Correlation of Appearance of MRI Perinidal T2 Hyperintensity Signal and Eventual Nidus Obliteration Following Photon Radiosurgery of Brain AVMs: Combined Results of LINAC and Gamma Knife Centers

• DOI: 10.1055/s-0039-1678710
• Publication Date: 2019-03-21T02:52:23Z
• Authors: Osama Abdelaziz; Ahmed Shereen; Takuro Inoue; Hisao Hirai; Ayako Shima
• Keywords: Arteriovenous malformation

Background A wide variety of radiologic changes occur within and adjacent to the nidus arteriovenous malformations (AVMs) after stereotactic radiosurgery (SRS). Our objective was study magnetic resonance imaging(MRI)-defined following photon AVMs specifically correlate appearance a perinidal T2 hyperintensity signal with eventual angiographic obliteration an AVM in response SRS treatment. Material Methods This retrospective conducted on 62 patients brain who received treatments between 2004 2017, using either technique based linear accelerator at Alexandria LINAC Radiosurgery Center Egypt (21 patients/AVMs) or gamma unit Koto Memorial Gamma Knife Japan (41 patients/AVMs). All included had serial clinical follow-ups for ≥ 2 years treatments. Results In combined series patients/AVMs treated SRS, follow-up MRIs revealed that 50 (80.6%) showed nonvisualized 12 (19.4%) decreased size. Radiation-induced changes, defined as hyperintensities post-SRS MRIs, occurred 34 (54.8%). Of 35 available studies, 30 (85.7%) demonstrated complete mean 36 months (range: 8–66 months) SRS. both MRI evidence verification obliteration, 20 (66.7%) were associated prior average 6–45 five size partial four (80%) MRIs. Lower Spetzler-Martin grade (p = 0.013), smaller volume 0.017), 0.007) statistically significant independent predictors obliteration. The sensitivity 66.7%, specificity 20%, overall accuracy 60% predicting nidus. Conclusions present may help improve our current understanding mechanisms behind radiation-induced tissue Because SRS-induced hemodynamic initiate cascade subsequent formation vasogenic edema, high would be valuable indicator development strongest predictive factor 0.007), relatively (60%) fairly low (20%), prognostic sign