Research article summary (published 29 Sep 2009):

Early results of CyberKnife radiosurgery for arteriovenous malformations.

Full Abstract

OBJECT: The authors describe a method that utilizes an image-guided robotic radiosurgical apparatus (the CyberKnife) for treatment of cerebral arteriovenous malformations (AVMs). This procedure required the development of an original technique that allows a high degree of automation. METHODS: Angiographic images were imported into the treatment planning software by coregistering CT and 3D rotational angiography. The nidus contour was delineated using the contouring tools of the treatment planning system. Functional MR imaging was employed for contouring critical cortical regions, such as the motor cortex and language areas. Once the radiation dose to be delivered to the target volume and dose constraints to critical structures were prescribed, the inverse treatment planning function determined the optimal treatment plan. RESULTS: A series of 279 patients with cerebral AVMs underwent CyberKnife radiosurgery. One transitory adverse effect of the radiation procedure was observed. Eight bleeding occurrences were noted before complete AVM obliteration. Of the 102 patients with follow-up > 36 months, 80 underwent angiographic evaluation. In this group, 65 patients (81.2%) showed complete angiographic obliteration of their AVM. In 8 more patients, complete angiographic obliteration was demonstrated by MR angiography only. CONCLUSIONS: This is the first report describing a technique developed for CyberKnife radiosurgery of cerebral AVMs. The use of different imaging modalities for automatic delineation of the target and critical structures combined with the employment of the inverse treatment planning capability is the crucial point of the procedure. The procedure proved to be safe and efficient.

Author information

Author/s: Colombo, Federico (F); Cavedon, Carlo (C); Casentini, Leopoldo (L); Francescon, Paolo (P); Causin, Francesco (F); Pinna, Vittore (V);

Affiliation: Centre of Stereotactic Radiosurgery, City Hospital, Vicenza, Italy. federico.colombo(-atsign-)ulssvicenza.it

Journal and publication information

Publication Type: Journal Article

Journal: Journal of neurosurgery (J Neurosurg), published in United States. (Language: eng)

Reference: 2009-Oct; vol 111 (issue 4) : pp 807-19

Dates: Created 2009/10/02; Completed 2009/10/23;

PMID: 19344220, status: MEDLINE (last retrieval date: 10/23/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent Adult Aged Cerebral Angiography Child Female Follow-Up Studies Humans Intracranial Arteriovenous Malformations - pathology; radiography; surgery Magnetic Resonance Imaging

Magnetic Resonance Imaging Male Middle Aged Radiation Dosage Radiosurgery - adverse effects; methods Retrospective Studies Robotics - methods Tomography, X-Ray Computed Treatment Outcome Young Adult

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