Integration of Three-Dimensional Rotational Angiography in Radiosurgical Treatment Planning of Cerebral Arteriovenous Malformations

Journal Article · Tue Nov 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.12.024· OSTI ID:21590420

Conti, Alfredo ^[1]; Pontoriero, Antonio ^[2]; Farago, Giuseppe ^[3]; Midili, Federica; Siragusa, Carmelo ^[4]; Granata, Francesca; Pitrone, Antonio ^[3]; De Renzis, Costantino ^[2]; Longo, Marcello ^[3]; Tomasello, Francesco ^[1]

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1. Department of Neurosurgery, University of Messina, Messina (Italy)
2. Department of Radiation Oncology, University of Messina, Messina (Italy)
3. Department of Neuroradiology, University of Messina, Messina (Italy)
4. Department of Medical Physics, University of Messina, Messina (Italy)

Purpose: Accuracy in delineating the target volume is a major issue for successful stereotactic radiosurgery for arteriovenous malformations. The aim of the present study was to describe a method to integrate three-dimensional (3D) rotational angiography ( (3DRA)) into CyberKnife treatment planning and to investigate its potential advantages compared with computed tomography angiography (CTA) and magnetic resonance angiography. Methods and Materials: A total of 20 patients with a diagnosis of cerebral arteriovenous malformation were included in the present study. All patients underwent multislice computed tomography and 3D-volumetric CTA, (3DRA), and 3D magnetic resonance angiography. The contouring of the target and critical volumes was done separately using CTA and thereafter directly using (3DRA). The composite, conjoint, and disjoint volumes were measured. Results: The use of CTA or (3DRA) resulted in significant differences in the target and critical volumes. The target volume averaged 3.49 {+-} 3.01 mL measured using CTA and 3.26 {+-} 2.93 mL measured using (3DRA), for a difference of 8% (p < .05). The conjoint and disjoint volume analysis showed an 88% volume overlap. The qualitative evaluation showed that the excess volume obtained using CTA was mostly tissue surrounding the nidus and venous structures. The mean contoured venous volume was 0.67 mL measured using CTA and 0.88 mL (range, 0.1-2.7) measured using (3DRA) (p < .05). Conclusions: (3DRA) is a volumetric angiographic study that can be integrated into computer-based treatment planning. Although whether (3DRA) provides superior accuracy has not yet been proved, its high spatial resolution is attractive and offers a superior 3D view. This allows a better 3D understanding of the target volume and distribution of the radiation doses within the volume. Additional technical efforts to improve the temporal resolution and the development of software tools aimed at improving the performance of 3D contouring are warranted.

• OSTI ID: 21590420
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 81, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2010.12.024; PII: S0360-3016(11)00012-5; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

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MAGNETIC RESONANCE
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RADIATION DOSES
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