| The Predictive Value of 3D Time-of-Flight MR Angiography in Assessment of Brain Arteriovenous Malformation Obliteration after Radiosurgery. | |
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MedLine Citation:
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PMID: 22095967 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE:The purpose of radiosurgery of bAVMs is complete angiographic obliteration of its nidus. We assessed the diagnostic accuracy of 1.5T T2-weighted MR imaging and TOF-MRA images for detecting nidus obliteration after radiosurgery.MATERIALS AND METHODS:The pre- and postradiosurgery MR images and DSA images from 120 patients who were radiosurgically treated for a bAVM were re-evaluated by 2 observers for patency of the nidus (preradiosurgery) and obliteration (postradiosurgery: final follow-up MR imaging), by using a 3-point scale of confidence. Consensus reading of the DSA after radiosurgery was considered the criterion standard for obliteration. Sensitivity, specificity, PPVs, and NPVs, and overall diagnostic performance by using ROC were determined.RESULTS:Mean bAVM volume during radiosurgery was 3.4 mL (95% CI, 2.6-4.3 mL). Sixty-six patients (55%) had undergone previous endovascular embolization. The mean intervals between radiosurgery and follow-up MR imaging and for DSA, respectively, were 35.6 months (95% CI, 32.3-38.9 months) and 42.1 months (95% CI, 40.3-44.0 months). With ROC, an area under curve of 0.81-0.83 was found. PPVs and NPVs of final follow-up MR imaging for definitive obliteration varied between 0.85 and 0.95 and 0.55 and 0.62. An average false-positive rate, meaning overestimation of nidus obliteration, of 0.08 and an average false-negative rate, meaning underestimation of nidus obliteration of 0.48, were found.CONCLUSIONS:MRA is insufficient to diagnose obliteration in the follow-up of bAVMs after radiosurgery. A remaining nidus diameter <10 mm seems to be the major limiting factor for reliable assessment of obliteration. We highly recommend follow-up DSA for definitive diagnosis of complete obliteration. |
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Authors:
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D R Buis; J C J Bot; F Barkhof; D L Knol; F J Lagerwaard; B J Slotman; W P Vandertop; R van den Berg |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-17 |
Journal Detail:
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Title: AJNR. American journal of neuroradiology Volume: - ISSN: 1936-959X ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8003708 Medline TA: AJNR Am J Neuroradiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Departments of Neurosurgery, Neuroradiology, Epidemiology and Biostatistics, and Radiation Oncology, Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; and Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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