Target delineation for radiosurgery of a small brain arteriovenous malformation using high-resolution contrast-enhanced cone beam CT. (30th August 2013)

• Record Type: Journal Article
• Authors: van der Bom, Imramsjah M J; Gounis, Matthew J; Ding, Linda; Kühn, Anna Luisa; Goff, David; Puri, Ajit S; Wakhloo, Ajay K
• Is Part Of: Journal of neurointerventional surgery. Volume 6:Number 5(2014)
• Page Start: e34
• Page End: e34
• Publication Date: 2013-08-30
• Subjects: Arteriovenous Malformation -- Technique -- CT; Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2013-010763.rep
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Three years following endovascular embolization of a 3 mm ruptured arteriovenous malformation (AVM) of the left superior colliculus in a 42-year-old man, digital subtraction angiography showed continuous regrowth of the lesion. Thin-slice MRI acquired for treatment planning did not show the AVM nidus. The patient was brought back to the angiography suite for high-resolution contrast-enhanced cone beam CT (VasoCT) acquired using an angiographic c-arm system. The lesion and nidus were visualized with VasoCT. MRI, CT and VasoCT data were transferred to radiation planning software and mutually co-registered. The nidus was annotated for radiation on VasoCT data by an experienced neurointerventional radiologist and a dose/treatment plan was completed. Due to image registration, the treatment area could be directly adopted into the MRI and CT data. The AVM was completely obliterated 10 months following completion of the radiosurgery treatment.