ReviewJournal of medical imaging and radiation oncology2024
Moving beyond mean heart dose: The importance of cardiac substructures in radiation therapy toxicity.
Review in Journal of medical imaging and radiation oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Associations between reported atrial fibrillation burden and cardiac substructure dosimetric variables in patients receiving thoracic radiotherapy for malignancies involving the thorax: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- Estimation of Detailed Cardiac Doses for Pediatric Radiation Therapy Patients in National Wilms Tumor Study.International journal of radiation oncology, biology, physics · 2026Article
- AI-surrogate structure and dose correlation for left anterior descending artery in lung stereotactic body radiotherapy.Journal of applied clinical medical physics · 2026Article
- Cardiac substructure dosimetry in thoracic radiotherapy: moving beyond mean heart dose and toward precision cardiac risk mitigation.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Review
- Transformer-based cardiac substructure segmentation from contrast and non-contrast computed tomography for radiotherapy planning.Physics and imaging in radiation oncology · 2026Article
- Long-Term Risk of Cardiovascular Disease After Contemporary Left-Sided Breast Radiation Therapy.JAMA network open · 2026Article
- Radiation Doses to Cardiac Substructures Predict Elevation in High-sensitivity Cardiac Troponin T Levels in Radiation Therapy for Lung Cancer.International journal of radiation oncology, biology, physics · 2026Article
- Article
- Beyond mean heart dose: differentiated electrocardiographic manifestations and dosimetric mechanisms of cardiac injury in left-sided versus right-sided breast cancer after intensity-modulated radiotherapy.Frontiers in oncology · 2026Article
- Beyond mean heart dose: quantitative impact of sub-structure spatial dosimetrics on subclinical myocardial strain in thoracic radiotherapy.Frontiers in cardiovascular medicine · 2026Article
- RapidPlan Knowledge-Based Radiotherapy Planning Compared to Manual Planning in Locally Advanced Non-Small-Cell Lung Cancer.Cancers · 2025Article
- Preclinical characterisation of changes in cardiac function and circulating biomarkers following differential irradiation of thoracic volumes.Frontiers in oncology · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Normal tissue tolerance dose limits to the heart have been established to reduce the risk of radiation-induced cardiac disease (RICD). Dose constraints have been developed based on either the mean dose delivered to the whole heart (MHD) or the dose delivered to a specific volume, for example, volume of heart receiving equal to or greater than 30 Gy (V30). There is increasing evidence that the impact of thoracic radiation on cardiac morbidity and mortality has been underestimated. Consequently, there is a need to reduce the dose delivered to the heart in radical radiotherapy treatment planning. The pathophysiology of RICD may relate to dose to specific cardiac substructures (CS) rather than the traditionally observed MHD for common toxicities. The MHD or V30 Gy threshold dose rarely represents the true dose delivered to individual CS. Studies have shown the dose to specific areas may be more strongly correlated with overall survival (OS). With advances in modern radiotherapy techniques, it is vital that we develop robust, evidence-based dose limits for CS, to fully understand and reduce the risk of RICD, particularly in high-risk populations with cardiac risk factors. The following review will summarise the existing evidence of dose limits to CS, explain how dose limits may vary according to different disease sites or radiation techniques and propose how radiotherapy plans can be optimised to reduce the dose to these CS in clinical practice.
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