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J Korean Soc Ther Radiol Oncol > Volume 19(1); 2001 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2001;19(1): 1-9.
Clinical Experience of LINAC-based Stereotactic Radiosurgery for Angiographically Occult Vascular Malformations
Dae Yong Kim, Yong Chan Ahn, Jung Il Lee, Do Hyun Nam, Do Hoon Lim, Jeong Eun Lee, Inhwan J Yeo, Seung Jae Huh, Young Joo Noh, Seong Soo Shin, Seung Chyul Hong, Jong Hyun Kim
1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
To establish the role of stereotactic radiosurgery (SRS) for the treatment of patients with angiographically occult vascular malformation (AOVM).
Eleven patients (12 lesions) with AOVM were treated with linear accelerator-based SRS between February 1995 and December 1999. A magnetic resonance imaging of each patients showed well-circumscribed vascular lesion with reticulated core of heterogeneous signal intensity and peripheral rim of low signal intensity. SRS were performed with the median peripheral dose of 16 Gy (range 13~25). A single isocenter was used with median collimator size of 14 mm (range 8~20) diameter.
With a median follow-up period of 42 months (range 12~56), rebleeding occurred in 3 AOVMs at 5, 6 and 12 months after SRS but no further bleeding did. Two patients experienced radiation-induced necrosis associated with permanent neurologic deficit and one patient showed transient edema of increased T2 signal intensity.
SRS may be effective for the prevention of rebleeding in AOVM located in surgically inaccessible region of the brain. Careful consideration should be needed in the decision of case selection and dose prescription because the incidence of radiation-induced complications is too high to be accepted.
Key Words: Stereotactic radiosurgery, Angiographically occult vascular malformation, Rebleeding, Complication
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