Stereotactic radiotherapy using a linear accelerator for arteriovenous malformation and arteriovenous fistula identification using 320-row angiography-computed tomography images, case series and a single-center experience

Objective: Stereotactic radiotherapy (SRT) and stereotactic radiosurgery (SRS) are useful treatments for arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs). In this study, 320-row four-dimensional (4D) computed tomography angiography (CTA) was used to determine the irradiation range before SRT/SRS, and the treatment effect was retrospectively evaluated. Methods: Five patients with an AVM and two with an AVF who underwent 4D CTA were included. Treatment was planned and performed based on the 320-row CTA images. Treatment efficacy was evaluated using magnetic resonance imaging and CTA. Results: Shrinkage was observed in four of the five AVMs and both AVFs. Additional irradiation was performed in one AVM patient and one AVF patient. One AVM patient experienced seizures 6 years after treatment. No other adverse neurological events or cerebral hemorrhages occurred. Conclusion: 320-row 4D CTA image fusion was useful for lesion identification in determining radiation treatment plans for AVMs and AVFs. It also was able to demonstrate post-treatment shrinkage and disappearance of lesions.