A Statistical Analysis of the Effect of Different Embolization Materials on Gamma Knife Arteriovenous Malformation Dose Distributions

TL;DR

This study uses Monte Carlo simulations to analyze how different embolization materials affect radiation dose distributions in Gamma Knife radiosurgery for AVMs, revealing significant dosimetric differences among materials.

Contribution

It provides the first statistical comparison of dose attenuation effects of Onyx, cyanoacrylate, and PVA in Gamma Knife AVM treatments using Monte Carlo simulations.

Findings

Significant dose differences among embolization materials.

Onyx, cyanoacrylate, and PVA show distinct attenuation effects.

Monte Carlo simulation effectively evaluates dose distributions.

Abstract

Gamma Knife Radiosurgery (GKRS) is a treatment choice in newly diagnosed AVMs and residual AVMs following endovascular interventions. Aim of this study is to determine if commercially available liquid embolic agents reduce the radiation dose to the target due to the attenuation of the 60Co beam. Doses accumulated by three different embolization materials, namely: Onyx, cyanoacrylate and polyvinyl alcohol (PVA) were analysed. A collimator helmet size of 8mm was employed in a Monte-Carlo simulation implemented in Geant4 simulation toolkit. Obtained dose accumulations were evaluated and results demonstrated statistically significant differences in the dosimetries calculated.