Format

Send to

Choose Destination

See 1 citation found by title matching your search:

Childs Nerv Syst. 2019 Feb;35(2):301-308. doi: 10.1007/s00381-018-4008-2. Epub 2018 Nov 24.

Radiosurgical treatment of arteriovenous malformations in a retrospective study group of 33 children: the importance of radiobiological scores.

Author information

1
Department of Neurosurgery and Gamma Knife Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. jody.capitanio@gmail.com.
2
Department of Neurosurgery and Gamma Knife Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
3
Department of Medical Physics, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
4
Department of Neuroradiology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.

Abstract

PURPOSE:

Arteriovenous malformations' (AVMs) obliteration depends on several factors; among the many factors that must be considered to obtain a high rate of obliteration and a low rate of complications, Flickinger-Pollock Score (FPS) seems to have an important role but still have to be validated in the pediatric population while Paddick-Conformity Index (PCI) still has no demonstration of its utility on the outcome and is considered only as a treatment quality marker.

METHODS:

We retrospectively analyzed 33 consecutive children (2-18 years) with an AVM, treated with stereotactic radiosurgery Gamma Knife (SRS-GK) from 2001 to 2014 in our institution. We assess angiographic (DSA) Obliteration Rate (OR) as well FPS and PCI to draw conclusions.

RESULTS:

DSA-OR was 60.6% with a rate of hemorrhage of 0%. median target volume (TV) was 3.60 cc (mean 4.32 ± 3.63; range 0.15-14.2), median PD was 22 Gy (mean 21.4 ± 2.6; range 16.5-25). Median percentage of coverage was 98% (mean 97 ± 3; range 84-100). The median modified FPS was 0.78 (mean 0.89 ± 0.52; range 0.21-2.1) and highly correlate with OR (p = 0.01). The median PCI was 0.65 (mean 0.65 ± 0.14; range 0.34-0.95) A PCI lower than 0.57 highly correlates with final OR (p = 0.02).

CONCLUSION:

SRS-GK was safe and gradually effective in children. A prescription dose-like that used in adult population (i.e. > 18 and between 20 and 25 Gy) is essential to achieve obliteration. A PD of 23 Gy and 22 Gy did impact OR, respectively (p = 0.02) and (p = 0.05). FPS and PCI are valuable scores that seem to correlate with the OR also in the pediatric population although further prospective studies are needed to confirm these observations.

KEYWORDS:

Children; Gamma knife; Pediatric brain malformations; Pediatric radiosurgery

PMID:
30474715
DOI:
10.1007/s00381-018-4008-2

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center