Fast, M F; Lydiard, S; Boda-Heggemann, J; Tanadini-Lang, S; Muren, L P; Clark, C H; Blanck, O (2023) Precision requirements in stereotactic arrhythmia radioablation for ventricular tachycardia. Physics and Imaging in Radiation Oncology, 28. 100508 ISSN 24056316

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Abstract

The desire for high precision in stereotactic body radiotherapy (SBRT) is ingrained in the radiotherapy community, covering all the usual steps of a course of treatment [1–3]. However, increased precision often comes at the cost of increased complexity and resource con�sumption. At first glance, clinical outcomes after SBRT appear similar with either passive (internal target volume) or active (gating and tracking) motion management strategies, e.g., for peripheral lung tu�mours [4]. Upon closer scrutiny, differences in local tumour control and organ-at-risk doses, and thus potential toxicity between active and passive motion management strategies, can be observed for upper abdominal tumours where motion is generally more pronounced [5]. If treatment precision is strongly desired and active motion management such as tracking [6] or gating with breath hold [7,8] is unavailable or impractical, several options can be explored to enhance passive motion management strategies such as abdominal compression (AC) [8,9] and online plan adaptation [10,11]. Recently, lessons from SBRT of solid tumours have been translated into the cardiology realm to tackle another socioeconomic concerning disease, cardiac arrhythmias, by delivering SBRT to the heart in a novel treatment called STereotactic Arrhythmia Radioablation (STAR), also referred to as cardiac radio�ablation or cardiac SBRT. Given our prior knowledge from conventional SBRT, our current understanding of the radiosensitivity of the heart and the fact that the heart exhibits potentially the most complex motion in the human body, the required treatment precision for STAR is naturally an important consideration for the radiotherapy community.

Item Type:	Article
Subjects:	Ionising Radiation > Dosimetry
Divisions:	Medical, Marine & Nuclear
Identification number/DOI:	10.1016/j.phro.2023.100508
Last Modified:	24 Feb 2026 14:00
URI:	https://eprintspublications.npl.co.uk/id/eprint/10292