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The number of cancer patients with cardiac implantable electronic devices receiving radiotherapy is increasing. Irradiation of such patients can cause malfunctions in pacemakers and implantable cardioverter-defibrillators. In this respect, it is necessary to make a proper irradiation plan for such cancer patients to minimize the dose received by both cardiac devices and pacing leads. However, planning computed tomography (CT) scans have metal artifacts that degrade the image quality and make it difficult to create a qualitative radiation plan. In fact, there is a problem of correct contouring not only of critical organs and planning target volume, but also of cardiac devices and pacing leads during the planning of CT scan operations.

Use of the Metal Deletion Technique for Radiotherapy Planning in Patients with Cardiac Implantable Devices