Consistency between Targets Delineated by Angiography, Computed Tomography, and Magnetic Resonance Imaging in Stereotactic Radiosurgery for Arteriovenous Malformation

Background: Target identification is important for radiosurgery for arteriovenous malformations (AVMs). Targets defined by different imaging modalities may be inconsistent in practice. Objectives: The goal of this study is to review and analyze the consistency between targets defined by different imaging modalities in radiosurgery for AVMs. Methods: From March 2007 to June 2011, AVM patients for radiosurgery whose targets were delineated by angiography/computed tomography (CT)/magnetic resonance imaging (MRI) were reviewed. Spetzler-Martin grades, hemorrhage history, and treatment volumes were checked. Dice similarity coefficients (DSCs) between targets were calculated and analyzed. Results: Twenty-three patients were enrolled. The mean DSCs were between 0.37 and 0.51 for targets by different modalities. There was no significant difference in DSCs regarding Spetzler-Martin grades and hemorrhage history. For CT-delineated target volumes 3, MRI-delineated target volumes 3, and angiography-delineated target volumes 3, the DSCs between the different image modalities were significantly decreased. Conclusions: Consistency between targets delineated using different image modalities was likely to be unsatisfactory and worsen significantly in niduses with volumes 3. An iterative multimodality approach to confirm the delineated targets of AVMs is suggested to be indispensable for robust treatment in radiosurgery.
Stereotact Funct Neurosurg 2017;95:236-242

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