title: Utility of CT-cisternogram for radiosurgery in trigeminal neuralgia: A not-to-be forgotten technique.
abstract: Radiosurgery (RS) is a well-established ablative therapy for trigeminal neuralgia (TGN). Successful RS requires the delivery of an extremely high dose of radiation to a small cisternal portion of the nerve, which lies amidst critical structures. This study describes the utility of CT-cisternogram in RS targeting for TGN. We report on patients with TGN who required CT-cisternogram for target identification for CyberKnife (CK) RS at our institution between September 2010 and April 2015. CT-cisternogram is a well-tolerated procedure that adds useful information to RS planning. Illustrative cases with complex anatomy and MRI artifacts related to postoperative changes and Teflon implant are described. CT-cisternogram is a complementary imaging modality that is useful in some patients, for RS target delineation.
authors.affiliation: Department of Radiation Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada.|Department of Radiation Oncology, National University Cancer Institute, Singapore.
authors.forename: Balamurugan
authors.identifier: http://orcid.org/0000-0002-1077-1840
authors.initials: B
authors.lastname: Vellayappan
authors.affiliation: Department of Medical Imaging, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Santanu
authors.initials: S
authors.lastname: Chakraborty
authors.affiliation: Department of Radiation Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Saif
authors.initials: S
authors.lastname: Althagafi
authors.affiliation: Department of Radiation Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Jillian
authors.initials: J
authors.lastname: MacLean
authors.affiliation: Department of Radiation Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Janos
authors.initials: J
authors.lastname: Szanto
authors.affiliation: Department of Neurosurgery, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Sinclair
authors.affiliation: Department of Radiation Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Shawn
authors.initials: S
authors.lastname: Malone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009192:Myelography / Q000379:methods*; D016634:Radiosurgery / Q000379:methods*; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000000981:diagnostic imaging* / Q000532:radiotherapy*