Evaluation of Motion Compensation Methods for Noninvasive Cardiac Radioablation of Ventricular Tachycardia

Prusator, Michael T.; Samson, Pamela; Cammin, J.; Robinson, Clifford G.; Cuculich, Phillip S.; Knutson, Nels C.; Goddu, S; Moore, Kaitlin; Hugo, Geoffrey D.

doi:10.1016/j.ijrobp.2021.06.035

Cited by 19 publications

(28 citation statements)

References 34 publications

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“…The clinical target volume was contoured by the radiation oncologist and cardiologist, based on the available data in RayStation (Figure S2). Cardiac muscle contraction was not corrected for in the clinical target volume, 22 but a planning target volume (PTV) margin of 3 mm was applied when tracking was possible on the ICD probe. For one patient, ICD probe tracking was not possible.…”

Section: Methodsmentioning

confidence: 99%

Stereotactic Radioablation for Ventricular Tachycardia in the Setting of Electrical Storm

Ninni

Gallot-Lavallée

Klein

et al. 2022

Circ: Arrhythmia and Electrophysiology

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Background: Stereotactic body radiotherapy (SBRT) has been reported as a safe and efficient therapy for treating refractory ventricular tachycardia (VT) despite optimal medical treatment and catheter ablation. However, data on the use of SBRT in patients with electrical storm (ES) is lacking. The aim of this study was to assess the clinical outcomes associated with SBRT in the context of ES. Methods: This retrospective study included patients who underwent SBRT in the context of ES from March 2020 to March 2021 in one tertiary center (CHU Lille). The target volume was delineated according to a predefined workflow. The efficacy was assessed with the following end points: sustained VT recurrence, VT reduced with antitachycardia pacing, and implantable cardioverter defibrillator shock. Results: Seventeen patients underwent SBRT to treat refractory VT in the context of ES (mean 67±12.8 age, 59% presenting ischemic heart disease, mean left ventricular ejection fraction: 33.7± 9.7%). Five patients presented with ES related to incessant VT. Among these 5 patients, the time to effectiveness ranged from 1 to 7 weeks after SBRT. In the 12 remaining patients, VT recurrences occurred in 7 patients during the first 6 weeks following SBRT. After a median 12.5 (10.5–17.8) months follow-up, a significant reduction of the VT burden was observed beyond 6 weeks (−91% [95% CI, 78–103]), P <0.0001). The incidence of implantable cardioverter defibrillator shock and antitachycardia pacing was 36% at 1 year. Conclusions: SBRT is associated with a significant reduction of the VT burden in the event of an ES; however, prospective randomized control trials are needed. In patients without incessant VT, recurrences are observed in half of patients during the first 6 weeks. VT tolerance and implantable cardioverter defibrillator programming adjustments should be integrated as part of an action plan defined before SBRT for each patient.

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Section: Methodsmentioning

confidence: 99%

Stereotactic Radioablation for Ventricular Tachycardia in the Setting of Electrical Storm

Ninni

Gallot-Lavallée

Klein

et al. 2022

Circ: Arrhythmia and Electrophysiology

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“…22,23 However, due to anatomical changes, for VT patients this is much lower, on the order of 3-5 mm in the SI, LR and AP directions, with maximum values up to 8 mm in the SI direction and 6•5 mm in the AP direction. 24,25 To manage this motion, an Internal target Volume (ITV) concept seems clinically feasible, although MRI-guided radiotherapy can optimise management of cardiorespiratory motion.…”

Section: Respiratory Motion Managementmentioning

confidence: 99%

STereotactic Arrhythmia Radioablation: current status of the art. The old world and the new world connected

Trombetta

Verhoeff

2023

J Radiother Pract

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“…It has been shown in the literature that both cardiac and respiratory motions impact target position. Prusator et al [4] reported mean amplitudes of cardiac target displacements caused by heart contraction of 3.4 mm left/right, 4.3 mm anterior/posterior, and 4.1 mm superior/inferior. Mean target displacements induced by respiration have been reported as 3.9 mm left/right, 4.1 mm anterior/posterior, and 4.7 mm superior/inferior.…”

Section: Introductionmentioning

confidence: 99%

“…Mean target displacements induced by respiration have been reported as 3.9 mm left/right, 4.1 mm anterior/posterior, and 4.7 mm superior/inferior. Additionally, these motions are highly patient-specific, depending on the location of the target in the heart and the respiration amplitude [4,5]. The main target motion management technique used in CR, especially when using a C-arm linear accelerator, is the generation of a cardiorespiratory internal target volume (ITV) based on cardiac-gated and/or respiration-gated four-dimensional computed-tomography (4D-CT) scans [3].…”

Section: Introductionmentioning

confidence: 99%

Cardiac radioablation for ventricular tachycardia: Which approach for incorporating cardiorespiratory motions into the planning target volume?

et al. 2022

View full text Add to dashboard Cite

Evaluation of Motion Compensation Methods for Noninvasive Cardiac Radioablation of Ventricular Tachycardia

Cited by 19 publications

References 34 publications

Stereotactic Radioablation for Ventricular Tachycardia in the Setting of Electrical Storm

Stereotactic Radioablation for Ventricular Tachycardia in the Setting of Electrical Storm

STereotactic Arrhythmia Radioablation: current status of the art. The old world and the new world connected

Cardiac radioablation for ventricular tachycardia: Which approach for incorporating cardiorespiratory motions into the planning target volume?

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