Quality assurance process within the RAdiosurgery for VENtricular TAchycardia (RAVENTA) trial for the fusion of electroanatomical mapping and radiotherapy planning imaging data in cardiac radioablation

Michael Mayinger; Judit Boda-Heggemann; Felix Mehrhof; David Krug; Stephan Hohmann; Jingyang Xie; Stefanie Ehrbar; Boldizsar Kovacs; Roland Merten; Melanie Grehn; Adrian Zaman; Jens Fleckenstein; Lena Kaestner; Daniel Buergy; Boris Rudic; Anne Kluge; Leif-Hendrik Boldt; Jürgen Dunst; Hendrik Bonnemeier; Ardan M Saguner; Nicolaus Andratschke; Oliver Blanck; Achim Schweikard

doi:10.1016/j.phro.2022.12.003

Quality assurance process within the RAdiosurgery for VENtricular TAchycardia (RAVENTA) trial for the fusion of electroanatomical mapping and radiotherapy planning imaging data in cardiac radioablation

Phys Imaging Radiat Oncol. 2022 Dec 26:25:100406. doi: 10.1016/j.phro.2022.12.003. eCollection 2023 Jan.

Authors

Michael Mayinger¹, Judit Boda-Heggemann², Felix Mehrhof³, David Krug⁴, Stephan Hohmann⁵, Jingyang Xie⁶, Stefanie Ehrbar¹, Boldizsar Kovacs⁷, Roland Merten⁸, Melanie Grehn⁴, Adrian Zaman⁹, Jens Fleckenstein², Lena Kaestner², Daniel Buergy², Boris Rudic¹⁰, Anne Kluge³, Leif-Hendrik Boldt¹¹, Jürgen Dunst⁴, Hendrik Bonnemeier⁹, Ardan M Saguner⁷, Nicolaus Andratschke¹, Oliver Blanck⁴, Achim Schweikard⁶

Affiliations

¹ Department of Radiation Oncology, University Hospital Zürich, University of Zürich, Zürich, Switzerland.
² Department of Radiation Oncology, University Medicine Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
³ Department of Radiation Oncology, Charité University Medicine Berlin, Berlin, Germany.
⁴ Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, Germany.
⁵ Department of Cardiology and Angiology, Hannover Heart Rhythm Center, Hannover Medical School, Hannover, Germany.
⁶ Institute for Robotics and Cognitive Systems, Univesity of Lübeck, Lübeck, Germany.
⁷ Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Switzerland.
⁸ Department of Radiotherapy, Hannover Medical School, Hannover, Germany.
⁹ Department of Internal Medicine III, Section for Electrophysiology und Rhythmology, University Medical Center Schleswig-Holstein, Kiel, Germany.
¹⁰ Medizinische Klinik I, Abteilung für Elektrophysiologie und Rhythmologie, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
¹¹ Department of Cardiology, University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany.

Abstract

A novel quality assurance process for electroanatomical mapping (EAM)-to-radiotherapy planning imaging (RTPI) target transport was assessed within the multi-center multi-platform framework of the RAdiosurgery for VENtricular TAchycardia (RAVENTA) trial. A stand-alone software (CARDIO-RT) was developed to enable platform independent registration of EAM and RTPI of the left ventricle (LV), based on pre-generated radiotherapy contours (RTC). LV-RTC were automatically segmented into the American-Heart-Association 17-segment-model and a manual 3D-3D method based on EAM 3D-geometry data and a semi-automated 2D-3D method based on EAM screenshot projections were developed. The quality of substrate transfer was evaluated in five clinical cases and the structural analyses showed substantial differences between manual target transfer and target transport using CARDIO-RT.

Keywords: CARDIO-RT; Cardiac radioablation; Electroanatomical mapping; Quality assurance; Radiotherapy planning.