Ischemia, Myocardial, Ventricular Tachycardia, Monomorphic, Ventricular Tachycardia (V-Tach)
Conditions
Keywords
Cardiac radioablation, Stereotactic arrhythmia radioablation, Ischemic fibrosis, Late iodine enhancement CT, CT perfusion, Late gadolinium enhanced MRI
Brief summary
Cardiac radioablation is a new treatment for ventricular tachycardia (VT), which uses beams of radiation to treat heart scar that causes VT. To identify the scar areas, magnetic resonance imaging (MRI) and computed tomography (CT) imaging are often used. These are both types of medical imaging that allow clinicians to examine scar area without having to do invasive surgery. Researchers have developed new heart imaging protocols using both MRI and CT. Their MRI protocol method can now spot both dense and scattered scar tissue. The CT protocol combines multiple different types of scans into a single appointment and uses a special scanner that captures the motion of the heart. For this study, patients will undergo CT and MRI imaging according to these new imaging protocols. With this study, researchers aim to show that these new imaging protocols can be undergone by patients with ventricular tachycardia and can be used to identify scar. Researchers will also use these scans to make radiation treatment plans to identify which types of treatment can be delivered safely to patients.
Interventions
DIAGNOSTIC_TESTCT and MRI
All participants will undergo both CT imaging and MRI imaging to identify areas of ischemic scar. Treatment plans will be created based on CT scans, for all participants using various treatment delivery and motion management techniques.
Sponsors
Stewart Gaede
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Ischemic cardiomyopathy with monomorphic VT * Referred by cardiologists * 18 years of age or older
Exclusion criteria
* • Polymorphic ventricular tachycardia * Ventricular fibrillation * Pregnant or breastfeeding or planning to become pregnant or breastfeed during the study * Estimated glomerular filtration rate ≤ 30 mL/min/1.73m2 * Previous allergic reaction to CT contrast agent Note that participants with contraindications for MRI can still be enrolled in this study but will not undergo MRI parts of this protocol.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Agreement among cardiologists for target regions, assessed by an inter- and intra-observer variability study using similarity metrics such as the Dice coefficient and Hausdorff distance. | 6 months after conclusion of study | Imaging protocols will be delivered to participants. Targets will be delineated by experts. Agreement between experts will be assessed.. |
| Adherence of treatment plans to dose constraints and deliverability of treatment plans. | 6 months after conclusion of study | Treatment plans will be created using various motion management and radiation treatment delivery strategies. Adherence of treatment plans to dose constraints will be assessed by comparing treatment plans to institutional dose constraints. Beam deliverability will be assessed by delivering the treatment plan to a static phantom and comparing the deposited dose to the expected dose. Treatment deliverability, as it relates to motion management, will be assessed by delivering the treatment plan to a moving phantom and comparing the deposited dose to the expected dose. |
Secondary
| Measure | Time frame |
|---|---|
| Agreement between CT/MRI areas of interest (scar), assessed using similarity metrics such as the Dice coefficient and Hausdorff distance. | 6 months after conclusion of study |
Countries
Canada
Contacts
Primary ContactStewart Gaede, PhD
Outcome results
None listed