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 - 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 - https://www.scopus.com/pages/publications/85063286880
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 -