| Stereotactic Radiosurgery with Cyberknife for Cerebral Arteriovenous Malformations (AVMs) |
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Sung Ik Cho, Seung Hwa Jeong, Sang Hyo Kim, Kyung Jin Lee, Chung Kee Chough, Hae Kwan Park, Hyoung Kyun Rha |
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Department of Neurosurgery, Yeouido St. Mary's Hospital Neuroscience Center, College of Medicine, The Catholic University of Korea, Seoul, Korea |
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| Abstract |
Objective
Stereotactic radiosurgery has been proven to be an effective treatment modality for patients with cerebral arteriovenous malformations (AVMs). The aim of this study is to analyze treatment results and possible complications after stereotactic
radiosurgery with the Cyberknife.
Materials and Methods: A total of 20 patients with cerebral AVMs received stereotactic radiosurgery with the Cyberknife
(CKRS) between March 2004 and July 2011. The records of these patients were retrospectively reviewed. The clinical and radiologic follow up periods ranged from 7 months to 105 months, and mean period is 69.2 months (SD : ±32.3. Magnetic resonance imaging or computed tomography scans were performed as non-invasive radiologic following up methods, and a transfemoral cerebral angiography was performed only when obliteration was expected. Twelve patients (60%) had eloquent area
AVMs, and eight patients (40%) had prior treatment with embolization. The mean prescription dose was 20.0Gy (80% isodose ;
range 18–24Gy). The mean target volume of AVMs was 8.7cc. Five patients were reported to have large-sized AMV. The angiographic obliteration rate, and complications were analyzed for each case.
Results
The obliteration rate was 60% (12 patients) and the period of complete obliteration ranged from 7 months to 36
months, and mean periods is 21.6 months (SD : ±8.5). Five patients (25%) experienced complications during the latency period ; hemorrhage was reported in three patients and radiation necrosis with cyst formation in two patients
Conclusions
The Cyberknife is considered an effective and relatively safe method in for radiosurgery of AVM.
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| Key Words:
Cyberknife, Stereotactic radiosurgery, Cerebral arterovenous malformation. |
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