Abstract
Purpose: We investigated the feasibility of novel approach for frameless 3D AVM localization within the coordinate space of an angiographic cone‐beam CT(CBCT) dataset. The localization is based on characterization and calibration of 2D digital subtraction angiography(DSA) and CBCT acquisition modes available on a commercial flat panel detector C‐arm neuroangiography system. This localization method in combination with image‐guided Cyberknife delivery could provide consistent approach to frameless AVM radiosurgery.Method and Materials: We introduced preset AVM localization protocols comprising anterior‐posterior (AP) and lateral (LAT) DSA series combined with CBCT without couch displacement between acquisitions. The AP and LAT C‐arm positions were selected by matching AP/LAT phantom images to corresponding projections from the CBCT series. We subsequently evaluated the accuracy and the reproducibility of the 2D–3D correspondence for the various protocols by imaging a CBCTcalibration phantom with embedded markers. Paired marker centers were automatically extracted in the AP/LAT images and the corresponding CBCT acquisition frames. The maximum and the mean distance between the marker centers were calculated as a metrics for 2D‐to‐3D correspondence accuracy. The reproducibility was investigated by repeating the imaging protocols in different sessions and displacing the C‐arm between the sessions. Results: The accuracy of the DSA‐CBCT correspondence depended on the protocol and the C‐arm position for the DSA acquisitions within the protocol. For further clinical investigations we retained a protocol with an AP and left LAT DSA modes that reproducibly resulted in maximum/mean paired marker distance of 0.68 mm and 0.4 mm (AP) and 0.29 mm and 0.15 mm (left LAT) in the C‐arm isocenter plane. Conclusion: With proper patient immobilization, frameless AVM localization within the angiographic CBCT dataset based on calibrated AP and left LAT views is feasible with an uncertainty of 0.7–0.8 mm. Conflict of Interest: This work is supported by Siemens Medical Solutions.
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.
