube  1101  can have a distal end portion  1101   d  that resides in an inwardly extending neck  105  of the luer hub  105 , axially aligned with the channel  102   c  of the sleeve  102 . 
     As shown in  FIG. 10C , a proximal end portion  1101   p  of the support tube  1101  can terminate proximate an outer end of the support flange  108 . The support tube  1101  can reside inside the sleeve  102   s  and can terminate short of the proximal end portion  101   p  of the stylet  101 . The proximal end portion  101   p  of the style  101  can be affixed to the plunger flange  110  via a bond  1112  inside the channel  102   c  under the flange  110 . 
     The stylet  101  can be configured to slide longitudinally inside the support tube  1101  and the sleeve  102  can slide longitudinally outside the support tube  1101 . The support tube  1101  can have a stationary configuration inside the support body  106 . At least one end portion of the support tube  1101  can be affixed, such as via a bond  1113 , to the support tube  106 , shown as indirectly attached to the support tube  106 , to anchor the support tube  1101  in a fixed position in the plunger assembly  100 . 
     Turning now to  FIGS. 11 and 12 , another embodiment of a plunger assembly  100 ′ is shown. In this embodiment, a drive screw  220  can be used to translate the stylet  101  instead of a plunger  102 , which may provide for increased precision over manual plunger operation using the plunger flange. The stylet  101  can be attached to the drive screw  220  inside the support body  106 , above the luer hub  105  with the seal  103 . The plunger assembly  100 ′ can include a collar  210  that is affixed to the screw  220 . Rotation of the collar  210  can translate the drive screw  220 , which retracts or extends the stylet  101 . 
     One full rotation of the collar  210  can translate the stylet  101  a defined distance, such as a distance in a range of about 0.1 mm and about 2 mm. In some embodiments, one rotation of the collar  210  can be configured to provide about 1 mm of longitudinal travel (retraction and extension) of the stylet  101 . 
     The stylet  101  can be affixed to the drive screw  220 . The proximal end portion  101   p  of the stylet can extend into a channel in the screw  220 . The proximal end portion  101   p  of the stylet  101  can be bonded to the screw  220 . 
     The collar  210  can be fixed to the support body  106 . A set screw  240  can thread into the support body  106 . The set screw  240  can prevent the drive screw  220  from rotating inside the collar  210 . 
     A dowel pin  230  can engage an interior groove  230   g  in the collar  210  to keep the collar  210  assembled to the support body  106  and/or prevent the drive screw  220  from rotating. The collar  210  can have internal threads  212  that engage the threads  221  of the drive screw  220 . 
     A proximal end portion  220   p  of the drive screw  220  can extend out of the collar  210 . The threads  212  can extend over a sub-length of the collar  210  inside the collar  210 . 
     Although not shown, the support tube  1101  discussed above, can be provided in the support body  106 , under the drive screw  220 . 
     Referring to  FIG. 14 , the assembly  200  can extend through a tubular support  260  of a trajectory guide  1250   t  that can be held by a base or frame e.g., a stereotactic frame that can be secured to the patient or that can be secured to a holder residing over the patient. A lock  170  can be used to secure the assembly  200  at a desired position in the tubular support  260  to place the distal end  10   d  at a target region A and withdraw or delivery substance F. See, e.g., U.S. Pat. Nos. 8,315,689, 8,175,677 and 8,374,677 and US Patent Application Publication No. 2010/0198052 (Ser. No. 12/694,865) for descriptions of patient planning and entry protocols and frames and trajectory guides, the contents of which are hereby incorporated by reference as if recited in full herein. 
       FIG. 13  illustrates an MRI-guided interventional system  500  with an MRI scanner  1220 , a clinician workstation  1230  with at least one circuit  1230   c , at least one display  1232 , an MRI compatible trajectory guide  1250   t  and a fluid transfer assembly  200 . The system  500  can be configured to render or generate near real time or real time visualizations of the target anatomical space using MM image data and predefined data of at least one surgical tool (e.g., tubular cannula  20  and/or trajectory guide  1250   t ) to segment the image data and place the trajectory guide  1250   t  and the cannula  20  in the rendered visualization in the correct orientation and position in 3D space (which is the MM surgical space for MM embodiments), anatomically registered to a patient. The trajectory guide  1250   t  and the cannula  20  can include or cooperate with tracking, monitoring and/or other interventional components. 
     The trajectory guide  1250   t  can be configured to provide one or more of an X-Y adjustment and/or pitch and roll adjustment in order to accurately position the assembly  200  at a desired location within a patient. For additional discussion of examples of suitable trajectory guides, see U.S. Pat. No. 8,374,677, the contents of which are hereby incorporated by reference as if recited in full herein. However, it is noted that other trajectory guide configurations may be used and embodiments of the invention are not limited by the examples of the trajectory guides herein. 
     According to some embodiments, the systems are configured to provide a substantially automated or semi-automated and relatively easy-to-use MRI-guided system with defined workflow steps and interactive visualizations. In particular embodiments, the systems define and present workflow with discrete steps for finding target and entry point(s), guiding the alignment of the targeting cannula to a planned trajectory, monitoring the insertion of the cannula assembly  200 , and adjusting the (X-Y) position in cases where the placement needs to be corrected. During steps where specific MR scans are used, the circuit or computer module can display data for scan plane center and angulation to be entered at the console. The workstation/circuit can passively or actively communicate with the MR scanner. The system can also be configured to use functional patient data (e.g., fiber tracks, fMRI and the like) to help plan or refine a target surgical site and/or access path. 
     The system  500  may also include a decoupling/tuning circuit that allows the system to cooperate with the MRI scanner  1220  and filters and the like. See, e.g., U.S. Pat. Nos. 6,701,176; 6,904,307 and U.S. Patent Application Publication No. 2003/0050557, the contents of which are hereby incorporated by reference as if recited in full herein. 
     The assembly  200  can be configured to flowably introduce, infuse and/or inject a desired therapy substance (e.g., antigen, gene therapy, chemotherapy or stem-cell or other therapy type). 
     In some embodiments, the intrabody fluid transfer assembly  200  is configured to deliver a drug therapy to the brain. The drug therapy can comprise substance F delivered to the target site or region A ( FIG. 14 ) through the fluid/flow channel  10   f  ( FIG. 6B ) and may be any suitable and desired substance for drug discovery, animal or human clinical trials and/or approved medical procedures. According to some embodiments, the substance F is a liquid or slurry. In the case of a tumor, the substance may be a chemotherapeutic (cytotoxic) fluid. In some embodiments, the substance can include certain types of advantageous cells that act as vaccines or other medicaments (for example, antigen presenting cells such as dendritic cells). The dendritic cells may be pulsed with one or more antigens and/or with RNA encoding one or more antigen. Exemplary antigens are tumor-specific or pathogen-specific antigens. Examples of tumor-specific antigens include, but are not limited to, antigens from tumors such as renal cell tumors, melanoma, leukemia, myeloma, breast cancer, prostate cancer, ovarian cancer, lung cancer and bladder cancer. Examples of pathogen-specific antigens include, but are not limited to, antigens specific for HIV or HCV. In some embodiments, the substance F may comprise radioactive material such as radioactive seeds. Substances F delivered to a target area in accordance with embodiments of the present invention may include, but are not limited to, the following drugs (including any combinations thereof) listed in Table 1: 
     
