Why the study?
Does designating the mitral valve and coronary arteries as critical structures reduce ventricular radiation dose during radiosurgical ablation of atrial fibrillation?
Does designating the mitral valve and coronary arteries as critical structures reduce ventricular radiation dose during radiosurgical ablation of atrial fibrillation?
This dosimetric study demonstrates the feasibility of minimizing ventricular radiation dose during radiosurgical ablation of atrial fibrillation by designating specific cardiac structures as critical.
Supports dosimetric feasibility of structure sparing in AF radiosurgery; hypothesis-generating and requires clinical validation before practice change.
In a treatment planning study, radiosurgical treatment plans designed to produce lesions on the left atrium were created using two different methodologies. In one, structures in the heart (mitral valve and coronary arteries) were designated as critical structures while this was not done in the second plan. The treatment plans that were created were compared with standards for heart dose used when treating spine tumors. Although the dosage for the whole heart greatly exceeded the dose standards, when only the dose to the ventricles was considered, the plan where the mitral valve was spared was very close to the dose standards. The ventricles received a substantially higher dose in the plan where the mitral valve was not a critical structure. Although neither treatment plan was delivered, this study demonstrated the feasibility of treating the heart while minimizing dose to the ventricles.
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Gardner et al. (2016) studied this question.
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