By J. W. Berkelbach van der Sprenkel, N. M. J. Knufman, P. C. van Rijen, P. R. Luyten (auth.), L. Symon, L. Calliauw, F. Cohadon, J. Lobo Antunes, F. Loew, H. Nornes, E. Pásztor, J. D. Pickard, A. J. Strong, M. G. Yaşargil (eds.)
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Extra resources for Advances and Technical Standards in Neurosurgery
Substraction should be used. In some cases in order to better define the target, superselective catheterization is useful. It might clarify the contribution from different arterial territories to the different parts of the AVM. Concomitant stereotactic angiography and MRI may facilitate a better definition of the nidus. CT and MRI Imaging The stereotactic instrument used for the determination of target coordinates is compatible with CT, MR, PET or Magnetoencephalography imaging equipment. Special Plexiglass boxes with fiducial markers for CT or MRI are attached to the base ring.
STEINER et al. may result in glial and endothelial damage (Hopewell et al. 1970). Tumour tissue and vascular malformations often respond to a much lower dosage, because of the higher proliferative activity of the pathological cell populations, as compared with the healthy brain. The high doses typical of clinical radiosurgery (20-200 Gy) may considerably decrease the probability of survival of irradiated proliferative cells, down to 10- 6, or less. Analysis of data for cell lines derived from tumour or healthy cells from a study by Hall et al.
Optimal dose fall-off occurs outside the target volume. The multiple non-coplanar converging arcs technique was first described by Betti and Derechinsky (1983, 1984). The patient is seated in a treatmentchair, the target receives the beams through a series of 140 arcs each for a different treatment-chair angle (Betti et al. 1989). Colombo et al. developed a multiple converging arcs technique with the patient in the supine position. Five 110 arcs deliver the radiation energy. For each arc the position of the treatment couch is different.