       
         
           
               
               
             
               
                 TABLE 1 
               
               
                   
               
               
                 DRUG (generic name) 
                 DISORDER(S) 
               
               
                   
               
             
            
               
                 Caprylidene 
                 Alzheimer&#39;s disease 
               
               
                 Donepezil 
                 Alzheimer&#39;s disease 
               
               
                 Galantamine 
                 Alzheimer&#39;s disease 
               
               
                 Memantine 
                 Alzheimer&#39;s disease 
               
               
                 Tacrine 
                 Alzheimer&#39;s disease 
               
               
                 vitamin E 
                 Alzheimer&#39;s disease 
               
               
                 ergoloid mesylates 
                 Alzheimer&#39;s disease 
               
               
                 Riluzole 
                 Amyotrophic lateral sclerosis 
               
               
                 Metoprolol 
                 Benign essential tremors 
               
               
                 Primidone 
                 Benign essential tremors 
               
               
                 Propanolol 
                 Benign essential tremors 
               
               
                 Gabapentin 
                 Benign essential tremors &amp; Epilepsy 
               
               
                 Nadolol 
                 Benign essential tremors &amp; Parkinson&#39;s disease 
               
               
                 Zonisamide 
                 Benign essential tremors &amp; Parkinson&#39;s disease 
               
