Integrated MRI simulation for intramedullary spinal cord arteriovenous malformation radiosurgery: illustrative case

Radiosurgery is a standard treatment modality for arteriovenous malformations (AVMs). Spinal cord AVMs represent a particular challenge for radiosurgery due to the significant involvement of normal spinal cord tissues that are inseparable from the AVM.

MR and CT images of the spine acquired using different patient setups and immobilization can be challenging to co-register for accurate radiosurgery planning due to the mobility of the spine and resulting differences in spine position between imaging studies. Integrating MRI simulation into radiosurgery treatment design solves this issue and can be valuable for accurately targeting spinal cord AVMs while sparing normal adjacent spinal cord tissue.

Here the authors present the case of a female patient with cervical spinal cord AVM who was treated with spinal cord radiosurgery that uses this approach. https://thejns.org/doi/10.3171/CASE25413.