Modifications based on computed tomographic imaging in planning the radiosurgical treatment of arteriovenous malformations.

Early in the course of treating arteriovenous malformations with radiosurgery, it was noted that the nidus isocenter and diameter, as identified by stereotactic angiography, often differed from that identified by stereotactic enhanced computed tomography (CT). To assess the sources of discrepancy between the arteriographic and CT representations of the nidus, dosimetry (from treatment records stored on an optical disk) was reviewed in 81 consecutive cases. In 44 cases, the isocenters differed by an average of 3.6 mm and the collimator size differed. Fourteen nidi were larger on CT (average, 2.6 mm), and 30 were smaller on CT (average, 4.0 mm). Overall, the angiographic and the CT nidus differed in 75% of the cases reviewed. Sources of error in the angiographic nidus determination included overlapping vessels, bony structures, fine filamentous arterioles, and irregular shapes.

[1]  E. Alexander,et al.  Radiosurgery using a modified linear accelerator. , 1992, Neurosurgery clinics of North America.

[2]  D. Larson.  Introduction to radiosurgery. , 1990, Clinical neurosurgery.

[3]  R L Siddon,et al.  Stereotaxic localization of intracranial targets. , 1987, International journal of radiation oncology, biology, physics.

[4]  E J Holupka,et al.  Treatment planning for stereotactic radiosurgery of intra-cranial lesions. , 1991, International journal of radiation oncology, biology, physics.

[5]  Y. Hosobuchi,et al.  Stereotactic heavy-ion Bragg peak radiosurgery for intra-cranial vascular disorders: method for treatment of deep arteriovenous malformations. , 1984, The British journal of radiology.

[6]  M Kessler,et al.  Image correlation of MRI and CT in treatment planning for radiosurgery of intracranial vascular malformations. , 1991, International journal of radiation oncology, biology, physics.

[7]  F J Bova,et al.  The University of Florida radiosurgery system. , 1989, Surgical neurology.

[8]  F. Bova,et al.  Linear accelerator radiosurgery at the University of Florida. , 1992, Neurosurgery clinics of North America.

[9]  P Suetens,et al.  Angiographic localizer ring for the BRW stereotactic system. , 1987, Acta neurochirurgica. Supplementum.

[10]  F J Bova,et al.  Stereotactic angiography: an inadequate database for radiosurgery? , 1991, International journal of radiation oncology, biology, physics.

[11]  M. Phillips,et al.  Stereotactic heavy-charged-particle Bragg-peak radiation for intracranial arteriovenous malformations. , 1990, The New England journal of medicine.

[12]  L D Lunsford,et al.  Stereotactic radiosurgery for arteriovenous malformations of the brain. , 1991, Journal of neurosurgery.

[13]  J I Fabrikant,et al.  Heavy charged-particle stereotactic radiosurgery: cerebral angiography and CT in the treatment of intracranial vascular malformations. , 1989, International journal of radiation oncology, biology, physics.

[14]  Physics for radiosurgery with linear accelerators. , 1992, Neurosurgery clinics of North America.

[15]  C. Strother,et al.  MR imaging in the management of supratentorial intracranial AVMs. , 1988, AJR. American journal of roentgenology.

[16]  E Kanal,et al.  A comparison between magnetic resonance imaging and computed tomography for stereotactic coordinate determination. , 1992, Neurosurgery.

[17]  F J Bova,et al.  Linear accelerator radiosurgery for arteriovenous malformations. , 1992, Journal of neurosurgery.

[18]  William A. Friedman,et al.  Limitations of angiographic target localization in planning radiosurgical treatment. , 1992, Neurosurgery.