Document Detail

Validation of the radiosurgery-based arteriovenous malformation score in a large linear accelerator radiosurgery experience.
MedLine Citation:
PMID:  19445567     Owner:  NLM     Status:  MEDLINE    
OBJECT: The radiosurgery-based arteriovenous malformation (AVM) score (RBAS) is a grading system designed to predict patient outcomes after Gamma Knife surgery for AVMs. This study seeks to validate independently the predictive nature of the RBAS, not only after single treatment but for retreatment, and to assess the overall outcome regardless of number of radiosurgeries. METHODS: The authors analyzed 403 patients treated with linear accelerator (LINAC) radiosurgery for AVMs between May 1988 and June 2008. The AVM scores were determined by the following equation: AVM score = (0.1 x volume in cm(3)) + (0.02 x age in years) + (0.3 x location). The location values are as follows: frontal/temporal = 0, parietal/occipital/corpus callosum/cerebellar = 1, and basal ganglia/thalamus/brainstem = 2. RESULTS: Testing demonstrated that the RBAS correlated with excellent outcomes after single or repeat radiosurgery (p < 0.001 for both variables). One hundred sixty-two (49%) of 330 patients had excellent outcomes (obliteration without deficit) after a single treatment. Excellent outcomes were achieved in 74, 64, 50, and 11% of patients with AVM scores of < 1.0 (Group 1), between 1.0 and < 1.8 (Group 2), between 1.8 and < 2.5 (Group 3), and >or= 2.5 (Group 4), respectively. Fifty-one patients (70%) obtained radiosurgical cure and 46 (63%) achieved excellent outcomes after repeat radiosurgery. Of these, 100% achieved excellent outcomes in Group 1, 70% did so in Group 2, 47% in Group 3, and 14% in Group 4. The RBAS correlated with excellent outcomes after overall treatment (p < 0.001). Two hundred seventy-seven patients (69%) obtained AVM obliteration, and 62% achieved excellent outcomes. In Group 1, 87% achieved excellent outcomes, 75% did so in Group 2, 61% in Group 3, and 24% in Group 4. CONCLUSIONS: The RBAS is a good predictor of patient outcomes after LINAC radiosurgery.
Scott J Raffa; Yueh-Yun Chi; Frank J Bova; William A Friedman
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  111     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-02     Completed Date:  2009-10-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  832-9     Citation Subset:  AIM; IM    
Department of Neurosurgery, University of Florida, Gainesville, Florida 32610, USA.
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MeSH Terms
Child, Preschool
Follow-Up Studies
Intracranial Arteriovenous Malformations / diagnosis,  surgery*
Middle Aged
Outcome Assessment (Health Care) / methods*
Predictive Value of Tests
Radiosurgery / methods*
Retrospective Studies
Severity of Illness Index*
Treatment Outcome
Young Adult

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