Patient-Specific Dynamic Model for Optimization of Cardiac Radioablation

Cardiac radiotherapy ablation, or radioablation, is a promising treatment for refractory ventricular tachycardia. However, its precision may be hampered by cardiac and respiratory motions. The purpose of this work was, based on cardiac and respiratory dynamic CT scans, to generate a patient-specific dynamic model of the structures of interest. Deep leaning-based segmentation was used to extract the geometry of the cardiac structures, whose deformations and displacements were assessed using deformable and rigid image registrations. The combination of the model with dose maps enabled to evaluate the dose locally accumulated during the treatment. Each step was evaluated considering expert references. The exploitation of the model was illustrated on the data of two patients, demonstrating that the impact cardiorespiratory dynamics is not negligible and is highly patient-specific.