• Arteriovenous malformation patients

• Cerebral cavernous malformation patients

• Sigmoid/cavernous sinus dural AV fistula patients

• Large/giant AVM patients

• High-risk vascular lesions

• Gamma Knife trainees

Taipei VGH Gamma Knife Radiosurgery Team, led by Drs. Wan-Yuo Guo and Cheng-Chia Lee, integrates Functional Neurosurgery, Neuroradiology, and Radiation Oncology as Taiwan's only team performing both pre- and post-op outcome evaluation. Past 10 years: 1,602 AVM cases treated, gamma knife accounting for 72.5% (1,162). Eight world-first innovations: (1) treatment of giant AVMs; (2) volume-staged technique for brain AVMs; (3) dosimetry boosting large AVM cure rate while reducing risk; (4) MRI perfusion to validate gamma knife efficacy (AJNR Cover Story); (5) application of quantitative DSA (QDSA); (6) MRI-based follow-up replacing DSA; (7) AI-based outcome prediction model; (8) world-exclusive patent for AI auto-segmentation of brain AVM tissue (sensitivity 89.86%, specificity 92.36%; ROC Taiwan I637187 & US 10,346,719 B2 patents). AVM cure rate 60-90% with rebleeding <2%; DAVF cure rate >75% with case volume comprising half of global cases; CCM rebleeding reduced from 23.6-31.3% to 1.74-3.2%. Published 110 academic papers in JNS/NSGY/AJNR/Red Journal.

• Multidisciplinary team (Neurosurg/Neuroradiol/Rad Onc)

• World-first giant AVM treatment

• World-first volume-staged technique

• World-first MRI follow-up replacing DSA

• World-exclusive AI AVM segmentation patent

• Taiwan-only pre/post-op evaluation team

• 32 Years of Gamma Knife Treatment for AVMs:1315 Cases

• DAVF cases comprise half of global total

• Largest CCM case series worldwide

• 110 cerebral vascular malformation papers

• Established multiple domestic/intl gamma knife centers

• AVM cure rate 60-90%, rebleeding <2%

• DAVF cure rate >75%

• CCM rebleeding 23.6-31.3% → 1.74-3.2%

• AVM/CCM post-op seizure control: TPE VGH highest

• AI auto-segmentation sensitivity 89.86%, specificity 92.36%

• Best large-AVM treatment outcomes globally

• Multi-modal stereotactic image-guided QA

• MRI + X-ray angiography integration since 1993

• Open-craniotomy-free, no post-op ICU

• Significantly reduced large AVM treatment risk

• Small 12Gy field outside lesion, high coverage

• Aligned with IRRF, Asian Gamma Knife Academy education

• Patients praise open-craniotomy-free option

• Significantly improves post-op health & quality of life

• Intl patients seek treatment abroad

• Media coverage and public acclaim

• Dr. Hideyuki Kano (UPMC) endorses TPE VGH approach

• Patient family appreciation

• 110 cerebral vascular malformation papers

• Published in JNS/NSGY/AJNR/Red Journal

• AJNR Cover Story feature

• World-exclusive AI patents (ROC/USA)

• Faculty for IRRF and Asian Gamma Knife Academy

• Comparative data from 32 countries; intl talks

• Established Gamma Knife centers at Shuang Ho, CSMU, Chiayi VGH, KSVGH

• Trained physicians from Shanghai, Singapore, India, Sweden

• AI smart medical device development with NYCU

• Led Taiwan Smart Healthcare Alliance (TSHA)

• TPE VGH DAVF treatment = global standard

• Domestic/intl gamma knife demonstration center