               
                 Carmustine 
                 Brain tumor 
               
               
                 Lomustine 
                 Brain tumor 
               
               
                 Methotrexate 
                 Brain tumor 
               
               
                 Cisplatin 
                 Brain tumor &amp; Neuroblastoma 
               
               
                 Ioversol 
                 Cerebral arteriography 
               
               
                 Mannitol 
                 Cerebral Edema 
               
               
                 Dexamethasone 
                 Cerebral Edema &amp; Neurosarcoidosis 
               
               
                 Baclofen 
                 Cerebral spasticity 
               
               
                 Ticlopidine 
                 Cerebral thrombosis/embolism 
               
               
                 Isoxsuprine 
                 Cerebrovascular insufficiency 
               
               
                 Cefotaxime 
                 CNS infection &amp; Meningitis 
               
               
                 Acyclovir 
                 Encephalitis 
               
               
                 Foscarnet 
                 Encephalitis 
               
               
                 Ganciclovir 
                 Encephalitis 
               
               
                 interferon alpha-2a 
                 Encephalitis 
               
               
                 Carbamazepine 
                 Epilepsy 
               
               
                 Clonazepam 
                 Epilepsy 
               
               
                 Diazepam 
                 Epilepsy 
               
               
                 divalproex sodium 
                 Epilepsy 
               
               
                 Ethosuximide 
                 Epilepsy 
               
               
                 Ethotoin 
                 Epilepsy 
               
               
                 Felbamate 
                 Epilepsy 
               
               
                 Fosphenytoin 
                 Epilepsy 
               
               
                 Levetiracetam 
                 Epilepsy 
               
               
                 Mephobarbital 
                 Epilepsy 
               
               
                 Paramethadione 
                 Epilepsy 
               
               
                 Phenytoin 
                 Epilepsy 
               
               
                 Trimethadione 
                 Epilepsy 
               
               
                 Pregabalin 
                 Epilepsy &amp; Neuralgia 
               
               
                 immune globulin 
                 Guillain-Barre Syndrome 
               
               
                 intravenous 
               
               
                 interferon beta-1b 
                 Guillain-Barre Syndrome &amp; Multiple sclerosis 
               
               
                 Azathioprine 
                 Guillain-Barre Syndrome &amp; Multiple sclerosis &amp; 
               
               
                   
