Development of an Angiography Guide Indicator for Stereotactic Radiosurgery for High Precision

Abstract

Stereotactic radiosurgery (SRS) is effectively used for treating various cerebrovascular diseases, including arteriovenous malformations. As image-based surgery is the gold standard technique in SRS, the quality of stereotactic angiography images greatly influences the surgical approach for cerebrovascular diseases. Despite several studies in the relevant literature, research on auxiliary devices, including angiography indicators used for cerebrovascular disease surgeries, is limited. Thus, the development of angiographic indicators may provide meaningful data for stereotactic surgery. This study aimed to develop a stereotactic radiographic angiography guide indicator and evaluate its accuracy and precision. A centerline was drawn, and a guideline was attached such that the "+" and "X" centers of the existing angiography guide indicator intersect. Further, a guideline wire connecting "+" and "X" was fixed using a tape. Based on the presence or absence of the guide indicator, angiography anterior-posterior (AP) and lateral (LAT) images were taken 10 times each, and statistical analysis was performed. The average and standard deviation of the conventional AP and LAT indicators were 10.22 ± 0.53 and 9.02 ± 0.33 mm, and those of the developed AP and LAT indicators were 10.3 ± 0.57 and 8.92 ± 0.23 mm, respectively. The results confirmed that the use of the lead indicator developed in this study provides higher accuracy and precision compared to that of the use of the conventional indicator. Furthermore, the developed guide indicator may provide meaningful information during SRS.