ArticleMedical physics2025
Feasibility of volumetric-modulated arc therapy gating for cardiac radioablation using real-time ECG signal acquisition and a dynamic phantom.
Article in Medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- STAR in a Second: Ultra-High-Dose-Rate Spread-Out Bragg Peak Proton Therapy for Breath-Hold Stereotactic Arrhythmia Radioablation.Advances in radiation oncology · 2026Article
- Stereotactic Body Radiotherapy for Refractory Ventricular Tachycardia: From Serendipity to Precision Biological Ablation.Reviews in cardiovascular medicine · 2026Review
- The role of abdominal compression in the reduction of respiratory motion for cardiac radioablation.Journal of applied clinical medical physics · 2026Article
- Robustness of heart dose against cardiac cycle in breast cancer radiotherapy with deep inspiration breath-hold.Radiological physics and technology · 2026Article
- Robustness evaluation of carbon ion radiotherapy for ventricular tachycardia.Physics and imaging in radiation oncology · 2026Article
- Feasibility of volumetric-modulated arc therapy gating for cardiac radioablation using real-time ECG signal acquisition and a dynamic phantom.Medical physics · 2025Article
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7 authors.
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Abstract
backgroundStereotactic arrythmia radioablation (STAR) is a noninvasive technique to treat ventricular tachycardia (VT). Management of cardiorespiratory motion plays an essential role in VT-STAR treatments to improve treatment outcomes by reducing positional uncertainties and increasing dose conformality. Use of an electrocardiogram (ECG) signal, acquired in real-time, as a surrogate to gate the beam has the potential to fulfil that intent. PURPOSE: To investigate the gated delivery of volumetric-modulated arc therapy (VMAT) for STAR on a TrueBeam linear accelerator (linac) using a real-time acquired ECG signal and a dynamic cardiac phantom. METHODS AND MATERIALS: Dosimetric characteristics of a 6 MV flattening filter free (FFF) beam from a Varian TrueBeam linac were initially evaluated under high-frequency gating scenarios relevant to cardiac rhythms with respect to dose linearity, beam output, and energy quality. A microcontroller board was used to interface and gate the linac, sending a beam on/off signal. For real-time cardiac gated measurements, an AD8232 Heart Monitor board was used to acquire the ECG signal and synchronize the VMAT delivery to an ArcCHECK detector to a specific phase of the cardiac cycle. Gated dose distributions were compared against those acquired for a non-gated delivery mode. An in-house dynamic cardiac phantom was developed to simulate cardiorespiratory motion that correlates target position with the signal to gate the beam. Measured dose distributions using gafchromic film were also compared against the static (reference) mode in different scenarios with and without gating.
resultsMaximum difference in dose per monitor unit (MU) was found to be no greater than 1% as compared to static mode with variation in the chamber response within 0.2% in the range of 50 MUs to 200 MUs. Maximum percentage differences for the beam output and beam qualiy index (TPR
conclusionA 6 MV-FFF TrueBeam is stable for performing gating in STAR under high-frequency gate windows within typical cardiac cycles. Agreement between measured dose distributions for a VMAT plan in static and ECG-synchronized deliveries and between static and target-position gated modes shows that the proposed methodology is feasible and can be implemented on a TrueBeam platform.
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