ArticleCureus2016
Treatment Planning Considerations for Robotic Guided Cardiac Radiosurgery for Atrial Fibrillation.
Article in Cureus, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Stereotactic Radiotherapy Ablation and Atrial Fibrillation: Technical Issues and Clinical Expectations Derived From a Systematic Review.Frontiers in cardiovascular medicine · 2022Pooled it
- ICD lead and primary metal artifact detection and inpainting in cardiac CT images.Medical physics · 2025Article
- Enhancing Precision in Cardiac Segmentation for Magnetic Resonance-Guided Radiation Therapy Through Deep Learning.International journal of radiation oncology, biology, physics · 2024Article
- Article
- ASSET: Auto-Segmentation of the Seventeen SEgments for Ventricular Tachycardia Ablation in Radiation Therapy.Cancers · 2023Article
- Combined clustered scan-based metal artifact reduction algorithm (CCS-MAR) for ultrasound-guided cardiac radioablation.Physical and engineering sciences in medicine · 2022Article
- Atrial fibrillation cardiac radioablation target visibility on magnetic resonance imaging.Physical and engineering sciences in medicine · 2022Article
- Stereotactic Ablative Radiotherapy of Ventricular Tachycardia Using Tracking: Optimized Target Definition Workflow.Frontiers in cardiovascular medicine · 2022Article
- Advantages and challenges for noninvasive atrial fibrillation ablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2021Article
- Stereotactic Arrhythmia Radioablation as a Novel Treatment Approach for Cardiac Arrhythmias: Facts and Limitations.Biomedicines · 2021Review
- Tumor-dose-rate variations during robotic radiosurgery of oligo and multiple brain metastases.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Article
- A proof of concept treatment planning study of gated proton radiotherapy for cardiac soft tissue sarcoma.Physics and imaging in radiation oncology · 2021Article
- Dosimetric feasibility of stereotactic ablative radiotherapy in pulmonary vein isolation for atrial fibrillation using intensity-modulated proton therapy.Journal of applied clinical medical physics · 2021Article
- Radiosurgery for ventricular tachycardia: preclinical and clinical evidence and study design for a German multi-center multi-platform feasibility trial (RAVENTA).Clinical research in cardiology : official journal of the German Cardiac Society · 2020Article
- Stereotactic body radiotherapy for ventricular tachycardia (cardiac radiosurgery) : First-in-patient treatment in Germany.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2020Article
- Swine Atrioventricular Node Ablation Using Stereotactic Radiosurgery: Methods and In Vivo Feasibility Investigation for Catheter-Free Ablation of Cardiac Arrhythmias.Journal of the American Heart Association · 2017Article
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Authors and funding
14 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRobotic guided stereotactic radiosurgery has recently been investigated for the treatment of atrial fibrillation (AF). Before moving into human treatments, multiple implications for treatment planning given a potential target tracking approach have to be considered. MATERIALS &
methodsTheoretical AF radiosurgery treatment plans for twenty-four patients were generated for baseline comparison. Eighteen patients were investigated under ideal tracking conditions, twelve patients under regional dose rate (RDR = applied dose over a certain time window) optimized conditions (beam delivery sequence sorting according to regional beam targeting), four patients under ultrasound tracking conditions (beam block of the ultrasound probe) and four patients with temporary single fiducial tracking conditions (differential surrogate-to-target respiratory and cardiac motion).
resultsWith currently known guidelines on dose limitations of critical structures, treatment planning for AF radiosurgery with 25 Gy under ideal tracking conditions with a 3 mm safety margin may only be feasible in less than 40% of the patients due to the unfavorable esophagus and bronchial tree location relative to the left atrial antrum (target area). Beam delivery sequence sorting showed a large increase in RDR coverage (% of voxels having a larger dose rate for a given time window) of 10.8-92.4% (median, 38.0%) for a 40-50 min time window, which may be significant for non-malignant targets. For ultrasound tracking, blocking beams through the ultrasound probe was found to have no visible impact on plan quality given previous optimal ultrasound window estimation for the planning CT. For fiducial tracking in the right atrial septum, the differential motion may reduce target coverage by up to -24.9% which could be reduced to a median of -0.8% (maximum, -12.0%) by using 4D dose optimization. The cardiac motion was also found to have an impact on the dose distribution, at the anterior left atrial wall; however, the results need to be verified.
conclusionRobotic AF radiosurgery with 25 Gy may be feasible in a subgroup of patients under ideal tracking conditions. Ultrasound tracking was found to have the lowest impact on treatment planning and given its real-time imaging capability should be considered for AF robotic radiosurgery. Nevertheless, advanced treatment planning using RDR or 4D respiratory and cardiac dose optimization may be still advised despite using ideal tracking methods.
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