Document Detail


Intracranial arteriovenous malformations treated with LINAC-based conformal radiosurgery: validation of the radiosurgery-based arteriovenous malformation score as a predictor of outcome.
MedLine Citation:
PMID:  17659161     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To validate the radiosurgery-based arteriovenous malformation score (RBAS) as a predictor of outcome in patients with arteriovenous malformations (AVMs) treated with LINAC-based conformal radiosurgery. METHODS: We analysed 40 patients with a mean follow-up of 22 months. One patient (2.5%) pertained to Spetzler-Martin Grade I, 11 (27.5%) to Grade II, 19 (47.5%) to Grade III, eight (20%) to Grade IV and one (2.5%) to grade V. The mean RBAS was 2.0 (range: 0.76-5.56). The mean obliteration prediction index (OPI) and the Karlsson index (KI) were 0.74 (range: 0.2-2.86) and 109.48 (range: 3.0-350.7) respectively. Outcomes were analysed according to the OPI, KI and RBAS. RESULTS: We analysed different cutoff points in the RBAS and found a significant difference to predict the outcome in four scores: 1.2, 1.6, 1.7 and 1.8. In the group with RBAS < or = 1.8, 13 (68%) had an excellent outcome and six (33%) did not, while with RBAS>1.8, seven (32%) had an excellent outcome and 14 (67%) did not (p = 0.02). We did not find any correlation between Spetzler-Martin grading scale or OPI and outcome (p = 0.7 and p = 0.3 respectively). The KI predicted the excellent outcome in 8/9 patients (89%) with KI < or = 27 and in 12/31 patients (39%) with KI>27 (p = 0.08). CONCLUSION: The RBAS seems to be a good predictor of outcome in patients with AVMs treated with LINAC-based conformal radiosurgery as in patients treated with Gamma Knife. It remains only to find the best cutoff point based on a larger series and longer follow-up.
Authors:
Sergio Moreno-Jimenez; Miguel Angel Celis; José Manuel Larraga-Gutierrez; Jose de Jesus Suarez-Campos; Amanda Garcia-Garduñno; Mariana Hernandez-Bojorquez; Guillermo A Gutiérrez-Aceves
Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Neurological research     Volume:  29     ISSN:  0161-6412     ISO Abbreviation:  Neurol. Res.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2008-01-04     Completed Date:  2008-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7905298     Medline TA:  Neurol Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  712-6     Citation Subset:  IM    
Affiliation:
Department of Radiosurgery, Instituto Nacional de Neurología y Neurocirugía MVS, Insurgentes Sur 3877 Col. La Fama, Tlalpan, México City 14269, Mexico.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Disability Evaluation
Female
Follow-Up Studies
Humans
Intracranial Arteriovenous Malformations / diagnosis*,  physiopathology,  surgery*
Male
Middle Aged
Outcome Assessment (Health Care) / methods*
Predictive Value of Tests
Radiation Dosage
Radiosurgery / statistics & numerical data*
Reproducibility of Results
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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