Dose Perturbation Caused by Stents: Experiments with a Model 90Sr/90Y Source

Wilczek, Krzysztof; Petelenz, Barbara; Strzała, A.; Marczewska, B.; Traczyk, Marek; Poloński, Lech

doi:10.1007/s00270-007-9148-9

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…Against this hypothesis, Nath and Yue 9 tested the shielding effect of metallic encapsulation and radiographic contrast agents for catheter-based intravascular brachytherapy, by using both photonand ␤-emitting radionuclides, and showed that if the shielding effect was present when low-energy photon emitters were used, it became minimal for high-energy photons (range of energy used in radiation therapy). Wilczek et al 10 tested the dose perturbation induced by different stents in brachytherapy and noticed that the shielding effect exists and depends on the strut thickness and mesh attenuation rather than on the atomic number of the metal. Shtraus et al 11 found that the measured attenuation of Onyx placed in a bottle was 3% higher than the attenuation of water.…”

Section: Discussionmentioning

confidence: 99%

Liquid Embolization Material Reduces the Delivered Radiation Dose: Clinical Myth or Reality?

Fan¹,

Doucet²,

Lacroix³

et al. 2011

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:To be radiopaque, BAVM embolization products must contain highatomic-number materials, which may also attenuate photon beams delivered with radiosurgery. This "shielding effect" has been invoked to explain why radiation therapy may be less effective for previously embolized BAVMs. To evaluate the impact of embolization material on radiation dose, we measured and compared the dose delivered to the center of an AVM model, before and following embolization with various materials in a LINAC.

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Section: Discussionmentioning

confidence: 99%

Liquid Embolization Material Reduces the Delivered Radiation Dose: Clinical Myth or Reality?

Fan¹,

Doucet²,

Lacroix³

et al. 2011

AJNR Am J Neuroradiol

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show abstract

“…54 The shield effect is the subject of controversy, but several reports suggest that embolic material partially decreases the delivered dose. 4,12,42,66 With the introduction of Onyx (ev3), clinicians believed that these disadvantages of prior embolic materials would be significantly reduced. First of all, it is well known that embolization with a liquid embolic agent such as Onyx has a lower recanalization rate than embolization with particles.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic radiosurgery for arteriovenous malformations after Onyx embolization: a case-control study

Lee

Chen

Ball

et al. 2015

JNS

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E mbolization of intracranial arteriovenous malformations (AVMs) was first introduced by Luessenhop and Spence in 1960. 32 Over the next few decades, advances in embolization materials and techniques, including the introduction of transfemoral embolization, detachable or calibrated-leak balloons, particle or liquid embolization, and superselective angiography, made embolization a valuable tool for the management of intracranial AVM. Several reports demonstrated 0%-94% cure rate, 5%-35% morbidity rate, and 0%-5% mortality rate. 1,8,18,23,29,34,37,44,52 Following the introduction of radiosurgical technique in the early 1960s, Steiner et al. successfully treated a brain AVM with stereotactic radiosurgery (SRS) in 1970. 62Since then, SRS has been established as an effective treatment alternative for intracranial AVMs, particularly for those with small-or medium-sized nidi located in eloquent or deep regions. In previously reported series, intracranial AVMs treated with 20-25 Gy have 3-year obliteration rates between 55% and 81% and complication rates ranging from 2.5% to 9.3%. 16,22,49,67,68 Endovascular embolization and radiosurgery each have specific advantages, and either may be used as a standaBBreViatiONS ARE = adverse radiation effect; AVM = arteriovenous malformation; DSA = digital subtraction angiography; EVOH = ethylene-vinyl alcohol; GKS = Gamma Knife surgery; LINAC = linear accelerator; MRA = MR angiography; nBCA = n-butyl-2-cyanacrylate; PVA = polyvinyl alcohol; RBAS = radiosurgery-based AVM score; SRS = stereotactic radiosurgery. OBJect Onyx, an ethylene-vinyl alcohol copolymer mixed in a dimethyl sulfoxide solvent, is currently one of the most widely used liquid materials for embolization of intracranial arteriovenous malformations (AVMs). The goal of this study was to define the risks and benefits of stereotactic radiosurgery (SRS) for patients who have previously undergone partial AVM embolization with Onyx. methOdS Among a consecutive series of 199 patients who underwent SRS between January 2007 and December 2012 at the University of Virginia, 25 patients had Onyx embolization prior to SRS (the embolization group). To analyze the obliteration rates and complications, 50 patients who underwent SRS without prior embolization (the no-embolization group) were matched by propensity score method. The matched variables included age, sex, nidus volume before SRS, margin dose, Spetzler-Martin grade, Virginia Radiosurgery AVM Scale score, and median imaging follow-up period. reSultS After Onyx embolization, 18 AVMs were reduced in size. Total obliteration was achieved in 6 cases (24%) at a median of 27.5 months after SRS. In the no-embolization group, total obliteration was achieved in 20 patients (40%) at a median of 22.4 months after SRS. Kaplan-Meier analysis demonstrated obliteration rates of 17.7% and 34.1% in the embolization group at 2 and 4 years, respectively. In the no-embolization group, the corresponding obliteration rates were 27.0% and 55.9%. The between-groups difference in obliteration rate...

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The effect of metallic tracheal stents on radiation dose in the airway and surrounding tissues

Evans

Lee

Jain

et al. 2014

Journal of Surgical Research

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Dose Perturbation Caused by Stents: Experiments with a Model 90Sr/90Y Source

Cited by 4 publications

References 28 publications

Liquid Embolization Material Reduces the Delivered Radiation Dose: Clinical Myth or Reality?

Liquid Embolization Material Reduces the Delivered Radiation Dose: Clinical Myth or Reality?

Stereotactic radiosurgery for arteriovenous malformations after Onyx embolization: a case-control study

The effect of metallic tracheal stents on radiation dose in the airway and surrounding tissues

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