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Titolo:
COMPUTED-TOMOGRAPHY SLICE-BY-SLICE TARGET-VOLUME DELINEATION FOR STEREOTAXIC PROTON IRRADIATION OF LARGE INTRACRANIAL ARTERIOVENOUS-MALFORMATIONS - AN ITERATIVE APPROACH USING ANGIOGRAPHY, COMPUTED-TOMOGRAPHY,AND MAGNETIC-RESONANCE-IMAGING
Autore:
LEVY RP; SCHULTE RWM; FRANKEL KA; STEINBERG GK; MARKS MP; LANE B; HEILBRONN LH; MEINASS HJ; GALINDO RA; SLATER JD; SLATER JM;
Indirizzi:
LOMA LINDA UNIV,MED CTR,DEPT RADIAT MED,11234 ANDERSON ST LOMA LINDA CA 92354 UNIV CALIF BERKELEY,LAWRENCE BERKELEY LAB,DIV LIFE SCI BERKELEY CA 94720 STANFORD UNIV,DEPT NEUROSURG,MED CTR STANFORD CA 94305 STANFORD UNIV,DEPT RADIOL,MED CTR STANFORD CA 94305
Titolo Testata:
International journal of radiation oncology, biology, physics
fascicolo: 3, volume: 35, anno: 1996,
pagine: 555 - 564
SICI:
0360-3016(1996)35:3<555:CSTDFS>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
BRAGG PEAK RADIOSURGERY; RADIATION; RADIOTHERAPY; DATABASE; MR; CT;
Keywords:
AVMS; TREATMENT PLANNING; MULTIMODALITY IMAGING; CT; MRI; ITERATIVE TARGET DELINEATION; STEREOTAXIC RADIOSURGERY; PROTONS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
28
Recensione:
Indirizzi per estratti:
Citazione:
R.P. Levy et al., "COMPUTED-TOMOGRAPHY SLICE-BY-SLICE TARGET-VOLUME DELINEATION FOR STEREOTAXIC PROTON IRRADIATION OF LARGE INTRACRANIAL ARTERIOVENOUS-MALFORMATIONS - AN ITERATIVE APPROACH USING ANGIOGRAPHY, COMPUTED-TOMOGRAPHY,AND MAGNETIC-RESONANCE-IMAGING", International journal of radiation oncology, biology, physics, 35(3), 1996, pp. 555-564

Abstract

Purpose: Target-volume delineation for stereotactic irradiation is problematic for large and irregularly shaped arteriovenous malformations(AVMs), The purpose of this report is to quantify modifications in the target volume that result from iterative treatment planning that incorporates multimodality imaging data. Methods and Materials: Stereotactic neuroimaging procedures were performed for 20 consecutive patientswith AVM volumes > 10 cm(3), Angiographically defined extrema were transformed into computed tomography (CT) space, The resulting target contours were then modified by a multidisciplinary treatment planning team after iterative review of angiographic, CT, and magnetic resonance imaging (MRI) data, Volumes of interest and dose-volume histograms forproton irradiation were calculated before and after iterative target delineation. Results: Initial (angiographically defined) target volumes ranged from 15.3 to 96.1 cm(3) (mean, 43.6 cm(3)), Final (iteratively defined) target volumes ranged from 10.7 to 114.0 cm(3) (mean, 38.4 cm(3)), The volume of presumed normal tissue excluded by iterative planning ranged from 2.6 to 47.0 cm(3) (mean, 15.5 cm(3)), Initially untargeted AVM, most commonly obscured by embolization material, was identified in all cases (range, 0.3 to 57.8 cm(3); mean, 10.3 cm(3)), Corresponding dose-volume histograms demonstrated marked differences regarding lesion coverage and sparing of normal tissue structures. Conclusions: Iterative target-volume delineation resulted in significant modifications from initial, angiographically defined target volumes, Substantial amounts of apparently normal tissue were excluded from the final target, and additional abnormal vascular structures were identified for incorporation, We conclude that an iterative multimodality approach to target-volume delineation may improve the overall results for stereotactic irradiation of large and complex AVMs.

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Documento generato il 29/11/20 alle ore 06:58:34