Abstract
Radiosurgery of arteriovenous malformations (AVMs) is a challenging procedure. Accuracy of target volume contouring is one major issue to achieve AVM obliteration while avoiding disastrous complications due to suboptimal treatment. We describe a technique to improve the understanding of the complex AVM angioarchitecture by 3D prototyping of individual lesions.Arteriovenous malformations of ten patients were prototyped by 3D printing using 3D rotational angiography (3DRA) as a template. A target volume was obtained using the 3DRA; a second volume was obtained, without awareness of the first volume, using 3DRA and the 3D-printed model. The two volumes were superimposed and the conjoint and disjoint volumes were measured. We also calculated the time needed to perform contouring and assessed the confidence of the surgeons in the definition of the target volumes using a six-point scale.The time required for the contouring of the target lesion was shorter when the surgeons used the 3D-printed model of the AVM (p=0.001). The average volume contoured without the 3D model was 5.6 ± 3 mL whereas it was 5.2 ± 2.9 mL with the 3D-printed model (p=0.003). The 3D prototypes proved to be spatially reliable. Surgeons were absolutely confident or very confident in all cases that the volume contoured using the 3D-printed model was plausible and corresponded to the real boundaries of the lesion. The total cost for each case was 50 euros whereas the cost of the 3D printer was 1600 euros.3D prototyping of AVMs is a simple, affordable, and spatially reliable procedure that can be beneficial for radiosurgery treatment planning. According to our preliminary data, individual prototyping of the brain circulation provides an intuitive comprehension of the 3D anatomy of the lesion that can be rapidly and reliably translated into the target volume.
Highlights
Stereotactic radiosurgery (SRS) can induce the obliteration of cerebral arteriovenousHow to cite this article Conti A, Pontoriero A, Iatì G, et al (April 29, 2016) 3D-Printing of Arteriovenous Malformations for Radiosurgical Treatment: Pushing Anatomy Understanding to Real Boundaries
Arteriovenous malformations of ten patients were prototyped by 3D printing using 3D rotational angiography (3DRA) as a template
Since we reported the value of this imaging modality for the treatment of arteriovenous malformations (AVMs) [16], the treatment planning systems have evolved offering a streamlined integration of this imaging modality and the possibility of performing the contouring of AVMs using the impressively detailed 3D reconstructions of the 3DRA
Summary
Stereotactic radiosurgery (SRS) can induce the obliteration of cerebral arteriovenousHow to cite this article Conti A, Pontoriero A, Iatì G, et al (April 29, 2016) 3D-Printing of Arteriovenous Malformations for Radiosurgical Treatment: Pushing Anatomy Understanding to Real Boundaries. Stereotactic radiosurgery (SRS) can induce the obliteration of cerebral arteriovenous. Several factors will influence the outcome of stereotactic radiosurgery (SRS), including the volume, prescription dose, patient age, lesion location, angioarchitecture, and previous embolization [1,2,3,4,5,6]. The so-called “nidus” of the AVM, a tangle of malformed blood vessels, should be entirely included in the target volume to achieve obliteration of the lesion. Because high radiation doses are necessary to result in AVM resolution, highly conformal dose distributions should be achieved to reduce, as much as possible, the risk of radiation-induced brain complications
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
