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A Tool to Integrate Electrophysiological Mapping for Cardiac Radioablation of Ventricular Tachycardia

PURPOSE: Cardiac radioablation is an emerging therapy for recurrent ventricular tachycardia. Electrophysiology (EP) data, including electroanatomic maps (EAM) and electrocardiographic imaging (ECGI), provide crucial information for defining the arrhythmogenic target volume. The absence of standardiz...

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Autores principales: Wang, Hesheng, Barbhaiya, Chirag R., Yuan, Ye, Barbee, David, Chen, Ting, Axel, Leon, Chinitz, Larry A., Evans, Andrew J., Byun, David J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320498/
https://www.ncbi.nlm.nih.gov/pubmed/37415904
http://dx.doi.org/10.1016/j.adro.2023.101272
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author Wang, Hesheng
Barbhaiya, Chirag R.
Yuan, Ye
Barbee, David
Chen, Ting
Axel, Leon
Chinitz, Larry A.
Evans, Andrew J.
Byun, David J.
author_facet Wang, Hesheng
Barbhaiya, Chirag R.
Yuan, Ye
Barbee, David
Chen, Ting
Axel, Leon
Chinitz, Larry A.
Evans, Andrew J.
Byun, David J.
author_sort Wang, Hesheng
collection PubMed
description PURPOSE: Cardiac radioablation is an emerging therapy for recurrent ventricular tachycardia. Electrophysiology (EP) data, including electroanatomic maps (EAM) and electrocardiographic imaging (ECGI), provide crucial information for defining the arrhythmogenic target volume. The absence of standardized workflows and software tools to integrate the EP maps into a radiation planning system limits their use. This study developed a comprehensive software tool to enable efficient utilization of the mapping for cardiac radioablation treatment planning. METHODS AND MATERIALS: The tool, HeaRTmap, is a Python-scripted plug-in module on the open-source 3D Slicer software platform. HeaRTmap is able to import EAM and ECGI data and visualize the maps in 3D Slicer. The EAM is translated into a 3D space by registration with cardiac magnetic resonance images (MRI) or computed tomography (CT). After the scar area is outlined on the mapping surface, the tool extracts and extends the annotated patch into a closed surface and converts it into a structure set associated with the anatomic images. The tool then exports the structure set and the images as The Digital Imaging and Communications in Medicine Standard in Radiotherapy for a radiation treatment planning system to import. Overlapping the scar structure on simulation CT, a transmural target volume is delineated for treatment planning. RESULTS: The tool has been used to transfer Ensite NavX EAM data into the Varian Eclipse treatment planning system in radioablation on 2 patients with ventricular tachycardia. The ECGI data from CardioInsight was retrospectively evaluated using the tool to derive the target volume for a patient with left ventricular assist device, showing volumetric matching with the clinically used target with a Dice coefficient of 0.71. CONCLUSIONS: HeaRTmap smoothly fuses EP information from different mapping systems with simulation CT for accurate definition of radiation target volume. The efficient integration of EP data into treatment planning potentially facilitates the study and adoption of the technique.
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spelling pubmed-103204982023-07-06 A Tool to Integrate Electrophysiological Mapping for Cardiac Radioablation of Ventricular Tachycardia Wang, Hesheng Barbhaiya, Chirag R. Yuan, Ye Barbee, David Chen, Ting Axel, Leon Chinitz, Larry A. Evans, Andrew J. Byun, David J. Adv Radiat Oncol Scientific Article PURPOSE: Cardiac radioablation is an emerging therapy for recurrent ventricular tachycardia. Electrophysiology (EP) data, including electroanatomic maps (EAM) and electrocardiographic imaging (ECGI), provide crucial information for defining the arrhythmogenic target volume. The absence of standardized workflows and software tools to integrate the EP maps into a radiation planning system limits their use. This study developed a comprehensive software tool to enable efficient utilization of the mapping for cardiac radioablation treatment planning. METHODS AND MATERIALS: The tool, HeaRTmap, is a Python-scripted plug-in module on the open-source 3D Slicer software platform. HeaRTmap is able to import EAM and ECGI data and visualize the maps in 3D Slicer. The EAM is translated into a 3D space by registration with cardiac magnetic resonance images (MRI) or computed tomography (CT). After the scar area is outlined on the mapping surface, the tool extracts and extends the annotated patch into a closed surface and converts it into a structure set associated with the anatomic images. The tool then exports the structure set and the images as The Digital Imaging and Communications in Medicine Standard in Radiotherapy for a radiation treatment planning system to import. Overlapping the scar structure on simulation CT, a transmural target volume is delineated for treatment planning. RESULTS: The tool has been used to transfer Ensite NavX EAM data into the Varian Eclipse treatment planning system in radioablation on 2 patients with ventricular tachycardia. The ECGI data from CardioInsight was retrospectively evaluated using the tool to derive the target volume for a patient with left ventricular assist device, showing volumetric matching with the clinically used target with a Dice coefficient of 0.71. CONCLUSIONS: HeaRTmap smoothly fuses EP information from different mapping systems with simulation CT for accurate definition of radiation target volume. The efficient integration of EP data into treatment planning potentially facilitates the study and adoption of the technique. Elsevier 2023-05-19 /pmc/articles/PMC10320498/ /pubmed/37415904 http://dx.doi.org/10.1016/j.adro.2023.101272 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Scientific Article
Wang, Hesheng
Barbhaiya, Chirag R.
Yuan, Ye
Barbee, David
Chen, Ting
Axel, Leon
Chinitz, Larry A.
Evans, Andrew J.
Byun, David J.
A Tool to Integrate Electrophysiological Mapping for Cardiac Radioablation of Ventricular Tachycardia
title A Tool to Integrate Electrophysiological Mapping for Cardiac Radioablation of Ventricular Tachycardia
title_full A Tool to Integrate Electrophysiological Mapping for Cardiac Radioablation of Ventricular Tachycardia
title_fullStr A Tool to Integrate Electrophysiological Mapping for Cardiac Radioablation of Ventricular Tachycardia
title_full_unstemmed A Tool to Integrate Electrophysiological Mapping for Cardiac Radioablation of Ventricular Tachycardia
title_short A Tool to Integrate Electrophysiological Mapping for Cardiac Radioablation of Ventricular Tachycardia
title_sort tool to integrate electrophysiological mapping for cardiac radioablation of ventricular tachycardia
topic Scientific Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320498/
https://www.ncbi.nlm.nih.gov/pubmed/37415904
http://dx.doi.org/10.1016/j.adro.2023.101272
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