Quantitative Assessment of the Relationship Between Myocardial Lesion Formation Detected by Delayed Contrast-Enhanced Magnetic Resonance Imaging and Proton Beam Planning Dose for Treatment of Ventricular Tachycardia

摘要

Proton beam therapy has recently been proposed as a noninvasive approach for treating ventricular tachycardia(VT), where target regions are identified in the myocardium and treated using external beam therapy. Effectivetreatment requires that lesions develop at target sites of myocardial tissue in order to stop arrhythmic pathways.Precise characterization of the dose required for lesion creation is required for determining appropriate doselevels in future clinical treatement of VT patients. In this work, we use a deformable registration algorithm toalign proton beam delivery isodose lines planned from baseline computed-tomography scans to follow-up delayedcontrast-enhanced magnetic resonance imaging scans in three swine studies. The relationship between myocardiallesion formation and delivered dose from external proton beam ablation therapy is then quantitatively assessed.The current study demonstrates that myocardial tissue receiving a dose of 20Gy or higher tends to develop intolesion, while tissue exposed to less than 10Gy of dose tends to remain healthy. Overall, this study quantifies therelationship between external proton beam therapy dose and myocardial lesion formation which is important fordetermining dose levels in future clinical treatment of VT patients.