Integration of corticospinal tractography reduces motor complications after radiosurgery

Tomoyuki Koga, Masahiro Shin, Keisuke Maruyama, Kyousuke Kamada, Takahiro Ota, Daisuke Itoh, Naoto Kunii, Kenji Ino, Shigeki Aoki, Yoshitaka Masutani, Hiroshi Igaki, Tsuyoshi Onoe, Nobuhito Saito

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Purpose: To evaluate whether the use of diffusion-tensor tractography (DTT) of the corticospinal tract could reduce motor complications after stereotactic radiosurgery (SRS). Methods and Materials: Patients with arteriovenous malformation (AVM) in the deep frontal lobe, deep parietal lobe, basal ganglia, and thalamus who had undergone radiosurgery since 2000 and were followed up for more than 3 years were studied. DTT of the corticospinal tract had been integrated into treatment planning of SRS since 2004, and the maximum dose received by the corticospinal tract was attempted to be less than 20 Gy. Treatment outcomes before (28 patients, Group A) and after (24 patients, Group B) the introduction of this technique were compared. Results: There were no statistical differences between the two groups (Group A vs. Group B) in patients' age (34 years vs. 33 years, p = 0.76), percentage of patients with hemorrhagic events before treatment (50% vs. 29%, p = 0.12), or percentage of AVM involving the basal ganglia and thalamus (36% vs. 46%, p = 0.46). Obliteration rates were 69% and 76% at 4 years in Groups A and B, respectively (p = 0.68), which were not significantly different. Motor complications were observed in 5 patients in Group A (17.9%) but only in 1 patient in Group B (4.2%), which was significantly less frequent (p = 0.021). Conclusion: Integrating DTT of the corticospinal tract into treatment planning contributed to reduction of motor complications without compromising the obliteration rate for AVM adjacent to the corticospinal tract.

Original languageEnglish (US)
Pages (from-to)129-133
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume83
Issue number1
DOIs
StatePublished - May 1 2012

Keywords

  • Arteriovenous malformation
  • Corticospinal tract
  • Diffusion-tensor tractography
  • Morbidity
  • Stereotactic radiosurgery

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