Semi-automated reproducible target transfer for cardiac radioablation - A multi-center cross-validation study within the RAVENTA trial.

CARDIO-RT Cross-validation EAMapReader Quality assurance RAVENTA STAR Semi-automated software solutions Stereotactic Arrhythmia Radioablation Target transfer Target volume definition Ventricular tachycardia

Journal

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192

Informations de publication

Date de publication:
04 Sep 2024
Historique:
received: 07 04 2024
revised: 26 07 2024
accepted: 19 08 2024
medline: 7 9 2024
pubmed: 7 9 2024
entrez: 6 9 2024
Statut: aheadofprint

Résumé

Stereotactic arrhythmia radioablation (STAR) is a therapeutic option for ventricular tachycardia (VT) where catheter-based ablation is not feasible or has previously failed. Target definition and its transfer from electro-anatomic maps (EAM) to radiotherapy treatment planning systems (TPS) is challenging and operator-dependent. Software solutions have been developed to register EAM with cardiac CT and semi-automatically transfer 2D target surface data into 3D CT volume coordinates. Results of a cross-validation study of two conceptually different open-source software solutions using data from the RAVENTA trial (NCT03867747) are reported. Clinical Target Volumes (CTVs) were created from target regions delineated on EAM using two conceptually different approaches by separate investigators on data of 10 patients, blinded to each other's results. Targets were transferred using 3D-3D registration and 2D-3D registration, respectively. The resulting CTVs were compared in a core-lab using two complementary analysis software packages for structure similarity and geometric characteristics. Volumes and surface areas of the CTVs created by both methods were comparable: 14.88 ± 11.72 ml versus 15.15 ± 11.35 ml and 44.29 ± 33.63 cm The STAR targets transferred from EAM to TPS using both software solutions resulted in nearly identical 3D structures. Both solutions can be used for QA (quality assurance) and EAM-to-TPS transfer of STAR-targets. Semi-automated methods could potentially help to avoid mistargeting in STAR and offer standardized workflows for methodically harmonized treatments.

Sections du résumé

BACKGROUND BACKGROUND
Stereotactic arrhythmia radioablation (STAR) is a therapeutic option for ventricular tachycardia (VT) where catheter-based ablation is not feasible or has previously failed. Target definition and its transfer from electro-anatomic maps (EAM) to radiotherapy treatment planning systems (TPS) is challenging and operator-dependent. Software solutions have been developed to register EAM with cardiac CT and semi-automatically transfer 2D target surface data into 3D CT volume coordinates. Results of a cross-validation study of two conceptually different open-source software solutions using data from the RAVENTA trial (NCT03867747) are reported.
METHODS METHODS
Clinical Target Volumes (CTVs) were created from target regions delineated on EAM using two conceptually different approaches by separate investigators on data of 10 patients, blinded to each other's results. Targets were transferred using 3D-3D registration and 2D-3D registration, respectively. The resulting CTVs were compared in a core-lab using two complementary analysis software packages for structure similarity and geometric characteristics.
RESULTS RESULTS
Volumes and surface areas of the CTVs created by both methods were comparable: 14.88 ± 11.72 ml versus 15.15 ± 11.35 ml and 44.29 ± 33.63 cm
CONCLUSION CONCLUSIONS
The STAR targets transferred from EAM to TPS using both software solutions resulted in nearly identical 3D structures. Both solutions can be used for QA (quality assurance) and EAM-to-TPS transfer of STAR-targets. Semi-automated methods could potentially help to avoid mistargeting in STAR and offer standardized workflows for methodically harmonized treatments.

Identifiants

DOI: 10.1016/j.radonc.2024.110499 PMID: 39242029
pubmed: 39242029
pii: S0167-8140(24)00769-2
doi: 10.1016/j.radonc.2024.110499
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT03867747']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

110499

Informations de copyright

Copyright © 2024. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Stephan Hohmann (S)

Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.

Jingyang Xie (J)

Institute for Robotics and Cognitive Systems, University of Lübeck, Lübeck, Germany.

Miriam Eckl (M)

Department of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Germany.

Melanie Grehn (M)

Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, Germany.

Nizar Karfoul (N)

Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.

Christian Janorschke (C)

Institute for Robotics and Cognitive Systems, University of Lübeck, Lübeck, Germany.

Roland Merten (R)

Department of Radiotherapy, Hannover Medical School, Hannover, Germany.

Boris Rudic (B)

Department of Internal Medicine I, Section for Electrophysiology and Rhythmology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg, Mannheim, Germany.

Daniel Buergy (D)

Department of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Germany.

Evgeny Lyan (E)

Department of Internal Medicine III, Section for Electrophysiology und Rhythmology, University Medical Center Schleswig-Holstein, Kiel, Germany.

David Krug (D)

Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, Germany.

Felix Mehrhof (F)

Department of Radiation Oncology, Charité University Medicine Berlin, Germany.

Leif-Hendrik Boldt (LH)

Department of Cardiology, Charité University Medicine Berlin, Berlin, Germany.

Stefanie Corradini (S)

Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.

Hannah Fanslau (H)

Department of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Germany.

Lena Kaestner (L)

Department of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Germany.

Adrian Zaman (A)

Department of Internal Medicine III, Section for Electrophysiology und Rhythmology, University Medical Center Schleswig-Holstein, Kiel, Germany.

Frank A Giordano (FA)

Department of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Germany.

David Duncker (D)

Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.

Jürgen Dunst (J)

Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, Germany.

Roland R Tilz (RR)

Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg, Kiel Lübeck, Germany.

Achim Schweikard (A)

Institute for Robotics and Cognitive Systems, University of Lübeck, Lübeck, Germany.

Oliver Blanck (O)

Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, Germany.

Judit Boda-Heggemann (J)

Department of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Germany. Electronic address: judit.boda-heggemann@umm.de.

Classifications MeSH