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