                 Neurosarcoidosis 
               
               
                 Risperidone 
                 Head injury 
               
               
                 Tetrabenazine 
                 Huntington&#39;s disease 
               
               
                 Acetazolamide 
                 Hydrocephalus &amp; Epilepsy 
               
               
                 Alteplase 
                 Ischemic stroke 
               
               
                 Clopidogrel 
                 Ischemic stroke 
               
               
                 Nimodipine 
                 Ischemic stroke &amp; Subarachnoid hemorrhage 
               
               
                 Aspirin 
                 Ischemic stroke &amp; Thromboembolic stroke 
               
               
                 Amikacin 
                 Encaphalitis 
               
               
                 Ampicillin 
                 Encaphalitis 
               
               
                 ampicillin/sulbactam 
                 Encaphalitis 
               
               
                 Ceftazidime 
                 Encaphalitis 
               
               
                 Ceftizoxime 
                 Encaphalitis 
               
               
                 Cefuroxime 
                 Encaphalitis 
               
               
                 Chloramphenicol 
                 Encaphalitis 
               
               
                 cilastatin/imipenem 
                 Encaphalitis 
               
               
                 Gentamicin 
                 Encaphalitis 
               
               
                 Meropenem 
                 Encaphalitis 
               
               
                 Metronidazole 
                 Encaphalitis 
               
               
                 Nafcillin 
                 Encaphalitis 
               
               
                 Oxacillin 
                 Encaphalitis 
               
               
                 Piperacillin 
                 Encaphalitis 
               
               
                 Rifampin 
                 Encaphalitis 
               
               
                 sulfamethoxazole/ 
                 Encaphalitis 
               
               
                 trimethoprim 
               
               
                 Tobramycin 
                 Encaphalitis 
               
               
                 Triamcinolone 
                 Encaphalitis 
               
               
                 Vancomycin 
                 Encaphalitis 
               
               
                 Ceftriaxone 
                 Encaphalitis &amp; Neurosyphilis 
               
               
                 Penicillin 
                 Encaphalitis &amp; Neurosyphilis 
               
               
                 Corticotrophin 
                 Multiple sclerosis 
               
               
                 Dalfampridine 
                 Multiple sclerosis 
               
               
                 Glatiramer 
                 Multiple sclerosis 
               
               
                 Mitoxantrone 
                 Multiple sclerosis 
               
               
                 Natalizumab 
                 Multiple sclerosis 
               
               
                 Modafinil 
                 Multiple sclerosis 
               
               
                 Cyclophosphamide 
                 Multiple sclerosis &amp; Brain tumor &amp; 
               
               
                   
                 Neuroblastoma 
               
               
                 interferon beta-1a 
                 Multiple sclerosis &amp; Neuritis 
               
               
                 Prednisolone 
                 Multiple sclerosis &amp; Neurosarcoidosis 
               
               
                 Prednisone 
                 Multiple sclerosis &amp; Neurosarcoidosis 
               
               
                 Amantadine 
                 Multiple sclerosis &amp; Parkinson&#39;s disease 
               
               
                 Methylprednisolone 
                 Neuralgia 
               
               
                 Desvenlafaxine 
                 Neuralgia 
               
               
                 Nortriptyline 
                 Neuralgia 
               
               
                 Doxorubicin 
                 Neuroblastoma 
               
               
                 Vincristine 
                 Neuroblastoma 
               
               
                 Albendazole 
                 Neurocystecercosis 
               
               
                 chloroquine phosphate 
                 Neurosarcoidosis 
               
               
                 Hydroxychloroquine 
                 Neurosarcoidosis 
               
               
                 Infliximab 
                 Neurosarcoidosis 
               
               
                 Pentoxyfilline 
                 Neurosarcoidosis 
               
               
                 Thalidomide 
                 Neurosarcoidosis 
               
               
                 Apomorphine 
                 Parkinson&#39;s disease 
               
               
                 Belladonna 
                 Parkinson&#39;s disease 
               
               
                 Benztropine 
                 Parkinson&#39;s disease 
               
               
                 Biperiden 
                 Parkinson&#39;s disease 
               
               
                 Bromocriptine 
                 Parkinson&#39;s disease 
               
               
                 Carbidopa 
                 Parkinson&#39;s disease 
               
               
                 carbidopa/entacapone/ 
                 Parkinson&#39;s disease 
               
               
                 levodopa 
               
               
                 carbidopa/levodopa 
                 Parkinson&#39;s disease 
               
               
                 Entacapone 
                 Parkinson&#39;s disease 
               
               
                 Levodopa 
                 Parkinson&#39;s disease 
               
               
                 pergolide mesylate 
                 Parkinson&#39;s disease 
               
               
                 Pramipexole 
                 Parkinson&#39;s disease 
               
               
                 Procyclidine 
                 Parkinson&#39;s disease 
               
               
                 Rasagiline 
                 Parkinson&#39;s disease 
               
               
                 Ropinirole 
                 Parkinson&#39;s disease 
               
               
                 Rotiotine 
                 Parkinson&#39;s disease 
               
               
                 Scopolamine 
                 Parkinson&#39;s disease 
               
               
                 Tolcapone 
                 Parkinson&#39;s disease 
               
               
                 Trihexyphenidyl 
                 Parkinson&#39;s disease 
               
               
                 Seleginline 
                 Parkinson&#39;s disease 
               
               
                 Rivastigmine 
                 Parkinson&#39;s disease &amp; Alzheimer&#39;s disease 
               
               
                 Anisindione 
                 Thromboembolic stroke 
               
               
                 Warfarin 
                 Thromboembolic stroke 
               
               
                 5-hydroxytryptophan 
                 Depression &amp; Anxiety &amp; ADHD 
               
               
                 Duloxetine 
                 Depression &amp; Anxiety &amp; Bipolar disorder 
               
               
                 Escitalopram 
                 Depression &amp; Anxiety &amp; Bipolar disorder 
               
               
                 Venlafaxine 
                 Depression &amp; Anxiety &amp; Bipolar disorder &amp; 
               
               
                   
