Application of diffusion tensor-based tractography in treatment of brain arteriovenous malformations: a systematic review

Authors

Ataollah Shahbandi, School of Medicine, Tehran University of Medical Sciences, Enghelab Street, Tehran, Iran.
Shahab Aldin Sattari, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Maryam Haghshomar, Department of Radiology, Northwestern University, Chicago, IL, USA.
Sakineh Shab-Bidar, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA. michael.lawton@barrowbrainandspine.com.Follow

Document Type

Article

Abstract

There is no systematic review investigating the utility of Diffusion tensor-based tractography findings for treating brain arteriovenous malformations (bAVMs). This systematic review aims to investigate the outcomes following bAVM treatment when tractography data is incorporated into treatment planning. PubMed/MEDLINE, Scopus, and Cochrane Library, were searched for published studies. Prospective or retrospective studies involving at least one patient with confirmed bAVM and available data on tractography and clinical outcomes were included. A total of 16 studies were eligible for this review, consisting of 298 patients. 48.2% of patients were female. The mean age of the patients was 27.5 years (range: 5-77). Stereotactic radiosurgery (SRS) and microsurgical resection each were the treatment of choice in eight studies, respectively. Two-hundred forty-eight patients underwent SRS as the primary treatment, while microsurgery was used to resect the bAVMs in 50 patients. The corticospinal tract, optic pathway, and arcuate fasciculus were the most widely investigated white matter tracts. Tractography disruption and failure frequencies were 19.1% and 1.8%, respectively. The pooled proportions (95% CI) of obliteration rates were 88.78% (73.51-95.76) for microsurgery and 51.45% (13-17-88.10) following SRS. Treatment-related non-hemorrhagic complications rates occurred in 24.2% and 9.9% of patients who underwent microsurgical resection and SRS, respectively. Tractography findings can contribute to providing a more accurate dosimetry analysis of functional white matter tracts at risk prior to SRS and minimizing the surgical morbidity following microsurgical resection.

Medical Subject Headings

Humans; Female; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Male; Retrospective Studies; Prospective Studies; Brain; Intracranial Arteriovenous Malformations (diagnostic imaging, surgery); Diffusion Tensor Imaging; Radiosurgery; Treatment Outcome

Publication Date

5-10-2023

Publication Title

Neurosurgical review

E-ISSN

1437-2320

Volume

46

Issue

1

First Page

115

PubMed ID

37162690

Digital Object Identifier (DOI)

10.1007/s10143-023-02017-0

Recommended Citation

Shahbandi, Ataollah; Sattari, Shahab Aldin; Haghshomar, Maryam; Shab-Bidar, Sakineh; and Lawton, Michael T., "Application of diffusion tensor-based tractography in treatment of brain arteriovenous malformations: a systematic review" (2023). Neurosurgery. 1776.
https://scholar.barrowneuro.org/neurosurgery/1776