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Published in: Clinical Neuroradiology 4/2023

28-06-2023 | Brain Arteriovenous Malformation | Original Article

Nidus Compacity Determined by Semi-Automated Segmentation is a Strong Quantitative Predictor of Brain Arterio-Venous Malformation Cure

Authors: Aurélien Pacini, Eimad Shotar, Benjamin Granger, Franck Maizeroi-Eugène, Mariette Delaitre, Atika Talbi, Anne-Laure Boch, Charles-Ambroise Valéry, Kévin Premat, Mehdi Drir, Stéphanie Lenck, Charbel Mounayer, Nader-Antoine Sourour, Frédéric Clarençon

Published in: Clinical Neuroradiology | Issue 4/2023

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Abstract

Background and Objective

A compact nidus is a well-known feature of good outcome after treatment in brain arteriovenous malformations (bAVM). This item, included in the “Supplementary AVM grading system” by Lawton, is subjectively evaluated on DSA. The present study aimed to assess whether quantitative nidus compacity along with other angio-architectural bAVM features were predictive of angiographic cure or the occurrence of procedure-related complications.

Materials and Methods

Retrospective analysis of 83 patients prospectively collected data base between 2003 to 2018 having underwent digital subtraction 3D rotation angiography (3D-RA) for pre-therapeutic assessment of bAVM. Angio-architectural features were analyzed. Nidus compacity was measured with a dedicated segmentation tool. Univariate and multivariate analyses were performed to test the association between these factors and complete obliteration or complication.

Results

Compacity was the only significant factor associated with complete obliteration in our predictive model using logistic multivariate regression; the area under the curve for compacity predicting complete obliteration was excellent (0.82; 95% CI 0.71–0.90; p < 0.0001). The threshold value maximizing the Youden index was a compacity > 23% (sensitivity 97%; specificity 52%; 95% CI 85.1–99.9; p = 0.055). No angio-architectural factor was associated with the occurrence of a complication.

Conclusion

Nidus high compacity quantitatively measured on 3D-RA, using a dedicated segmentation tool is predictive of bAVM cure. Further investigation and prospective studies are warranted to confirm these preliminary results.
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Metadata
Title
Nidus Compacity Determined by Semi-Automated Segmentation is a Strong Quantitative Predictor of Brain Arterio-Venous Malformation Cure
Authors
Aurélien Pacini
Eimad Shotar
Benjamin Granger
Franck Maizeroi-Eugène
Mariette Delaitre
Atika Talbi
Anne-Laure Boch
Charles-Ambroise Valéry
Kévin Premat
Mehdi Drir
Stéphanie Lenck
Charbel Mounayer
Nader-Antoine Sourour
Frédéric Clarençon
Publication date
28-06-2023
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 4/2023
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-023-01313-y

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