TY - JOUR
T1 - Lessons Learned From the First Human Low-Field MRI Guided Radiation Therapy of the Heart in the Presence of an Implantable Cardiac Defibrillator
AU - Gach, H. Michael
AU - Green, Olga L.
AU - Cuculich, Phillip S.
AU - Wittland, Erin J.
AU - Marko, Areti
AU - Luchtefeld, Molly E.
AU - Entwistle, Jill M.
AU - Yang, Deshan
AU - Wilber, David J.
AU - Mutic, Sasa
AU - Robinson, Clifford G.
N1 - Funding Information:
Sources of support: This publication was supported by the Washington University in St. Louis Departments of Radiation Oncology and Cardiology.Disclosures: Washington University in St. Louis receives research funding and nonfinancial support from ViewRay unrelated to this work. Drs Mutic, Robinson, and Green receive speaker and consulting fees from ViewRay unrelated to this work. Dr Cuculich receives consulting fees from Medtronic unrelated to this work. Sources of support: This publication was supported by the Washington University in St. Louis Departments of Radiation Oncology and Cardiology. Disclosures: Washington University in St. Louis receives research funding and nonfinancial support from ViewRay unrelated to this work. Drs Mutic, Robinson, and Green receive speaker and consulting fees from ViewRay unrelated to this work. Dr Cuculich receives consulting fees from Medtronic unrelated to this work.
Publisher Copyright:
© 2019 American Society for Radiation Oncology
PY - 2019/7/1
Y1 - 2019/7/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85063286880&partnerID=8YFLogxK
U2 - 10.1016/j.prro.2019.02.003
DO - 10.1016/j.prro.2019.02.003
M3 - Article
C2 - 30790716
AN - SCOPUS:85063286880
SN - 1879-8500
VL - 9
SP - 274
EP - 279
JO - Practical Radiation Oncology
JF - Practical Radiation Oncology
IS - 4
ER -