Embolization before Gamma Knife radiosurgery for cerebral arteriovenous malformations does not negatively impact its obliteration rate: a series of 190 patients

Effect of Cobalt-60 Treatment Dose Rate on Arteriovenous Malformation Obliteration After Stereotactic Radiosurgery With Gamma Knife

“…2 Smaller nidus volume and lower Spetzler-Martin (SM) grade are correlated with successful AVM obliteration, while associated aneurysm(s), prior hemorrhage, or prior embolization tend to decrease obliteration rates after SRS. 2,[5][6][7][8][9][10][11] Higher SRS dose and biologically effective dose (BED) are associated with increased AVM obliteration. 6,7,[9][10][11][12][13][14][15][16][17][18] However, there is limited evidence regarding the effect of cobalt-60 treatment dose rate on SRS treatment efficacy and associated toxicity.…”

“…2,[5][6][7][8][9][10][11] Higher SRS dose and biologically effective dose (BED) are associated with increased AVM obliteration. 6,7,[9][10][11][12][13][14][15][16][17][18] However, there is limited evidence regarding the effect of cobalt-60 treatment dose rate on SRS treatment efficacy and associated toxicity. Although BED is dependent on many factors including total treatment time, lesion size, and marginal prescription dose, SRS dose rate is an unbiased variable that is only dependent on the age of the cobalt-60 sources in the gamma knife (GK) machine.…”