Key result
MR-guided stereotactic radiosurgery achieves complete metabolic response for recurrent left atrial tumoral thrombus.
Why the study?
Intracardiac thrombi can complicate lung cancer, and while radiotherapy is a treatment option, effective intracardiac irradiation is technically challenging.
Does MR-guided stereotactic radiosurgery with comprehensive motion management improve metabolic response in a patient with a recurrent left atrial tumoral thrombus?
Case Report (n=1)
Does MR-guided stereotactic radiosurgery with comprehensive motion management improve metabolic response in a patient with a recurrent left atrial tumoral thrombus?
MR-guided stereotactic radiosurgery with comprehensive motion management is a feasible and effective non-invasive treatment option for mobile intracardiac tumors.
Supports feasibility for mobile intracardiac tumors; hypothesis-generating Level 5 evidence requiring prospective validation before clinical adoption.
Lung cancer is often complicated by hypercoagulability, with intracardiac thrombi not an uncommon consequence. While radiotherapy can be a treatment option, effective intracardiac irradiation can be technically challenging. We present the case of a 54-year-old non-small-cell lung cancer (NSCLC) patient treated for a recurrent left atrial tumoral thrombus. The patient responded well after a first course of chemo-immuno radiotherapy. Follow up imaging showed a metabolic reactivation of the left atrial thrombus. The patient subsequently underwent an 18 Gy stereotactic radiosurgery using a 1.5 T Unity MR-Linac (Elekta AB, Sweden, Stockholm) using comprehensive motion management (CMM) to account for respiratory motion. Treatment was well tolerated. Complete metabolic response was observed 2 months after treatment. This case represents the first ever reported use of CMM on a 1.5 T MR-Linac to target an intracardiac lesion.
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Chammah et al. (2026) conducted a case report in Non-small-cell lung cancer with recurrent left atrial tumoral thrombus (n=1). MR-guided stereotactic radiosurgery with comprehensive motion management was evaluated on Metabolic response. MR-guided stereotactic radiosurgery using comprehensive motion management successfully treated a recurrent left atrial tumoral thrombus, achieving a complete metabolic response at two months.
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