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Multiple brain metastases workflow

Manage Multiple
Brain Metastases
Quickly and Efficiently
with SRS

Multiple brain metastases workflow

Manage Multiple Brain Metastases Quickly and Efficiently with SRS

Treat your patients to less time per treatment

Reduce your treatment delivery times by irradiating multiple brain metastases simultaneously without treating the whole brain. This pre-planning and planning workflow, comprised of an array of automation-supported software applications, addresses specific clinical challenges at each stage of the planning process. The Multiple Brain Mets Workflow allows you to create single isocenter plans in minutes, guaranteeing target coverage while offering excellent conformity and steep dose gradients.

Demo Elements Multiple Brain Mets SRS in three minutes

Preparing for multiple brain metastases planning

Automation is a part of each step of our pre-planning workflow, which includes image fusion, distortion correction, object outlining and segmentation. Expedite your planning and treatment times with these fast and reliable tools.

Rigid and deformable co-registration

Elements Distortion Correction applies a deformable registration exclusively for the cranium to correct patient-specific distortions by the MR scanner while respecting the anatomical ground truth.

Organ-at-risk segmentation

Elements Anatomical Mapping automates the time-consuming process of contouring organs at risk by efficiently, consistently and accurately registering datasets to a synthetic full-body tissue model including more than 100 cranial structures.

3D target outlining

Elements SmartBrush defines volumes on just two slices and supports your planning with quick and interactive outlining of tumors and other relevant structures incorporating multiple modalities. Delineate the object on just two slices, the volume is automatically generated and respective reports can be created.

Creating the dose plan with Elements Multiple Brain Mets SRS

With pre-planning complete, you can now move to dose planning with Elements Multiple Brain Mets SRS. This software is designed for speed and consistency not only during delivery but also planning. Filled with features to help expedite planning for single isocenter multiple target treatments, the software optimizes and automates several steps of the workflow to help you create a high-quality radiosurgery plan in minutes.

Inverse optimized dynamic conformal arc treatments

Inversely calculated DCA apertures enables optimized gradient index and conformity index while fulfilling all constraints and PTV coverage. The optimization of the conformity index (CI) and gradient index (GI) eliminates the need for any optimization structures in planning.

Standardized margins

Automatic GTV to PTV margin generation based on complex rules including the distance to the isocenter and lesion enables you to generate adjusted and optimized PTV margins and reduce toxicity to normal structures.

Simplified plan analysis

Take advantage of dedicated tools for plan analysis, like an intuitive traffic light display and automatically calculated plan qualifiers (Vx, CI, GI) for each target both locally and for the global plan.

Optimizing planning outcome

The DCA complexity slider gives you the power to prioritize between enabling the algorithm to actively close fields to reduce bridging dose or to focus on monitor efficiency.

3D dose visualizations

The dose interface and unique 3D views highlight the most relevant dose coverage metrics and allow comprehensive assessment of dose distribution.

Highly precise beam modeling and dose calculation

By using Brainlab reference beam models, the measurements for the highly accurate Monte Carlo dose calculation algorithm are reduced by 90% for all TrueBeam platforms with HD120 or Millenium MLC with 6MV and 10MV, standard and FFF mode.

Click on the link below to learn more about how the Brainlab Reference Beam Models were developed and validated.

Download white paper

Retreatment Review 1

Comprehensive presentation of all previously delivered treatments in one place

Elements Retreatment Review gives physicians an overview of all treatments as well as the current patient status. This software supports the follow-up and decision-making process for multiple brain metastases patients and easily facilitates retreatment planning.


Color-coded display of previous and new targets, dose overlay of all previously delivered doses including weighting options for potential cell repair, DVH display and automatic calculation of all Max OAR doses.

Automatic alignment of all previous treatment information created in Elements or third party systems.

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Explore more about the multiple brain metastases workflow

Clinical paper

Chea et al. 2021

Read more about the dosimetric study between a single isocenter dynamic conformal arc therapy technique and gamma knife radiosurgery for multiple brain metastases treatment: impact of target volume geometrical characteristics.

Read more

Clinical literature library

Advancing medical technology through scientific evidence

Brainlab Clinical Affairs conducts advanced research and gathers scientific evidence to help create safe, efficient, cost-effective medical technology.

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Paradigm Shift in Management of Intracranial Metastases: A Review of the Kaiser Series Utilizing Elements Multiple Brain Mets SRS

The two experts Michael R. Girvigian, MD and Javad Rahimian, Ph.D. discuss clinical workflows for Elements Multiple Brain Mets SRS and Contrast Clearance Analysis, specific treatment plans, case and quality assurance examples, as well as clinical outcomes and more.

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1 Not yet commercially available in several countries. Please contact your sales representative.