Impact of abdominal compression on heart and stomach motion for stereotactic arrhythmia radioablation
Date
2023-09-07
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Abstract
Stereotactic arrhythmia radioablation (STAR) is a promising novel treatment using radiotherapy to treat heart arrhythmias, particularly ventricular tachycardia. Similar to other radiotherapy techniques, the cardiac and respiratory-induced motion throughout the treatment of the target and surrounding organs-at-risk is a common concern for treatment planning and delivery; this may lead to increased radiation exposure to healthy tissue, causing negative side-effects if proper management or mitigation is not considered. Reducing respiratory-induced motion of targets via abdominal compression (AC) is well established as an effective target motion management method for liver patients, which can lead to reduced healthy tissue exposure. However, AC has yet to be studied for its effect on the respiratory-induced motion of cardiac structures. Furthermore, the impact of AC on the motion of the stomach, the primary organ-at-risk for STAR, is also undocumented. The purpose of this thesis is to evaluate motion differences of STAR targets between patients treated with AC against those without (free-breathing) using relative centre of mass translations of contoured cardiac structures as well as the stomach. Motion comparisons were performed in magnitude and range of motion in the three cardinal directions to evaluate the effect of AC on anisotropic treatment margins. The relative motion of potential target locations and the stomach were evaluated to observe possible treatment volume overlap with the stomach, which could cause stomach overexposure. This research indicates that AC has a patient-specific effect on STAR target motion and does not significantly affect the likelihood of stomach overlap with the treatment volume. The primary contribution of this thesis is to recommend that AC not be employed as a respiratory motion management method during future STAR treatments.
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Cecchi, D. (2023). Impact of abdominal compression on heart and stomach motion for stereotactic arrhythmia radioablation (Master's/Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.