SPINE DOSE PLANNING

STREAMLINED WORKFLOW TO TRANSFORM MANAGEMENT OF SPINAL LESIONS

Elements Spine SRS* presents solutions to many of the current challenges in spine radiosurgery and automatically produces a highly conformal dose to avoid the critical spinal cord structure.

Spine SRS header

Automatic Treatment Planning

AUTOMATIC TREATMENT PLANNING

Planning critical lesions like those for spine stereotactic radiosurgery often demands significant experience and time from treatment planners. Automatic treatment planning is a way of raising the overall plan quality, to consistently create high-quality treatment plans in an efficient manner. Users need only define OAR constraints once using protocols for specific fractionation schemes.

  • Protocol-driven treatment plan creation 
  • Traffic light display of clinical constraints
  • Specialized gradient approach for target-cord interface
  • Arcs are automatically adjusted based on case requirements
Enhanced Spinal Blocking

Selective vertebral exposure for enhanced spinal blocking

Creating a highly conformal dose for spinal lesions can be complex due to the unusual shape of vertebrae. The Spine SRS algorithm internally breaks down the PTV into a number of smaller targets to achieve excellent dose planning metrics.

  • Superior spinal cord sparing achieved without additional user input
  • Minimized leaf motion results in a robust dosimetry and highly conformal dose
  • Efficient delivery time while at the same time enhancing normal tissue sparing

 

Dynamic Gradient and MU Optimization

DYNAMIC GRADIENT AND MU OPTIMIZATION

In order to create the sharpest dose gradient and most MU-efficient plans, the unique Brainlab VMAT approach is an elegant mixture of automation and control. It is characterized by intuitive optimization tools that enable the user to make subtle plan modifications.

  • Unique VMAT algorithm accesses high dose rates necessary for SRS treatment
  • Plans are MU efficient; using specialized optimization constraint techniques
  • Plan modifications can be quickly visualized and implemented with intuitive tools, affecting MU and normal tissue metrics (CI and GI)
Monte Carlo Optimization

MONTE CARLO VMAT OPTIMIZATION

To achieve balance between calculation speed and accuracy, plans are classically generated with an approximate dose calculation to determine optimum machine parameters and then recalculated with a more accurate dose engine. Spine SRS offers a tightly integrated approach to combine speed with even higher accuracy.

  • Classic approach: Pencil beam dose calculation during optimization and Monte Carlo for the final dose calculation for fast planning
  • Integrated approach: Hybrid method that uses both pencil beam and Monte Carlo at different stages of the optimization and Monte Carlo for the dose calculation in the final optimization step
Dose Illustration of Vertebra-Spine Cord Interface

DOSE ILLUSTRATION OF VERTEBRA-SPINAL CORD INTERFACE

Control over planning parameters is facilitated via straightforward views and unique dose displays. These have been implemented for not only PTV but also the most critical OAR so that tradeoffs can be readily assessed.

  • Comprehensive dose evaluation in 3D
  • Dose distributions are displayed simultaneously on various image sets, showing dose effects on as much anatomical information as possible
  • The dose surface view, maximum intensity projection view, beams eye view and arc view allow the user to see coverage, conformity, MLC motion and arc distribution simultaneously
  • An angular overview can be maintained with the beams eye view shown at incremental angles while covering the entire PTV 
*Work in progress.