May 18, 2020

Technical Note: Cardiac Synchronized Volumetric Modulated Arc Therapy for Stereotactic Arrhythmia Radioablation - Proof of Principle

Medical Physics
Justin PoonSteven Thomas

Abstract

Ventricular tachycardia (VT) is a rapid, abnormal heart rhythm that can lead to sudden cardiac death. Current treatment options include antiarrhythmic drug therapy and catheter ablation, both of which have only modest efficacy and have potential complications. Cardiac radiosurgery has the potential to be a non-invasive and efficient treatment option for VT. Cardiac motion, however, must be accounted for to ensure accurate dose delivery to the target region. Cardiac synchronized volumetric modulated arc therapy (CSVMAT) aims to minimize the dose delivered to normal tissues by synchronizing beam delivery with a cardiac signal, irradiating only during the quiescent intervals of the cardiac cycle (when heart motion is minimal) and adjusting the beam delivery speed in response to heart rate changes. A CSVMAT plan was adapted from a conventional VMAT plan and delivered on a Varian TrueBeam linear accelerator. The original VMAT plan was divided into three interleaved CSVMAT phases, each consisting of alternating beam-on and beam-off segments synchronized to a sample heart rate. Trajectory log files were collected for the original VMAT and CSVMAT deliveries and the dose distributions were measured with Gafchromic EBT-XD film. Analysis ...Continue Reading

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Mentioned in this Paper

Sudden Cardiac Death
Volume Modulated Arc Therapy
Radiotherapy Systems, Linear Accelerator
Cardiac Arrhythmia
Radiosurgery
Exchange Transfusion, Whole Blood
Heart Rate
Pharmacotherapy
Delivery of Health Care
Tachycardia, Ventricular

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