Proton or photon radiosurgery for cardiac ablation of ventricular tachycardia? Breath and ECG gated robust optimization
| Autor: | L. Widesott, Maurizio Del Greco, Francesco Dionisi, Maurizio Centonze, Maurizio Amichetti, F. Fracchiolla, Francesco Tommasino |
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| Rok vydání: | 2020 |
| Předmět: |
Heartbeat
medicine.medical_treatment Biophysics General Physics and Astronomy Ventricular tachycardia Radiosurgery 030218 nuclear medicine & medical imaging 03 medical and health sciences Heart disorder Electrocardiography 0302 clinical medicine Proton Therapy Medicine Humans Radiology Nuclear Medicine and imaging Radiation treatment planning Proton therapy Photons business.industry Radiotherapy Planning Computer-Assisted Robust optimization Radiotherapy Dosage General Medicine Cardiac Ablation medicine.disease 030220 oncology & carcinogenesis Tachycardia Ventricular Protons business Nuclear medicine |
| Zdroj: | Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB). 78 |
| ISSN: | 1724-191X |
| Popis: | Purpose Ventricular tachycardia (VT) is a life-threatening heart disorder. The aim of this preliminary study is to assess the feasibility of stereotactic body radiation therapy (SBRT) photon and proton therapy (PT) plans for the treatment of VT, adopting robust optimization technique for both irradiation techniques. Methods ECG gated CT images (in breath hold) were acquired for one patient. Conventional planning target volume (PTV) and robust optimized plans (25GyE in single fraction) were simulated for both photon (IMRT, 5 and 9 beams) and proton (SFO, 2 beams) plans. Robust optimized plans were obtained both for protons and photons considering in the optimization setup errors (5 mm in the three orthogonal directions), range (±3.5%) and the clinical target volume (CTV) motion due to heartbeat and breath-hold variability. Results The photon robust optimization method, compared to PTV-based plans, showed a reduction in the average dose to the heart by about 25%; robust optimization allowed also reducing the mean dose to the left lung from 3.4. to 2.8 Gy for 9-beams configuration and from 4.1 to 2.9 Gy for 5-beams configuration. Robust optimization with protons, allowed further reducing the OAR doses: average dose to the heart and to the left lung decreased from 7.3 Gy to 5.2 GyE and from 2.9 Gy to 2.2 GyE, respectively. Conclusions Our study demonstrates the importance of the optimization technique adopted in the treatment planning system for VT treatment. It has been shown that robust optimization can significantly reduce the dose to healthy cardiac tissues and that PT further increases this gain. |
| Databáze: | OpenAIRE |
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