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Multiple Brain Mets SRS 

Fast Treatment. Focused Dose. Revolutionary Technology.

Elements Multiple Brain Mets SRS rapidly generates consistent radiosurgery plans for simultaneous treatment of multiple brain metastases with a single isocenter. The newest version utilizes a patented algorithm that guarantees target coverage and optimizes MLC apertures for conformity and steep dose gradient.

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For the creation of fast, consistent radiosurgery plans for the treatment of brain metastases
Generates highly automated plans quickly to treat multiple brain metastases

Consistent Automated Planning with Advanced Flexibility

Brainlab software consistently and rapidly generates plans for the efficient treatment of multiple metastases. The software automatically creates a volumetrically optimized radiosurgery plan in a matter of minutes once all metastases have been outlined, allowing the clinical user to focus on reviewing and approving the plan.

  • Offers automatic prescription selection based on tumor volume criteria
  • Different treatment options are possible based on a clinical paradigm selection—from single fraction radiosurgery to fractionated SRS or SRT
  • Automatically selects a group of metastases, but has the ability to unselect metastases that should not be treated under the automated single isocenter (i.e. easy clustering of regional subgroups)
  • Isodose Line Prescription allows user to control desired maximal dose within the target
  • Extra Arcs can be effectively chosen per individual metastasis
  • Advanced editing mode to modify relevant clinical and setup parameters during planning
Elements Multiple Brain Mets SRS automatically creates plans with highly conformal radiation doses with low dose spread to the rest of the brain

Optimized Highly Conformal Dose

Elements Multiple Brain Mets SRS has a patented algorithm that uses up to 10 arcs at five table positions. Each arc automatically delivers a dose to a sub group of metastases, if two metastases line up in the direction of the leaf motion, the software adds another arc in the reverse direction, treating the second metastasis in line. This concept leads to optimized conformal treatments combined with low dose spread to the rest of the brain.

  • Optimization of multi-leaf collimator apertures and collimator angles for highly conformal beam delivery
  • Comprehensive assessment of dose distribution related to each metastasis
  • Monte Carlo optimization in addition to Pencil Beam optimization
  • Automatic 3D dose visualizations for individual tumor prescription and half prescription IDL
  • Global 3D dose projection visualization for complete normal tissue dose evaluation
  • Individual Conformity Index calculations for each metastasis
Creates radiosurgery plans for the efficient treatment of many brain metastases simultaneously

Fast & Efficient Treatment Delivery

Current treatment patterns offer radiosurgery only for patients with one metastasis. For multiple metastases, time increases at the same rate as the number of targets. Elements Multiple Brain Mets SRS software enables ‘monitor-unit’ and time-efficient treatment while minimizing dose to healthy tissue. Treatment delivery and planning time can be reduced drastically, even for multiple metastatic tumors in the brain.

  • Treatment of multiple metastases without repositioning the patient
  • Arcs rotate forward and backward at the same table position, covering any metastasis either by the first or the second arc
  • Dose Gradient optimization for improved normal tissue sparing
  • Organs at Risk (OAR) sparing achieved with minimal user input
Generates efficient radiosurgery plans to accommodate even hypo-fractionated treatments

Feasible Hypo-Fractionation 

Elements Multiple Brain Mets SRS offers clinicians the possibility for hypo-fractionated treatments. Current practice patterns call for lowering the single fraction treatment dose when treating large metastases or the combined volume of all metastases. The software enables efficient radiosurgery planning and delivery while minimizing dose to normal tissue and offering new, practical possibilities for larger volumes and higher number of metastases, even for hypo-fractionated treatments.

  • Elements Multiple Brain Mets SRS makes for hypo-fractionated treatments of multiple targets feasible
  • Enables higher biologically effective dose while potentially keeping the risk of necrosis down
  • Allows for re-oxygenation of the tumor in between fractions
ExacTrac X-Ray Patient Positioning & Monitoring system supports multiple brain metastases planning with Elements software

Straightforward Implementation with ExacTrac 

Challenges appear for patient positioning as the detrimental effects of remaining rotations are magnified when the isocenter shifts are outside the volume of the lesion. The single isocenter approach of the software speeds up treatment delivery by setting up to five couch angles during treatment. Brainlab ExacTrac® robotic alignment is therefore essential for treatments of multiple metastases.

  • ExacTrac robotic positioning eliminates angular deviation that may result in incomplete target coverage and conformity index degradation
  • Provides internal verification of the patient’s position regardless of couch and gantry angle
  • Even at non-coplanar couch angles and during beam-on, ExacTrac can detect potential misalignment of the patient
  • Complete stereotactic workflow including highly accurate treatment and positioning