                 Autism &amp; Social anxiety disorder 
               
               
                 Desvenlafaxine 
                 Depression &amp; Anxiety &amp; PTSD &amp; ADHD 
               
               
                 Paroxetine 
                 Depression &amp; Anxiety &amp; PTSD &amp; Social anxiety 
               
               
                   
                 disorder 
               
               
                 fluoxetine/olanzapine 
                 Depression &amp; Bipolar disorder 
               
               
                 1-methylfolate 
                 Depression &amp; BPD 
               
               
                 Amitriptyline 
                 Depression &amp; PTSD 
               
               
                 Sertraline 
                 Depression &amp; PTSD &amp; Bipolar disorder &amp; Social 
               
               
                   
                 anxiety disorder 
               
               
                 Fluvoxamine 
                 Depression &amp; PTSD &amp; Social anxiety disorder 
               
               
                 Olanzapine 
                 Depression &amp; Schizophrenia &amp; Bipolar disorder 
               
               
                 Paliperidone 
                 Depression &amp; Schizophrenia &amp; Bipolar disorder 
               
               
                 Aripiprazole 
                 Depression &amp; Schizophrenia &amp; Bipolar disorder 
               
               
                   
                 &amp; Autism 
               
               
                 Quetiapine 
                 Depression &amp; Schizophrenia &amp; PTSD &amp; BPD &amp; 
               
               
                   
                 Bipolar disorder 
               
               
                 Risperidone 
                 Depression &amp; Schizophrenia &amp; PTSD &amp; BPD &amp; 
               
               
                   
                 Bipolar disorder &amp; Autism 
               
               
                 Amisulpride 
                 Depression &amp; Social anxiety disorder 
               
               
                 Chlorpromazine 
                 Psychosis 
               
               
                 Droperidol 
                 Psychosis 
               
               
                 Fluphenazine 
                 Psychosis 
               
               
                 Periciazine 
                 Psychosis 
               
               
                 Perphenazine 
                 Psychosis 
               
               
                 Thiothixene 
                 Psychosis 
               
               
                 Triflupromazine 
                 Psychosis 
               
               
                 Haloperidol 
                 Psychosis &amp; Dementia 
               
               
                 Prazosin 
                 PTSD 
               
               
                 Clozapine 
                 Schizophrenia 
               
               
                 Flupenthixol 
                 Schizophrenia 
               
               
                 Iloperidone 
                 Schizophrenia 
               
               
                 Loxapine 
                 Schizophrenia 
               
               
                 Mesoridazine 
                 Schizophrenia 
               
               
                 Promazine 
                 Schizophrenia 
               
               
                 Reserpine 
                 Schizophrenia 
               
               
                 Thioridazein 
                 Schizophrenia 
               
               
                 Zuclopenthixol 
                 Schizophrenia 
               
               
                 Asenapine 
                 Schizophrenia &amp; Bipolar disorder 
               
               
                 Levomepromazine 
                 Schizophrenia &amp; Bipolar disorder 
               
               
                 Ziprasidone 
                 Schizophrenia &amp; Bipolar disorder 
               
               
                 Molindone 
                 Schizophrenia &amp; Psychosis 
               
               
                 Pimozide 
                 Schizophrenia &amp; Psychosis 
               
               
                 Thioridazine 
                 Schizophrenia &amp; Psychosis 
               
               
                 Cytarabine 
                 Chemotherapy, hematological malignancies 
               
               
                   
               
            
           
         
       
     
