ArticleMedical physics2025
A motion analysis of cardiac substructures for guiding stereotactic arrhythmia radiotherapy motion management.
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 3 papers.
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Who cites it
3 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
- A respiratory motion analysis for guiding stereotactic arrhythmia radiotherapy motion management.Medical physics · 2026Article
- Robustness evaluation of carbon ion radiotherapy for ventricular tachycardia.Physics and imaging in radiation oncology · 2026Article
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Authors and funding
8 authors.
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Abstract
backgroundStereotactic arrhythmia radiotherapy (STAR) has recently emerged as a novel noninvasive treatment option for critically ill and drug-refractory VT patients who cannot be treated or re-treated by catheter ablation. However, STAR requires precise management of cardiorespiratory motion to minimize radiation toxicity to the healthy heart and nearby organs-at-risk (OARs) and to ensure the radiation precision to deliver the prescribed dose to the VT target. PURPOSE: To investigate the characteristics of cardiac motion of VT patients to facilitate cardiac motion management for STAR treatments.
methodsBreath-hold cardiac 4DCTs (c4DCT) of 18 patients previously treated with STAR were analyzed retrospectively. Each c4DCT contained ten 3DCTs corresponding to 10 phases of an entire cardiac motion cycle. For each c4DCT, a group-wise deformable image registration (DIR) method was used to register all ten 3DCTs, resulting in ten 3D deformation vector fields (DVFs) and an average position 3DCT. The DVFs were computed from each phase to the average position 3DCT instead of between pairs of phases. Metal artifacts caused by the Implantable Cardioverter-Defibrillator (ICD) leads were reduced using a diffusion procedure before DIR. The heart chambers were segmented on the average position 3DCT using an AI segmentation tool, followed by manual evaluation and correction. Cardiac motion characteristics (magnitude and direction) were investigated temporally over the 10 cardiac phases and spatially for the outer myocardium walls of the heart and per chamber, AV (atrium-ventricle) valves, septa (the muscular walls dividing the chambers), and STAR targets.
resultsThe motion magnitude maximum over cardiac phases was computed by taking each voxel's maximum motion magnitude in 10 phases, referring to the average position. The cardiac motion magnitudes were found to be strongly patient-specific. The maximum, 99
conclusionsThe cardiac motion characteristics (magnitude, direction, and spatial distribution) of STAR patients provided in this study would further facilitate cardiac motion management.
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