Lessons Learned From the First Human Low-Field MRI Guided Radiation Therapy of the Heart in the Presence of an Implantable Cardiac Defibrillator

H. Michael Gach, Olga L. Green, Phillip S. Cuculich, Erin J. Wittland, Areti Marko, Molly E. Luchtefeld, Jill M. Entwistle, Deshan Yang, David J. Wilber, Sasa Mutic, Clifford G. Robinson

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Magnetic resonance imaging (MRI) guided radiation therapy is reported for the first time in a patient with an implantable cardioverter defibrillator (ICD) and cardiac fibroma in the left ventricle. Stereotactic body radiation therapy was delivered in 5 fractions at a dose of 700 cGy/fraction using a 0.35 T MRI–linear accelerator with real-time tumor tracking and beam gating. The average treatment time per fraction was 12.13 minutes, including gating dead time and gantry rotation, and the average duty cycle was 56.8%. Lessons learned included the need for MRI safety workflows that address the ICD and are tailored to the radiation oncology environment, selection of a suitable tracking target to ensure satisfactory duty cycle, and the presence of null band artifacts within the tracking target caused by ferrous components in the ICD.

Original languageEnglish
Pages (from-to)274-279
Number of pages6
JournalPractical Radiation Oncology
Volume9
Issue number4
DOIs
StatePublished - Jul 1 2019

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