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To investigate the possible advantages of using 4pi‐optimized arc trajectories in stereotactic body radiation therapy of ventricular tachycardia (VT‐SBRT) to minimize exposure of healthy tissues.

Thorax computed tomography (CT) data for 15 patients were used for contouring organs at risk (OARs) and defining realistic planning target volumes (PTVs). A conventional trajectory plan, defined as two full coplanar arcs was compared to an optimized‐trajectory plan provided by a 4pi algorithm that penalizes geometric overlap of PTV and OARs in the beam's‐eye‐view. A single fraction of 25 Gy was prescribed to the PTV in both plans and a comparison of dose sparing to OARs was performed based on comparisons of maximum, mean, and median dose.

A significant average reduction in maximum dose was observed for esophagus (18%), spinal cord (26%), and trachea (22 …