Target delineation for radiosurgery of a small brain arteriovenous malformation using high-resolution contrast-enhanced cone beam CT

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 nidu...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2013-08, Vol.2013, p.bcr2013010763
Main Authors: van der Bom, Imramsjah M J, Gounis, Matthew J, Ding, Linda, Kühn, Anna Luisa, Goff, David, Puri, Ajit S, Wakhloo, Ajay K
Format: Article
Language:English
Subjects:
Adult
Cone-Beam Computed Tomography - methods
Contrast Media
Embolization
Hemorrhage
Humans
Hydrocephalus
Intracranial Arteriovenous Malformations - diagnostic imaging
Intracranial Arteriovenous Malformations - pathology
Intracranial Arteriovenous Malformations - surgery
Male
Medical imaging
Neuroimaging
Radiation therapy
Radiosurgery
Radiosurgery - methods
Sensors
Software
Visualization
Work stations
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2013-010763