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• W4313443497 abstract "Cardiac radioablation (CR) is a promising treatment for patients with refractory ventricular tachycardia. Several medical centers around the world reported patient treatments using Cyberknife. Some of these teams used the implantable cardioverter defibrillator (ICD) lead as the sole tracking surrogate during treatment. However, the motions of CR target and ICD lead may differ along the cardiac cycle. The objectives of this study were to evaluate: (i) the reliability of the ICD lead to track the target position along the cardiac cycle; (ii) the geometrical impact of the tracking uncertainties on the target volume. Contrast-enhanced breath-hold cardiac ECG-gated computed tomography (c4D-CT) of 15 patients suffering from arrhythmias were acquired and reconstructed in 10 3D images datasets. A CR target was delineated on one phase of the c4D-CT for each patient and propagated to the other phases of the c4D-CT, using deformable image registration. The tip of the ICD lead was manually located on each phase of the c4D-CT for each patient. Target and ICD lead motion discrepancies were evaluated by comparing the positions of the centroids of both objects (i.e., target and lead) across phases. At each phase of the cardiac cycle, we defined the motion vector of an object, as the distance between its current position and the average position of the object across all phases. The Mean Absolute Error (MAE) between motion vectors of the target and the ICD lead on the same phase was calculated for each patient as a metric of motion discrepancies. For each patient an Internal Target Volume (ITV) has been built as the volume encompassing all the positions of the target relatively to the lead along the cardiac cycle. The mean (min - max) MAE was of 3.3 (1.5–4.9) mm. The distance between the ICD lead and the target (d) has also been evaluated, and its mean (min–max) value was 65 (19–120) mm. No correlation was found between MAE and d (Pearson = 0.38, P = 0.16). The relative volume increase between CTV and ITV was 104 (39–151) %. Non-negligible discrepancies were observed between cardiac-induced motions of ICD lead and target in cardiac radioablation. An ITV that encompasses the relative positions of the target with respect to the ICD lead is, on average, twice the volume of the CTV." @default.
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• W4313443497 date "2023-01-01" @default.
• W4313443497 modified "2023-09-26" @default.
• W4313443497 title "Motion discrepancies between cardiac target and ICD lead, and their impact on target volume for cardiac radioablation" @default.
• W4313443497 doi "https://doi.org/10.1016/j.acvdsp.2022.10.182" @default.
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