- 作者：Alfredo Conti M.D. ; Ph.D.&lowast ; ; ; alfredo.conti@unime.it ; Antonio Pontoriero M.D.&dagger ; ; Giuseppe Faragò ; M.D.&Dagger ; ; Federica Midili Ph.D.§ ; ; Carmelo Siragusa Ph.D.§ ; ; Francesca Granata M.D.&Dagger ; ; Antonio Pitrone M.D.&Dagger ; ; Costantino De Renzis M.D.&dagger ; ; Marcello Longo M.D.&Dagger ; ; Francesco Tomasello M.D.&lowast ;
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2011
- 出版时间：1 November 2011
- 年：2011
- 卷：81
- 期：3
- 页码：e29-e37
- 全文大小：967 K
Purpose
Accuracy in delineating the target volume is a major issue for successful stereotactic radiosurgery for arteriovenous malformations. The aim of the present study was to describe a method to integrate three-dimensional (3D) rotational angiography () into CyberKnife treatment planning and to investigate its potential advantages compared with computed tomography angiography (CTA) and magnetic resonance angiography.Methods and Materials
A total of 20 patients with a diagnosis of cerebral arteriovenous malformation were included in the present study. All patients underwent multislice computed tomography and 3D-volumetric CTA, , and 3D magnetic resonance angiography. The contouring of the target and critical volumes was done separately using CTA and thereafter directly using . The composite, conjoint, and disjoint volumes were measured.
Results
The use of CTA or resulted in significant differences in the target and critical volumes. The target volume averaged 3.49 ¡À 3.01 mL measured using CTA and 3.26 ¡À 2.93 mL measured using , for a difference of 8 % (p < .05). The conjoint and disjoint volume analysis showed an 88 % volume overlap. The qualitative evaluation showed that the excess volume obtained using CTA was mostly tissue surrounding the nidus and venous structures. The mean contoured venous volume was 0.67 mL measured using CTA and 0.88 mL (range, 0.1?.7) measured using (p < .05).
Conclusions
is a volumetric angiographic study that can be integrated into computer-based treatment planning. Although whether provides superior accuracy has not yet been proved, its high spatial resolution is attractive and offers a superior 3D view. This allows a better 3D understanding of the target volume and distribution of the radiation doses within the volume. Additional technical efforts to improve the temporal resolution and the development of software tools aimed at improving the performance of 3D contouring are warranted.