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Prostate Radiation Flummoxes Cardiac Devices

October 6, 2011
Written by: , Filed in: Abdominal Imaging, Cardiac Imaging
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Intensity modulated radiation therapy (IMRT) for prostate cancer patients can cause implanted cardiac devices to malfunction, according to a study presented Wednesday at the American Society for Radiation Oncology (ASTRO) Annual Meeting in Miami Beach, Florida.

The sample size was small, but the devices malfunctioned for 25 percent of the patients in the study who had pacemakers or defibrillators (6 of 24). In each case, the device reset to its default settings. Said Steven DiBiase, MD, lead author of the study:

The memory was erased.

Dr. DiBiase, a radiation oncologist at the Robert Wood Johnson Medical School in Camden, New Jersey, explained, “What happens is, the devices go back to factory settings. The devices still work, but the specifics the cardiologist wanted” are lost.

None of the patients developed cardiac problems, but two of the devices could not be reprogrammed and had to be replaced.

Dr. DiBiase was quoted by DOTmed News. You can also find details of the presentation in this ASTRO news release.

Previous reports had suggested that such interactions with implanted cardiac devices were rare. Dr. DiBiase and his team weren’t even looking for them. They were studying a group of 505 men before and after they underwent IMRT treatment for prostate cancer, and 24 of the patients happened to have implanted devices. Said Dr. DiBiase:

It’s new data that everyone should be aware of.

IMRT, introduced about a decade ago, has quickly become a favored treatment technique because it allows more precise doses that spare healthy tissue. It also generates higher levels of radiation than older treatments, which may have something to do with the device interference.

Perhaps radiation oncologists should check with the Johns Hopkins University School of Medicine cardiologists we discussed in yesterday’s post. They developed a protocol for safely using MRI on patients with implanted cardiac devices.

Among other things, the cardiologists reprogram the device to a safe mode during the procedure, then restore the proper settings afterward. MR and radiation are two different things, obviously, and Dr. DiBiase’s team currently can only speculate about the interference mechanism.

Still, comparing notes couldn’t hurt.

* * *

Yesterday’s tweets: Oregon’s whole-patient team model for health care and another TSA airport fiasco. Today’s? Check here and find out.

Related seminar: Abdominal & Pelvic Imaging: CT/MR/US


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