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Optimized target delineation procedure for the radiosurgery treatment of ventricular tachycardia: observer-independent accuracy

J. Hecko, L. Knybel, M. Rybar, M. Penhaker, O. Jiravsky, R. Neuwirth, M. Sramko, J. Haskova, J. Kautzner, J. Cvek

. 2024 ; 29 (3) : 280-289. [pub] 20240722

Status not-indexed Language English Country Poland

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc24018188

BACKGROUND: Part of the current stereotactic arrythmia radioablation (STAR) workflow is transfer of findings from the electroanatomic mapping (EAM) to computed tomography (CT). Here, we analyzed inter- and intraobserver variation in a modified EAM-CT registration using automatic registration algorithms designed to yield higher robustness. MATERIALS AND METHODS: This work is based on data of 10 patients who had previously undergone STAR. Two observers participated in this study: (1) an electrophysiologist technician (cardiology) with substatial experience in EAM-CT merge, and (2) a clinical engineer (radiotherapy) with minimum experience with EAM-CT merge. EAM-CT merge consists of 3 main steps: segmentation of left ventricle from CT (CT LV), registration of the CT LV and EAM, clinical target volume (CTV) delineation from EAM specific points. Mean Hausdorff distance (MHD), Dice Similarity Coefficient (DSC) and absolute difference in Center of Gravity (CoG) were used to assess intra/interobserver variability. RESULTS: Intraobserver variability: The mean DSC and MHD for 3 CT LVs altogether was 0.92 ± 0.01 and 1.49 ± 0.23 mm. The mean DSC and MHD for 3 CTVs altogether was 0,82 ± 0,06 and 0,71 ± 0,22 mm. Interobserver variability: Segmented CT LVs showed great similarity (mean DSC of 0,91 ± 0,01, MHD of 1,86 ± 0,47 mm). The mean DSC comparing CTVs from both observers was 0,81 ± 0,11 and MHD was 0,87 ± 0,45 mm. CONCLUSIONS: The high interobserver similarity of segmented LVs and delineated CTVs confirmed the robustness of the proposed method. Even an inexperienced user can perform a precise EAM-CT merge following workflow instructions.

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$a Optimized target delineation procedure for the radiosurgery treatment of ventricular tachycardia: observer-independent accuracy / $c J. Hecko, L. Knybel, M. Rybar, M. Penhaker, O. Jiravsky, R. Neuwirth, M. Sramko, J. Haskova, J. Kautzner, J. Cvek
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$a BACKGROUND: Part of the current stereotactic arrythmia radioablation (STAR) workflow is transfer of findings from the electroanatomic mapping (EAM) to computed tomography (CT). Here, we analyzed inter- and intraobserver variation in a modified EAM-CT registration using automatic registration algorithms designed to yield higher robustness. MATERIALS AND METHODS: This work is based on data of 10 patients who had previously undergone STAR. Two observers participated in this study: (1) an electrophysiologist technician (cardiology) with substatial experience in EAM-CT merge, and (2) a clinical engineer (radiotherapy) with minimum experience with EAM-CT merge. EAM-CT merge consists of 3 main steps: segmentation of left ventricle from CT (CT LV), registration of the CT LV and EAM, clinical target volume (CTV) delineation from EAM specific points. Mean Hausdorff distance (MHD), Dice Similarity Coefficient (DSC) and absolute difference in Center of Gravity (CoG) were used to assess intra/interobserver variability. RESULTS: Intraobserver variability: The mean DSC and MHD for 3 CT LVs altogether was 0.92 ± 0.01 and 1.49 ± 0.23 mm. The mean DSC and MHD for 3 CTVs altogether was 0,82 ± 0,06 and 0,71 ± 0,22 mm. Interobserver variability: Segmented CT LVs showed great similarity (mean DSC of 0,91 ± 0,01, MHD of 1,86 ± 0,47 mm). The mean DSC comparing CTVs from both observers was 0,81 ± 0,11 and MHD was 0,87 ± 0,45 mm. CONCLUSIONS: The high interobserver similarity of segmented LVs and delineated CTVs confirmed the robustness of the proposed method. Even an inexperienced user can perform a precise EAM-CT merge following workflow instructions.
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$a Knybel, Lukas $u Department of Oncology, University Hospital Ostrava and, Ostrava, Czech Republic $u Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
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$a Rybar, Marian $u Department of Biomedical Technology ,Czech Technical University in Prague, Kladno, Czech Republic
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$a Penhaker, Marek $u VŠB-Technical University of Ostrava, Ostrava, Czech Republic
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$a Jiravsky, Otakar $u Department of Cardiology, Podlesi Hospital, Trinec, Czech Republic $u Faculty of Medicine, Masaryk University, Brno, Czechia
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$a Neuwirth, Radek $u Department of Cardiology, Podlesi Hospital, Trinec, Czech Republic $u Faculty of Medicine, Masaryk University, Brno, Czechia
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$a Sramko, Marek $u Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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$a Haskova, Jana $u Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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$a Kautzner, Josef $u Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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$a Cvek, Jakub $u Department of Oncology, University Hospital Ostrava and, Ostrava, Czech Republic $u Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
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