Target delineation for radiosurgery of a small brain arteriovenous malformation using high-resolution contrast-enhanced cone beam CT
Target delineation for radiosurgery of a small brain arteriovenous malformation using high-resolution contrast-enhanced cone beam CT
复制标题
使用高分辨率对比增强锥形束 CT 进行小脑动静脉畸形放射外科靶区勾画
DOI：
10.1136/bcr-2013-010763
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发表时间：
2013
期刊：
影响因子：
0.9
通讯作者：
A. Wakhloo
中科院分区：
文献类型：
--
作者：
I. van der Bom;M. Gounis;L. Ding;A. Kühn;D. Goff;A. Puri;A. Wakhloo
1例42岁男性患者，在对左侧上级丘3 mm破裂动静脉畸形（AVM）进行血管内栓塞后3年，数字减影血管造影显示病变持续再生。 为治疗计划采集的薄层MRI未显示AVM病灶。患者被带回血管造影室，使用血管造影C型臂系统进行高分辨率对比增强锥形束CT（VasoCT）。用VasoCT显示病变和病灶。将MRI、CT和VasoCT数据传输至放射计划软件并相互配准。由经验丰富的神经介入放射科医生在VasoCT数据上注释病灶的辐射，并完成剂量/治疗计划。由于图像配准，治疗区域可以直接采用MRI和CT数据。在放射外科治疗完成后10个月，AVM完全消失。
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.