Electrocardiogram-gated cardiac computed tomography-based patient- and segment-specific cardiac motion estimation method in stereotactic arrhythmia radioablation for ventricular tachycardia
Background and purpose: Motion management strategies such as gating under breath-hold can reduce breathing-induced motion during stereotactic arrhythmia radioablation (STAR) for refractory ventricular tachycardia. However, heartbeat-induced motion is essential to define an appropriate cardiac intern...
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2025-01-01
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| author | Jingyang Xie Alicia S. Bicu Melanie Grehn Mustafa Kuru Adrian Zaman Xinyu Lu Christian Janorschke Luuk H.G. van der Pol Martin F. Fast Jens Fleckenstein Marcus Both Stephan Hohmann Egor Borzov Peter Winkler Roland R. Tilz Dirk Rades Frank A. Giordano Daniel Buergy Boris Rudic David Duncker Roland Merten Tomer Charas Mahmoud Suleiman Thomas Brunner Daniel Scherr Evgeny Lian Achim Schweikard Oliver Blanck Judit Boda-Heggemann Lena Kaestner |
| author_facet | Jingyang Xie Alicia S. Bicu Melanie Grehn Mustafa Kuru Adrian Zaman Xinyu Lu Christian Janorschke Luuk H.G. van der Pol Martin F. Fast Jens Fleckenstein Marcus Both Stephan Hohmann Egor Borzov Peter Winkler Roland R. Tilz Dirk Rades Frank A. Giordano Daniel Buergy Boris Rudic David Duncker Roland Merten Tomer Charas Mahmoud Suleiman Thomas Brunner Daniel Scherr Evgeny Lian Achim Schweikard Oliver Blanck Judit Boda-Heggemann Lena Kaestner |
| author_sort | Jingyang Xie |
| collection | DOAJ |
| description | Background and purpose: Motion management strategies such as gating under breath-hold can reduce breathing-induced motion during stereotactic arrhythmia radioablation (STAR) for refractory ventricular tachycardia. However, heartbeat-induced motion is essential to define an appropriate cardiac internal target volume (ITV) margin. In this study, we introduce a patient- and segment-specific cardiac motion estimation method and cardiac motion data of the clinical target volume (CTV), ICD lead tips and left ventricle (LV) segments. Materials and methods: Data from 10 STAR-treated patients were retrospectively analyzed. The LV was semi-automatically segmented according to the 17-segment model. Electrocardiogram-gated contrast-enhanced breath-hold cardiac CTs were automatically non-rigidly registered for motion estimation. The correlation and significant differences between ICD tip motion and CTV motion were assessed using the Pearson correlation coefficient (PCC) and Wilcoxon signed-rank test, while spatial discrepancies with both CTV and segment motion were quantified using the Euclidean distance. Results: The CTVs (center of mass) moved 3.4 ± 1.4 mm and the ICD lead tips moved 4.9 ± 2.2 mm. The maximum motion per patient was observed in basal and mid-cavity LV segments in 3D. The PCC showed a strong positive motion correlation between the ICD tip and CTV in 3D (0.84), while the p-values indicated statistically significant differences in the right-left, anterior-posterior and 3D directions. Conclusion: The proposed methods enable patient- and segment-specific cardiac ITV margin estimation. The motion in most LV segments was limited, however, cardiac ITV margins may need adjustment in individual cases. The impact of cardiac motion on the dosimetry needs further investigation. |
| format | Article |
| id | doaj-art-4b2ada3f725f45cca43ed30f8aca2926 |
| institution | Kabale University |
| issn | 2405-6316 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Physics and Imaging in Radiation Oncology |
| spelling | doaj-art-4b2ada3f725f45cca43ed30f8aca29262025-01-24T04:45:24ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162025-01-0133100700Electrocardiogram-gated cardiac computed tomography-based patient- and segment-specific cardiac motion estimation method in stereotactic arrhythmia radioablation for ventricular tachycardiaJingyang Xie0Alicia S. Bicu1Melanie Grehn2Mustafa Kuru3Adrian Zaman4Xinyu Lu5Christian Janorschke6Luuk H.G. van der Pol7Martin F. Fast8Jens Fleckenstein9Marcus Both10Stephan Hohmann11Egor Borzov12Peter Winkler13Roland R. Tilz14Dirk Rades15Frank A. Giordano16Daniel Buergy17Boris Rudic18David Duncker19Roland Merten20Tomer Charas21Mahmoud Suleiman22Thomas Brunner23Daniel Scherr24Evgeny Lian25Achim Schweikard26Oliver Blanck27Judit Boda-Heggemann28Lena Kaestner29Institute of Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany; Corresponding author at: Institute of Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany.Department of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute, University Medical Center Mannheim, GermanyDepartment of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, GermanyDepartment of Radiology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Internal Medicine III (Cardiology, Angiology, and Internal Intensive Care Medicine), University Medical Center Schleswig-Holstein, Kiel, GermanyInstitute of Robotics and Cognitive Systems, University of Luebeck, Luebeck, GermanyInstitute of Robotics and Cognitive Systems, University of Luebeck, Luebeck, GermanyDepartment of Radiotherapy, University Medical Center Utrecht, Utrecht, the NetherlandsDepartment of Radiotherapy, University Medical Center Utrecht, Utrecht, the NetherlandsDepartment of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute, University Medical Center Mannheim, GermanyDepartment of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel, GermanyHannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany; Cardiology & Internal Intensive Care Medicine, St. Bernward Hospital, Hildesheim, GermanyDepartment of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, Germany; Department of Radiotherapy, Division of Oncology, Rambam Health Care Campus, Haifa, IsraelDepartment of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, AustriaDepartment of Rhythmology, University Heart Center Luebeck, University