Non-invasive follow-up of patients with intracranial arteriovenous malformations after proton-beam radiation therapy.

Abstract

In order better to follow non-invasively the effect of proton beam therapy upon intracranial arteriovenous malformations, transcranial Doppler sonography (TCD) was used in 10 patients, in addition to conventional follow-up with angiography and computed tomography (CT); in six patients, pre- and postradiation TCD studies were obtained. The mean flow values obtained from the major arteries in the circle of Willis indicate an early flow reduction through the AVM of approximately 15% with further reduction between 2/3 and 1/2 of the initial values within 15 months of follow-up. CT showed a reduction of contrast enhancement in those patients in whom scans could be compared. In this limited experience, TCD was proven to yield additional information, in repeated non-invasive studies, on the haemodynamic influence of AVMs and the effect of proton beam therapy.