ESTRO 2024 - Abstract Book

S4345

Physics - Intra-fraction motion management and real-time adaptive radiotherapy

ESTRO 2024

Conclusion:

By accounting for anatomical variations with breathing and its impact on dosimetry we were able to demonstrate the difference to the original clinical treatment plan parameters for both target and sample critical organs for one specific Cyberknife workflow applied in clinical STAR. Ongoing work includes validation of the proposed workflow, in particular image registration and transformation of complementary dose distributions using the digital XCAT phantom [4] with the availability of structures at each phase and also associated ‘ground truth‘ deformation vector fields, reproducing the analysis using commercial (image registration/dose accumulation) software and mutual results comparison, including more clinical patients but also investigating the impact of the STAR specifics such as the impact of ICD induced metal-motion artefacts resulting from combined respiratory and cardiac motion. In addition, other STAR treatment modalities including mainstream C-arm linac with 3D/4D CBCT at both free-breathing and breath-hold, will be included. Displaying the potential difference between what we think we deliver and what we actually deliver for these patients can be crucial in establishing dose-effect relationships in future investigations.

Keywords: radioablation, motion, ventricular-tachycardia

References:

[1] Brownstein J, Afzal M, Okabe T, et al. (2021) Method and Atlas to Enable Targeting for Cardiac Radioablation Employing the American Heart Association Segmented Model. Int. J. Radiat. Oncol. Biol. Phys. 2021;111:178–185.

[2] Dvorak P, Knybel L et al (2022) Stereotactic Ablative Radiotherapy of Ventricular Tachycardia Using Tracking: Optimized Target Definition Workflow. Front. Cardiovasc. Med. 9:870127. doi: 10.3389/fcvm.2022.870127

[3] https://www.slicer.org