Universität zu Köln

Kluge, Anne, Ehrbar, Stefanie, Grehn, Melanie, Fleckenstein, Jens, Baus, Wolfgang W., Siebert, Frank-Andre, Schweikard, Achim, Andratschke, Nicolaus, Mayinger, Michael C., Boda-Heggemann, Judit, Buergy, Daniel, Celik, Eren, Krug, David, Kovacs, Boldizsar, Saguner, Ardan M., Rudic, Boris, Bergengruen, Paula, Boldt, Leif-Hendrik, Stauber, Annina, Zaman, Adrian, Bonnemeier, Hendrik, Dunst, Jurgen, Budach, Volker ORCID: 0000-0002-2191-9871, Blanck, Oliver ORCID: 0000-0003-1391-1308 and Mehrhof, Felix ORCID: 0000-0003-0553-4290 (2022). Treatment Planning for Cardiac Radioablation: Multicenter Multiplatform Benchmarking for the RAdiosurgery for VENtricular TAchycardia (RAVENTA) Trial. Int. J. Radiat. Oncol. Biol. Phys., 114 (2). S. 360 - 373. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1879-355X

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Abstract

Purpose: Cardiac radioablation is a novel treatment option for patients with refractory ventricular tachycardia unsuitable for catheter ablation. The quality of treatment planning depends on dose specifications, platform capabilities, and experience of the treating staff. To harmonize the treatment planning, benchmarking of this process is necessary for multicenter clinical studies such as the RAdiosurgery for VENtricular TAchycardia trial. Methods and Materials: Planning computed tomography data and consensus structures from 3 patients were sent to 5 academic centers for independent plan development using a variety of platforms and techniques with the RAdiosurgery for VENtricular TAchycardia study protocol serving as guideline. Three-dimensional dose distributions and treatment plan details were collected and analyzed. In addition, an objective relative plan quality ranking system for ventricular tachycardia treatments was established. Results: For each case, 3 coplanar volumetric modulated arc (VMAT) plans for C-arm linear accelerators (LINAC) and 3 non-coplanar treatment plans for robotic arm LINAC were generated. All plans were suitable for clinical applications with minor deviations from study guidelines in most centers. Eleven of 18 treatment plans showed maximal one minor deviation each for target and cardiac substructures. However, dose-volume histograms showed substantial differences: in one case, the planning target volume >= 30 Gy ranged from 0.0% to 79.9% and the ramus interventricularis anterior V-14Gy ranged from 4.0% to 45.4%. Overall, the VMAT plans had steeper dose gradients in the high-dose region, while the plans for the robotic arm LINAC had smaller low-dose regions. Thereby, VMAT plans required only about half as many monitor units, resulting in shorter delivery times, possibly an important factor in treatment outcome. Conclusions: Cardiac radioablation is feasible with robotic arm and C-arm LINAC systems with comparable plan quality. Although cross-center training and best practice guidelines have been provided, further recommendations, especially for cardiac substructures, and ranking of dose guidelines will be helpful to optimize cardiac radioablation outcomes. (C) 2022 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kluge, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Ehrbar, Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Grehn, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Fleckenstein, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Baus, Wolfgang W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebert, Frank-Andre UNSPECIFIED UNSPECIFIED UNSPECIFIED Schweikard, Achim UNSPECIFIED UNSPECIFIED UNSPECIFIED Andratschke, Nicolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Mayinger, Michael C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boda-Heggemann, Judit UNSPECIFIED UNSPECIFIED UNSPECIFIED Buergy, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Celik, Eren UNSPECIFIED UNSPECIFIED UNSPECIFIED Krug, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Kovacs, Boldizsar UNSPECIFIED UNSPECIFIED UNSPECIFIED Saguner, Ardan M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudic, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Bergengruen, Paula UNSPECIFIED UNSPECIFIED UNSPECIFIED Boldt, Leif-Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Stauber, Annina UNSPECIFIED UNSPECIFIED UNSPECIFIED Zaman, Adrian UNSPECIFIED UNSPECIFIED UNSPECIFIED Bonnemeier, Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Dunst, Jurgen UNSPECIFIED UNSPECIFIED UNSPECIFIED Budach, Volker UNSPECIFIED orcid.org/0000-0002-2191-9871 UNSPECIFIED Blanck, Oliver UNSPECIFIED orcid.org/0000-0003-1391-1308 UNSPECIFIED Mehrhof, Felix UNSPECIFIED orcid.org/0000-0003-0553-4290 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-691986
DOI:	10.1016/j.ijrobp.2022.06.056
Journal or Publication Title:	Int. J. Radiat. Oncol. Biol. Phys.
Volume:	114
Number:	2
Page Range:	S. 360 - 373
Date:	2022
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1879-355X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STEREOTACTIC BODY RADIOTHERAPY; HEART SUBSTRUCTURES; CATHETER ABLATION; RADIATION; SBRT Multiple languages Oncology; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69198