ArticleJournal of applied clinical medical physics2020
Incorporating sensitive cardiac substructure sparing into radiation therapy planning.
Article in Journal of applied clinical medical physics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 29 citations in OpenAlex.
- Deducing cardiorespiratory motion of cardiac substructures using a novel 5D-MRI workflow for radiotherapy.Physics in medicine and biology · 2026Article
- Modality-AGnostic image Cascade (MAGIC) for multi-modality cardiac substructure segmentation.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2026Article
- Dosimetric Performance of Orthogonal Dual-Layer Multi-Leaf Collimator System on Locally Advanced Lung Cancer: Cardiac Substructures Sparing Plans.Advances in radiation oncology · 2025Article
- Deep Learning-Based Cardiac Chamber Segmentation in Magnetic Resonance-Guided Adaptive Radiation Therapy.Advances in radiation oncology · 2025Article
- Modality-AGnostic Image Cascade (MAGIC) for Multi-Modality Cardiac Substructure Segmentation.ArXiv · 2025Article
- Cardiac substructure dose distributions in node-positive and node-negative breast cancer patients undergoing 3D-CRT: comparing the predictive accuracy of mean heart dose and mean left ventricular dose.Radiation oncology (London, England) · 2025Article
- Cardiotoxicity following thoracic radiotherapy for lung cancer.British journal of cancer · 2025Review
- Moving beyond mean heart dose: The importance of cardiac substructures in radiation therapy toxicity.Journal of medical imaging and radiation oncology · 2024Review
- The Use of Magnetic Resonance Imaging in Radiation Therapy Treatment Simulation and Planning.Journal of magnetic resonance imaging : JMRI · 2024Review
- Development and first implementation of a novel multi-modality cardiac motion and dosimetry phantom for radiotherapy applications.Medical physics · 2024Article
- A planning strategy may reduce the risk of heart diseases and radiation pneumonia: Avoiding the specific heart substructures.Journal of applied clinical medical physics · 2023Article
- Open-source, fully-automated hybrid cardiac substructure segmentation: development and optimisation.Physical and engineering sciences in medicine · 2023Article
- On the feasibility of cardiac substructure sparing in magnetic resonance imaging guided stereotactic lung radiotherapy.Medical physics · 2023Article
- Radiation-Induced Cardiac Dysfunction: Optimizing Radiation Delivery and Postradiation Care.Heart failure clinics · 2022Review
- Mediastinal irradiation and valvular heart disease.Cardio-oncology (London, England) · 2022Review
- Hypofractionated Whole-Breast Irradiation Focus on Coronary Arteries and Cardiac Toxicity-A Narrative Review.Frontiers in oncology · 2022Review
- SBRT of ventricular tachycardia using 4pi optimized trajectories.Journal of applied clinical medical physics · 2021Article
- Evaluation of the dosimetric impact of heart function-based volumetric modulated arc therapy planning in patients with esophageal cancer.Radiological physics and technology · 2021Article
- Impact of Cardiac Dose on Overall Survival in Lung Stereotactic Body Radiotherapy (SBRT) Compared to Conventionally Fractionated Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer (LA-NSCLC).Journal of cancer therapy · 2021Article
- Quantifying inter-fraction cardiac substructure displacement during radiotherapy via magnetic resonance imaging guidance.Physics and imaging in radiation oncology · 2021Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
purposeRising evidence suggests that cardiac substructures are highly radiosensitive. However, they are not routinely considered in treatment planning as they are not readily visualized on treatment planning CTs (TPCTs). This work integrated the soft tissue contrast provided by low-field MRIs acquired on an MR-linac via image registration to further enable cardiac substructure sparing on TPCTs.
methodsSixteen upper thoracic patients treated at various breathing states (7 end-exhalation, 7 end-inhalation, 2 free-breathing) on a 0.35T MR-linac were retrospectively evaluated. A hybrid MR/CT atlas and a deep learning three-dimensional (3D) U-Net propagated 13 substructures to TPCTs. Radiation oncologists revised contours using registered MRIs. Clinical treatment plans were re-optimized and evaluated for beam arrangement modifications to reduce substructure doses. Dosimetric assessment included mean and maximum (0.03cc) dose, left ventricular volume receiving 5Gy (LV-V5), and other clinical endpoints. As metrics of plan complexity, total MU and treatment time were evaluated between approaches.
resultsCardiac sparing plans reduced the mean heart dose (mean reduction 0.7 ± 0.6, range 0.1 to 2.5 Gy). Re-optimized plans reduced left anterior descending artery (LADA) mean and LADA
conclusionsBy introducing 0.35T MRIs acquired on an MR-linac to verify cardiac substructure segmentations for CT-based treatment planning, an opportunity was presented for more effective sparing with limited increase in plan complexity. Validation in a larger cohort with appropriate margins offers potential to reduce radiation-related cardiotoxicities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.