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Arteriovenous Malformations Treated With Frameless Robotic Radiosurgery Using Non-Invasive Angiography: Long-Term
Ryan Kelly1, Anthony Conte2, M Nathan Nair2
1Georgetown University School of Medicine, Washington, DC, United States.
Frontiers in Oncology
|December 17, 2020
Summary
Frameless robotic radiosurgery offers a safe and effective alternative for treating intracranial arteriovenous malformations (AVMs). This non-invasive technique achieved high obliteration rates, minimizing side effects for AVM patients.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Medical Imaging
Background:
- Intracranial arteriovenous malformations (AVMs) require effective treatment options.
- Traditional treatments involve invasive catheter-angiography and frame-based radiosurgery.
- Frameless robotic radiosurgery presents a novel, non-invasive alternative.
Purpose of the Study:
- To evaluate the safety and efficacy of CT-guided, frameless robotic radiosurgery for intracranial AVMs.
- To compare this technique with traditional invasive methods.
- To determine optimal radiation dosage for AVM obliteration.
Main Methods:
- Retrospective study of 20 patients with intracranial AVMs treated with single-fraction frameless robotic radiosurgery (CyberKnife).
- Pre-treatment planning utilized CT angiogram (CTA) and MRI.
- Patients were followed for at least four years or until AVM obliteration.
Main Results:
- 81.3% of patients achieved complete AVM obliteration after a median follow-up of 42 months.
- All patients receiving 1,800 cGy demonstrated complete obliteration.
- One patient experienced temporary toxicity at 2,200 cGy; one had post-treatment hemorrhage.
Conclusions:
- Frameless robotic radiosurgery is a safe and effective treatment for intracranial AVMs.
- It serves as a viable alternative to invasive catheter-angiography and frame-based methods.
- 1,800 cGy in a single fraction is effective for AVM obliteration with minimal side effects.
