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- W3094075172 abstract "Accurate delineation of target is the key to any successful radiosurgery. Contrast enhance MRI/MRA is also being used for target delineation although with inherent limitations. C-arm Dyna CT/3DCT angiography (3DCTA) has the potential of improving the accuracy of nidus delineating due to high temporo-spatial resolution of angio architecture. Here we present comparison of nidus delineation and dosimetric parameters between digital 3DCTA and MRI. Seven consecutive patients treated for brain AVMs at our institution were included in this study. Prior to treatment, all patients underwent MRI/MRA, and 3DCTA. All images were co-registered using the Multiplan planning system. AVM was delineated by radiation oncologist and neuro-radiologist using either 3DCTA or contrast enhanced MRI, resulting in 2 volumes: V3DCTA (3DCTA) and VMRI (CEMRI/MRA). Dicom images were transferred to 3D slicer and by using segment comparison tool, Hausdorff distance matrices and dice similarity matrices were analyzed. SRS plan was developed for both the volumes. T –Test was used to compare the two plans using SPSS ver21 software. The average volume of treatment targets delineated using 3DCTA and CEMRI were 1534mm3 and 1881 mm3. These volumes were not similar and significant regions of nonoverlap exist. Overall volume was less in 3DCTA. Volume difference ranged from 96mm3 to 749mm3 and mean difference was 347mm3 between 3DCTA and CEMRI. Mean of maximum and average Hausdroff distance is 4.02 mm (SD ± 0.84 mm) and 0.89 mm (SD ± 0.32 mm) for 3DCTA and MRA respectively. Dice similarity co-efficient ranged from 0.46 to 0.98 with a mean value of 0.68 (SD ± 0.16). Mean overlapping value was 78% (SD ± 3.16). Mean center variation between 3DCTA and MRI was 0.66 mm, 0.78 mm,0.38 mm for x, y, and z direction respectively. Using VMRI as a primary volume no coverage variation was found in V3DCTA. Mean D10 (Brain-GTV) was 7.7Gy, 6.5Gy for MR and CT based plan (p = 0.01). When VMRI was used as primary volume for planning, conformity index (CI) deteriorated from 1.47 to 2.47 for VMRI to V3DCTA volumes. When V3DCTA was used as primary volume for planning there was a mean under coverage of VMRI by nearly 27.7% and CI deteriorate from 1.43 to 1.89. Nidus volume was significantly altered with the use of 3DCTA compared to that of MRA/MRI images. Using multimodality imaging is the key for more accurate target delineation and thereby increasing the chances of successful obliteration of nidus." @default.
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- W3094075172 date "2020-11-01" @default.
- W3094075172 modified "2023-10-17" @default.
- W3094075172 title "Comparison of Nidus Delineation and Dosimetric Comparison in Arterio-venous Malformation Radiosurgery: DynaCT versus MRI" @default.
- W3094075172 doi "https://doi.org/10.1016/j.ijrobp.2020.07.2280" @default.
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