Cengel Keith A, Belal Zayne, Kim Michele M, Hagan Sarah, Camps Saskia, Kalinin Alexander, Hsue Weihow, Diffenderfer Eric, Garonna Adriano, Tschabrunn Cory
Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA.
EBAMed SA, Geneva, Switzerland.
Clin Transl Radiat Oncol. 2024 Dec 21;51:100904. doi: 10.1016/j.ctro.2024.100904. eCollection 2025 Mar.
Cardiac stereotactic body radiotherapy is a promising noninvasive treatment for patients with refractory ventricular tachycardia. With the aim to prove feasibility of a novel image guided radiotherapy and heart motion gating device, cardiac proton radiotherapy was performed using a porcine model. Using a novel adaptation of γ - H2AX tissue staining techniques, we have been able to localize a radiation beam in large animal tissue to assess targeting accuracy within a defined field. Cardiorespiratory-gated irradiations of the animals were successfully completed and analysis of the γ-H2AX staining intensity of the excised heart after radiation demonstrated radiotherapy was delivered close to or within the expected region. We simulated the irradiated volumes under different gating scenarios, showing significant reduction when using combined cardiorespiratory gating. The results of this study show the feasibility of proton irradiation of the heart left ventricle with a novel ultrasound based cardiorespiratory gating technology with the benefit of reduced irradiation volumes and increased healthy tissue sparing.
心脏立体定向体部放射治疗是一种对难治性室性心动过速患者有前景的非侵入性治疗方法。为了证明一种新型图像引导放射治疗和心脏运动门控装置的可行性，使用猪模型进行了心脏质子放射治疗。通过对γ-H2AX组织染色技术的一种新型改进，我们能够在大型动物组织中定位辐射束，以评估在限定区域内的靶向准确性。动物的心肺门控照射成功完成，对放射后切除心脏的γ-H2AX染色强度分析表明，放射治疗在预期区域附近或区域内进行。我们模拟了不同门控方案下的照射体积，结果显示使用联合心肺门控时照射体积显著减小。本研究结果表明，采用基于新型超声的心肺门控技术对心脏左心室进行质子照射是可行的，其优点是照射体积减小且健康组织受照剂量降低。
