Key result
CT-derived radial deformation outperforms longitudinal deformation in discriminating STAR target-positive segments.
Why the study?
The spatial relationship between STAR targets and mechanically derived deformation abnormalities remains incompletely understood.
Does CT-derived ED-ES radial deformation assessment correlate with clinically defined STAR targets in patients undergoing stereotactic arrhythmia radioablation for ventricular tachycardia?
Observational (n=9)
Does CT-derived ED-ES radial deformation assessment correlate with clinically defined STAR targets in patients undergoing stereotactic arrhythmia radioablation for ventricular tachycardia?
CT-derived radial deformation abnormalities show substantial spatial association with clinically defined STAR targets, suggesting potential utility in complementing substrate characterization for ventricular tachycardia.
Small series links deformation abnormalities to STAR targets; leaves open whether integration refines planning or outcomes.
BACKGROUND: Stereotactic arrhythmia radioablation (STAR) targets are typically defined by electroanatomical mapping and imaging-based substrate characterization, yet their spatial relationship to mechanically derived deformation abnormalities remains incompletely understood. OBJECTIVE: To evaluate the spatial association between CT-derived end-diastolic-end-systolic (ED-ES) radial deformation abnormalities and clinically defined STAR targets. METHODS: In nine patients undergoing STAR, three-dimensional left ventricular shells were reconstructed from ECG-gated contrast-enhanced CT. Radial deformation between ED and ES was estimated from the inter-phase displacement field, and abnormal regions defined by a patient-specific threshold at the lower 10th percentile of voxel-wise radial deformation. STAR targets were transferred from voltage maps onto the CT geometry. Spatial relationships were assessed using centroid distance, mean surface distance, volumetric overlap, and segment-level concordance. RESULTS: Eleven abnormal radial deformation regions and 11 STAR targets were identified. At the segment level, radial deformation discriminated target-positive segments (AUC 0.80, 95% CI 0.73-0.88) significantly better than longitudinal deformation (AUC 0.71, 95% CI 0.66-0.76; DeLong p < 0.001). Median centroid distance between abnormal regions and STAR targets was 20.4 mm (IQR 15.4-33.7) and median mean surface distance 6.0 mm (IQR 2.8-9.7). Partial volumetric overlap occurred in 9 of 11 deformation-defined regions, and 10 of 11 STAR targets overlapped at least one deformation-defined abnormality. Abnormal radial deformation was present in 18 of 21 target-positive segments (86%) versus 41 of 129 target-negative segments (32%). CONCLUSIONS: CT-derived ED-ES radial deformation abnormalities show substantial spatial association with clinically defined STAR targets, alongside partial discordance, and may complement substrate characterization in patients undergoing STAR.
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Lu et al. (2026) conducted an observational in Ventricular Tachycardia (n=9). CT-derived radial deformation vs. Longitudinal deformation was evaluated on Discrimination of target-positive segments (AUC 0.80, 95% CI 0.73-0.88, p=< 0.001). CT-derived radial deformation discriminated STAR target-positive segments significantly better than longitudinal deformation (AUC 0.80 vs 0.71; p<0.001).
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