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Abstract #0803

First in Human: MRI-guided radiation therapy of the heart with implantable cardiac defibrillator

H Michael Gach1, Olga L Green2, Phillip S Cuculich3, Erin J Wittland4, Areti Marko4, Molly E Luchtefeld4, Jill M Entwistle4, Deshan Yang5, David J Wilber6, Sasa Mutic2, and Clifford G Robinson2

1Radiation Oncology, Radiology, and Biomedical Engineering, Washington University in St Louis, St Louis, MO, United States, 2Radiation Oncology, Washington University in St Louis, St Louis, MO, United States, 3Cardiovascular Diseases and Electrophysiology, Washington University in St Louis, St Louis, MO, United States, 4Radiation Oncology, Barnes Jewish Hospital, St Louis, MO, United States, 5Radiation Oncology and Biomedical Engineering, Washington University in St Louis, St Louis, MO, United States, 6Cardiology, Loyola University Medical Center, Maywood, IL, United States

Low-field (0.35 T) magnetic resonance imaging guided radiation therapy (MR-IGRT) was used for the first time to treat a patient with a cardiovascular implantable electronic device (CIED) and a cardiac fibroma located on the left ventricle. Stereotactic body radiation therapy (SBRT) was delivered in 5 fractions at a dose of 700 cGy/fraction with MRI-based real-time tumor tracking and beam gating. Lessons learned include the need for metal artifact suppression, higher MRI temporal resolution, and MRI safety workflows adapted to radiation oncology.

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