Hospital Schleswig-Holstein, Luebeck, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, GermanyDepartment of Radiation Oncology, University of Luebeck, Luebeck, GermanyDepartment of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute, University Medical Center Mannheim, GermanyDepartment of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute, University Medical Center Mannheim, GermanyDepartment of Internal Medicine I, Section for Electrophysiology and Rhythmology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg, Mannheim, GermanyHannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, GermanyDepartment of Radiotherapy, Hannover Medical School, Hannover, GermanyDepartment of Radiotherapy, Division of Oncology, Rambam Health Care Campus, Haifa, IsraelDivision of Pacing and Electrophysiology, Rambam Health Care Campus, Haifa, IsraelDepartment of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, AustriaDivision of Cardiology, Medical University of Graz, Graz, AustriaDepartment of Internal Medicine III (Cardiology, Angiology, and Internal Intensive Care Medicine), University Medical Center Schleswig-Holstein, Kiel, GermanyInstitute of Robotics and Cognitive Systems, University of Luebeck, Luebeck, GermanyDepartment of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, GermanyDepartment of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute, University Medical Center Mannheim, GermanyDepartment of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute, University Medical Center Mannheim, GermanyBackground and purpose: Motion management strategies such as gating under breath-hold can reduce breathing-induced motion during stereotactic arrhythmia radioablation (STAR) for refractory ventricular tachycardia. However, heartbeat-induced motion is essential to define an appropriate cardiac internal target volume (ITV) margin. In this study, we introduce a patient- and segment-specific cardiac motion estimation method and cardiac motion data of the clinical target volume (CTV), ICD lead tips and left ventricle (LV) segments. Materials and methods: Data from 10 STAR-treated patients were retrospectively analyzed. The LV was semi-automatically segmented according to the 17-segment model. Electrocardiogram-gated contrast-enhanced breath-hold cardiac CTs were automatically non-rigidly registered for motion estimation. The correlation and significant differences between ICD tip motion and CTV motion were assessed using the Pearson correlation coefficient (PCC) and Wilcoxon signed-rank test, while spatial discrepancies with both CTV and segment motion were quantified using the Euclidean distance. Results: The CTVs (center of mass) moved 3.4 ± 1.4 mm and the ICD lead tips moved 4.9 ± 2.2 mm. The maximum motion per patient was observed in basal and mid-cavity LV segments in 3D. The PCC showed a strong positive motion correlation between the ICD tip and CTV in 3D (0.84), while the p-values indicated statistically significant differences in the right-left, anterior-posterior and 3D directions. Conclusion: The proposed methods enable patient- and segment-specific cardiac ITV margin estimation. The motion in most LV segments was limited, however, cardiac ITV margins may need adjustment in individual cases. The impact of cardiac motion on the dosimetry needs further investigation.http://www.sciencedirect.com/science/article/pii/S2405631625000053Ventricular tachycardiaStereotactic arrhythmia radioablationCardiac motion estimationAHA 17-segment modelICD lead tip motionCardiac ITV margin estimation |
| spellingShingle | Jingyang Xie Alicia S. Bicu Melanie Grehn Mustafa Kuru Adrian Zaman Xinyu Lu Christian Janorschke Luuk H.G. van der Pol Martin F. Fast Jens Fleckenstein Marcus Both Stephan Hohmann Egor Borzov Peter Winkler Roland R. Tilz Dirk Rades Frank A. Giordano Daniel Buergy Boris Rudic David Duncker Roland Merten Tomer Charas Mahmoud Suleiman Thomas Brunner Daniel Scherr Evgeny Lian Achim Schweikard Oliver Blanck Judit Boda-Heggemann Lena Kaestner Electrocardiogram-gated cardiac computed tomography-based patient- and segment-specific cardiac motion estimation method in stereotactic arrhythmia radioablation for ventricular tachycardia Physics and Imaging in Radiation Oncology Ventricular tachycardia Stereotactic arrhythmia radioablation Cardiac motion estimation AHA 17-segment model ICD lead tip motion Cardiac ITV margin estimation |
| title | Electrocardiogram-gated cardiac computed tomography-based patient- and segment-specific cardiac motion estimation method in stereotactic arrhythmia radioablation for ventricular tachycardia |
| title_full | Electrocardiogram-gated cardiac computed tomography-based patient- and segment-specific cardiac motion estimation method in stereotactic arrhythmia radioablation for ventricular tachycardia |
| title_fullStr | Electrocardiogram-gated cardiac computed tomography-based patient- and segment-specific cardiac motion estimation method in stereotactic arrhythmia radioablation for ventricular tachycardia |
| title_full_unstemmed | Electrocardiogram-gated cardiac computed tomography-based patient- and segment-specific cardiac motion estimation method in stereotactic arrhythmia radioablation for ventricular tachycardia |
| title_short | Electrocardiogram-gated cardiac computed tomography-based patient- and segment-specific cardiac motion estimation method in stereotactic arrhythmia radioablation for ventricular tachycardia |
| title_sort | electrocardiogram gated cardiac computed tomography based patient and segment specific cardiac motion estimation method in stereotactic arrhythmia radioablation for ventricular tachycardia |
| topic | Ventricular tachycardia Stereotactic arrhythmia radioablation Cardiac motion estimation AHA 17-segment model ICD lead tip motion Cardiac ITV margin estimation |
| url | http://www.sciencedirect.com/science/article/pii/S2405631625000053 |
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