Radiosurgery of complex shaped brain arteriovenous malformations using multileaf collimator. Interest of 3D X-ray angiography and fusion with MRI for the delineation of the target
Abstract
AP and lateral projection from digital substracted angiography are rarely sufficient to assess the precise shape of complex AVMs. 3D X-ray angiography provides additional informations thanks to its capability to display the AVM in all directions. However, 3D angiography cannot be directly used to delineate teh target because the fiducials are not currently reconstructed. 3D angiography is nevertheless helfull for (1) finding an oblique view which van be reproduced as a DSA projection and used to improve the initial target delineation obtained on biplane AP and lateral views. (2) merging 3D angiography and 3D MRI to visualize the relationshops between the target and eloquent ares using a prototype software for semi-automatic multimodality fusion.