ArticleCureus2024
Linear Accelerator (LINAC) Radiosurgical Management of Brain Arteriovenous Malformations: An Experience From a Tertiary Care Center.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Stereotactic radiotherapy using a linear accelerator for arteriovenous malformation and arteriovenous fistula identification using 320-row angiography-computed tomography images, case series and a single-center experience.Fujita medical journal · 2026Article
- Review
- A comparison of the shaping efficiency of three Ni-Ti heat-treated files in second primary molars pulpectomy: an in-vitro CBCT study.European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2026Article
- Design, Preparation and Activity Evaluation of Long-Acting Insulin Analogues.The protein journal · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionBrain arteriovenous malformations (AVM) are complex vascular pathologies with a significant risk of hemorrhage. Stereotactic radiosurgery (SRS) is an effective treatment modality for AVM, initially popularized on the Gamma Knife (Elekta AB, Stockholm, Sweden) platform, and now benefits from the modern advances in linear accelerator (LINAC)-based platforms. This study evaluates the outcomes of LINAC-based SRS/hypofractionated stereotactic radiotherapy (hFSRT) for cerebral AVMs. MATERIALS AND
methodsBetween December 2018 and April 2024, 15 patients with cerebral AVMs underwent SRS/hFSRT at a tertiary government hospital. Patient selection was based on AVM size, location, surgical unsuitability, and patient preference. All patients underwent MRI and cerebral angiography for nidus delineation. SRS was planned using Monaco TPS (treatment planning system) (Elekta AB, Stockholm, Sweden) with VMAT (volumetric modulated arc therapy) technique, delivering a median dose of 20 Gy in single fractions for small AVMs and 28 Gy in four fractions for large AVMs. Patients were followed up with annual MRI and angiography to assess obliteration.
resultsThe cohort had a median age of 22 years, with a median nidus volume of 3.76 cc. The crude obliteration rate was 60%, confirmed by MRI/angiography. Actuarial obliteration rates at two, three, and five years were 65.71%, 73.57%, and 77.14%, respectively. Smaller AVMs (<3 cc) and those with a modified AVM radiosurgery score <1.5 had nearly 100% obliteration rates. Large AVMs (>10 cc) treated with hypofractionated SRT showed partial responses only. Significant predictors of obliteration included prescription dose, AVM volume, and modified AVM radiosurgery score.
conclusionLINAC-based SRS demonstrates comparable efficacy to other modalities for treating cerebral AVMs, with obliteration rates influenced by dose, AVM volume, and pre-treatment radiosurgery score. Larger AVMs pose a greater challenge, suggesting a need for adjunctive treatments or higher fractionated doses to improve outcomes.
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