     According to some embodiments, the intrabody fluid transfer system  200  can be configured as an infusate delivery system that is delivered to a patient at an infusion rate in the range of from about 1 μL/minute to about 3 μL/minute. 
     Insertion of the surgical cannula assembly  200  (or any other surgical, e.g., delivery, cannula) can be tracked in near real time by reference to a void in the patient tissue caused by the surgical cannula assembly  200  and reflected in the MR image. In some embodiments, one or more MRI-visible fiducial markers may be provided on the surgical tubular cannula  10 , MR scanned and processed, and displayed on the UI. In some embodiments, components of the surgical cannula assembly  200  may itself be formed of an MRI-visible material, MR scanned and processed, and displayed on the UI. 
     According to some embodiments, the surgical cannula/plunger assembly  200  may include an embedded intrabody MRI antenna (not shown) that is configured to pick-up MRI signals in local tissue during an MRI procedure. The MM antenna can be configured to reside on a distal end portion of the surgical cannula. In some embodiments, the antenna has a focal length or signal-receiving length of between about 1-5 cm, and typically is configured to have a viewing length to receive MRI signals from local tissue of between about 1-2.5 cm. The MRI antenna can be formed as comprising a coaxial and/or triaxial antenna. However, other antenna configurations can be used, such as, for example, a whip antenna, a coil antenna, a loopless antenna, and/or a looped antenna. See, e.g., U.S. Pat. Nos. 5,699,801; 5,928,145; 6,263,229; 6,606,513; 6,628,980; 6,284,971; 6,675,033; and 6,701,176, the contents of which are hereby incorporated by reference as if recited in full herein. See also U.S. Patent Application Publication Nos. 2003/0050557; 2004/0046557; and 2003/0028095, the contents of which are also hereby incorporated by reference as if recited in full herein. 
     While the devices have been described by way of example as delivery devices and methods for delivering a substance to a patient, in accordance with some embodiments of the invention, the devices can be used to withdraw and/or aspirate a substance (e.g., spinal fluid, cardiac fluid or neuro fluid) from a patient. Thus, it will be appreciated that the devices and methods as disclosed herein can be used to transfer a substance into and/or from a patient. 
     While the devices have been described herein primarily with reference to MRI-guided insertion and infusion procedures, in some embodiments the devices can be used in procedures without MRI guidance, such as using other imaging modalities, such as, but not limited to, CT imaging systems, where image-guided surgical navigation is desired. 
     While the cannula/plunger assembly  200  has been described with the surgical assembly  200  coupled to a trajectory guide  1250   t , other types of trajectory guidance or stereotactic frames or without a stereotactic frame or trajectory guide. 
       FIG. 15  is a flow chart of exemplary actions that can be carried out according to embodiments of the present invention. A cannula assembly having a luer connector on a proximal end thereof and having a longitudinally opposing distal end is provided (block  600 ). A plunger assembly that is coupleable to or coupled to the cannula assembly is provided. The plunger assembly comprises a stylet extending from the proximal end to a position proximate, flush with or beyond the distal end of the cannula assembly (block  610 ). A target fluid is intaken into the distal end of the cannula assembly about the stylet in a fluid/flow channel created/defined by the stylet and the cannula assembly (block  620 ). The cannula assembly and the plunger assembly can cooperate to generate a vacuum that causes the fluid to be intaken into the distal end portion and upstream thereof (but typically below the plunger luer hub). 
     The plunger assembly can comprise a drive screw residing at least partially inside a support body and coupled to the stylet and a collar rotatably coupled to the drive screw configured to retract and extend the stylet (block  617 ). 
     The cannula assembly with the plunger assembly coupled thereto and holding the fluid can be placed into a trajectory guide of a surgical navigation system whereby the plunger flange is above the trajectory guide and the distal end of the cannula assembly and stylet are in a body of a patient (block  622 ). 
     The fluid can be delivered to a target intrabrain location by pushing a plunger toward the distal end of the cannula assembly and dispensing the intaken fluid (block  624 ). 
     The plunger assembly comprises a plunger flange allowing a user to push and pull the plunger to intake and dispense the fluid (block  625 ). 
     The plunger assembly is configured to extend to (concurrently) extend out of the proximal and distal ends of the cannula assembly (block  611 ) (during at least the delivery/dispensing operation). 
     A luer connector of the plunger assembly can be connected to the luer connector of the cannula assembly (block  613 ). 
     The plunger assembly comprises an internal seal at the luer connector and the stylet merges into a plunger segment or drive screw inside a support body (block  614 ). 
     The plunger segment can have a first segment of a first cross-section size and a second segment of a larger cross-sectional size, optionally the first segment is a stylet and the second segment can be defined by a sleeve affixed to the stylet (block  615 ). 
     The fluid comprises stem cells (block  627 ). 
     The foregoing is illustrative of the present invention and is not to be construed as limiting thereof. Although a few exemplary embodiments of this invention have been described, those skilled in the art will readily appreciate that many modifications are possible in the exemplary embodiments without materially departing from the teachings and advantages of this invention. Accordingly, all such modifications are intended to be included within the scope of this invention as defined in the claims. The invention is defined by the following claims, with equivalents of the claims to be included therein.