{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:44:49Z","timestamp":1790646289778,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T00:00:00Z","timestamp":1666742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the feasibility of cardiac synchronized gating in stereotactic body radiation therapy (SBRT) of ventricular tachycardia (VT) using a real\u2010time electrocardiogram (ECG) signal acquisition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and materials<\/jats:title><jats:p>Stability of beam characteristics during simulated ECG gating was examined by developing a microcontroller interface to a Varian Clinac iX linear accelerator allowing gating at frequencies and duty cycles relevant to cardiac rhythm. Delivery accuracy was evaluated by measuring dose linearity with an ionization chamber, and flatness and symmetry with a two\u2010dimensional detector array, for different gating windows within typical human cardiac cycle periods. To establish a practical method of gating based on actual ECG signals, an AD8232 Heart Monitor board was used to acquire the ECG signal and synchronize the beam delivery. Real\u2010time cardiac gated delivery measurements were performed for a single 10\u00a0\u00d7\u00a010\u00a0cm<jats:sup>2<\/jats:sup> field and for a VT\u2010SBRT plan using intensity\u2010modulated radiation therapy (IMRT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and discussion<\/jats:title><jats:p>Dose per monitor unit (MU) values were found to be linear within most gating windows investigated with maximum differences relative to non\u2010gated delivery of &lt;2% for gating windows \u2265200\u00a0ms and for &gt;10\u00a0MUs. Beam profiles for both gated and non\u2010gated modes were also found to agree with maximum differences of 0.5% relative to central axis dose for all sets of beam\u2010on\/beam\u2010off combinations. Comparison of dose distributions for intensity\u2010modulated SBRT plans between non\u2010gating and cardiac gating modes provided a gamma passing rate of 97.2% for a 2% 2\u00a0mm tolerance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Beam output is stable with respect to linearity, flatness, and symmetry for gating windows within cardiac cycle periods. Agreement between dose distributions for VT\u2010SBRT using IMRT in non\u2010gated and cardiac cycle gated delivery modes shows that the proposed methodology is feasible. Technically, gating for delivery of SBRT for VT is possible with regard to beam stability.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.13814","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T13:39:23Z","timestamp":1666791563000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Evaluation of the feasibility of cardiac gating for SBRT of ventricular tachycardia based on real\u2010time ECG signal acquisition"],"prefix":"10.1002","volume":"24","author":[{"given":"Cristiano Q. 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