title: Cone-beam CT angiography (Dyna CT) for intraoperative localization of cerebral arteriovenous malformations.
abstract: BACKGROUND
  Arteriovenous malformations (AVMs) of the brain are commonly treated in multimodality fashion, with endovascular embolization followed by surgical extirpation being one of the most effective strategies. Modern endovascular suites enable rotational angiography, also known as cone-beam CT angiography (CBCT-A), using the full capability of modern C-arm digital angiography systems. This imaging modality offers a superior image quality to current options such as digital subtraction angiography, MRI, or CT angiography. Preoperative planning can be greatly aided by the resolution of angioarchitecture seen in CBCT-A images. Furthermore, these images can be used for intraoperative neuronavigation when integrated with widely used frameless stereotactic systems. The utility and outcome of the use of CBCT-A for preoperative planning and intraoperative localization of AVMs was evaluated.
  
  
  METHODS
  A retrospective review was performed of 16 patients in which CBCT-A was performed, including radiological review and all clinical data.
  
  
  RESULTS
  CBCT-A was successfully employed in all cases including those with (n=9) and without (n=7) rupture. Complete resection confirmed by postoperative angiography was achieved in all cases.
  
  
  CONCLUSIONS
  We present a novel application of CBCT-A in the treatment of AVMs, both for preoperative surgical planning and an intraoperative reference during neuronavigation.
authors.affiliation: Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Visish M
authors.initials: VM
authors.lastname: Srinivasan
authors.affiliation: Siemens Healthcare USA, Madison, Wisconsin, USA.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schafer
authors.affiliation: Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Michael G Z
authors.initials: MG
authors.lastname: Ghali
authors.affiliation: Department of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute and University of Tennessee, Memphis, Tennessee, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Arthur
authors.affiliation: Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA Department of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute and University of Tennessee, Memphis, Tennessee, USA.
authors.forename: Edward A M
authors.initials: EA
authors.lastname: Duckworth
mesh_terms: D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Angiography; Arteriovenous Malformation; Brain; CT Angiography; Vascular Malformation