Figure 3

Outcomes after Left Ventricular (LV) Freewall Irradiation.

(a) Transverse and coronal plane of a treatment plan with two lateral carbon beams (40 Gy). Details as described for Fig. 1a. (b) Anteroposterior view of by-product β⁺-activity during irradiation via PET, superimposed on the coronal plane of a contrast-enhanced CT scan. Black contour = target contour, β⁺-activity shown as color-wash. (c) Intracardiac ultrasound image of the LV freewall after irradiation, hyperechoic lesion area marked by dotted lines. (d) Left anterior oblique view of an endocardial voltage map of the LV 6 months after irradiation. As indicated in the legend, local voltage >1.0 mV is depicted in magenta. Voltage <0.5 mV in red. Other colors mark voltages in-between. White dots = fragmented potentials. (e) Macroscopic LV epicardial lesion outcome six months after irradiation with the dashed line marking the contoured target zone. (f) Endocardial lesion outcome six months after irradiation. Ao = Descending aorta; F = Freewall; LAA = Left atrial appendage; LAD = Left anterior descending coronary artery; LIPV = Left inferior pulmonary vein; LVOT = Left ventricular outflow tract behind the mitral valve leaflet; LL = Left lung; IVC = Inferior vena cava; LV = Left ventricle; LV-A = Left ventricular apex; RIPV = Right inferior pulmonary vein; RL = Right lung; RV = Right ventricle; S = Septal site.