Imaging Markers Associated With Radiation-Induced Changes in Brain Arteriovenous Malformations After Radiosurgery

Yong Sin Hu, Huai Che Yang, Chung Jung Lin, Cheng Chia Lee, Wan Yuo Guo, Chao Bao Luo, Kang Du Liu, Wen Yuh Chung, Hsiu Mei Wu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Radiation-induced changes (RICs) in brain tissue, seen as increased perinidal T2-weighted hyperintensity on MRI, are commonly observed in patients with brain arteriovenous malformations (BAVMs) within 2 years after Gamma Knife (Elekta) radiosurgery (GKRS). Objective: To explore the imaging markers associated with RICs in patients with BAVMs. Methods: We retrospectively included 106 treatment-naïve patients with BAVMs who received GKRS alone between 2011 and 2018 and had ≥24 months of clinical and MRI follow-up. Pre-GKRS angiography and MRIs were analyzed for morphological characteristics and quantitative digital subtraction angiography parameters. RIC severity was categorized as mild (grade I), moderate (grade II), or severe (grade III). Firth logistic regression analysis was conducted to determine the associations between the parameters and RICs. Results: Among the 106 patients, 83 (78.3%) developed RICs, with 16 categorized as grade I, 62 as grade II, and 5 as grade III. RICs were symptomatic in 19 patients (17.9%). In multivariable models, BAVMs with a volume of >5 cm3 (odds ratio [OR]: 4.322, P =.024) and neoangiogenesis on angiography before treatment (OR: 3.846, P =.029), and thrombus within nidus or drainage vein on follow-up MRI (OR: 3.679, P =.001) were independently associated with grade II or III RICs. Symptomatic RICs were more likely to develop in basal ganglia or brainstem. Conclusion: Large BAVMs and neoangiogenesis were associated with moderate to severe RICs in treatment-naïve patients with BAVMs. Our findings may assist with the complication risk assessment for these patients.

Original languageEnglish
Pages (from-to)464-474
Number of pages11
JournalNeurosurgery
Volume90
Issue number4
DOIs
StatePublished - 1 Apr 2022

Keywords

  • Angioarchitecture
  • Digital subtraction angiography
  • Gamma Knife radiosurgery
  • Hemodynamics
  • Intracranial arteriovenous malformation
  • Radiation-induced changes
  • Stereotactic radiosurgery

Fingerprint

Dive into the research topics of 'Imaging Markers Associated With Radiation-Induced Changes in Brain Arteriovenous Malformations After Radiosurgery'. Together they form a unique fingerprint.

Cite this