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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