3172 - End-to-End Test of using Three-Dimensional Rotational Angiogram for Arteriovenous Malformations GammaKnife Radiosurgery with a Grid Phantom

12:30pm - 01:45pm ET

Poster Hall - Exhibit Hall A

Screen: 13

POSTER

Presenter(s)

Zhiheng Wang, PhD - University of Texas MD Anderson Cancer Center, Houston, TX

Z. Wang¹, Y. Zlateva¹, C. Young², D. Mackin¹, S. L. McGovern³, T. A. Swanson³, J. Li³, and T. M. Briere¹; ¹Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, ²Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, ³Department of CNS Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX

Purpose/Objective(s): Conventionally two-dimensional (2D) orthogonal angiograms acquired with a frame and localizer box have been used for arteriovenous malformations (AVM) GammaKnife radiosurgery (SRS). Three-dimensional (3D) rotational angiograms can provide more details for AVM target contouring and can potentially avoid the inconvenience of acquiring angiograms with a frame and localizer box attached to patients. In this study, we used a grid phantom to perform an end-to-end test of using frameless 3D rotational angiogram for AVM GammaKnife radiosurgery.

Materials/Methods: A grid phantom without a frame and localizer box was scanned with a 3D rotational angiogram scanner. Since 3D rotational angiogram images cannot be read by the current Gamma Knife planning system, the 3D rotational angiogram images were sent to Brainlab Elements system. Simulation CT images were also acquired and sent to Brainlab Elements and registered with the 3D rotational angiograms. Target contours were drawn on the 3D rotational angiograms and sent to GammaKnife planning system along with the simulation CT images. For GammaKnife SRS delivery, cone beam CT (CBCT) images were used for localization. Targets in the central location and off-axis locations along right, left, anterior, posterior, inferior and superior directions were used to compare localization accuracy.

Results: For all targets in the central location and off-axis locations along right, left, anterior, posterior, inferior and superior directions, the localization accuracy was within 0.5 mm. No geometrical distortions were observed with 3D rotational angiogram images.

Conclusion: 3D rotational angiogram images can be used for AVM GammaKnife radiosurgery. A frame and localizer box is not required during angiogram acquisition. A third-party software is needed to use 3D rotational angiogram images for the current version of GammaKnife.