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Dosimetric measurements of an n‐butyl cyanoacrylate embolization material for arteriovenous malformations

Overview of attention for article published in Medical Physics, March 2015
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Title
Dosimetric measurements of an n‐butyl cyanoacrylate embolization material for arteriovenous malformations
Published in
Medical Physics, March 2015
DOI 10.1118/1.4915080
Pubmed ID
Authors

Zacariah E. Labby, Neeraj Chaudhary, Joseph J. Gemmete, Aditya S. Pandey, Donald A. Roberts

Abstract

The therapeutic regimen for cranial arteriovenous malformations often involves both stereotactic radiosurgery and endovascular embolization. Embolization agents may contain tantalum or other contrast agents to assist the neurointerventionalists, leading to concerns regarding the dosimetric effects of these agents. This study investigated dosimetric properties of n-butyl cyanoacrylate (n-BCA) plus lipiodol with and without tantalum powder. The embolization agents were provided cured from the manufacturer with and without added tantalum. Attenuation measurements were made for the samples and compared to the attenuation of a solid water substitute using a 6 MV photon beam. Effective linear attenuation coefficients (ELAC) were derived from attenuation measurements made using a portal imager and derived sample thickness maps projected in an identical geometry. Probable dosimetric errors for calculations in which the embolized regions are overridden with the properties of water were calculated using the ELAC values. Interface effects were investigated using a parallel plate ion chamber placed at set distances below fixed samples. Finally, Hounsfield units (HU) were measured using a stereotactic radiosurgery CT protocol, and more appropriate HU values were derived from the ELAC results and the CT scanner's HU calibration curve. The ELAC was 0.0516 ± 0.0063 cm(-1) and 0.0580 ± 0.0091 cm(-1) for n-BCA without and with tantalum, respectively, compared to 0.0487 ± 0.0009 cm(-1) for the water substitute. Dose calculations with the embolized region set to be water equivalent in the treatment planning system would result in errors of -0.29% and -0.93% per cm thickness of n-BCA without and with tantalum, respectively. Interface effects compared to water were small in magnitude and limited in distance for both embolization materials. CT values at 120 kVp were 2082 and 2358 HU for n-BCA without and with tantalum, respectively; dosimetrically appropriate HU values were estimated to be 79 and 199 HU, respectively. The dosimetric properties of the embolization agents are very close to those of water for a 6 MV beam. Therefore, treating the entire intracranial space as uniform in composition will result in less than 1% dosimetric error for n-BCA emboli smaller than 3.4 cm without added tantalum and n-BCA emboli smaller than 1.1 cm with added tantalum. Furthermore, when effective embolization can be achieved by the neurointerventionalist using n-BCA without tantalum, the dosimetric impact of overriding material properties will be lessened. However, due to the high attenuation of embolization agents with and without added tantalum for diagnostic energies, artifacts may occur that necessitate additional imaging to accurately identify the spatial extent of the region to be treated.

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Geographical breakdown

Country Count As %
Mexico 1 6%
France 1 6%
Unknown 15 88%

Demographic breakdown

Readers by professional status Count As %
Other 5 29%
Student > Doctoral Student 2 12%
Researcher 2 12%
Student > Ph. D. Student 1 6%
Student > Bachelor 1 6%
Other 2 12%
Unknown 4 24%
Readers by discipline Count As %
Medicine and Dentistry 7 41%
Neuroscience 2 12%
Physics and Astronomy 1 6%
Business, Management and Accounting 1 6%
Psychology 1 6%
Other 1 6%
Unknown 4 24%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 April 2015.
All research outputs
#16,620,927
of 24,453,338 outputs
Outputs from Medical Physics
#5,358
of 7,869 outputs
Outputs of similar age
#176,227
of 290,983 outputs
Outputs of similar age from Medical Physics
#124
of 155 outputs
Altmetric has tracked 24,453,338 research outputs across all sources so far. This one is in the 21st percentile – i.e., 21% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,869 research outputs from this source. They receive a mean Attention Score of 3.4. This one is in the 25th percentile – i.e., 25% of its peers scored the same or lower than it.
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We're also able to compare this research output to 155 others from the same source and published within six weeks on either side of this one. This one is in the 15th percentile – i.e., 15% of its contemporaries scored the same or lower than it.