Boda-Heggemann, Judit, Blanck, Oliver ORCID: 0000-0003-1391-1308, Mehrhof, Felix ORCID: 0000-0003-0553-4290, Ernst, Floris, Buergy, Daniel, Fleckenstein, Jens, Tueluemen, Erol, Krug, David, Siebert, Frank-Andre, Zaman, Adrian, Kluge, Anne K., Parwani, Abdul Shokor, Andratschke, Nicolaus, Mayinger, Michael C., Ehrbar, Stefanie, Saguner, Ardan M., Celik, Eren, Baus, Wolfgang W., Stauber, Annina, Vogel, Lena, Schweikard, Achim, Budach, Volker ORCID: 0000-0002-2191-9871, Dunst, Juergen, Boldt, Leif-Hendrik ORCID: 0000-0002-3320-0880, Bonnemeier, Hendrik and Rudic, Boris (2021). Interdisciplinary Clinical Target Volume Generation for Cardiac Radioablation: Multicenter Benchmarking for the RAdiosurgery for VENtricular TAchycardia (RAVENTA) Trial. Int. J. Radiat. Oncol. Biol. Phys., 110 (3). S. 745 - 757. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1879-355X

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Abstract

Purpose: Cardiac radioablation is a novel treatment option for therapy-refractory ventricular tachycardia (VT) ineligible for catheter ablation. Three-dimensional clinical target volume (CTV) definition is a key step, and this complex interdisciplinary procedure includes VT-substrate identification based on electroanatomical mapping (EAM) and its transfer to the planning computed tomography (PCT). Benchmarking of this process is necessary for multicenter clinical studies such as the RAVENTA trial. Methods and Materials: For benchmarking of the RAVENTA trial, patient data (epicrisis, electrocardiogram, high-resolution EAM, contrast-enhanced cardiac computed tomography, PCT) of 3 cases were sent to 5 university centers for independent CTV generation, subsequent structure analysis, and consensus finding. VT substrates were first defined on multiple EAM screenshots/videos and manually transferred to the PCT. The generated structure characteristics were then independently analyzed (volume, localization, surface distance and conformity). After subsequent discussion, consensus structures were defined. Results: VT substrate on the EAM showed visible variability in extent and localization for cases 1 and 2 and only minor variability for case 3. CTVs ranged from 6.7 to 22.9 cm(3), 5.9 to 79.9 cm(3), and 9.4 to 34.3 cm(3); surface area varied from 1087 to 3285 mm(2), 1077 to 9500 mm(2), and 1620 to 4179 mm(2), with a Hausdorff-distance of 15.7 to 39.5 mm, 23.1 to 43.5 mm, and 15.9 to 43.9 mm for cases 1 to 3, respectively. The absolute 3-dimensional center-of-mass difference was 5.8 to 28.0 mm, 8.4 to 26 mm, and 3.8 to 35.1 mm for cases 1 to 3, respectively. The entire process resulted in CTV structures with a conformity index of 0.2 to 0.83, 0.02 to 0.85, and 0.02 to 0.88 (ideal 1) with the consensus CTV as reference. Conclusions: Multicenter efficacy endpoint assessment of cardiac radioablation for therapy-refractory VT requires consistent CTV transfer methods from the EAM to the PCT. VT substrate definition and CTVs were comparable with current clinical practice. Remarkable differences regarding the degree of agreement of the CTV definition on the EAM and the PCT were noted, indicating a loss of agreement during the transfer process between EAM and PCT. Cardiac radioablation should be performed under well-defined protocols and in clinical trials with benchmarking and consensus forming. (C) 2021 Elsevier Inc. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Boda-Heggemann, JuditUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blanck, OliverUNSPECIFIEDorcid.org/0000-0003-1391-1308UNSPECIFIED
Mehrhof, FelixUNSPECIFIEDorcid.org/0000-0003-0553-4290UNSPECIFIED
Ernst, FlorisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buergy, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fleckenstein, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tueluemen, ErolUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krug, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Siebert, Frank-AndreUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zaman, AdrianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kluge, Anne K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Parwani, Abdul ShokorUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Andratschke, NicolausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mayinger, Michael C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ehrbar, StefanieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Saguner, Ardan M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Celik, ErenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baus, Wolfgang W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stauber, AnninaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vogel, LenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schweikard, AchimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Budach, VolkerUNSPECIFIEDorcid.org/0000-0002-2191-9871UNSPECIFIED
Dunst, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boldt, Leif-HendrikUNSPECIFIEDorcid.org/0000-0002-3320-0880UNSPECIFIED
Bonnemeier, HendrikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rudic, BorisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-600042
DOI: 10.1016/j.ijrobp.2021.01.028
Journal or Publication Title: Int. J. Radiat. Oncol. Biol. Phys.
Volume: 110
Number: 3
Page Range: S. 745 - 757
Date: 2021
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 1879-355X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
BODY RADIATION-THERAPY; CATHETER ABLATION; LUNG-CANCER; HEART; SEGMENTATION; SCAR; ELECTROCARDIOGRAM; RADIOTHERAPY; NOMENCLATURE; MORTALITYMultiple languages
Oncology; Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60004

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